We are responding with an update in relation to videofluoroscopic swallow study (VFSS) and ongoing advocacy work that IASLT has been engaging in.

In 2023 a HIQA report published highlighted concern in relation to some practices:

"Inspectors were satisfied that in most cases, individual medical exposures took place under the clinical responsibility of a practitioner, as defined in the regulations. However, clinical evaluation of the outcome of medical exposures, which is an aspect of clinical responsibility under this regulation, was being carried out for certain fluoroscopy procedures by a person not recognised under these regulations as a practitioner."

Under legislation, radiographers have "practitioner" status. Despite the fact that SLTs have the relevant skills and training to conduct VFSS and have been doing so nationally, as a profession we are not legislated as ‘practitioners’. As per legislation, Speech and Language Therapists cannot hold clinical responsibility for radiological procedures, dosage, including the clinical evaluation of the outcome of the procedures, which is an aspect of clinical responsibility. Legislative changes are required in order for the SLT profession to have ‘practitioner status’. Despite ongoing advocacy by IASLT with the Government and HSE we understand that changes to legislation are not currently under consideration by the Irish Government.

Given that SLTs do not have practitioner status we recommend the following:

• a local agreement should be put in place that allows a legislated practitioner to sign a report assuming responsibility for the radiation dose to the patient and justification of the exam.

• the SLT should continue to provide a more detailed and comprehensive SLT report. This report should be filed in line with local policy. IASLT recommends, where appropriate, reports should be scanned to NIMIS to be saved with the VFSS procedure.

IASLT will continue to advocate for referrer and practitioner rights for Speech and Language Therapists and for a change in current legislation.