NHS Education for Scotland project


Like all speech and language therapy, Augmentative and Alternative Communication (AAC) services have to compete with other health care interventions for what are becoming increasingly scarce resources. Therefore services need to be able to demonstrate that they represent good value for money. Successful funding bids have to include a convincing business case to show the costs of providing AAC and AAC interventions are outweighed by the benefits they deliver. 

In 2012, the 'Scottish Government published A Right to Speak', a guidance document setting out a vision for Scotland where people who use AAC are fully included in society. The report identified four strategic aims supported by eight specific recommendations and those relevant to the context of demonstrating value for money are stated below:

Strategic Aim 4: Services supporting people who use AAC contribute to developing a robust evidence base for the effectiveness and cost-effectiveness of AAC. (Page 11)

Recommendation 2 of the report supports this strategic aim. It recognises the limitations of current evidence regarding the cost effectiveness of AAC and AAC interventions. It explicitly notes that improving the availability of such information could support service commissioners direct resources towards AAC provision.  

Recommendation 3: National statistics on AAC to be gathered by relevant agencies. This is to support future gathering of cost effectiveness data on AAC and ensure that AAC funding is sustained in the long term. (Page 3)

In a project funded by NHS Education for Scotland (NES), the RCSLT, in partnership with the RTK Ltd., has developed on-line cost benefit tools for AAC services delivering to two specific groups: 

  • Children with cerebral palsy (CP)
  • Children with autistic spectrum disorder (ASD)

The tools give AAC services an easy way of putting together evidence-based business cases. They produce figures for relative costs and benefits drawn from fully referenced research.  They are simple to use. Providers enter their own local cost data and patient profiles or use the estimates provided. The tools will produce cost/benefit figures, supported by charts and tables that can be simply downloaded into documents to produce robust business cases.

We know that AAC services currently have limited access to robust performance measures. In the face of ever increasing pressures on budgets, the lack of adequate service delivery information is a major challenge. However, as more services use tools like this, the evidence they collect on impact will help deliver increasingly accurate cost and benefit data to help commissioners make better decisions about which service to fund.

You can download the Final report Augmentative and Alternative Communication (AAC) support in Scotland: A review of the research literature and cost benefit analyses 

AAC model for Cerebral Palsy

AAC model for Autism

Contact the NES AAC project for further information  

For enquiries relating to this project and/or the calculators please contact Gemma Lotha.

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