Jean Gross: education and health should work together to support children's speech and language

As local authorities and the NHS struggle with their budgets, there has been a 58 per cent rise in the last five years in the number of children needing support for speech, language and communication problems.

In a final wide-ranging report, marking the end of the two-year role, Jean Gross sets out 30 recommendations to Government departments for education and health, local authorities, and the voluntary sector.

A key recommendation is that the Health and Social Care Bill, currently going through Parliament, should be amended to make joint commissioning of children’s community health services compulsory, to improve services for the one million children in the UK with speech, language and communication needs (SLCN).

Areas where integrated services are available for children of all ages are in the minority, Ms Gross says, but are ‘a common thread’ in areas where practice is particularly effective.

Although, there has been a rise in speech and language therapy services being commissioned jointly by the NHS and local authorities, this is only happening in three out of ten areas.

Without joint commissioning, the responsibility for meeting children’s SLCN needs can be passed from one agency to another, leaving parents and children stuck in the middle of disputes.

The report gives examples of the impact of these commissioning failures, such as a speech and language therapist being forced to choose which of three disabled children should be given a communication aid.

‘This joint commissioning is vitally important, because the care pathway for children with SLCN includes school and nursery-based provision; effective clinical outcomes rely on what practitioners do, as well as what SLTs do,’ Ms Gross says.

The report coincides with the end of the ‘National Year’ of communication, which grew out of MP John Bercow’s 2008 review into services for children and young people with SLCN, which called for the appointment of a communication champion.

It is based on findings from meetings with local commissioners and service providers throughout England.

During her time in post, Ms Gross visited 105 out of 152 local authority and NHS Primary Care Trust pairings and her report highlights areas of concern, as well as praising some of the excellent work she has witnessed.

Examples of best practice include the Stoke Speaks Out early years campaign that has reduced the percentage of three-and four-year-olds with language delay from 64 per cent in 2004 to 39 per cent in 2010.

The report also says that data shows that the Every Child A Talker programme has led to an average 40 per cent reduction in the proportion of children with delayed listening and attention skills in settings involved in the scheme.

Although Government funding for this initiative ended in March 2011, the report notes that the initiative’s success has led to some local commissioners finding the resources to keep the scheme going.

In her conclusion, Ms Gross said, ‘Much remains to be done, however, and the reductions to front-line services are of great concern. At a time of austerity it is to be expected that commissioners and providers will seek to find savings.

‘Nevertheless, we have to remember that, as the Bercow Review demonstrated, services for children with SLCN come from a low base. Reducing them further seems neither fair nor, in the longer term cost-effective.’

Recommendations for early years