Written evidence submitted by The Royal College of Speech and Language Therapists (PHS0590)

Summary

1. The Royal College of Speech and Language Therapists is pleased to make a submission to the Health Selection Committee for its consideration as a topic of its intended inquiry into prevention.
2. We welcome that prevention is a key focus for the committee, and the recent comments by your Chair Steve Brine MP about our ill health as a nation being a driving factor in rising demand for healthcare.
3. We encourage the committee to consider the needs of people with speech, language and communication needs (SLCN) across the topics of mental health and disease prevention as areas already being considered for the inquiry, but also to encourage the committee to include health inequalities as well as children and young people as additional topics in the inquiry.

Speech, language and communication needs (SLCN)

1.       The inquiry should recognise that an underlying factor impacting on prevention for many vulnerable members of society is misunderstanding information given to them.

2.       Speech, language and communication needs (SLCN) affect people with a range of conditions including developmental language disorder (DLD), learning disabilities, autism, dementia and stroke.

3.       The impact of these risks include health inequality, poor health literacy, social isolation and poor mental wellbeing, and ultimately lead to barriers in accessing and engaging with NHS and social care, for example information regarding screening, health checks, immunisations such as the flu jab, may not be understood and ignored. 

Mental health

4.       The inquiry should consider the impact of SLCN on people with mental health problems.

5.       Communication is challenging for people with mental health problems and SLCN prevents a barrier to accessing verbally delivered psychological programmes which are reliant on participants’ language and verbal reasoning capabilities.

6.       When communication difficulties are not identified, it can lead to inaccurate diagnoses of mental health problems, preventing timely access to appropriate interventions.

7.       People with communication difficulties may have lower levels of health literacy and as a result have less understanding of, and insight into, managing and maintaining their own mental health. 

8.       Speech and language difficulties create barriers to recovery and affect longer-term resilience of patients. The incidence of dysphagia in the mental health population is increased by the side effects of psychiatric medication.

Disease prevention

9.       Good healthcare is highly dependent on good communication and a high level of health literacy.

10.   People with SLCN – those with learning difficulties, mental health difficulties, dementia for example - often struggle to access services and understand information about their health.

11.   Information requires high levels of health literacy to fully understand and process. Complex information is difficult for those with poor health literacy to access. In one study 61% of adults struggled to understand health information that included both text and numbers.

12.   SLCN will lead to poor health literacy which in turn leads to poorer health outcomes.

Children and young people

13.   The inquiry should also consider the needs of children with conditions that will persist throughout their lives including SLCN, and young people and adults whose needs have not been addressed in the early years.

14.   Over 10% of children and young people have SLCN. In areas of social disadvantage around 50% of children start school with delayed language and other identified SLCN.  If those issues are not addressed they have long-term impact seen in later years in the NHS and the community:

• Young adults with language difficulties experience higher levels of anxiety than their peers
• 88% of long term unemployed young men had SLCN.
• 60% of young offenders have SLCN.

Health inequalities

15.   The link between the social conditions in which a person lives and health inequalities has been understood and documented often.

16.   The pandemic demonstrated the real impact of these unequal levels of health in the form of excess mortality in some population groups, with working age adults in England’s most deprived areas estimated to be almost four times more likely to die from COVID-19 than those in the least deprived.

17.   The rising cost of living now threatens to entrench and further deepen existing health inequalities including for people with SLCN.

18.   It is therefore imperative that this inquiry considers the impact of health inequalities as part of this inquiry.

Feb 2023