An overview of answers to key questions asked throughout phases one and two of the pre-registration EDS competencies project.
About the competencies
Find out more about the competencies, including how we developed them, why they are being implemented and how they fit in with other dysphagia competencies.
How were the competencies developed?
These competencies were developed collaboratively with RCSLT members. Read about the RCSLT’s guidance development process.
Why is this framework being implemented at a time when there has been, and continues to be, great pressure on practice educators due to COVID-19?
The RCSLT understands that this is an unprecedented and difficult time for all involved in health, education, and social care.
Early in 2020, speech and language therapy managers and universities were asked how the RCSLT could best support them. COVID-19 highlighted the shortage of speech and language therapists (SLTs) trained in eating, drinking and swallowing (EDS). Managers also reported the clinical need to have a workforce in both adults and paediatrics that can be more actively engaged and useful in the field on graduation.
The project therefore became a high priority. Implementing this framework is the clearest way to reach this target.
How do the pre-registration competencies fit in with other RCSLT EDS-related frameworks? Do they replace any aspects of previously published frameworks?
The eating, drinking and swallowing competency framework (EDSCF) is not intended for use by speech and language therapists. Speech and language therapists should instead use the profession-specific RCSLT dysphagia training and competency framework.
We will be reviewing the dysphagia training and competency framework (2014) to ensure consistency of career progression.
Why should learners be required to spend time completing these competencies when they may not be interested in specialising in dysphagia?
HCPC and other bodies recognise that the scope of the speech and language therapy profession includes eating, drinking and swallowing and that it is the lead profession in dysphagia management.
To future-proof the workforce, and ensure that we are fulfilling our professional mission to create better lives for people with communication and swallowing needs, it is vital that all graduates are trained to understand eating, drinking and swallowing needs at a basic level.
Once learners have successfully achieved their EDS competencies, will they be able to practice in dysphagia after they qualify and start working, or will they still need to do the post-graduate training?
If they gain a role which requires them to work with people with dysphagia, they will need to have a supervisor who is dysphagia trained. They will discuss their portfolio with them and look at any areas they need support and supervision in. For some trusts, this may mean they need to be supervised, to complete in-house training, or to attend a post-graduate training course. It is down to the individual and supervisor to decide what is needed to become fully independent with dysphagia. There may be some learners who finish their competencies and have a good level of knowledge on dysphagia and require less support to become independent.
For part-time courses, will learners who started on the course before the competencies were published but who may qualify after the cut off date of academic year 2025-2026 still have to evidence the competencies at the time of graduation?
Any learner starting before September 2022 but graduating on or after academic year 2025-2026 will not be expected to complete all the competencies in order to graduate although it is likely they may be able to sign off some of them.
Are HCPC updating SOPs to acknowledge the 60 exposure hours?
HCPC will be updating their SOPs to reflect the need to be competent to the level agreed but the consultation process on how this will look has not started. HCPC will be releasing new SOPs in spring 2022, but it is expected that there will be a further update closer to 2025-2026 which include specific reference to these EDS competencies.
However, it is important to note that the current SOPs already include references to EDS.
Who is responsible for the overall sign off of the completed 60 exposure hours?
HEIs will regularly review progress against these hours and be responsible for overall signoff.
Have questions or feedback about the pre-registration EDS competencies? Let us know.
The competencies and practice placements
Find out how the pre-registration competencies fit in with practice placements.
Interested in examples of competency implementation on placement? Read our case studies.
Looking for more information on the definition of a placement hour? Download our guide to what constitutes an hour of eating, drinking and swallowing (EDS) exposure (PDF).
How do the pre-registration EDS competencies fit within the broader move towards practice placement expansion and innovation?
The RCSLT hopes that introducing these competencies will encourage more services to offer practice placements that allow learners to work towards completing the EDS competencies.
It is our vision that through practice placements, innovative opportunities for EDS exposure will be found within traditional communication practice placements as well.
Read more about practice-based learning.
Do certain aspects of the knowledge competencies need to be completed before the beginning of the practical competencies or practice placement hours?
There is no requirement to map knowledge competencies along a certain timeline with practice placement hours or practical competencies. It is up to each HEI’s discretion when in the course they will plan for each aspect to be completed. However, we would encourage an early introduction of the EDS competencies to allow competencies to potentially be signed off during any placement.
Will practice placement opportunities all require EDS-specialised staff?
