Speech and Language Therapy (ENT)

We operate 3-4 multidisciplinary laryngology clinics per week with ENT and Speech and Language Therapists working jointly to see patients with a wide range of voice disorders. These may range from subtle performance issues to neurological voice disorders, vocal fold paralysis and complex airway issues. There is also a specialist paediatric multidisciplinary voice clinic running 2-3 times monthly.

Our voice service accepts referrals for both children and adults from local GPs as well as national services. Many of the cases are referred to the clinic from other centres for expert second opinion and management. Following an ENT assessment and diagnosis, patients may then be referred for Speech and Language therapy for ongoing treatment.

Voice disorders (i.e. hoarseness, loss of voice or discomfort on speaking) are common. The impact of voice problems are well documented in occupations with high vocal demand, resulting in significant financial losses to the British economy due to voice-related absence from work. An audit of 1,665 referrals to our department showed that the most common occupations referred were retired people, followed by singers and then teachers.

A loss or change in our voice, can not only affect our ability to work but can also impact us socially and increase the risk of social isolation - which in turn, can undermine our sense of wellbeing and personal identity. Research into the diagnosis and management of voice disorders is increasingly recognised as important within Ear, Nose and Throat services worldwide.

Our voice therapy service is provided by one of the largest voice specialist speech and language therapy teams in the UK. An expert team offers assessment and therapy for a multitude of benign ear, nose and throat and complex voice problems.  Following a referral from a UCLH ENT consultant, one of our speech and language therapists will offer an initial assessment appointment which may take place either face-to-face or virtually. Assessment may include a variety of measures of the presenting voice problem and a therapy plan is collaboratively agreed upon with the patient.

We are the UK’s largest voice specialist SLT team. Our expert therapists assess and treat benign (non-cancerous), complex voice problems. After UCLH ENT referral, your therapy appointment will be face to face or virtual.

We assess and treat adult outpatients with swallowing symptoms including coughing/choking when eating or drinking or sensation of something sticking in the throat. We provide Fibreoptic Endoscopic Evaluation of Swallowing (FEES)  and Videofluoroscopy where indicated.

Neurogenic or oncological dysphagia are not treated.

We run Speech and Language Therapy-led voice clinics, using specialist equipment (videostrobolaryngoscopy) to examine the larynx and vocal function. This assessment reveals how the diagnosed voice disorder affects the voice in action. A highly specialist Speech and Language Therapist undertakes the procedure and the images are recorded.

We have in-depth knowledge of conditions where the larynx becomes over-reactive such as: chronic cough, habitual throat clearing, laryngeal hypersensitivity, inducible laryngeal obstruction and breathlessness starting in the upper chest. We work with individuals to help understand the origin of their condition, after a thorough ENT review. We provide practical advice and strategies to help manage and reduce these conditions.

We offer regular virtual group voice education seminars for patients who would benefit from voice care advice to encourage better ongoing vocal health.

These sessions cover:

• how voice is produced
• how to practice good vocal hygiene and voice care
• how silent reflux can impact the voice
• how certain medications can impact the larynx
• how certain behaviours can negatively affect the vocal mechanism.

Time is also given for general Q&A, and participants are offered individual follow-up from the seminar, if clinically appropriate.

The Speech and Language Therapy team works with our laryngology specialist ENT surgical colleagues, providing expert input into the multidisciplinary voice clinics. These clinics have state-of-the-art equipment, offering videostrobolaryngoscopic examinations, resulting in accurate diagnoses.

We operate up to 4 multidisciplinary laryngology clinics per week with ENT surgeons and speech and language therapists working jointly to see patients who are experiencing voice problems which could relate to issues such as vocal trauma or overuse, underlying medical conditions, etc.
The voice clinic is actively involved in teaching, audit and research.
 

The paediatric voice clinic is run by a consultant ENT laryngologist and a specialist speech and language therapist, with assistance from specialist paediatric nursing staff and access to a play specialist. The clinic runs twice monthly and accepts local and national referrals from GPs, as well as colleagues seeking second opinions.

We are one of just three clinics specialising in paediatric voice disorders in the United Kingdom. We see children who are experiencing a range voice disorders, which could be impacting them socially, and educationally or hindering their aspirations to participate in the performing arts. We offer a complete service, for all under 18-year-olds, from assessment to diagnosis and completion of treatment - including voice therapy or surgical management, if required.

When reaching adulthood, we can seamlessly transfer our patients into our adult clinics - without the need to change hospital or clinician - providing excellent continuity of care. We have state-of-the-art equipment to perform the assessment of videostrobolaryngscopy, allowing for improved diagnoses and therefore appropriately targetted treatment.

The neurolaryngology voice clinic is run by a Consultant ENT/Laryngologist and a Consultant Speech and Language Therapist. Patients are assessed for complex neurological movement disorders including spasmodic dysphonia.

