New oral suctioning in community guidance developed
Oral suctioning uses a Yankauer catheter and portable suction machine to remove saliva and pooled secretions when someone cannot clear them due to impaired swallowing, neuromuscular weakness or excess saliva. This is common in MND, Parkinson’s, head and neck cancer and for people nearing end of life.
Provision across Greater Manchester (GM) varies significantly. Some localities have clear pathways, while others manage requests individually. This inconsistency has led to delays in equipment, unclear responsibility for assessment and training, and variable standards of care. With no GM‑wide service or national guidance, a coordinated approach was needed.
The network led a project to develop shared GM guidance while allowing local flexibility. This involved mapping current practice, engaging community teams and equipment services, identifying inconsistent pathways, consulting neurology and neurorehabilitation clinicians, and producing guidance with toolkit resources. Local SOPs, training materials and equipment information were gathered to support teams.
Instead of a single GM SOP, the guidance outlines core components every locality should include, recognising differences in staffing, budgets and equipment routes. It covers scope of practice, medical pathway, assessment, roles, clinical process, equipment, training, escalation and procurement responsibilities. Localities can adapt this framework to create a realistic pathway that supports consistent care across GM.
You can download the guidance and associated Oldham examples of best practice on our webpage.