RCSLT news March 2023: Priorities and wins in Scotland, the budget, SEND and prescribing campaign

In the March 2023 issue we cover:
- The context of speech language therapy in Scotland right now
- RCSLT's five key priorities for Scotland
- An important win for funding in Edinburgh
- The UK budget
- SEND reform announcement and what it means
- An overview of a recent event in Swansea
- Discussions about the HCPC fee increase
- Two big campaigns: 'Send in the specialists' and 'Prescribing now'.

This interview was conducted by Victoria Harris, Head of Learning at The Royal College of Speech and Language Therapists and features Derek Munn, Director of Policy and Public Affairs at the RCSLT and Glenn Carter, Head of the RCSLT Scotland Office.

Release date:
20 March 2023

Transcript

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HOST:                      0:00:13 Welcome to the Royal College of Speech and Language Therapists news podcast for March 2023. I’m Vicky and, as always for our monthly catch-ups, I’m here with Derek Munn, the Director of Policy and Public Affairs at the RCSLT. We’re delighted to be joined by special guest, Glenn Carter, who is the RCSLT’s Head of the Scotland Office, and he will be giving insights into what’s going on there in relation to speech and language therapy. There’s a lot that’s been happening since last month’s podcast so there’s quite a good amount to chat about. 

                                 Good morning, Glenn. Lovely to have you on the podcast. I wonder if you can start by telling us, what are the key issues for speech and language therapy in Scotland at the moment?

GLEN:                      0:00:54 Thanks Vicky. Yeah, it won’t be a surprise to hear me say that our profession’s under a huge pressure at the moment. There’s been a significant increase in demand in the last few years and there aren’t enough SLTs in Scotland to meet that demand. Funding for children and young people’s services is a particular area of vulnerability and, despite the pressure, I am constantly amazed by the innovation, resilience and can-do attitude of my colleagues here in Scotland.

HOST:                       0:01:20 That’s great, thanks. I wonder if you can start by telling us a little bit about RCSLT’s Scotland priorities, please?

GLEN:                      0:01:26 Yeah, of course. When I started this role in January 2022, I took some time over a number of months to listen to speech and language therapists, to hear what’s important to them and also spend time developing a relationship with third sector organisations, AHP leaders, Scottish Government and politicians. Following that period, we developed five key priorities. They are: supply and funding for SLT, leadership, wellbeing and engagement of our members, the National Care Service, and a children and young people’s delivery plan for Scotland.

HOST:                      0:01:58 Great, thank you. And I wonder if you can tell us, have you made any progress in these areas please?

GLEN:                      0:02:03 Yeah, we’ve made good progress in a lot of these areas and, I suppose, before I get into the detail it’s important to say that, of course, we’re striving to increase awareness of what SLTs do and why they’re important and, indeed, raising the profile of people with communication and swallowing needs. And in Scotland, we’ve had lots of media coverage, including pieces on voice, transgender, justice in early years, and I’ve been on BBC Radio Scotland and STV talking about some of these issues. And that’s a really important foundation for influencing and facilitating change. 

But, let me just cover some of those priorities. One of them is the wellbeing and engagement of members, and it’s been a real privilege to travel across Scotland meeting services to continue to listen about the challenges and hear about their fantastic innovation. That’s important so that we ensure that RCSLT Scotland’s priorities are relevant. And I plan to visit all health boards by the end of September. I think if we deliver on the key priorities that I’ve listed, that will, of course, support the wellbeing of our members.

Another priority is leadership. There’s lots going on to develop leadership at all levels in the profession. We are trialling a leadership development programme for Band 6 therapists and we have a leadership conference on 13 June. In regard to the National Care Service, this is potentially one of the biggest changes we’ll see in our generation. We’re working with our colleagues in the AHP Federation Scotland to influence the design of the National Care Service and to ensure that AHP leadership and approaches are core to that change. But, of course, with the imminent change of the First Minister in Scotland, the development and progress of the National Care Service feels like it’s been paused for now.