• Plan your visit
• Initial appointments are in person or via video call or telephone. They may last up to an hour. Follow up appointments typically last 30 minutes. If you are late the session may have to be shortened or rebooked.
• An initial appointment may be individual, group or in Speech and Language Therapy Led Voice Clinic. Please bring details of your medications.
• A supervised student may observe or deliver your treatment. Please let us know if you prefer a student not to be present.
• For more information on video sessions, please visit MyCare.
• An interpreter can be arranged for you if required. Please contact 020 3456 5180.More information on the UCLH interpreting service.

• Please contact us on 020 3456 5180 (direct line). Please leave a message clearly stating your name and telephone number.
• We are committed to providing a high quality service. Appointments are wasted due to patients failing to attend or not giving cancellation notice.
• Attendance policy:  Unless exceptional circumstances, you will be discharged if you fail to attend without cancellation or you change more than two therapy sessions.
• If discharged, we require a new referral from your ENT consultant and you will be placed back on our waiting list.

• Ask you about the problem you are experiencing
• Encourage you to ask questions
• Carry out assessments of your difficulties
• Offer advice and exercises to carry out at home
• You may bring a relative, carer or friend subject to hospital restrictions (COVID-19 information for patients and visitors : University College London Hospitals NHS Foundation Trust (uclh.nhs.uk)) , but please do not bring small children (unless there is someone to look after them)
• A report on the session will be sent to you, the referring ENT consultant and your GP with your permission
• Your therapist will discuss with you whether further treatment would be of benefit. If appropriate, further appointments will be arranged with you.

• Please contact our department on 020 3456 5180 (direct line). Please leave a message for your therapist and clearly state your name and telephone number.
• We are committed to providing a high-quality service as promptly as possible. Numerous appointments are wasted due to patients failing to attend or not giving enough notice when cancelling an appointment.
• Please note: our department’s attendance policy is as follows:  Unless there are exceptional circumstances, you will be discharged from our service if you fail to attend any appointment on two occasions without cancellation or if you change more than two therapy sessions.
• If discharged from our service, you will require a new referral from your ENT consultant and you will be placed back on our waiting list.
• Plan your visit

Ruth holds several honorary fellowships and honorary associate professor positions at the division of surgery and interventional science UCL, and at MGH Institute of Health Professions, Boston, as well as other academic institutions in the UK and abroad. In addition to her clinical role, Ruth is a co-lead of the voice pathology module on the Performing Arts Medicine course at UCL. Qualifying in 1977, she has extensive experience in leading clinical research projects. In the past two years Ruth has taken a leading role in the UCL/UCLH SAFE RETURN study and AMRC funded Perform-2 study, investigating risks associated with inhalation transmission of SAR-CoV-2. She has published extensively on various aspects of voice and voice therapy. 
 

She is actively involved in research projects within the SLT (ENT) team. She has published in peer-reviewed journals on voice, and most recently on the effects of Covid on the voice and swallowing. She lectures and presents regularly.

Philippa qualified in 1984. Her role involves management of complex clinical issues in voice, airway and swallowing. She is a member of the multidisciplinary team in joint advanced diagnostic voice clinics.

She is actively involved in research projects within the SLT (ENT) team. She has published in peer-reviewed journals on voice, and most recently on the effects of Covid on the voice and swallowing. She lectures and presents regularly.
 

Gary has worked in ENT since 1994, working with voice disorders and ENT swallowing problems. He has specialised further in sub-specialties of voice including hypermobility disorders. He is a senior member of the ENT swallowing service, which assesses and treats ENT-related swallowing issues.

Anne qualified in 1985 and has a varied clinical background and has worked in South Africa, Canada and England. She has clinical expertise in the assessment and treatment of voice and is a senior member of the ENT swallowing service.  She is involved in the training of postgraduate students. Her research interests include patient and professional perception of voice disorders, as well as occupational voice disorders.

Marion qualified in 1994. She has taken a lead in the development of the paediatric voice service and is involved in the multi-disciplinary paediatric voice clinic. She takes a lead in the Speech and Language Therapy-led voice clinics. She has participated in a wide range of audit projects and research, including looking at the incidence of voice disorders, patient and professional perceptions of voice disorders and occupational voice disorders. She has presented at local and international conferences on these topics.

Fiona qualified in 2007. She specialises in working with adults and children with chronic cough/laryngeal hypersensitivity, inducible laryngeal obstruction, upper airway breathlessness and Long Covid. Fiona is seconded to Whittington Health as Clinical Lead for voice therapy within Haringey and Islington. She lectures on upper airway conditions, the relationship between breathing and voice and the effects of Long Covid.

Brian is a voice specialist speech and language therapist and clinical researcher. Qualifying in 2011, he has clinical expertise in the assessment and management of a wide range of voice disorders and considerable experience as a professional voice user. His research interests lie in basic voice science, voice assessment, identifying novel voice therapy techniques and modalities as well as furthering the evidence base around more established practice.

Maria qualified in 2018. She delivers both adult and paediatric therapy and supports the swallowing assessment service. She runs the voice education seminars and is involved with student training, lecturing and audit.