Focus on Speech and Language Therapy

30th June 2011

  • At almost every event and every consultation we have organised in the past two years, parents have raised concerns about a lack of Speech and Language Therapy (SLT) input for their children. We want to do something about this.

    The situation in Sheffield

    SLT services in Sheffield are provided by the PCT (Primary Care Trust) and commissioned by NHS Sheffield and Sheffield City Council. There is no city-wide approach to the planning and commissioning of SLT, and no city-wide core offer.

    A 2009 review* of NHS-commissioned SLT services found that there are significantly fewer children on the active caseload of the SLT service than would be expected for Sheffield’s child population. The capacity of the service (in terms of whole time equivalent) is 40% lower than the national average. The service itself estimates that it only meets 25% of the identified need through direct intervention. (NB The SLT service in Sheffield operates a model whereby therapists mainly assess children and design interventions, and then train other staff, such as Teaching Assistants, to deliver the therapy. This makes it difficult to compare Sheffield with other areas, where therapists may be more “hands on”.) By the service’s own admission, it is merely “scratching the surface”.

    So why is it that children in Sheffield get such a raw deal? Well, it seems that having two hospitals in the city is a major factor. Both the Children’s Hospital and the Teaching Hospital have seen a steady increase in high-risk cases requiring clinical SLT intervention, such as help with eating and swallowing. This diverts money away from non-clinical services delivered in the community. Since NHS Sheffield needs to save £40m during the 2011/12 financial year, there is no new money to improve the situation.

    Both the NHS and the education system are currently undergoing massive changes. Health reforms will see GPs consortiums take control of health care commissioning. Schools wills be given much greater autonomy over their budgets, and will have to buy in services that used to be free at the point of delivery. How will all this impact on SLT? Nobody seems to know.

    Next steps

    Where to start when so much needs to be done? We can’t change everything at once, so we will have to focus our energies on a few issues that really matter.
    We propose the following campaign targets:

    1. The capacity of the service to be brought in line with the national average.
    2. Therapists to clearly state in their assessment reports how much therapy they think a child needs, and how often their progress should be reviewed.
    3. A clear accountability framework for the delivery of SLT programmes.
    4. Parents to be given the opportunity to be involved in their child’s therapy. Parents should be offered training, and they should be invited to attend therapists’ school visits and receive assessment reports. These should include the next review date and contact details of the therapist in case of queries.
    5. The NHS, the Council, schools, universities and parents to work together to develop innovative solutions, e.g. using SLT students and newly qualified therapists as volunteers in schools.

    Training for parents

    Parents may not always be able to do regular exercises with their child, but they can still support their child’s therapy programme by just doing everyday things a little differently. We asked parents what kind of training they would like, and used funding from the Achievement for All pilot to organise a programme of parent training workshops. These were delivered by the Sheffield Speech and Language Therapy service and Early Years Inclusion Service in June and July 2011 and received very positive feedback from parents. We are planning to organise another series of workshops later this year.

    Tell us your views

    We’d really like to get some feedback from you.

    • What do you think about our proposed campaign targets?
    • Do you want to be told when a therapist comes into school to see your child?
    • Do you want training?
    • Would you like us to keep you informed about upcoming training sessions for parents?
    • Please call us on 0114 2521913 or email and let us know.*The information in this article is based on a report by Kate Laurance, Children’s Service Strategy Manager NHS Sheffield, to the Children’s Joint Commisioning Group. The full report is available for download from the “Resources” section of our website.