How should I approach a multidisciplinary referral for a patient with complex communication needs?

When approaching a multidisciplinary referral for a patient with complex communication needs, it is crucial to ensure early and comprehensive assessment, involving the patient and their family or carers NICE NG213,NICE NG62.

• For disabled children and young people with severe complex needs, refer to specialised augmentative and alternative communication (AAC) services if they meet the eligibility criteria NICE NG213.
• Follow the specific referral process and eligibility criteria outlined in NHS England guidance for commissioning AAC services and equipment NICE NG213.
• It is important not to add requirements for referrals to be made by specific practitioners (such as occupational therapists), as this can cause delays NICE NG213.
• For children and young people with cerebral palsy, regularly assess for concerns about speech, language, and communication, and refer for specialist assessment if concerns are identified NICE NG62. If there are ongoing problems with using AAC systems, refer to a specialist service to tailor interventions to their individual needs NICE NG62.
• For adults after a stroke, speech and language therapists should assess if they could benefit from a communication aid NICE NG236. If persisting communication difficulties are identified at 6-month or annual reviews, refer them back to a speech and language therapist for detailed assessment and treatment NICE NG236.

• A multidisciplinary team for patients with complex needs can include a doctor, nurse, therapists, mental health practitioner, pharmacist, dietitian, specialists in the person's conditions, social worker, housing specialist, and voluntary sector practitioners NICE NG27.
• For children and young people with cerebral palsy, specialist assessment of communication skills should be conducted by a multidisciplinary team that includes a speech and language therapist NICE NG62.
• The multidisciplinary team should receive appropriate information, education, and training to enable them to support and communicate effectively with people who have communication difficulties and their families and carers NICE NG236.
• Speech and language therapy, a key component, should be led and supervised by a specialist speech and language therapist working collaboratively with other trained individuals NICE NG236.

• When assessing for communication aids, consider how they will function across multiple settings (e.g., school and home) NICE NG213.
• If possible, provide equipment directly to the individual rather than to a service they use, allowing them to use it wherever they go NICE NG213.
• Ensure staff are provided with information and training to support the individual and make best use of the communication aid, with local AAC services able to provide this training NICE NG213.
• Agree on who is responsible for maintaining, servicing, and insuring the communication aid NICE NG213.
• Provide support during transitions (e.g., finishing education) to ensure continued use of the communication aid in new environments NICE NG213.
• Provide a paper-based backup for children and young people using powered systems NICE NG213.
• Arrange regular reviews for communication aids to ensure they continue to meet the individual's needs NICE NG213.
• Inform individuals and their families or carers about any support and mentoring groups that can help with communication and social interaction NICE NG213,NICE NG236.