Children's Commissioner warns of speech and language therapy postcode lottery

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Too many vulnerable young children are missing out on the speech and language help they need to be ready for school, according to a new report from the Children’s Commissioner.


The Children's Commissioner's report highlights the huge variation in spending on speech and language therapy

The report, the first to bring together data showing how much local areas spend on speech and language therapy (SLT) services, reveals a postcode lottery of spending, with ‘huge’ variations across different areas, risking children waiting months to be seen or worse, not receiving any support at all.

The Children’s Commissioner Anne Longfield warns this risks the Government’s ambition in its Social Mobility Action Plan to tackle the word gap in the early years.

According to the report -We Need To Talk: Access to Speech and Language Therapy’ - the top spending areas in England spend at least £16.53 per child, while the bottom 25 per cent spend 58p or less per child.

Local authority spend per child is highest in London at £7.29, followed by the south east of England (£5.73) and the East of England (£4.83). It is lowest in the East Midlands (34p), the West Midlands (90p) and Yorkshire and Humber (£1.18).

The report also shows that spending on SLT services is actually falling in many parts of the country. Nearly three-in-five areas saw a real-term fall in spend per child, while one-in-four saw a real-term increase in spend per child between 2016/17 and 2018/19.

On top of this, only half of health and local authorities in England are jointly commissioning services, even though they are expected to do so for children with identified special educational needs. The Children’s Commissioner called the finding ‘concerning as it means that local areas are not joining up all the different information they hold and are unable to ensure they are providing services for all children in the area who need them, making sure none fall through the gaps’.

The report concludes by making a number of recommendations, they are for:

  • The Government to hold local areas to account for the support they provide for children by collecting expenditure data on an ongoing basis. The Children’s Commissioner office will seek to work with other statutory bodies to collect this data. If this is not achieved within the next two years, then the Commissioner’s office will repeat this exercise and publish figures for each council and Clinical Commissioning Group (CCG).

  • A requirement that all local areas have a strategic plan in place that assesses the level of children’s speech and language need in their area, giving particular consideration to disadvantaged children. The plan should outline how they intend to meet need and provide details of how areas will asses the outcomes of that provision. This should include support for parents to help their children communicate and for children with complex needs.


Anne Longfield, the Children’s Commissioner for England, said, ‘Communication skills are vital for children starting school and for improving social mobility throughout a child’s education. We should be very concerned that almost one-in-five children aged five is behind in speech and language development and yet more than half of areas in England have seen a real-terms fall in spending on speech and language therapy in recent years.

‘Those who fail to receive help are at greater risk of falling behind in education, or developing behavioural problems. There are far too many children who have ended up in youth custody, who had speech and language problems at school.

‘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.’

Responding to the report, the Local Government Association (LGA) urged the Government to address the reductions to public health budgets and the gap in funding for special needs.

Councillor Anntoinette Bramble, chair of the Local Government Association’s Children and Young People Board, said, 'Good quality early years and education, with a focus on key early language and literacy skills, is essential in making sure that children get the best start in life and begin school ready to thrive.

'However significant financial pressures on councils’ public health and special needs budgets is severely impacting on their ability to support children with early language development.

'Public health budgets have been cut by £700 million while councils face a special needs funding gap of up to £1.6 billion by 2021, which we urge the Government to address in the Spending Review.

'Councils are also working closely with local early education and childcare providers and Clinical Commissioning Groups to make sure children are ready to start school, but insufficient funding is impacting on the quality of provision and support for children with special needs, as providers struggle to balance budgets.'

A Government spokesperson said, 'Speech and language therapy gives children in need the best start in life. As part of the NHS' Long Term Plan, we are working to improve support for children and young people including considering how to ensure we have the right numbers of speech and language therapists to meet demand.

'Good early years education is the cornerstone of social mobility. We are boosting local early years services with £8.5m to help establish best practice and are providing £50m to develop more high-quality school-based nursery provision for disadvantaged children, £26m to set up a network of English hubs and a national training centre, and £20m on the professional development of early years practitioners - ensuring every child can thrive.'

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