Who are we?
Adult Community Speech and Language Therapists work with people who have problems with their swallowing, speech, language or voice.
We work with a wide variety of clients, including people who have had strokes, acquired brain injuries, progressive neurological conditions, head and neck cancer, stammering, voice impairment and degenerative disease such as dementia.
Adult Community SLT services are provided by NHS Lothian within each Health and Social Care Partnership (HSCP).
Contact Details of NHS Adult Community SLT in each HSCP
Contact Details
Please note for email contact or referral, residents details should only be shared via an NHS secured email address.
For more information on obtaining a secure email address please see the Secure Email Account page
Edinburgh
Edinburgh Adult Community Speech and Language Therapy Service
Scientific Block, Astley Ainslie Hospital
133 Grange Loan
Edinburgh
EH9 2HL
Email: SLT.EAC@nhs.scot
Tel: 0131 537 9577
Midlothian
Midlothian Adult Community Speech and Language Therapy Service
Newbattle Medical Centre
Blackcot
Mayfield
Dalkeith
EH22 4AA
Email: SLT.MAC@nhs.scot
Tel: 0131 454 9544
East Lothian
East Lothian Adult Speech and Language Therapy Service
East Lothian Community Hospital
Alderston Road
Haddington
EH41 3PF
Email: SLT.ELAC@nhs.scot
Tel: 01620 642 704
West Lothian
Speech & Language Therapy Department
St John’s Hospital
Howden Road West
Livingston
EH54 6PP
Email: SLT.WLAC@nhs.scot
Tel: 01506 524 191
Manual for Mealtimes
Please use this resource before referring to SLT for problems with eating, drinking and swallowing – unless the referal meets criteria for an urgent referral.
This comprehensive resource for has been developed by NHS Lothian in conjunction with the Care Inspectorate, Scottish Care, Alzheimer Scotland and the Royal College of Speech and Language Therapists and provides guidance for problems with eating, drinking and swallowing.
There is also a narrated vimeo training presentation to guide staff in the use of the manual and a Manual for Mealtimes education page on this website
Recording what you have noticed
Care Home staff should go through the protocol in the Manual before requesting Speech and Language Therapy for other reasons, and we ask for your support with this. Some problems will not require SLT intervention, and only the more severe or persistent swallowing difficulties will need an urgent referral.
Staff can use the guidance in the Manual to problem solve the less severe difficulties, and have approval to use the documentation provided as evidence for the Care Inspectorate.
- Eating and Drinking Problem Chart – complete one for each person
- Eating and Drinking Trial of Change Record – complete one for each person, can be added to on different days
If self management strategies are not successful, please follow the referral process.
Promotion and sharing with staff
You can promote the Manual for Mealtimes in your care home using this poster and summary.
Referral to SLT
Who should I refer?
Anyone can request Speech and Language Therapy including the individual concerned.
Why Should I refer?
Immediate/Urgent Referral
Refer to SLT IMMEDIATELY if:
The resident has had several recent chest infections and you think there is a connection with eating and drinking
OR
The resident has frequent signs of aspiration (food or drink going into the airway) when eating or drinking i.e. one or more of the following:
- Frequent and troublesome coughing during mealtimes
- More than one choking incident, or one choke plus other signs
- Wet breath sounds or gurgly voice after swallowing
- Change of breathing after swallowing
- Change of colour after swallowing
- Eye watering whilst eating or drinking
Nurse practitioners can use the Sci Gateway to refer to SLT, but only where an urgent referral is indicated.
Care Home staff please use the referral form in the manual for mealtimes
Communication Issues
When to refer
Where there has been a change, for example
- If someone expresses concerns about their communication
- If someone experiences difficulties understanding what is being said to them
- If someone experiences difficulties expressing themselves or interacting with others
- To gain practical advice and support for people with communication needs to enable their decision making capacity
How to refer
- Nurse Practitioners can use the Sci Gateway referral
- Care Home staff should use the SLT referral form
Swallowing Issues
Unless urgent, Care Home staff should complete the manual for mealtimes and try self management strategies prior to referral to SLT.
To refer to SLT after completing the manual for mealtimes process you can refer using the referral form in the manual. You should attach one completed “problem chart” and one completed “”trial of changes record for each person. The Trial of Changes Record can be added to on different days.
Returning the referral form
You can return the form to us via email or post. Please send the form to the SLT team in your local HSCP area.
Please note for email contact or referral, residents details should only be shared via an NHS secured email address.
For more information on obtaining a secure email address please see the Secure Email Account page
Education
For information on Speech and Language (SLT) education please see the following page:
Manual for Mealtimes (Speech and Language Therapy)
Eating, Drinking and Swallowing & International Dysphagia Diet Standardisation Initiative (IDDSI)
Updated November 2025 RF, CA & HS
