Options appraisal

If you are asked to make cutbacks, it may help you and key decision makers if you can provide options for how your service might be reconfigured.

This will enable managers and commissioners to take a view on how your services can help to address local priorities without you having to second-guess where their views of the priorities lie.

Some budget holders and commissioners may not see speech and language therapy services as fitting neatly with 'health provision'. You should refer to the national and local drivers to illustrate how your service contributes to addressing local and national health priorities.

Managers and commissioners will have to make difficult decisions, so you should do all you can to help them make those choices in an informed manner.

Providing them with clearer options and better evidence may encourage them to look more favourably on your service.

Remember that your service contributes to other care pathways, which might be affected by the cutback. If you do have to propose a cutback in your service, highlight how this impacts on your ability to meet local priorities.

You should address the immediate and longer-term effects on patient health and future increases in care costs.

The responding to calls for cuts in your service and team and demand/capacity pages should help you develop a picture of this.