About our speech and language therapy service
Adult inpatients: Our team of speech and language therapists assess, treat and manage inpatients with acquired swallowing and communication disorders and altered airways (tracheostomy and laryngectomy) across the acute hospital setting. These include general medical, respiratory, gastroenterology, surgical, oncology, medicine for the elderly and critical care complex and acute stroke unit.
In addition the speech and language therapy team works closely with our therapy colleagues, occupational therapy, physiotherapy and dieticians to assess and manage patients with newly acquired swallow and communication disorders, either as a result of stroke, neuro trauma, or a new neurological diagnosis.. During in patient stays our teams liaise closely with our MDT colleagues, carers and family as well as our community partners. Referrals for a swallowing assessment need to be made by the treating medical team only, communication referrals are accepted from all health professionals.
Adult outpatients Our Adult Speech and Language Therapy team acceptsoutpatient referrals from NMUH Respiratory and Gastroenterology Consultants only, to assist with diagnosis of more complex swallowing disorders. A written referral is required from your NMUH Consultant. and should be sent to:
In addition we participate in a Consultant led persistent cough clinic.
Head and neck service
The head and neck Speech and Language Therapy team provides a specialist service to inpatients and outpatients who may experience difficulties following treatment for head and neck cancer. Our highly trained Speech and Language Therapists (SLTs) have expertise in dysphagia (swallowing difficulties), speech, voice, trismus (difficulties with jaw opening), laryngectomy rehabilitation, tracheostomy management and palliative care.
Our vision is to ensure that patients with communication, voice and swallowing difficulties following cancer treatment receive the highest standard of management and rehabilitation that is individualised to their needs, whether in the acute or longer-term stages. Our intervention is offered with the aim of maximising potential outcomes and quality of life for our patients.
We are part of the London Cancer Vanguard in partnership with UCLH- Cancer Collaborative and work closely with other London hospitals including Barnet and Chase Farm Hospitals and the Princess Alexandra Hospital in Harlow. As core members of the head and neck cancer multidisciplinary team (MDT), our SLTs work closely with specialist doctors and allied health professionals to ensure that the care provided is seamless, safe, efficient and centred on the patient.
Children's speech and language therapy
Our paediatric speech and language therapists provide a specialist service to neonates, babies and children on the Neonatal intensive care unit (NICU), Starlight and Rainbow Wards. We are involved in patient assessment, differential diagnosis and programmes of intervention for premature babies, neonates and children who have feeding and swallowing difficulties.
We see babies and children who have been referred by their NMUH Consultant, for feeding and swallowing assessments.
Videofluoroscopy: also known as modified barium swallow
We run a twice weekly clinic on Tuesdays and Thursdays for inpatients and outpatients. Videofluoroscopy is a dynamic x-ray of your swallow sometimes referred to as a modified barium swallow, it allows us to look at your swallow function and helps guide our treatment and rehabilitation of your swallowing.
Conditions we treat
A wide range swallowing and communication difficulties are assessed and managed including those as a result of Stroke, Acquired Brain Injury, Progressive Neurological Conditions, neuro trauma, respiratory disease, dementia and cancer.
Head and neck cancer
Symptoms and side-effects of radiotherapy and/or chemotherapy. Long term swallow, communication and voice changes as a result of head and neck cancer treatment.
We have expertise in managing feeding and swallowing disorders secondary to prematurity, congenital conditions including syndromes, neurological, respiratory and gastro-intestinal disorders as well as anatomical abnormality and behavioural/psychological feeding problems.
Videofluoroscopy can be used across a range of conditions including Stroke, brain injury, progressive neurological conditions such as MND, MS and Parkisons Disease and Head and Neck cancers. It can also provide information for people who difficulties with swallowing because of changes at the level of their oeseophagus (food pipe).
How to prepare for your visit
If you have been referred for an outpatient Speech and Language Therapy Assessment by your consultant, you will be asked to attend either directly or because of the current Covid-19 (Coronavirus) pandemic, via telephone call/video link. You will be contacted to discuss your preference.
