In this case study, written by Saiba Ahuja, we explore the rollout of video consulting in speech and language therapy services in Wales.

Saiba is a member of the TEC Cymru Young Representative Panel which is made up of young people from all across Wales. The group regularly meets with the TEC Cymru team to collaborate on projects.

As part of her role in the panel, Saiba has written a series of case studies on the NHS Wales Video Consulting Service.

Speech and language therapy session with little boy


Video consulting (VC) has been successfully rolled out and utilised within Speech and Language Therapy to continue providing support for patients.

Language development is a significant health inequality issue and young people with Speech, Language and Communication Needs (SCLN) are at higher risk of long-term outcomes on their wellbeing and mental health.

Video consultation appointments with Speech and Language therapists (SLTs) have served a range of purposes including helping those with Speech and Language delay, carrying out speech and sound assessments on young children, advising on dysphagia, working on autism diagnoses and therapy for those with aphasia.

User Story; Benefits and Challenges

In May 2020, a SLT from Betsi Cadwaladr UHB conducted an online therapy session with a child (and parents) who had an ‘overall delay in communication, play and motor skills.’

The clinician expressed that it was a ‘positive video call with parents’ and that VC allowed the clinician to continue ‘sharing information and coaching them through their home-made videos’, and despite intermittent audio quality issues, the VC quality was rated as ‘excellent’.

Both patient and clinician saw a range of benefits in conducting speech and language therapy virtually, and the VC worked so well that neither had a preference for a face-to-face appointment. Furthermore, this style of appointment was rated ‘very beneficial’ for the clinician’s time and improvement of access to care and the SLT also noted the benefits for the environment as 30 minutes of travel time was saved. As a result, this led to a lower rate of infection risk, leaving both the patient and clinician feeling happy with their overall experience.

Overall Clinician Response; Benefits and Challenges

This experience echoes that shared by other clinicians carrying out Speech and Language Therapy appointments via VC. Out of 200 of these appointments carried out from the 5th of May 2021 to the 7th of July 2021:

  • 41% clinicians rated their video consultation ‘Excellent’ or ‘Very Good’
  • 30% rated their appointment as ‘Good’.

With one clinician explaining how ‘Really good quality made speech and sound assessment so much easier.’

Meanwhile, 15% of clinicians rated their Video Consultation appointment as ‘Okay’ and 14% rated it as ‘Poor’. However, this was often due to external circumstances such as the ‘session being carried out from the car’ in one appointment where the clinician still found the appointment worked and was suitable for clinical needs. Other clinicians gave this rating as it ‘works well at home but not so well in clinic’ or due to ‘picture quality not being good’, emphasising the need for reliable connectivity for clinicians carrying out video consultations.

Overall Patient Response; Benefits and Challenges

The positive user story above reiterates that of other patients attending Speech and Language therapy through VC. Out of 200 of these appointments surveyed from the 31st of March 2021 to the 11th of July 2021, an overwhelming 114 patients who form 57% of this group declared their appointment was ‘Excellent’ with a further 28.5% expressing that the appointment was ‘Very Good’ with patients sharing how clinicians still made them feel ‘really relaxed’ over the video.

Furthermore, patients expressed how a ‘high level of service and care’ was maintained with ‘exercises completed successfully’ and in many instances ‘picture and voice quality was 100%’, something essential in Speech and Language appointments.

A further 9% of patients rated their video appointment with a SLT as ‘Good’, and 3% rated it as ‘Okay’. Only 2.5% of patients rated their experience as ‘Poor’ and in most instances this seemed to be due to broadband availability, with one patient expressing that ‘we live in a rural area several miles from the nearest server and several years away from fibre optic or satellite service.’ This highlights the necessity for better infrastructure and connectivity to address digital inequalities to ensure all patients can have the best access to care possible.


Overall, Speech and Language Therapy sessions have been an area in which feedback for video consultations has been overwhelmingly positive, and importantly, as expressed by one patient, ‘the appointment gave me confidence to continue with the exercises.’