Salford Primary Care Trust – your leader for health IN Salford Review of Services for Children and Young People (0-19) with Speech, Language and Communication Needs Interim Report March 2008 By: John Bercow MP Presented By: Michelle Morris Head of SLT Services,Salford

Why Speech, Language and Communication skills are increasingly recognised as a priority 1 : 10 children are estimated to have some SLC difficulties. 66% 0f teachers believe that half the children starting school don’t have the necessary communication skills for effective learning. ( Basic Skills Agency 2004) This figure can rise to 80% in areas of high deprivation. In the USA people with communication impairment cost between $154 and $186 billion/year in both under employment and over utilization of services.

Communication Skills are a protective factor and contribute towards:- Accessing education Economic prosperity Forming relationships Participating in society Developing psychologically and socially

August 2007 John Bercow, Conservative MP for Buckinghamshire was asked by Secretaries of State for Health (DH) and Children Schools and Families ( DCSF) to undertake a review of provision for children with Speech, Language and Communication needs and to suggest a way forward to improve services

Terms of Reference The range and composition of services required to meet the diverse Speech, Language and Communication (SLC) needs of children aged 0-19 in an affordable way How planning and performance management along with better cooperation between Health and Education at all levels in the system can promote early intervention and improve services Identify areas of best practice in commissioning and delivering services to provide a benchmark for others

Specific Issues to be considered by the review  How commissioning framework ensures sufficient Speech and Language Therapy (SLT) to meet local need  Clarify accountability and responsibility for planning / delivering services  Strategic, professional and operational leadership  Recruitment and deployment of SLTs  Identify good practice in joint commissioning, needs assessment and joint delivery  Recommend the balance between early intervention and to children throughout the age ranges including those in vulnerable situations such as risk of offending  Improve the skills of the wider workforce.  Provision of AAC  Transition into adult services

September 2007 Advisory Group established CEOs from AFASIC, ICAN, RCSLT, BSA Chair of the SEN Consortium Head of SEN, South Gloucestershire Professional Advice Workforce Advisors Officials for DCSF and DH

Evidence was sought in 3 ways 1) Consultation Questionnaire 2) Site visits 3) Consultation events

Consultation Questionnaire electronic questionnaire 2000 responses ( biggest ever response to a call for evidence ) from families Responses came from a disproportionately high number of families whose children had statements

Site Visits Several London Authorities Manchester Newcastle Essex Copenhagen Nottingham Leicester Salford Kent Middlesborough Norwich Plymouth Sussex

Consultation Events Focus Groups held for Children, Young people, Families, Professionals who work with CYP, Managers Some on specific issues eg Young offenders, AAC users, children with complex needs

Findings: 5 Key Themes 1) Communication is crucial 2) Early Identification and Intervention are essential to avoid poor outcomes 3) A continuum of services designed around the family is needed 4) Joint working is critical 5) The current system is characterised by high variability and lack of equity

Next steps and Points for discussion 1. What further action is needed to raise the importance of SLC on the national agenda 2. How info advice and signposting to services can be made more accessible to families 3. What support should be available at specific times, eg., on identification or at transition

Next steps and Points for discussion 4. How to improve families experience of “the system” including accessibility, continuity, transparency 5. How Ofsted Review of SEN (2009) might contribute to improving arrangements for children with SLCN 6. How to enhance the purpose of the Children’s Act, 2004 to ensure that children’s Trusts commission across agencies to address the needs of children with SLCN

Next steps and Points for discussion 7. The value of an audit tool to help local commissioners assess need 8. The need for guidance for commissioners of Universal, Targeted and Specialist services using a child centred pathway model. This may also consider regional commissioning 9. What future research needs to be carried out to enhance the evidence base

Next steps and Points for discussion 10. How to enhance the skills of specialists and to ensure the entire children’s workforce is trained to identify and support children with SLCN 11. The number of SLTs and deployment through the age ranges 12. Whether there is scope for improvement in the use of staff and facilities by Las and PCTs

Next steps and Points for discussion 13. What steps might be taken to encourage leaders in Education and Health to work more collaboratively 14. Accountability and performance management at national and local levels 15. Whether LAs accountability for provision of SLT for statemented pupils should be reviewed

July 2008 Final recommendations to be published following consultation on the interim report with key strategic stakeholders throughout England from the statutory and voluntary sectors