Telehealth for your service

Information and resources for service managers

It is feasible and beneficial to offer telehealth in your service to people living with aphasia.

Providing speech and language therapy care to people living with aphasia is classified as “digital therapeutics”. Ways of providing digital therapeutic care include:

  • Remote care
  • Use of applications to deliver therapy
  • Providing health information

You have likely been using telehealth in your practice for a while, by using the telephone to deliver care, using apps in your assessment or therapy, providing information about aphasia, or carrying out reviews or using video call appointments.

Considerations for implementation

Motivation

Providing care via telehealth does not compromise on the high-quality care healthcare professionals aim to deliver. It can take time to see the benefits of this change in service delivery, but this hard work will be worth it. Benefits to the service include:

  • Cost-effective use of healthcare resources
  • Enhanced service user experience, i.e., by reducing travel demands
  • Assist with managing caseloads, including delivery of intensive rehabilitation
  • Improved connection with family and loved ones

Royal College of Speech and Language Therapists, 2022 🌐

Persuading service used of the benefits of telehealth care may initially be a challenge, however the benefits to remote care will be evident quickly. Benefits to people living with aphasia include:

We have produced a handout to support conversations on the benefits of telehealth for people living with aphasia and their family and helpers. You can find it here 📄.

Incentives

The NHS England 10 year plan (UK Government, 2025), published in July 2025, clearly outlines the aim for increased use of technology in healthcare for coordinated accessible care. Although no service level incentives are described, services may be evaluates on how they are using technology and bench marked against similar service. This has implications for commissioning of services. Currently use of remote care is a trust and local service decisions.

Incentives for services to use telehealth in their delivery include:

Risk

When choice about appointment location is not offered, this may impact on service users’ engagement in therapy and attendance. We encourage services to offer this choice given the benefits of telehealth and remote care. However, we are aware this is not always possible in every service. There may be barriers for the service user to access telehealth, e.g., no internet connection at home, no access to a smartphone.

You can find information about addressing digital inequalities here 📄.

When delivering remote care, it can feel like you have less control over the therapy environment. Gathering information can address safeguarding concerns such as the service user becomes unwell during your appointment. Completing a local risk assessment to manage these potential issues may be indicated.

Suggestions for mitigating risk include:

  • Check who is present at the start of each session. This can improve your awareness of the service user’s space.
  • Have a correct phone number for the service user and next of kin should you get disconnected
  • Ask how the service user is feeling and take steps to help self-manage if they are not well i.e., support them to contact their GP
  • Agree on breaks and the length of the session, and watch for signs of fatigue.

Information governance

NHS England shares information on digital safety and information governance for videoconferencing consultations. Important considerations are:

  • Follow the information governance policy for your healthcare trust, i.e. find a quiet, confidential space for the appointment
  • Confirm the videoconferencing platforms agreed for use by your healthcare trust
  • Check your work PC/laptop for updates to the videoconferencing platform your trust uses
  • Only use a device that has been security protected by your trust
  • Ask if the service user has any concerns about using videoconferencing before the appointment
  • Conduct the appointment in a quiet, confidential place. Ensure no personal or confidential information can be viewed on your camera. If other healthcare professionals or students are present, inform the service user and gain consent for them to be present
  • Check the identity of the service user during the videoconferencing appointment if you have not met them before
  • Gain consent for recording, if being used
  • Check who is in the room with the service user
  • Write your notes as you would for an in-person appointment, stating the appointment was carried out via videoconferencing.

You can find more information about video consultations from NHS England digital transformation here 🌐. Specific video consultation tools can be found here 🌐.

Criteria for offering videoconferencing sessions

We recommend considering the following criteria when offering videoconferencing sessions to people living with aphasia.

  • Access to a device with a front facing camera (i.e. smartphone, tablet, laptop)
  • Has a working email account (i.e., able to access, knows password) or willing to have an email account set up
  • Access to internet with minimum download speed of 5mbps (test it on the device you will be using here: www.speedtest.net🌐)
  • Access to a quiet and private space for sessions where you can see the service user

If someone has access to a helper, this can support service users to get online. It can take the burden of joining video calls and support with troubleshooting if things go wrong in the session.

You can find a handout on how to decide who to offer videoconferencing sessions here 📄.

Technology recommendations

Devices and internet connectivity

Recent survey findings suggest that 95% of people in the UK own a smartphone, falling to 82% for people aged 65 and older.

Having access to a device with a front facing camera is essential for videoconferencing. During the FATE-A study, we found it was feasible to administer assessments with people on these devices:

  • Smartphone (i.e., Apple, Samsung, Google)
  • Tablet (i.e., iPad)
  • Laptop

Good things foundation 🌐 signpost to device banks to support services users to access devices if they cannot fund this. It also includes places you can access the internet for free.

We suggest that a minimum download speed of 5mbps is required for videoconferencing calls. To test this:

  • Use the device you plan to use for videoconferencing sessions
  • Search “internet speed test” into an internet browser or enter www.speedtest.net 🌐
  • Click ‘Go’ to test the internet speed. Check for a download speed of 5mbps or more

Videoconferencing platforms

Using videoconferencing for sessions is a common method of remote care delivery. This synchronous care enables direct contact with service users.
Knowing which platform is available to you for videoconferencing is key to implementation. If working for the NHS, you should be able to find this information on your trust intranet, from your local information governance policy or by contacting your IT department.
Different platforms offer different functions which facilitate online assessment. You can find a comparison table of three videoconferencing platforms here.
If you are working in Primary Care in England, you can contact commercial.procurementhub@nhs.net ✉️ for support with procurement of digital health tools if videoconferencing software is not currently available to you.