And then, lastly, the children and young people’s delivery plan. There’s lots going on. RCSLT Scotland and the children and young people’s leads have worked with Public Health Scotland to produce key recommendations on improving speech, language and communication for the children of Scotland. The Minister for Public Health, Marie Todd, has said she’s happy to make this a public health issue and we’ve helped facilitate six new early years regional leads for speech and language that are about to be advertised. And, of course, we’re working with people across the system to develop the strategic plan for this population.

HOST:                      0:04:22 Fabulous, it sounds like you’re very busy. I believe also there was an important win for SLT in Edinburgh recently. I wonder if you can tell me more about that please?

GLEN:                      0:04:31 Yeah, of course. This comes under our supply and funding priority. The context of this is that local authorities are under significant financial pressure at the moment but it’s something RCSLT Scotland has been shining a light on, is that SLT is in a somewhat uniquely vulnerable funding situation. And by that I mean we tend to be funded, certainly in children’s services, across health and education. 

But, when times are tight, education often put SLT on the table for cuts, and that’s what happened in Edinburgh. They were proposing very significant cut to their service level agreement – in fact, it was £3.4m over four years, and RCSLT Scotland supported the local service to challenge that cut. 

                                 And I suppose what I want to emphasise is my preference is to influence through developing trusting relationships and collaboration, but it became apparent that, in this situation, we needed to involve the media and move it into the political sphere. So, with help from our media and PR agency, we landed a story in the press outlining how these cuts would adversely affect the most vulnerable children in Edinburgh. 

We also worked with our members, who wrote to their councillors, and finally myself and the service lead attended a deputation at the full council meeting where we were asked quite a lot of tricky questions. 

And now, that does sound a lot, and it was a lot, but we were strategic and directing our resource for this, because Edinburgh’s obviously the capital of Scotland and everybody was watching the outcome of that.

                                 The fantastic news is that democracy works. All political parties withdrew the planned cuts to SLT in their budgets, so we went from what looked like a very significant cut to no cut. Obviously, we’re very delighted with the outcome, and myself and Lauren, our policy advisor in Scotland, and the local service learnt a lot from this.

DEREK:                    0:06:31 Glenn, I was keen to have you on today, partly because of this very impressive victory overturning the cut in Edinburgh and congratulations on that. But also because, obviously, Scotland is in the UK news at the moment because of the change of First Minister. You alluded to it briefly – does it have any further implications for what and how we influence in Scotland?

GLEN:                      0:06:57 Yeah, I suppose we are waiting to see the outcome of that. There’s likely to be change in personnel across ministers who we have been developing relationships with, so that will impact our influencing and we are going to have to wait and see about that. 

What I’m also learning is that, of course, we need to influence at that level but also at the local authority level, which is where this was landed, so we’re helping support members and leaders across Scotland to prepare for that eventuality and to understand how to influence at a local government level. There’s multi-layered influencing having to go on, but it feels like this has been a great win and has helped embolden the profession around it.

HOST:                      0:07:40 Thank you. Congratulations as well from me. And it sounds like it’s interesting times ahead. Thank you.

                                 Derek, I wonder if I could go to you next, please. The budget for England has just been released by the Chancellor. Is there anything of interest to speech and language therapy there, please?

DEREK:                    0:07:57 Thanks Vicky, and I’ll try and keep my comments brief this morning. Of course, it’s not just a budget for England, it’s a budget for the UK, but there is no separate budget for England. And where money is announced in devolved areas, like health and education, the Scottish Government and the other devolved nations get an equivalent sum, but they don’t have to spend it in that area; it’s quite complex. 

In terms of what was in the budget, you’ll have seen the headline speech that Jeremy Hunt did in the chamber, but then there’s hundreds and hundreds of pages of subsidiary stuff which doesn’t necessarily make the news.

There is a recommitment to the workforce plan for NHS and England that’s welcome insofar as it goes. It’s been committed and recommitted to for a long time now and we’ll have more to say about that in the very near future. 

Likewise, in the education area, the alternative provision specialist taskforce that we’ve been engaged with is going to be continued. That’s good. If there was a new thing, they published alongside the budget a white paper on disability and also employment support proposals for long-term sickness and disability. And we’re going to be looking at those with care to make sure the communication need and communication disability are appropriately recognised in them.

