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A Day in the Life of a Community NHS Speech and Language Therapist

Updated: Oct 22, 2020

Speech and Language Therapy is one of those professions where people have many preconceived notions of what we do. Either they have seen the Kings Speech or think we help children pronounce their ‘s’ or are just called to prescribe thickener to people with swallowing difficulties. Whilst it is true that working with people who stammer and children’s pronunciation and swallowing are parts of our profession, speech and language therapists work with so much more than that.

Speech Therapy Apps: Speech Therapy is a diverse profession that is very different to what many people think
Working on speech sounds in paediatric speech therapy

To note, speech and language therapists (SLTs) work across a number of different settings including early years, autism clinics, hearing impairment, mainstream schools, learning disability, the criminal justice system, elderly medicine, critical care, neurology & neurosurgery and general medicine. There are more but these are the main ones we work in.

I have worked in neurology since I graduated, meaning I see anyone whose brain has been affected by disease, infection or trauma and it is impacting on their communication or swallowing. So, I thought why not take you through my day and see if I can give a bit of perspective on a day in the life of me, your friendly neighbourhood speech and language therapist. Buckle in folks, it was an interesting day!


As I work in Central London usually we see patients via public transport or if it is sunny I can enjoy a 20-30 minute stroll.

The first person I went to see was a 27 year old man with a traumatic brain injury. To give you some background he was on a scooter and had a road traffic accident with a motorbike. He spent 3 months in hospital, had intensive rehabilitation and he came out as what we often refer to as “The Walking Wounded”. In his case he can walk, has no physical disability, looks very strong due to spending an inordinate amount of time in the gym pre-accident but is now unable to schedule his day, regulate his emotions or speak coherently or in a way that makes sense.

I had been working with him for approx. 6 weeks on his verbosity (he’s been using more words than needed in sentences). Today we were due to do an assessment video to reflect on his progress and see what we still needed to work on. When I entered his flat he appeared very low in mood, crying and said “I thought about killing myself this morning”.

Needless to say we didn’t do any work on verbosity today.


After a call with our team psychologist and the above gentleman’s GP, I walk to a residential care home 20 mins away to see my next patient. This lady has recently awoken from a coma. She had a massive stroke at a bus stop one day. She’s 53 years old, has 3 kids between the ages of 10-21 and has been in and out of a coma for the last 7 months.

Most people think with a coma you are either in one forever or wake up and are instantaneously great as per every TV programme and movie you have ever seen. The reality of this is much different, people can remain in what is known as a ‘minimally conscious state’ for months or even years. In this state you might be able to move a finger on command or open your eyes and sometimes maybe make sounds.

Image of a doctor looking at a brain scan
Looking at the extent of brain damage

This lady however also has significant brain damage as a result of her stroke which does not give her a good prognosis. I have been working with her over the last few weeks trying to aid her communication for when she is alert using a book created for her by my team and her family. She cannot speak verbally but does look at you when she is alert.

Today’s plan was to try and elicit some noise from her vocal chords like a cough or a hum to see if she capable of making noise. As I walked in and said “Hello, how are you today?” as per usual not expecting to hear a response. I reached to get something out of my bag I heard her say “I’m fine”.

I froze and slowly turned around to her.

She looked as surprised as I did.