Speech and language therapist

Speech and language therapists (SLTs) assess and treat people who have difficulty communicating, eating, drinking or swallowing. The job divides roughly into children’s work, which is mostly about speech, language and communication needs, and adult work, which covers stroke, brain injury, progressive conditions and swallowing problems. You need an HCPC-approved degree to use the protected title. Newly qualified SLTs in the NHS in England start on band 5, which pays £32,073 to £39,043 from 1 April 2026.

Working with children

Paediatric SLTs see children with delayed or disordered speech and language, stammering, developmental language disorder, autism, hearing impairment, cleft lip and palate, and complex needs. Much of the work happens in community clinics, nurseries and schools. You assess, set targets, model strategies, and coach parents and teaching staff, since most progress comes from what happens between sessions.

School-based therapists write advice for education, health and care plans and attend reviews. If you work closely with schools, you will spend a lot of time with SEN teaching assistants, SENCOs and SEND caseworkers. Caseloads in paediatric services are often large and waiting lists long, which is one of the most stressful parts of the job.

Working with adults

Adult SLTs work in hospitals, rehabilitation units, community teams, care homes and palliative care. On acute wards, much of the work is dysphagia (swallowing) assessment, often for people after a stroke, deciding whether it is safe to eat and drink and what textures to recommend. Getting this wrong risks choking or aspiration pneumonia, so it carries real clinical responsibility.

Adult communication work includes aphasia after stroke, dysarthria in conditions like Parkinson’s or motor neurone disease, voice disorders, and supporting people to use communication aids. Some SLTs specialise in head and neck cancer, critical care and tracheostomy, or learning disability services.

How to qualify

The main route is a BSc (Hons) in speech and language therapy, applied for through UCAS. Entry requirements vary. Many universities ask for A levels or equivalent, sometimes with an English, language or science subject, and GCSE English and maths. Graduates can take a two-year pre-registration MSc at some universities. Degree apprenticeships in speech and language therapy have also started, often recruiting therapy assistants already working in the NHS.

Once you complete the course, you register with the HCPC and pay the registration fee, which is tax-deductible. See the HCPC registration guide. Many SLTs also join the professional body, the Royal College of Speech and Language Therapists, though you should check whether that subscription is on HMRC’s approved list before claiming relief on it.

Newly qualified SLTs complete a period of supported practice with supervision before working fully independently. Dysphagia competencies are built up gradually, under supervision.

Pay

Band	Typical role	Pay from 1 April 2026 (England)
5	Newly qualified SLT	£32,073 to £39,043
6	Specialist SLT	£39,959 to £48,117
7	Highly specialist SLT, team lead	£49,387 to £56,515
8a	Clinical lead or service manager	£57,528 to £64,750

Most SLTs move to band 6 after their first period of practice, by applying for a specialist post. Scotland’s band 5 runs from £34,494 to £42,977. On band 5 entry pay you contribute 8.3% to the NHS Pension Scheme, and 9.8% from band 6 entry. The take-home pay calculator shows net pay at each level.

Some schools, academy trusts and councils employ SLTs directly on their own pay scales, and independent practice is common for experienced therapists.

Checks before you start

Speech and language therapists work closely with children and vulnerable adults, so employers carry out an enhanced DBS check with barred list checks. In England and Wales it costs £41.00 from 5 October 2026, while Scotland uses the PVG scheme and Northern Ireland uses AccessNI. You will also need references and an occupational health check. School-based therapists may be asked to follow the school’s safeguarding procedures as well as the NHS employer’s. The DBS check levels guide explains the different checks.

If you trained outside the UK, the HCPC has an international registration route, and you may also need a visa sponsored by the employer.

Hours

Community and school-based SLTs work weekday hours, often based around the school day and term dates for school-facing roles, though NHS contracts are usually all-year. Acute hospital SLTs also work weekdays, with some trusts running weekend dysphagia cover. Full-time NHS staff get 27 days’ annual leave plus eight public holidays on appointment, rising with service. Part-time and flexible working are common in the profession.

Finding a job

NHS posts appear on NHS Jobs, the NHS Scotland jobs site and HSC jobs in Northern Ireland, and school or council posts appear on council and education job sites. Many trusts recruit newly qualified SLTs in rounds near graduation. Current NHS posts are listed under allied health jobs, and the NHS supporting statement guide covers how to write an application that scores well.