Delivering cost effective quality services Children’s Integrated Speech and Language Therapy Service for Hackney and the City Annabelle Burns Children’s Integrated Speech and Language Therapy Service for Hackney and the City

………Aspects of your service development and delivery from which other services might learn in terms of providing quality, productivity and value for money……..

How our Service is Commissioned Children’s Integrated Speech and Language Therapy Service for Hackney and the City Pro-active approach to traded services Multiple commissioners with varying priorities SLAs and service specifications vs employer/management relationship

How our service is structured Children’s Integrated Speech and Language Therapy Service for Hackney and the City Virtual pooled budget  integrated service Locality based A B C D E F a6a

Traditional Service Structure Children’s Integrated Speech and Language Therapy Service for Hackney and the City MainstreamSpecial Needs Pre-school School age Clinics and nurseries Sure Start CDC and nurseries Special schools Mainstream schools Resource bases

Hackney Service Structure Children’s Integrated Speech and Language Therapy Service for Hackney and the City Cross Service Clinical Networks Geographically managed teams North, Central and South Sure Start Children’s Centres, Nurseries, early years centres CDC and special nurseries, mainstream primary and secondary schools, special schools, resourced schools, pupil referral units Early Years ASD Complex needs SLI Early Years Primary Secondary

How we manage staffing Children’s Integrated Speech and Language Therapy Service for Hackney and the City Sustainable student placements providing added value for existing services and a workforce for the future. Strong SLT management and leadership with clearly articulated vision in line with government and professional agendas Senior strategic management collaborated to resolve barriers around funding, employment and management of staff Senior SLT management re-organised with more defined responsibilities / cross service management matrix

How we measure outcomes Children’s Integrated Speech and Language Therapy Service for Hackney and the City Phase 1 Needs assessment and strategic planning Phase 2 Shaping and managing the market Phase 3 Improving performance, monitoring and evaluating

………Integrated Pathways for children with SLCN, across the NHS and local authority ……..

Integrated Pathways Children’s Integrated Speech and Language Therapy Service for Hackney and the City Integration across all levels Dual Citizenship Defined packages of intervention with clear aims and outcomes

Integrated Pathways Children’s Integrated Speech and Language Therapy Service for Hackney and the City

Integrated Pathways Children’s Integrated Speech and Language Therapy Service for Hackney and the City Talk at antenatal class Leaflet in New Birth Pack Training to Health Visitors Bookstart Pack and display at library Training for those giving Bookstart packs Leaflet and chat at 8- month checks Talk and leaflet at weaning party Joint meetings and training with dieticians and health visitors Talk at parent toddler group Liaison with midwives Liaison and training with Nursery Nurses Liaison with parent toddler organisers Pre-birth Talk to your new baby – start now! Birth Talk and listen to your new baby 6 months Enjoy eating & talking together 8 months Follow, copy and add words 1 year Talking is fun – celebrate first words 4 months Look and books and talk together

………Effective work at universal, targeted and specialist levels……..

Effective Work Children’s Integrated Speech and Language Therapy Service for Hackney and the City Specialist Targeted Universal Children with specific or complex needs Children with moderate needs Vulnerable children

Effective Work Children’s Integrated Speech and Language Therapy Service for Hackney and the City LEAD RESPONSIBILITY Speech and Language Therapist School/ Setting/ Parent/ other professional FOCUS OF INTERVENTION RCSLT position paper, 2006 ImpairmentParticipation Individual assessment in isolation Individual speech programme with modelling School run language group TRAINING Social skills group Curriculum planning and differentiation Curriculum based / classroom group Individual assessment in context

………Strategies to reach vulnerable/hard to reach groups……..

Vulnerable Groups Children’s Integrated Speech and Language Therapy Service for Hackney and the City

Vulnerable Groups Children’s Integrated Speech and Language Therapy Service for Hackney and the City Possible Risk Factors for Speech and Language Difficulties: Children with a history of glue ear or hearing impairment Children with low birth weight or born prematurely Families with low incomes or no wage earner Families in poor quality housing Families in neighbourhoods with few facilities Children or parents with special needs (including disability, special needs) Parents with little knowledge of child development Children with limited range of experiences

Vulnerable Groups Children’s Integrated Speech and Language Therapy Service for Hackney and the City Promotion and awareness raising amongst the local community Local and community based services Non-stigmatising

Vulnerable Groups Children’s Integrated Speech and Language Therapy Service for Hackney and the City Specific community tailored activities Cultural and Language advocates Training and awareness raising for SLTstaff

Learning to Listen Group Children’s Integrated Speech and Language Therapy Service for Hackney and the City Target GroupParents of two and three year old children with a history of otitis media Staff required SLT and support (e.g., 2 nd SLT or other MDT member or student) ResourcesQuiet room, variety of toys, song cards, books etc No. sessionsAim for 5-6 (i.e., weekly for a ½ term) Multi- disciplinary Support required Appropriate audiological management of otitis media (including hearing tests, medical management of condition)

Tension and Balance Children’s Integrated Speech and Language Therapy Service for Hackney and the City CurePrevention

………Regular review of how services operate, to increase quality and cost effectiveness & the use of robust outcome measures, with evaluation of different interventions to identify impact……..

Evaluation and Outcomes Children’s Integrated Speech and Language Therapy Service for Hackney and the City SLT

Parent Consultation Children’s Integrated Speech and Language Therapy Service for Hackney and the City ‘I want him to take part in class and listen to the teacher’ ‘We want SLT to make sure his talking gets better’ ‘I want him to do well at school’ ‘I want her to have friends and play’ ‘He should be happy like other children’ ‘I want your team to make him confident at school’ ‘I don’t want him to get bullied ’

Defining Service Packages Children’s Integrated Speech and Language Therapy Service for Hackney and the City Outcomes Is anyone better off? SMART targets and methods of monitoring Outputs What and how much do we do? Aiming for Access and Awareness Processes How well do we do it? Service commitments fsafhjljhg Inputs Staffing and resource costs Time and frequency

Collating and Presenting Data Children’s Integrated Speech and Language Therapy Service for Hackney and the City School data H-POD MOAT Other tools Population measures Needs Assessment