Exclusive: speech and language therapy suffers drop in scope and quality of services

A Royal College of Speech and Language Therapists survey of 116 services, shared exclusively with HSJ, found 106 were facing budget cuts this year.

The royal college has written to 36 services in England whose responses it believes indicated “real risks to patient care and patient outcomes”.

Seventy providers reported losses of NHS funding, 25 of local authority funding, and five of schools funding. Providers to 109 of England’s 151 primary care trusts responded. Of those experiencing cuts, 64 per cent said the losses had harmed service quality, and 81 per cent said the scope of services had been reduced.

Respondents reported job cuts and vacancy freezes leading to lengthening waiting times, the withdrawal of screening programmes for pre-school children, the reduction or removal of services, and clinicians spending time on administration.

Many respondents reported increased stress, low morale, and sickness absence among staff; a handful said they were unable to meet the college’s or National Institute for Health and Clinical Excellence guidelines, or their contract specifications.

College chief executive Kamini Gadhok said: “What the survey shows is that many decision makers are doing what has happened at previous times of crisis – which is what it must feel like locally – and taking a salami-slicing approach to finding efficiency savings.”

Ms Gadhok expressed particular concern about children’s speech and language services, in which joint commissioning had been effectively implemented.

She said they had “had a double whammy, because they’re having their budgets cut by both health and education”.

She called on the Department of Health to mandate NHS commissioners to work with clinicians and local authorities to find sustainable efficiencies.

Of the respondents reporting health budget cuts, 22 reported cuts of 6-10 per cent; 16 reported cuts of 11-20 per cent, and nine reported cuts of 20-40 per cent. A total of 16 services reported cuts of more than 10 per cent to their council funding, two of which were 100 per cent.

One respondent wrote that a 6 per cent cut in NHS funding last year had led to the withdrawal of services to children over the age of six who stammer.

This year they faced further cuts of 5 per cent from the NHS and 14 per cent from the council. They anticipated this would lead to “severe curtailing of the [autistic spectrum disorders] care pathway”, and reductions in services to children with phonological difficulties, language delay and learning difficulties.

DH spokesperson said: “We have seen numerous examples where allied health professionals, including speech and language therapists, have released money through leading redesign locally and through proactive engagement with their local communities. We hope to see more examples of innovation.”