HOST:                      0:09:15 Great, thank you. And I wonder what other key things are you working on right now in your team?

DEREK:                    0:09:20 I think the biggest thing that we’ve had to respond to in England in the last month has been, finally, the announcement on the SENDA Form. Special Educational Needs and Disability. That’s one of those terms that’s different in the four nations. Massive opportunity for members in England who work in that area. We knew that it was going to be, to some extent, a damp squib. 

There are things in it which we are pleased. We’re particularly pleased that’s something we’ve been working on with NHS England and the Department of Education. The acronym is ELSA, Early Language Support for every child. These are pathfinders, as always, they’re pilots, but there’s a focus on early identification, specific support for children with speech and language and communication needs. To have this as a specific programme out of NHS England is a first, and it’s very welcome.

We are pleased that the SENDA Form statement specifically mentioned the need for workforce planning and recognised that that hadn’t been there in the green paper. Commitment by 2025 to do joint health and education workforce planning, that’s a great principle; we need to see how it works. 

There’s also specific proposals on helping teachers and other education staff understand speech and language development and they’ve identified that as a priority for professional development resources, we need to see where that goes.

But there’s loads more that needs to happen on funding, on joint commissioning, on accountability. So, a mixed picture in the sense of the formal announcement.

We’ve continued to have discussions, and this is a UK-wide matter, with HCPC about the fee increase. They went ahead with the 20% increase. I was involved in a discussion on the board of the Allied Health Professions Federation. Fair to say that our ongoing exchanges with HCPC are robust and the fee increase is subject to parliamentary approval, both at Westminster and Holyrood, so we’re not quite finished with that issue yet.

I also just wanted to mention a big members’ event in Wales, which was really, really successful, a hundred speech and language therapists gathered in the snow in Swansea. Fascinating to hear about developments of innovation. And I was particularly struck by a programme working with dieticians and pharmacists around care homes where previously there had been three separate assessments, three separate appointments and an average wait of 78 days. And by combining it into one assessment and one appointment, they’ve taken it down by 75% in terms of the wait time. So, I’ll be looking to do something with that as good practice going forward.

HOST:                      0:12:18 Great, thank you. And I wonder if we can come back on the topic of SEND. You mentioned the SEND reform announcement, which segues nicely into a campaign that RCSLT is working on at the moment, the SEND and the SEND in the Specialist campaign. Can you tell me a bit more about that please, and our listeners?

DEREK:                    0:12:35 Certainly, it’s a bit coalition. There’s over a hundred organisations involved, but we’ve been one of the lead partners, along with National Deaf Children Society. All sorts of people are involved, Guide Dogs for the Blind. And it’s about ensuring that the right professions are available in the school context. In our context that will be speech and language therapy. We’ve continued to push on that, got a ministerial response and, actually, one of our main parliamentary supporters, Geraint Davies, has a debate in what’s called Westminster Hall. it’s not the main Commons Chamber but one of the committee rooms off the Commons, and there will be a parliamentary debate on that matter this week.

HOST:                      0:13:14 Excellent, thank you. And not just one campaign but there’s another one as well. The Prescribing Now campaign. Can you tell us about that please?

DEREK:                    0:13:24 Certainly, and I gather this is a UK wide one because prescribing rights operate across the UK. And we know that we’ve got a long-term ambition for, where it’s appropriate, speech and language therapists to be given full prescribing rights. And we’re not the only allied health profession in that situation, there are a number of others. So we’re working together with allied health colleagues to make the case and say, look nobody disagrees with this, everybody agrees in principle that it should happen, it’s about creating the space in the system to go through the necessary processes. 

For goodness sake, let’s begin that journey, because it will save money, it will make the system more flexible and it will improve the patient experience. We feel like we’ve waited long enough on this and we’re going to continue to press until we see movement.

HOST:                      0:14:11 Wonderful, thank you. Thank you so much to Derek and Glen. Until next month.

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