Key Responsibilities and Required Skills for Upper GI Therapist

🎯 Role Definition

The Upper GI Therapist is a specialist clinician focused on the assessment, management and rehabilitation of patients with disorders of the upper gastrointestinal tract—most commonly oropharyngeal dysphagia, post-operative swallowing impairment, head & neck and upper GI oncology-related problems, and complex gastroenterology patients. This role delivers both bedside and instrumental assessments (FEES, videofluoroscopy/VFSS), develops individualized therapy and nutrition plans, leads quality improvement and education, and collaborates with gastroenterology, surgery, ENT, dietetics and nursing to reduce aspiration risk, prevent complications and support safe discharge.

Key search terms: upper GI therapist, dysphagia therapist, FEES clinician, videofluoroscopy, swallowing disorders, gastroenterology, multidisciplinary team (MDT), enteral feeding, PEG management, aspiration prevention.

📈 Career Progression

Typical Career Path

Entry Point From:

Band 5–6 Speech and Language Therapist / Clinical Specialist in Dysphagia
Clinical Nurse Specialist (gastroenterology or ENT) with dysphagia training
Allied Health Professional with experience in head & neck or gastroenterology care

Advancement To:

Senior Upper GI Therapist / Clinical Lead (Band 7–8)
Multidisciplinary Dysphagia Service Lead or Clinical Specialist in Gastroenterology
Consultant Allied Health Professional / Service Development Lead

Lateral Moves:

Rehabilitation Team Lead (stroke, head & neck)
Gastroenterology Clinical Nurse Specialist
Dysphagia Research or Education Specialist

Core Responsibilities

Primary Functions

Conduct comprehensive, evidence-based clinical assessments of swallowing and upper GI function at the bedside and in outpatient settings, synthesizing medical history, oral-motor examination and nutritional status to develop risk-stratified management plans.
Perform and interpret instrumental assessments including Fibreoptic Endoscopic Evaluation of Swallowing (FEES) and collaborate in Videofluoroscopic Swallow Studies (VFSS) — documenting findings, making diagnostic recommendations and communicating implications to the MDT.
Design and implement individualized therapy programs for dysphagia and upper GI dysfunction including compensatory strategies, rehabilitative exercises, postural adjustments, diet and consistency modification and neuromuscular stimulation where indicated.
Manage and review enteral feeding decisions in partnership with dietitians and medical teams: advise on PEG/JEJ/NG tube placement, ongoing tube care, bolus vs continuous feeding strategies and transition to oral intake when clinically appropriate.
Provide pre- and post-operative swallowing assessment and rehabilitation for patients undergoing upper GI, head & neck or thoracic surgery—working alongside surgical teams to plan perioperative care that minimizes pulmonary complications.
Lead dysphagia risk assessment and aspiration prevention protocols across inpatient wards, ICU and outpatient clinics; escalate and coordinate urgent cases (e.g., suspected aspiration pneumonia) with medical teams.
Provide specialist input into MDT meetings (gastroenterology, ENT, surgery, oncology, dietetics, nursing, physiotherapy) to co-author care pathways, agree clinical goals and coordinate safe discharge planning.
Deliver clinical supervision and mentorship to junior therapists, rehabilitation assistants and nursing staff on dysphagia screening, feeding techniques, and safe mealtime assistance.
Develop, maintain and audit clinical protocols, outcome measures (e.g., Penetration-Aspiration Scale, FOIS), care bundles and standard operating procedures to ensure evidence-based, high-quality upper GI and swallowing services.
Triage and prioritize referrals using local pathways, ensuring timely assessment for high-risk patients (e.g., post-extubation, head & neck cancer patients, neurological injury).
Provide patient- and family-centered education about swallowing strategies, feeding techniques, texture-modified diets, long-term feeding options and goals of care, documenting shared decision-making conversations.
Facilitate and perform FEES clinics in endoscopy or clinic suites, maintaining infection control standards, scope checks and equipment maintenance, and ensuring competency with endoscopic handling and image capture.
Participate in sedation and monitoring protocols when involved in FEES or clinic-based procedures, liaising with anesthesia and nursing as required to ensure patient safety.
Interpret radiology and pathology reports related to upper GI function and liaise with radiology and ENT for integrated diagnostic pathways (e.g., barium swallow, CT, endoscopy).
Lead and participate in service development projects aimed at reducing length of stay, preventing readmissions for aspiration-related illness, and improving nutritional outcomes—using data to measure impact and ROI.
Contribute to research, quality improvement and clinical audit activity to expand the evidence base for upper GI therapy interventions and to drive continuous improvement in clinical practice.
Provide continuing professional development (CPD) and in-service training for hospital staff and community partners on dysphagia screening, safe feeding practices and management of complex upper GI cases.
Maintain thorough, contemporaneous clinical records in electronic health records and specialty systems (PACS, VFSS reporting tools), ensuring accurate coding, outcome measurement and compliance with governance standards.
Ensure compliance with infection prevention/control, consent procedures and local governance when delivering therapy or performing instrumental assessments.
Support rehabilitation and community transition plans by communicating recommendations to community speech & language therapy teams, home care providers and residential facilities to ensure continuity of care.
Act as a point of contact for complex clinical queries regarding upper GI and swallowing care across wards, clinics and urgent care settings—providing timely specialist advice to reduce escalation and improve patient management.
Provide education and support to palliative care teams regarding safe oral intake, texture modification and quality-of-life centered feeding decisions for patients with progressive upper GI dysfunction.
Participate in rota planning and service coverage to ensure inclusive outpatient, inpatient and urgent response availability for upper GI and dysphagia referrals.
Champion patient safety and clinical governance by participating in incident reviews, root cause analyses and implementation of corrective actions related to dysphagia care.