Head and neck service
If you are referred for radiotherapy and/or chemotherapy treatment for head and neck cancer at North Middlesex University Hospital, the SLT team will be involved in your care throughout your pathway, from initial provision of information and advice to rehabilitation or palliation once treatment is complete.
SLTs will carry out thorough assessments of your communication, swallow, voice and jaw opening at regular intervals to inform our treatment with the aim of maximising your function during and after treatment. Preventative and rehabilitation exercises will be provided along with advice around fluid and diet textures and consistencies.
As part of your treatment, the SLT team may use instrumental assessment to analyse your function and guide rehabilitation. These assessments may include:
- Videofluoroscopy: also known as a modified barium swallow, this is a dynamic x-ray of your swallow.
Specialist laryngectomy care is also offered, including:
- Laryngectomy videofluoroscopy: this is a dynamic x-ray of your swallow and can provide information as to your swallow function following surgery and inform the medical team around management of any difficulties you may experience.
- Voice prosthesis management: SLT input includes maintenance of voice prostheses (valves) and emergency procedures surrounding surgical voice restoration as well as trouble shooting to optimise voice production.
- Manometry: measuring your lung air pressure to optimise voice production.
If your baby or child is referred for an outpatient Speech and Language Therapy assessment you will be asked to attend either directly or because of the current Covid-19 (Coronavirus) pandemic, via telephone call/video link. You might be asked what time your baby/child eat/feeds so that an appointment can be offered at a time they usually feed to enable the SLT to observe them. If you attend for a face to face appointment you can bring in foods and drinks that your baby/child usually eats.
SLTs will carry out a thorough assessment of your baby or child's swallowing/feeding and will provide advice and follow up if required. They will be able to refer on to Community Paediatric services if required.
You do not have to be nil by mouth before this procedure, if you have particular requirements or preferences regarding foods and drinks please speak to your referring Speech and Language Therapist who can advise you.
Refer a patient
Referrals for Adult Speech and Language therapy are only accepted from NMUH Gastroenterology and Respiratory Medicine, all other referrals should be made to your local SLT Community Team:
Speech and Language Therapy
Level 1 Podium West
North Middlesex University Hospital, Sterling Way
London N18 1QX
Or via email firstname.lastname@example.org
Head and neck
Referrals typically come via MDT meetings and direct from Oncology consultants. If you have a patient you would like to refer, please send referral information and your contact details to email@example.com.
Outpatient paediatric referrals are accepted from NMUH consultants only and should be emailed to firstname.lastname@example.org. Alternatively you can contact 020 8887 2979 and speak to a member of the outpatient administration team.
We are currently unable to offer Paediatric Videofluorosocpy, please speak with your referring Speech and Language Therapist regarding alternative arrangements.
As part of your inpatient stay, your treating SLT may recommend a videofluoroscopy, to help guide your treatment and rehabilitation, this will be discussed with you and your treating medical team.
Community SLT teams may refer directly to our service following agreement from your GP. Completed x-ray request forms should be sent to email@example.com.
Meet the team
Head and neck service
Nicky Gilbody - Macmillan Clinical Specialist SLT
Nicky has been working with Head and Neck cancer since 2013 and started at North Middlesex University Hospital in 2020. She specialises in radiotherapy and laryngectomy care and has an interest in research, particularly around survivorship and improving quality of life for those with head and neck cancer.
Nicky says “So often we take eating, drinking and communicating for granted. I’m passionate about trying to improve these areas for people who are undergoing treatment for head and neck cancer as it can make a real difference to people’s quality of life.”
Georgia Carlile - Highly Specialist SLT
Georgia joined the team at North Middlesex University in 2019 and has been working in Adult Speech and Language Therapy since 2014. An expert in dysphagia assessment and management in adults, her specialist interests lie in head and neck cancer and rehabilitation following treatment.
Georgia says “The nature of this specialism allows us to work collaboratively with patients throughout treatment and beyond to achieve results.”
Your Videofluoroscopy will be performed by members of our SLT Acute Adult team and your treating SLT will be present. You will be provided with verbal feedback and any necessary advice following the procedure, this will followed up with a written report to your referring medical team and/or GP.