15 May 2024

Commissioned by the Department of Health and Social Care The Demand and Supply of Therapists for Children and Young People with Special Educational Needs and Disabilities: A Scoping Study looks at the workforce in England and focuses on three therapy services: speech and language therapy; physiotherapy, and occupational therapy. 

We welcome the report, which captures the scale and complexity of the huge challenges currently facing the speech and language therapy profession, along with other allied health professions. We know these challenges are having a significant impact on children and young people with special educational needs and disabilities, and their families. While we have had positive discussions with the Department for Education and NHS England over a number of months, we are calling on the Government to commit to take action, including: 

Increase funding and resources

  • Increase funding for speech and language therapy services to enable them to identify, assess and meet local needs. 
  • Specific support for service transformation to ensure that all services provide evidence-based care across the continuum of universal, targeted and specialist support, delivering improved outcomes for children and young people.  

Support and accountability for commissioning 

  • Provide quality standards for commissioners which specify that services should support prevention and early intervention, including for children and young people on SEN support, and through working with families and the wider workforce. 
  • Issue system guidance which sets out a clear expectation that support for children’s speech, language and communication should be jointly commissioned, with accompanying accountability measures.

Improve workforce data and modelling

  • NHS England to engage with RCSLT on future iterations of the workforce plan to ensure modelling includes demand scenarios for community children and young people’s speech and language therapy services.  
  • Assessment of the ways in which the Government can increase the supply of speech and language therapy training places in England, given it does not commission places. 

Maximising the role of the wider workforce 

  • Provide training and support to the children’s workforce, across education, health and social care, to enable them to identify and support children with speech, language and communication needs. 

Staff wellbeing and retention 

  • While measures to support staff wellbeing are welcome, the fundamental issues relating to funding, workload and service models must be addressed in order to improve staff retention, particularly within the NHS. 

Further information about the report  

The report was written by Professors Ian Kessler and Annette Boaz and published by NIHR Policy Research Unit in Health and Social Care Workforce following a commitment in the Government’s SEND Review Green Paper (March 2022) to “commission analysis to better understand the support that children and young people with SEND need from the health workforce.”  

The report’s findings include: 

Resource pressures are impacting care quality 

  • A marked increase in the need for therapies for children and young people with SEND 
  • Therapists’ caseloads varied but were generally high 
  • Staff shortages were reported across all three therapy professions 

Myriad commissioning challenges 

  • Gaps in service and unmet need 
  • Misalignment between commissioning and demand 
  • The design of commissioned services was ‘discretionary’ and varied significantly between areas – in the range of services available, how they are accessed, and where and how they are delivered. 

Therapy workforce data is lacking 

  • Determining the current therapy workforce who work with children and young people is difficult; specifying the workforce for children and young people with SEND even more so. 

The role of the wider workforce is central 

  • The training and development of the wider children’s workforce is central to the delivery of therapies for children and young people with SEND. 

Staff wellbeing is impacting retention 

  • The report describes the wellbeing of therapists as “under pressure and fragile”, noting the implications for their retention in the NHS. 
  • Therapists felt their ability to deliver quality care in line with their professional standards was too often compromised.