What would you do if......?

[slt101]

After starting the topic on how you would run a LEA (many interesting and comments there, many of which wouldn't require significant money to implement) I would now like to know how you would a run a SLT dept.

 

You have a set number staff with no increase in funding, what would you do to change the way your local SLT services are run?

[call me jaded]

Quite often SLT is the first referral a young child gets. I think this puts a huge strain on the service. The first referral should be to a paed/child psych, scarey though that may be to parents.

 

I would forget blocks of therapy: this is not successful IME at all. Better to allocate weekly hours to the setting, go in and fix something up immediately rather than people spending weeks in limbo waiting for the next stage to be presented to them.

 

Accountability to the governors of a school where therapy is taking place i.e. sharing information such as how many assessments have taken place, etc.

 

SLT's should be freer to train non-specialists, such as support staff in school. This has taken a long time to set up in the school I'm a governor at, but is considered a success (the PCT do keep citing it in all their PR - it was my idea).

 

Allocate time to an administrator who pursues funding for social/communication workshops. The voluntary sector can access funding for this. Forge links with them e.g. you supply staff, the VS gets the families to attend, the department's funds get boosted. Huge chunks of funding are available for 'parenting' skills. Everything I read on SLT leads to educating the parents to carry out 'therapy' at home as being the most effective use of resources.

 

In my PCT several of the SLTs handwrite reports and they then go for typing, with a huge delay and obvious typos. Skill these people in the use of IT. There is also something of a fear of technology: a couple of years ago I asked to email something to my son's SLT and she couldn't access it. I had email at work 10 years ago (admittedly an international company).

 

Also my PCT covers a long and narrow geographic area. I bumped into one of the SLTs at a hospital doing feeding assessments on new borns (I was heavily pregnant at the time). This was at one end of the PCT. She was then going on public transport to the other end to carry out assessments. She was in a hurry because it would take an hour and a half to do the twelve mile journey. So an adequate mileage allowance or even a small car would produce more SLT hours in the day (funded from the unfilled SLT vacancy that every dept has).

 

Term time working for SLTs wopuld perhaps aid retention. I've found that the head of therapy services says 'we offer all that', but staff cite inflexibility as one of their reasons for leaving. A case of flexibility until you're in post, perhaps?

 

Change the emphasis from measuring outcomes to measurement of need. In the quota-filled NHS the most needy are overlooked. I personally think this amounts to disability discrimination. The number of disabled people who die for reasons not related to their disability is (from memory) about twice the national average. Giving people basic communication skills so that they can indicate that they have pain, for example, should be a priority. One of my friends has two children who require speech therapy. The one with the lisp (measurable outcome) got a chunk of therapy; the one with Down's Syndrome has received nothing (until his parents sought private therapy through a DS charity).

 

I'm sure I can come up with a few more...