Speech and language therapy for adults

For patients who live in North Derbyshire (including South Normanton, Clay Cross, Chesterfield, Bolsover, Matlock, Bakewell, Buxton) and who can attend an outpatient appointment, please refer directly to the Speech & Language Therapy Team at Chesterfield Royal Hospital on: crhft.adultslt@nhs.net or 01246 512080.

We are qualified to assess and support certain needs. Please see our acceptance criteria for full details.

Is a referral needed?

We can help patients who have:

• Swallowing or communication problems associated with a neurological diagnosis such as MS, Parkinson’s disease, MND, stroke or dementia. 

AND any of the following:

• Frequent coughing or choking specifically when eating or drinking.
• Recurrent chest infections/pneumonia where aspiration is the suspected cause.
• Significant communication problems affecting daily life.
• Communication or swallowing problems where advice has been followed but needs have changed, i.e. a significant improvement or deterioration.

We can also help adults who stammer.

We cannot help patients with:

• Vomiting unrelated to dysphagia. Please refer to GP.
• Problems with taking tablets only. Please consult pharmacist.
• Problems with small appetite or refusing to eat and drink. Please consult dietitian.
• Problems with tube feeding or patients who need feeding tube insertion. Please refer to GP or gastrostomy nurse.
• Head and neck cancer or oesophageal cancer. Please consult GP and specialist SLT service.
• Swallowing or communication problems associated with developmental diagnoses (learning disabilities, Autism etc).

A Note on Coughing, Choking and Gagging in Adults
These three reflexes—while sometimes confused—are distinct and carry different implications, especially when related to eating or drinking. Understanding the differences can help you respond appropriately and avoid unnecessary alarm.

Coughing
Coughing is loud and forceful. It is a protective reflex designed to clear the airway of food, drink, or irritants using a strong burst of air. If a person is coughing, they are still breathing. However, persistent or frequent coughing during meals or fluids may indicate an underlying swallowing difficulty (dysphagia). If this occurs regularly, please consult a healthcare provider for assessment.

Choking
Choking occurs when the airway is completely blocked—no air or sound can pass through. It is silent and can become life-threatening very quickly. Signs include the inability to speak, breathe, or cough, and potentially a change in skin colour (e.g. lips or face turning blue). Immediate action is required. For guidance on what to do, visit First aid - NHS and scroll down to the section on Choking. Repeated choking episodes, particularly with solid food, may indicate a significant swallowing disorder and should be medically evaluated.

Gagging
Gagging is typically loud and may involve retching or heaving. It is a normal reflex that protects the throat and airway, especially when something touches the back of the mouth unexpectedly. In adults, occasional gagging while eating may occur due to texture, anxiety, or medical issues such as reflux. While it can be uncomfortable, gagging is not dangerous. However, if it happens frequently or interferes with eating, it’s worth discussing with a healthcare professional.

If you or someone you support is regularly experiencing any of these symptoms during meals, it may be appropriate to seek input from a speech and language therapist or a medical professional specializing in swallowing disorders.

To discuss possible referrals:

Please contact your local speech and language if you know who this is (see 'Contact Us' section to the right) or phone 0115 9512433.  

Or email: DCHST.SLTCentralReg@nhs.net

Our admin support workers will put you in touch with a therapist.

Care Homes:

• Download and fully complete the Adult care home referral form including the Meal Time Observation Checklist at the start.  We cannot accept the form without the completed checklist.
• Email it to the speech and language therapy Central Registration Office (email details on the form).

Other referrers (including community hospitals):

• Complete the adult community referral form.
• Email your completed form to dchst.sltcentralreg@nhs.net.
• If you are the patient and you cannot access the internet, we can take a referral over the phone. Professionals must use the referral form.

To refer an adult whose needs relate to learning disabilities:

For eating, drinking, swallowing or communication needs relating primarily to learning disabilities, please contact your local Learning Disability service.

North Derbyshire: phone 01246 565000 ext. 112 or visit DCHS Learning Disability Service

South Derbyshire: visit: DHCFT Disabilities Learning Service

What happens after referral:

We will look at the referral to decide whether the person needs an assessment and if so, how urgently.

We are not an urgent response or emergency service. We cannot guarantee a same-day visit. However we do triage all referrals and requests for contact as soon as possible. If triage indicates an immediate risk of harm relating to eating and drinking, we aim to contact and arrange a visit within 2 working days. If there are urgent concerns about the patient's health in the meantime, please contact the patient's GP or 111.

After triage/assessment, we may provide advice or help carers support someone experiencing communication or eating, drinking and swallowing difficulties.

If therapy is needed, we will agree a personalised therapy and discharge plan, according to the person’s changing needs.

• DCHS Visiting patients at home leaflet

The links below take you to websites giving more information about individual needs. Please note the DCHS speech and language therapy service is not responsible for the content of external websites.

Communication and Voice

• Aphasia Now
• Communication Matters
• Speakability
• The British Stammering Association
• The National Association of Laryngectomy Clubs

Dementia

• Cerebral Function Unit
• The Alzheimer’s Society

Head Injury

• Headway: The Brain Injury Association

Progressive Neurological Conditions

• Huntington’s Disease Association
• Motor Neurone Disease Association
• Multiple System Atrophy
• National Parkinson’s Foundation
• Parkinson’s Disease UK
• Progressive Supranuclear Palsy (PSP)
• The Multiple Sclerosis Society
• The Myasthenia Gravis Association

Stroke

• The Stroke Association

General Information

• Macmillan Cancer Support
• The Communication Disability Network

Professional Information

• Health and Care Professions Council 
• Royal College of Speech and Language Therapists