Hybrid approach to service delivery

Offering service users a choice about their appointment location can be an empowering experience for both people living with aphasia and clinicians (Comer et al., 2025 🌐). Meeting first or early in the therapeutic journey can help with acceptance of videoconferencing and provide opportunities to carry out assessments or therapeutic tasks in-person (i.e. practising set up of videoconferencing call for therapy, starting assessment such as receptive language tasks which require pointing).

During the FATE-A advisory groups with experts living with aphasia and their supporters, we found that offering a hybrid approach met people’s needs best. They spoke about how meeting each other in-person helped to get to know each other, and then often chose to meet online after this. One of our experts shared their reflections of online meetings:

“[On joining meetings online initially] Exhausting … quite a lot of anxiety of prepping and prepping and double checking and double checking … getting an email with very clear instructions … that [getting online] has improved just by doing this with us … definitely better than it was before you had to find it for yourself.

I think getting used to working online is positive … I can get up do what I want my normal in my house and then I can meet you to do a call whereas having to go through to actually come to somewhere is actually really good to accommodate things for me to do it at home”

Build capacity within your service

Ensuring staff can access training to develop their competency and confidence when using technology in their role is very important.

It is a Health & Care Professions Council (HCPC) standard of proficiency to maintain and develop digital skills and change practice according to new technologies.

Registrants must (HCPC, Oct 2023🌐):

  • 6.5: recognise that the concepts of confidentiality and informed consent extend to all mediums, including illustrative clinical records, such as photography, video and audio recordings and digital platforms
  • 7.7: use information, communication and digital technologies appropriate to their practice
  • 9.3: use digital record-keeping tools where required
  • 13.1: change their practice as needed to take account of new developments, technologies and changing contexts

Training your workforce

Providing protected time for continued professional development specific to telehealth and use of digital tools is key to building capacity in your workforce.

Talking about this change openly with your team and receiving feedback is important. Implementing ideas shared and agreed (where possible) can foster team adoption of telehealth.

Opportunities to train alongside a colleague or a whole team enables peer learning and support, which can facilitate behaviour change.

Investing in digital champions within your team can help others develop their skillset, build confidence and support behaviour change in staff.

You can find NHS England digital transformation guidance on improving digital confidence and competence of the workforce here 🌐.

The Royal College of Speech and Language Therapists also provide guidance on programmes available to improve digital literacy and competency🌐

Resources:

You can complete out training resource for online assessment here 🔗.

The HCPC Digital Skills and New Technologies factsheet can be downloaded here 📄.

NHS England provide information about the requirements for digital competency 📄for allied health care professionals.

You can download the Digital Competency Framework for speech and language therapists here 📄.

References:

Cetinkaya, B., Twomey, K., Bullard, B., El Kouaissi, S. & Conroy, P. (2024) Telerehabilitation of aphasia: a systematic review of the literature. Aphasiology, 38(7), 1271–1302.

Comer, A., Northcott, S., Behn, N., Roper, A., Devane, N. and Hilari, K. (2025) Experiences and perspectives of UK speech and language therapists on telehealth assessment with people living with post‐stroke aphasia. International journal of language & communication disorders, 60(2), p.e70018

Health & Care Professions Council (2023) Digital skills and new technologies. Available at : https://www.hcpc-uk.org/standards/standards-of-proficiency/revisions-to-the-standards-of-proficiency/digital-skills-and-new-technologies/ (Accessed August 2025)

Jacobs, M., Briley, P.M., Fang, X. and Ellis, C. (2021) Telepractice treatment for aphasia: Association between clinical outcomes and client satisfaction. Telemedicine Reports, 2 (1), 118–124.

Molini-Avejonas, D. R., Rondon-Melo, S., De La Higeura Amato, C. A., & Samelli, A. G. (2015) ‘A systematic review of the use of telehealth in speech, language and hearing sciences’, Journal of telemedicine and telecare, 21(7), 367-376.

Royal College of Speech and Language Therapists (2022) Telehealth Guidance. Available at: https://www.rcslt.org/members/delivering-quality-services/telehealth-guidance/#section-2 (Accessed September 2025)

Weidner, K., & Lowman, J. (2020). Telepractice for Adult Speech-Language Pathology Services: A Systematic Review. Perspectives of the ASHA Special Interest Groups, 5, 326-338.

Shah, D. A., Sall, D., Peng, W., Sharer, R., Essary, A. C., & Radhakrishnan, P. (2024) Exploring the role of telehealth in providing equitable healthcare to the vulnerable patient population during COVID-19. Journal of telemedicine and telecare, 30(6), 1047–1050.

UK Government (2025) Fit for the Future: The 10 Year Health Plan for England. Available at: https://assets.publishing.service.gov.uk/media/6888a0b1a11f859994409147/fit-for-the-future-10-year-health-plan-for-england.pdf (Accessed September 2025)

Scroll to Top