STP0049
Written Evidence submitted by the Royal College of Speech and Language Therapists
The Royal College of Speech and Language Therapists (RCSLT) is pleased to submit views to this inquiry.
Executive summary
The RCSLT would like to see:
- Speech and language therapists, along with other allied health professions, being encouraged and actively involved in the design and delivery of STPs. Their primary function would be to bring a different perspective based on their biopsychosocial model of care to support effective strategy and good governance;
- STPs drawing out the opportunities offered by AHPs and Speech and language therapists across all settings, from primary to acute, to community and schools, in extended scope roles and as part of integrated teams;
- A consistent approach to the involvement of speech and language therapists on Local Workforce Action Boards;
- Named clinical contacts for staff to engage with in all STPs.
Engagement and collaboration
1. Speech and language therapists have roles at the heart of the healthcare system, working across health, care, justice, housing and education. This submission will focus on how Speech and language therapists can contribute to the development of STPs, if they are engaged in the process.
2. Speech and language therapists play a key role in supporting Sustainability and Transformation Partnerships (STPs). There are around 12,000 registered speech and language therapists in England working in a range of surroundings including hospitals, people’s homes, clinics, surgeries, the justice system, local authorities, private and voluntary sectors and primary, secondary and tertiary education. Speech and language therapists work in many of the priority areas that are the focus of STP plans – they have roles in public health and prevention, in acute care, in the management of dementia, stroke and mental health. They often bridge a gap between hospital and community care, helping to reduce admissions and enabling people to return home more quickly and safely after treatment.
3. However, the role and activities of many STPs remain unclear to our members – although it is clear that some areas have been very much more proactive than others, reflecting their different stages of development. In a survey of members last year only 10% were aware of engagement from their STP.
4. We understand there are no clinical leads from the allied health professions (AHPs - of which speech and language therapy is one) on STP Boards so clarification is needed about how the full range of perspectives is being gathered. It is also unclear how many AHPs are involved on the Local Workforce Action Boards (LWABs). Involvement of the full range of health professions, with their unique clinical expertise, not just doctors and nurses, is vital to ensure that the opportunities of the STP process are not lost.
Integrated approaches
5. Inevitably much of the media attention around STPs is focussed on the impact on hospital beds or on possible closures. Part of the opportunity offered by the STP approach is to link up with other local initiatives to tackle complex social and/or health problems that are intertwined. One of our members said “.. the focus has been predominantly on adults - the main concern from a Healthwatch meeting was the reduction of 500 beds at the local acute hospital, and concerns from the public as to how the shortfall will be addressed by community services which are already stretched. Little has happened for children’s services.” In addition “[City] has recently become one of the DfE Opportunity Areas and locally we can see no evidence to date of how the two initiatives could be dovetailed together to gain maximum impact and value for money. If the initiatives were co-ordinated we could see a clearer process or pathway which could prevent children from experiencing speech, language and communication needs, identify need early and provide support for those with needs by looking at shared pathways between health and education. The two initiatives appear to be developing in parallel to one another.”
6. In our view too little attention is being paid to the long term prevention that will improve health outcomes and make a huge difference to lives – perhaps because the gains are in the future - but also because those gains are not always realised directly by the health system. While this has now been recognised in relation to childhood obesity for example, it has not been similarly recognised for children whose speech, language and communication needs remain untreated into adulthood. The diagram below is a stark illustration of the effects on society if prevention programmes are cut:
7. In conclusion, the RCSLT would like to see a transparent engagement process that draws in staff across all healthcare professions and engages them in honest discussion of options for improving services and thinking across traditional boundaries. That means taking the time to get it right in each area and not being driven by artificial deadlines or hiding a proper assessment of options and impacts behind financial constraints.
About the Royal College of Speech and Language Therapists
8. The Royal College of Speech and Language Therapists (RCSLT) is the professional body for speech and language therapists (SLTs), SLT students and support workers working in the UK. We have approximately 17,000 members.