Reforms and Cuts: Working together to secure the future of SLT services Kamini Gadhok - Chief Executive Officer Derek Munn – Director of Policy and Public Affairs Royal College of Speech and Language Therapists

A Picture of Cuts and Reforms £20 Billion £108.8 Billion 3 %

Findings of the 2011 cuts survey 4% of respondents experiencing cuts in school funding Mean cut: 10 % 22% of respondents experiencing cuts in Local Authority funding 60% of respondents experiencing cuts in Health Service funding Mean cut: 34 % Mean cut: 26 %

“A senior therapist retired and this post was downgraded to an SLTA” “No longer able to continue with screening clinics for pre-school children, assistants supporting nurseries. Referral criteria have been narrowed. Waiting times have already started to grow.” “Providing less expensive devices for patients when this is not the best solution” “Longer waiting lists. Tightening eligibility to access service. Using triage to identify priorities but this means that there are many children with clinical needs that we cannot address. Increased level of risk to service highlighted to organisation. Increase in complaints ” Source: RCSLT Cuts Survey 2011

The World We’re Now In….

...In other words Foundation Trusts Providers National Commissioning Board 1 national Board 4 regional 50 Local posts Health and wellbeing boards Clinical Commissioning Groups Local authorities Local Health watch Social care providers

New Legislation Children and Families Bill Education, health and care plans to age 25 Preparation for life Personal budgets More info on services Terminology - SEN or LD? Draft Care and Support Bill Wellbeing & prevention Personal budgets Support for carers Safeguarding More information HEE

Health and Wellbeing Boards Encourage integrated commissioning of services. Develop joint strategic needs assessments (JSNAs) and joint health and wellbeing strategies (JHWSs). Councillors will sit on HWBs –contact with local councillors has never been more important We already know of one SLT on a Health and Wellbeing Board

Clinical Commissioning Groups Commission majority of SLT services Governing bodies include GPs, registered nurse, secondary care specialist doctor and lay members. Access SLTs /AHPs via strategic clinical networks and clinical senates. We know of one SLT on a Clinical Commissioning Group already

Who is commissioning what? Clinical Commissioning Group ( CCG): Services for people with learning disabilities Community Health Services Rehab Mental Health Services NHS Commissioning Board: “Specialised” services  AAC & cleft Armed forces services Prison health and psychiatric services Specialised mental health services

And there’s more... Clinical Senates Clinical Networks Local Education & Training Boards (LETBs) Local Healthwatch Health Education England Public Health England Academies and schools as commissioners and employers

Reforms in the nations What’s changing in Scotland: Integration between health and social care (Bill) Budgetary constraints ongoing Self Directed Support (Bill) and self management given greater impetus Children’s Rights and Well Being (Bill) – outcome measures in statute Reducing prison numbers with emphasis on community disposal Wales – changes to special needs Northern Ireland – commissioning changes bedding in

The Giving Voice Campaign Initiated in the face of cuts A campaign used both proactively and reactively by members

Three campaign levels Decision-makers and budget-holders Media Grassroots

The Local Activity Menu: available at

What’s the impact? For Newly Qualified Therapists Changes to banding Quality, Innovation, Productivity and Prevention (QIPP) Health Improvement, Efficiency, Accessibility and Treatment (HEAT) in Scotland Impact on SLT services

What’s the RCSLT doing to help?

What outcomes are you trying to achieve? What are the key opportunities and / or threats to the delivery of SLT services? How do you want the service to be positioned and why? What evidence and information do you need and what’s available from the RCSLT website?

Who do you need to influence to achieve your outcomes? Who are the key decision makers who will have an impact on the future of SLT services? What do they know about the SLT service? Who are they listening to and why? Do the key people you need to influence talk to each other?

How do you go about this? Understand the priorities of those you want to influence vs the outcomes you want to achieve Find out what will make them interested in your service – the ‘so what’ question Use the Giving Voice toolkit and examples to organise an activity or event

Any Questions ?