It is expected that the practical competencies will be fulfilled through a wide range of practice placement experiences, and therefore there are many practice placement opportunities that will not require specialist dysphagia staff.
As eating, drinking and swallowing issues affect most of our service user groups it is our hope that such issues will be embedded within practice placement experiences to promote holistic, patient-centred evaluation.
Clinicians working with service users who have eating, drinking and swallowing needs – even if this is not their main focus – can supervise learners and sign off on their practical competencies. Some of the competencies can be achieved in all clinical areas, such as completing an oro-facial examination on clients without EDS difficulties.
What constitutes a paediatric practice placement?
Paediatric practice placements are those which occur within a paediatric service. All activities that include eating, drinking and swallowing issues are relevant. For example:
- Lunch time at a school with children who have physical or learning disabilities.
- Speaking to a parent about their child’s eating, drinking and swallowing needs.
- Working with a child with sensory and/or behaviour issues relating to food or drink.
- Discussing with other professionals what the issues are or how to best support the child.
- Evaluating the whole person, with EDS being one aspect.
We are working with paediatric EDS trained clinicians to develop eLearning that will support sign off of the competencies and completion of the paediatric hours.
To what skill level will learners be expected to function independently during practice placements and upon qualification?
Completing this framework won’t provide complete dysphagia training or lead to competency at a specialist level, i.e. this competency does not map directly onto Level C of RCSLT Dysphagia Training and Competency framework (2014). Rather, it aims to provide learners with exposure to EDS needs so that they are better prepared to enter the workforce.
Newly qualified practitioners (NQPs) who have completed the pre-registration competencies will be supervised to the same level that they would be in clinical areas related to communication.
As is current practice, individuals and organisations make judgement calls regarding capability and independence when it comes to recruitment, supervision and training in all roles. We have developed an end-point graduate criteria page to clarify the level of competence that is expected at graduation.
Further information on expectations for graduates and employers is in development. This document will detail examples of EDS work that a graduate can undertake with supervision and the roles and responsibilities for graduates and employers.
However, not all NQP roles will require EDS skills. These NQP will not need to continue with their EDS development unless it is specified by their employer.
Will newly trained EDS therapists be required to take on learners?
Clinicians should only take on learners in areas where they feel confident in their own ability. Clinicians are expected to be competent in all areas included in their job description, and to be able to take on learners in listed areas, including eating, drinking and swallowing.
Newly qualified practitioners (NQPs) may support learners on their practice placements, but according to the practice-based learning guidance, NQPs cannot supervise learners or sign off competencies in any clinical area. This precedent will be maintained in EDS.
Have questions or feedback about the pre-registration EDS competencies? Let us know.
Ensuring equal learning experiences
Read how equal learning experiences will be ensured and how learners’ EDS exposure will be measured.
How can equity of experience for learners be ensured when it is not always possible to predict what they will be exposed to on a certain practice placement?
As in communication practice placements, there is always some need for flexibility, and this framework fits in with the continued work to expand practice placement capacity and encourage innovation in all practice placement areas. This ought to reduce pressures resulting from practice placement shortages.
Learn more about the practice-based learning guidance.
Additionally, as is likely already part of the learning and education process in other areas, HEIs will have regular check-ups with learners to review their progress against the given competencies throughout the duration of the course to ensure they are on target for full sign off by graduation.
How will learners’ EDS exposure be measured under the framework?
Learners will have to achieve 60 hours in total as part of the overall pre-registration EDS sign off: 10 hours direct with paediatric clients, 30 hours direct with adult clients and 20 indirect hours. Hours achieved through technology enhanced learning and simulation can count towards direct hours with client groups. The hours sign off is in conjunction with double sign off of 16 out of 20 competencies. HEI’s will have ultimate responsibility for overall sign off but practice educators are likely to sign multiple competencies.
Have questions or feedback about the pre-registration EDS competencies? Let us know.
Simulation/technology enhanced learning and the competencies
A small number of competencies will need to be signed off following face-to-face experience. However, many will be able to be signed off via simulation or other teaching methods. Read which competencies require face-to-face exposure in the clinical setting (PDF).
The RCSLT will collaboratively promote and develop simulation/technology enhanced learning resources to support the implementation of the framework.
HEIs are encouraged to be innovative in their use of simulation for practice placements and learning, and they will be supported by the RCSLT in this endeavour.
Already working with simulation?
Email kathleen.graham@rcslt.org to let us know if your university is already doing simulation work.
Have questions or feedback about the pre-registration EDS competencies? Let us know.
