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<h3>Background</h3> The role of Speech and Language Therapy (SALT) in specialist palliative care (SPC) is growing. Patients receiving SPC often face issues with swallowing, oral hygiene, and communication, which can benefit from SALT interventions. There is currently no specific tool to measure the effectiveness of SALT in SPC. The aim is to develop an Outcome Measuring Tool (OMT) that assesses how patients experience communication, swallowing, or oral discomfort before and after SALT intervention in SPC. The tool measures the burden of symptoms, considering the inevitable progression of disease. <h3>Methods</h3> Preliminary research on the Symptom Assessment Scale (SAS), suggested that measuring distress related to communication, swallowing, and oral comfort is effective for assessing the benefits of SALT intervention. Results reflected that even if a patient’s function declined, their distress levels could improve with SALT interventions. Currently, SPC outcomes focus on symptoms like pain, nausea, and mobility (e.g., SAS or IPOS). No tool specifically addresses communication issues, dysphagia, and oral care. SALTs working in SPC across the UK and Ireland developed a two-part OMT. The tool measures patient-reported outcomes (PROMs) and clinician-rated outcomes when patients can’t articulate their concerns. It tracks the effectiveness of direct and indirect interventions, including rehabilitation and education, for patients with worsening health conditions. The therapist-led OMT was shared with SALTs working in SPC across the UK and Ireland, who used it to rate two case studies. The PROM was also used by patients before and after receiving SALT in palliative care. <h3>Results</h3> Therapist-led ratings demonstrated high inter-rater reliability, with four identical values and one differing by two points. The PROM indicated 66% stability or decrease in patient concern after SALT intervention. <h3>Conclusion</h3> The OMT developed provides an innovative way to measure SALT intervention in SPC. Further testing is planned to validate and confirm reliability of this tool.