Information for professionals

Inpatient referrals

We accept appropriate referrals for patients at Worcester City Inpatient Unit, Trust Mental Health wards on the Worcestershire Royal Hospital (WRH) site, and all community hospitals in Worcestershire for swallowing and communication problems. If you are referring an inpatient, please complete the form below and email it to us marked “inpatient referral”. We are a small service and aim to see inpatients within 10 working days. Please comment on clinical urgency on the referral form. Dysphagia referrals must be signed by a doctor/ ANP/ACP.

Inpatient referral form

 

Outpatient referrals

Please complete the referral form below with as much detail as possible and email it to us at whcnhs.adultsltreferrals@nhs.net. We aim to triage all referrals within 48 hours. If you feel the referral is highly urgent, please mark it as such. Please note dysphagia referrals must be signed by a doctor/ANP/ACP. If we reject your referral, we will contact you and explain why. We will not routinely contact the patient directly.

If someone you have referred presents with worsening symptoms, please do contact us with supporting information to expedite their referral. You must include specific clinical details of the changes, particularly if a dysphagia patient develops chest infections/ aspiration pneumonia or has a choking episode requiring first aid.

To help us manage our waiting lists, please let us know if the referral is no longer needed; for example, if a patient’s symptoms have resolved, they have chosen to feed at risk, or they are imminently approaching end of life or have died.

Outpatient referral form

 

Feeding at risk (FAR)/ Eating and drinking at acknowledged risk (EDAR)

Sometimes a swallowing assessment will indicate that a patient cannot safely manage any oral intake. In this case, the options are to continue with unsafe oral intake or move to non-oral feeding. This is a complex decision and, while SLT can comment on swallow safety and level of risk, we are not able to make the FAR decision. This must be made by the patient, if they have mental capacity to do so, with the appropriate medical team. A best interest decision must be made for patients who do not have mental capacity to choose for themselves. FAR decisions must be documented according to the guideline below and added to the patient’s ReSPECT form. If a FAR decision is reversed, this must be clearly documented and the ReSPECT form updated.

Some patients will choose to feed at risk rather than follow SLT advice. Again, a FAR decision must be documented as per the guidance below. If a patient you have referred for dysphagia chooses to feed at risk, please contact us to cancel their referral.

Feed at risk (FAR) guidelines