Children s Speech & Language Therapy Services

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1 Service Specification No. Service Commissioner Lead Children s Speech & Language Therapy Services Commissioning Lead, Planned, Children & Maternity Services (Stoke Clinical Commissioning Group) Provider Lead Speech and Language Therapy (Staffordshire and Stoke on Trent Partnership Trust) Period Date of Review 1. Population Needs Annually 1.1 National/local context and evidence base Timely and early access to speech and language therapy for disabled children with communication difficulties is essential to reduce the impact of the impairment on literacy development and all areas of learning and to prevent the compromise of later educational ability and employability, (Locke, Ginsborg et al, 2002). There is substantial evidence to show that there are significant economic costs involved in failing to support children with speech, language and communication difficulties (Royal College of Speech and Language Therapists, 2006). There is a growing body of evidence that failure to address developmental speech and language difficulties in young children will lead to a significant impact on mental health services and criminal justice systems. Studies have shown that a third of children with speech and language difficulties develop mental health problems with resulting criminal involvement in some cases, (Clegg, Hollis and Rutter, 1999) Research shows that initial intensive, specialist input for children with primary speech and language difficulties is cost effective over time (American-speech-language-hearing association, (1989). Early identification and intervention with a child who is at risk of communication delay or disability can facilitate the development and / or prevent subsequent manifestations of a delay or disability (Audit Commission, 2007). Any delay or disability that influences a young child s early communication development is likely to have a significant effect on that child s subsequent personal, social, academic and vocational life, (Gascoigne, 2006). Furthermore, the evidence shows that children who do not receive timely intervention by the age of 5 years will have significant impairments in all aspects of spoken and written language functioning and reading. Research on early intervention programmes for children has found that there are considerable savings to be made in the long term. The specification takes into account the recommendations of the 2008 Bercow Report on Services for Children and Young People (1-19) with Speech, Language and Communication Needs. 2. Outcomes 2.1 NHS Outcomes Framework Domains & Indicators Domain 1 Domain 2 Domain 3 Preventing people from dying prematurely Enhancing quality of life for people with long-term conditions Helping people to recover from episodes of ill-health or following injury X 1

2 Domain 4 Ensuring people have a positive experience of care X Domain 5 Treating and caring for people in safe environment and protecting them from avoidable harm 2.2 Local defined outcomes The benefits for children and young people may not become evident for many years after Speech and Language Therapy support has ended. The benefits for service users are: Improved communication skills Reduced social Isolation and Social exclusion for children Reduced behavioural difficulties from the children Increased potential to access National Curriculum by the children Increased educational attainment by the children Increased employment opportunities in the future Improved self-esteem for the children Reduced involvement with the criminal justice system 3. Scope 3.1 Aims and objectives of service Aims To support prevention of voice, speech, language, communication and swallowing disorders by working with patients, families, carers, professional colleagues and other staff to enable effective universal approaches to management of difficulties. To support professional colleagues and other staff to provide appropriate assessment and intervention where difficulties are manageable without the need for specialist intervention. To provide a targeted service to people with disorders of voice, speech, language, communication and swallowing whose needs can only be met by specialist intervention of Speech and Language Therapy staff. To be responsive to changes in the settings and contexts in which Speech and Language Therapy is provided to ensure that patients benefit fully from effective multi-disciplinary and multi-agency working. Objectives To provide timely access to specialist assessment and treatment and advice to children young people and their families. - Community dysphagia within 2 weeks - Community referrals communications within 6 weeks - Voice within 6 weeks To ensure timely effective liaison with other colleagues in Early Years and Educational settings. To ensure compliance with the statutory requirements of the code of practice for children with Special Educational Needs and the Children and Families Bill (draft 2013). 2