Secondary Functions

Develop and curate patient-facing resources (leaflets, videos) and digital content to support home-based swallowing exercises and diet modification guidance.
Collaborate with allied services to pilot telehealth FEES review sessions, virtual dysphagia clinics and remote monitoring for selected outpatient cohorts to improve access to specialist care.
Support training initiatives for community and primary care providers to improve early recognition and referral of swallowing and upper GI problems.
Contribute to service capacity planning by analyzing referral patterns, clinic throughput and demand to propose scalable models (one-stop clinic, joint FEES/VFSS sessions).
Represent the service in regional networks, professional forums and guideline development groups to align local practice with national standards.

Required Skills & Competencies

Hard Skills (Technical)

Advanced competency in dysphagia assessment and management (bedside clinical assessment, instrumental assessment — FEES competency and experience in VFSS interpretation).
Knowledge of upper GI anatomy, physiology and pathology including head & neck cancer, post-surgical changes, reflux-related disorders, and neurological dysphagia.
Experience advising on and managing enteral feeding (NG, PEG, jejunostomy) and transition between enteral and oral nutrition in collaboration with dietetics and medical teams.
Proficiency in documenting and interpreting outcome measures and standardized tools (e.g., Penetration-Aspiration Scale, Functional Oral Intake Scale (FOIS), Gugging Swallowing Screen).
Demonstrable ability to perform FEES safely: endoscope handling, image capture/storage, infection control and sedation liaison.
Competence with electronic medical records, PACS imaging review, VFSS reporting software and standard office tools (Word, Excel, presentation software).
Clinical governance skills: audit, service evaluation, risk assessment, incident reporting and policy development.
Knowledge of national and local guidelines for dysphagia, enteral feeding, and upper GI pathways; ability to translate guidance into local protocols.
Experience delivering staff training, clinical supervision and competency assessments for multidisciplinary colleagues.
Basic Life Support (BLS) / CPR certified and familiarity with emergency airway protection procedures (aspiration response, oxygen monitoring) in clinical settings.

Soft Skills

Excellent multidisciplinary communication skills: able to translate complex clinical findings into clear recommendations for surgeons, physicians, nurses and dietitians.
Strong clinical reasoning and prioritization skills under pressure in acute and inpatient environments.
Patient-centered empathy and shared decision-making skills, with the ability to discuss difficult prognoses and feeding options sensitively.
Leadership and change-management capability to drive service improvements and mentor junior staff.
Organized record-keeping and time-management; ability to manage high referral volumes while maintaining quality and safety.
Teaching and presentation skills for CPD sessions, MDT education and patient workshops.
Analytical mindset with the ability to interpret data, present outcomes and make evidence-based recommendations.
Adaptability and resilience in fast-paced clinical environments and when managing complex, uncertain cases.
Collaborative approach to problem-solving and a commitment to continuous learning and professional development.
Cultural sensitivity and ability to tailor communication and diet recommendations to diverse patient populations.

Education & Experience

Educational Background

Minimum Education:

Qualified and registered clinician in a relevant discipline (e.g., Speech and Language Therapy / Speech-Language Pathology, Registered Nurse with specialist dysphagia training, or Allied Health Professional with equivalent qualification).

Preferred Education:

Master's degree or postgraduate diploma in Speech & Language Therapy, Dysphagia, Neurorehabilitation or related field.
Postgraduate certification in FEES/Instrumental assessment or advanced dysphagia practice.

Relevant Fields of Study:

Speech-Language Therapy / Speech & Language Pathology
Dysphagia / Swallowing Disorders
Rehabilitation Sciences / Neurorehabilitation
Clinical Nutrition (postgraduate modules useful when managing enteral feeding)

Experience Requirements

Typical Experience Range: 2–5 years of clinical experience with at least 12–24 months working with dysphagia or upper GI patient cohorts.

Preferred:

3–5+ years of specialist experience in dysphagia management, demonstrable competence in FEES and participation in VFSS clinics.
Experience working within gastroenterology, ENT, head & neck oncology or critical care settings.
Experience leading audits, service improvement projects or teaching programs related to upper GI or dysphagia care.