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Background

Thickened fluids are an intervention for adults and children with difficulties swallowing fluids. In this context, thickened fluids refer to any liquid or drink that is taken orally. Thickened fluids may be naturally occurring or artificially thickened by commercial or non-commercial products.

The RCSLT has developed a position statement, paper, and resources to support dysphagia practitioners to understand the potential benefits and potential burdens associated with thickened fluids to support the practitioner to review their current practice. The position paper is not a systematic review of the literature but provides an overview of the current discussions around using or not using thickened fluids. It is important that each practitioner is aware of the current evidence base within their clinical specialism and decisions around thickened fluids are based on the principles of patient-centred care.

Speech and language therapists (SLTs) should approach this information through a model of evidence-based practice (EBP). SLTs are encouraged to reflect on current practice, base clinical decisions around the needs and preferences of each individual and be aware of the evidence base within their specific clinical area. SLTs should be aware of, and take into account, the position paper and associated documents and then exercise their own professional judgement and carry out research of the latest evidence-base when making clinical decisions.

Recommendations in the position paper advise that service users should not be prescribed thickener for fluids without a detailed drinking and swallowing assessment by a dysphagia trained practitioner. As one of the lead professions for eating, drinking and swallowing difficulties we would promote the vital role of SLTs to achieve this. As a profession which is under increasing pressure due to workforce vacancies and waiting lists, we would encourage commissioners to adequately fund services to achieve this recommendation with consideration of service models, such as rapid response services, which have the potential to be a more effective model of care.

RCSLT position statement and paper

In March 2023, we published our statement on the use of thickened fluids which was aimed at all dysphagia practitioners.

This was followed up with a position paper in January 2024, alongside a summary for SLTs and a summary for non-SLT clinicians as well as other resources which can be found in the resources section. All references are held within the position statement or position paper.

You can also find out more about how we develop our guidance.

Resources

To support the position statement and paper we have developed the following resources:

Related RCSLT guidance:

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