3 3.2 Service description/care pathway The services will provide assessment, diagnosis, therapy, practical advice, training and equipment to ensure that children and young people with speech, language, communication and/or swallowing difficulties and their carers/families are able to develop and achieve academically, socially and emotionally and to ultimately live and work according to their choice and ability by effectively managing their difficulties, improving function and reducing the impact of impairment on their quality of life. Impairment may be as a result of developmental difficulties, physical disabilities, stroke, neurological disability, head injury, cancer, disorders of voice production or other conditions for example: Complex special needs (Birth trauma, genetic disorder, acquired and congenital disorder) Autistic spectrum disorders Deafness or hearing impairment Specific language disorder Developmental delay Environmental circumstances Specific speech disorders Stammering Craniofacial and velopharyngeal disorders (cleft palate and related disorders) Learning disabilities Voice disorders 3.1 Service Model Direct intervention: Assessment, diagnosis, therapeutic intervention and management of significant delays and disorders of communication and/or swallowing. Assessment, diagnosis and therapy intervention with other appropriate professionals in a multi-disciplinary setting. Assessment and advice and direct therapy where indicated for specific delays and disorders. Indirect intervention: Advice to individuals, carers, families and professionals via telephone, face to face or reports Preparation of materials for advice or therapeutic intervention Child focussed training of carers, families, professionals and others as appropriate. Case conferences/reviews support of voluntary organisations Preventative advice Therapeutic programmes to be facilitated by others in the home and/or educational settings. Advice to those involved in service planning and design All children are assessed using the North Staffordshire Risk Matrix. Children whose needs can be met by Universal Services and are low risk are not offered direct therapy but are signposted for support into universal services or offered advice only. This model ensures that only those children with a specific need for therapeutic intervention receive a service. 3.2 Pathways The service is provided within 2 broad pathways as identified below. A) Pre-Referral identification and initial intervention for speech and language difficulties 3

4 4

5 B ) General pathway for referrals 5

6 There are specific pathways for: Specific Language Impairment Dysfluent Children Hearing Impairment Joint Pre-school Therapy City Mainstream Schools Care pathways for other specific conditions shall be developed with partner agencies, e.g. dysphagia, autism. Care Planning & Coordination: All children managed by the team will have a care plan developed and agreed with the child and family. This will include details of frequency of intervention. The service shall operate to the principles of team around the child, lead professional and multi-agency care coordination. Transition This shall be planned for all children at or shortly after referral to the service: Proactive engagement with adult services Health and / or Specialist Services (Social Care) shall commence as the child reaches 14 th Birthday. An individual transition care plan between paediatric and adult - oriented health services must provide coordinated and uninterrupted healthcare to avoid negative consequences. 3 Population covered The Child is registered with a North Staffordshire or Stoke-On-Trent GP The Child or young person is aged 16 years or under, with the following exceptions: The young person is in full time education up to the age of 19 years. Depending on the presenting condition and personal circumstances, adult and children s services will agree where the young person s needs can best be met in consultation with the young person and their family. Children with behavioural feeding difficulties will not be accepted on referral and the referral agent will be advised to refer the child onto to Clinical Psychology Services. Children with dyslexia and other literacy based language difficulties will not be accepted on referral and the referral agent will be advised to approach the child s school for support. Children who attend independent schools will not be offered school based intervention but will be seen in clinic settings. Children placed in Inspire or in care homes will only be seen in clinic settings. If previous discharge has been for non-attendance the SLT service will work with the referral agent to promote attendance at future appointments. 3.5 Interdependence with other services/providers The Speech and Language Therapy Service works with partners to address the speech, language, communication and swallowing needs of the individual. Key Relationships are : 6

7 Client and their families/carers Education Health Visitors and School Nurses Social Services Children and Lifelong Learning Community and Learning Partnerships Voluntary Agencies GPs and Consultants Stoke Speaks Out Early Years Settings Other Allied Health Professional Services, e.g. Dieticians, Occupational Therapists, Physiotherapists 4. Applicable Service Standards 4.1 Applicable national standards (eg NICE) Refer to Standard Contract 4.2 Applicable standards set out in Guidance and/or issued by a competent body (eg Royal Colleges) - Royal College of Speech and Language Therapy Clinical Guidelines - Health Professions Council Code of Professional Conduct 5. Applicable quality requirements and CQUIN goals 5.1 Applicable quality requirements (See Schedule 4 Parts A-D) Refer to children s services quality requirements 5.2 Applicable CQUIN goals (See Schedule 4 Part E) 6. Location of Provider Premises 7. Individual Service User Placement 7

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