Speach and Language Therapy (SALT) - Meetings, agendas, and ...

Executive summary
Background
Local people were asked to suggest key topics for in-depth health scrutiny
reviews in the Spring of 2003. The first of these, Access to Primary Care, has
been completed. The second priority topic was Speech and Language
Therapy and this review has been carried out over the period May to
September 2004. The review method included researching the local provision
and the establishment of best practice from experience elsewhere. It carried
out substantial enquiries with stakeholders, including two stakeholder
meetings and various visits. In addition a number of organisations and
individuals submitted written evidence. This included many letters from
individual parents.
Findings
We found that the supply of speech and language therapy services had been
insufficient to meet demands over many years. This had been recognised by
operational managers, both of the service provided by the NHS and also by
that provided by the Council’s own Education Service. In the latter case there
has been substantial new investment during the last few years. In the case of
the NHS it appears that the service has suffered from increasing demand with
no increase in budget and has responded by targeting the service to younger
children. It appears to the Panel that individual therapists have been working
tirelessly to provide the best service within limited resources. Nevertheless,
with regard to the NHS, the service seems to have suffered from repeated
reorganisation. The change from Barking and Havering Health Authority to
the Barking and Dagenham Primary Care Trust and Havering Primary Care
Trust has led to changes in commissioning arrangements. On the provider
side the original unitary service provided by the Barking, Havering and
Brentwood NHS Trust is now provided by one PCT (Barking and Dagenham)
to its own population and also to the populations of Havering Primary Care
Trust and the Billericay, Brentwood and Wickford Primary Care Trust. This
has meant that the three PCTs as commissioners have had to decide on what
services they wish to have supplied by the lead provider, the Barking and
Dagenham PCT and these arrangements are described in local Service Level
Agreements. There is now a greater understanding of the under funded
position. At present there is an apparent substantial shortfall within the
Barking and Dagenham PCT budget for the Speech and Language Therapy
Service. This shortfall represent approximately one third of the current
expenditure. One serious deficiency lies in the failure to deliver speech and
language services to statemented children and the almost total absence of
any service to mainstream schools. Another major concern has been the fact
that many parents have had to use the private sector for the assessment and
treatment of their children because of the inadequacies of the publicly funded
speech and language therapy services. In order to meet current demand the
service managers have proposed a staged increase in staff numbers and a
staged set of developments.
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