Revealed: The extent of speech and language therapy spending cuts across England

Spending on speech and language therapy (SLT) has been slashed in half of areas, according to a report which reveals the extent of cuts at a local level for the first time.

The report from Anne Longfield, the children’s commissioner for England has found “enormous variation” in the investment in SLT services across the country, despite almost one in five children starting school with lower than expected levels of communication.

More than half of England (57 per cent of areas) experienced a real-terms cut in SLT spending between 2016-17 and 2018-19, and Longfield has called on the government to hold local areas to account for their SLT spend and ensure they have a “strategic plan” to assess need.

Children from deprived backgrounds are more likely to require SLT, with 23 per cent of five-year-olds who are eligible for free school meals not meeting the expected levels in speech, language and communication by the end of reception, compared with 13 per cent of those not receiving free school meals.

In 2008, the Bercow review highlighted issues in SLT service including a postcode lottery in support available and a lack of joint working between health and education.

The government’s 2017 social mobility action plan identified “closing the word gap” as a key priority for improving social mobility, while last year the Department for Education committed to halving the number of children struggling with communication and literacy by the end of reception.

However, Longfield’s report warned that “problems around variation in spending, accountability and a lack of joined up services identified over 10 years ago are still there, and there is no strategy to address them”.

According to the report, almost two thirds (63 per cent) of areas saw a real-terms decline in local authority spend per child between 2016-17 and 2018-19, while over three quarters (77 per cent) experienced a real-terms decline in clinical commissioning groups’ spend per child.

The total reported spend by councils and clinical commissioning groups on SLT services in 2018-19 was £166 million, equivalent to £10.12 per child.

However, the top-spending quarter of areas spent at least £16.35 per child, while the bottom-spending quarter shelled out 58p or less.

For children with an identified speech and language need, the top 25 per cent of local authorities spent at least £291.65 per child, but the bottom 25 per cent spent £30.94 or less.


Rural areas lose out

The report found that spending was generally higher in urban areas as opposed to rural, and that only half of health and local authorities are jointly commissioning services, even though they are supposed to do so for children with identified special educational needs.

For local authorities, the highest spend recorded was in London (£7.29 per child), the south east (£5.73) and east of England (£4.83). It was lowest in the east midlands (34p per child), the west midlands (90p) and Yorkshire and the Humber (£1.18).

The north of England had the highest CCG spend per child (£17.61), followed by London on £17.14. The lowest was in the midlands and east NHS region (£10.20) and the south of England (£13.54).

Longfield said communication skills are “vital for children starting school and for improving social mobility throughout a child’s education” and warned that those who fail to receive help are “at a greater risk of falling behind in education or developing behavioural problems”.

“The next prime minister must make school readiness a priority if we are to give all children the chance to thrive. A well-resourced strategy for addressing speech, language and communication needs must be part of that.”

Anntoinette Bramble, chair of the Local Government Association’s children and young people board, said “significant financial pressures” are “severely impacting” the ability of councils to support children with early language development.

A government spokesperson said: “We are boosting local early years services with £8.5 million to help establish best practice and are providing £50 million to develop more high-quality school-based nursery provision for disadvantaged children, £26 million to set up a network of English hubs and a national training centre, and £20 million on the professional development of early years practitioners – ensuring every child can thrive.”

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