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Anne Longfield, the Children’s Commissioner for England, is today (Tuesday) publishing a new report “We need to talk: Access to speech and language therapy“, which shines a light on spending on speech and language therapy services (SLT) for children across the country to help identify where children who need support are falling through the gaps.

Previous research has shown that children with poor vocabulary skills are twice as likely to be unemployed when they grow up, and over 60% of children in Young Offender Institutions have communication difficulties.

Today’s report is the first time data has been brought together to show how much local areas spend on SLT services. This was previously hidden – there is no publicly available, reliable information about what is being spent, and there is no single body to hold to account for that spending.

While nearly one in five children are starting their school lives lacking the expected communication skills, the report reveals a ‘postcode lottery’ of spending, with huge variations across different areas. This risks children waiting months to be seen, or never receiving support at all.

The report also finds that over half of areas in England that reported spend (57%) saw a real-terms decrease in spending between 2016/17 and 2018/19. This comes despite the Government’s ambition in its Social Mobility Action Plan to tackle the ‘word gap’ in the early years.

It finds that the total reported spend by councils and clinical commissioning groups (CCGs) on SLT services in 2018/19 was around £166m, or £10.12 per child. However, there are substantial variations between different regions of the country:

• The top 25% of areas spent at least £16.35 per child, while the bottom 25% of areas spent 58p or less per child.  Amongst children with an identified speech and language need, the top 25% of local authorities spent at least £291.65 per child, with the bottom 25% of local authorities spending £30.94 or less.
• Local authority spend per child is highest in London at £7.29, and high in the South East of England (£5.73) and East of England (£4.83). It is lowest in the East Midlands (£0.34), the West Midlands (£0.90) and Yorkshire and Humber (£1.18).
• The North of England has the highest CCG spend per child (£17.61) followed by London (£17.14). The lowest CCG spend per child is in the Midlands & East NHS region (£10.20) followed by the South of England (£13.54).

The report also shows that spending on SLT services is actually falling in many parts of the country:

• Only 1 in 4 areas (23%) saw a real-terms increase in spend per child between 2016/17 and 2018/19. Nearly 3 in 5 areas (57%) saw a real-terms fall in spend per child.
• Almost two-thirds (63%) of areas saw local authority spend per child decline in real terms while over three quarters (77%) of areas experienced a decline in CCG spend per child in real terms.

The report finds that 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. This is concerning, as it means that local areas are not joining up all the different information that they hold and are unable to ensure that they are providing services for all children in the area who need them, and that none are falling through the gaps.

The Children’s Commissioner makes a number of recommendations for improving SLT provision so that children who need it can access support quickly, wherever they live:

• The Government must ensure that local areas are held to account for the support they provide for children by collecting expenditure data on an ongoing basis. The Children’s Commissioner’s Office will seek to work with other statutory bodies in order to collect this data. If this is not achieved within the next two years then we will endeavour to repeat this exercise, and will also publish the figures for each council and CCG.
• The Government should require that all local areas have a strategic plan in place which 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 assess 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, commenting on today’s report, 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.”

Find out more and read the report