Children's Disability Services: IASLT report following Stakeholder Engagement.

IASLT continues to highlight the need for change and improvements in relation to Children's Disability Services and advocate for children and families, our members and the SLT Profession.

IASLT has repeatedly requested meaningful and timely consultation with our profession regarding the current and future delivery of Children’s Disability Services. We have highlighted concerns to the Chief Clinical Officer, HSE, Oireachtas, our members and the public.

IASLT  issued a statement on the roll out of Progressing Disability Services (PDS) in August 22. Read the full statement here.

In October 2023, five representative HSCP Organisations united to voice concern over Children’s Disabilities Services amid calls for consultation. Occupational Therapists, Speech and Language Therapists, Social Workers, Physiotherapists and Psychologists expressed concerns regarding safety of Children’s Disability Services. This was an unprecedented joint statement that highlights the level of concern over clinical governance and risk management. You can read the full statement here.

When the HSE launched their Statement on the launch of the Roadmap for Service Improvement 2023 – 2026, Disability Services for Children and Young People in October 2023 IASLT expressed concern about the absence of engagement with families, front line clinicians, professional bodies and FORSA in developing this roadmap despite calls for engagement. All were excluded from key decisions and consultations. Read the IASLT statement here.

Much of IASLT’s work to date has primarily been in conjunction with members of our profession and interprofessional colleagues.  IASLT identified a need to meet with other stakeholders to explore what other offerings IASLT as the professional body for speech and language therapists could provide to support children and their families. Representatives from IASLT met with representatives from FUSS Ireland, ASIAM and parents of children attending CDNT’S in December 2023.

Clear areas of concerns and themes emerged through discussion.

All groups shared common concerns in relation to recruitment, retention and staff burnout for HSCPs working within Children’s Disability Services. There were also shared concerns in relation to the lack of therapists with specialisms, appropriate training and supervision.

The following key themes were identified:

1. Communication and Education:

• Requirement for CPD in specialist areas and consideration of how competency development is supported in specialist areas.
• Requirement for mentoring/supervision for specialisms.
• Requirement for all clinical spaces to be child friendly and neuro affirmative.
• Requirement for ongoing advocacy.
• Concern in relation to the high costs associated with accessing private speech and language therapy.
• Sourcing appropriate SLT/CPD: Parents want to understand what clinical approaches are evidence based and advised that it would be helpful to understand what CPD IASLT is offering and why, including the evidence base.

1. Advocacy:

 There is a shared desire amongst all groups and individuals to support and advocate for the provision of safe and effective services. There was agreement in relation to concerns with the rollout of Progressing Disability Services (PDS) and the evident inconsistencies in management structures, staffing, and clinical pathways.  Concerns were focused on, clinical governance, scope of practice, risk management, and clinical supervision.

Ongoing advocacy to support the implementation of safe services is required.

 IASLT Commits to the following actions:

1. Communication and Educations:

IASLT will support the SLT community to share and develop person centered, neuro affirmative practice. IASLT commits to the delivery of targeted interprofessional CPD in this area. This will include publication of information on neuro affirmative practice.

IASLT will prioritise the review of AAC Clinical Guidelines for Speech and Language Therapists and consider the inclusion of a competency framework as part of this review.

IASLT commits to the provision of a comprehensive SLT education programme for the Speech and Language Therapy community. The 2024 CPD plan targets specialist areas of practice, including FEDS, ARFID and AAC.

IASLT will share rationale for selecting particular CPD programmes/events alongside a summary of the rationale/ evidence base for same. This will support and empower parents when accessing speech and language therapy services for their children and our therapists.

1. Advocacy

• IASLT will advocate for Government commitment for the implementation of recommendations contained with the Joint Oireachtas Committee on Autism Oireachtas recommendations.
• IASLT will advocate for a full review of the Disability Act.
• Recruitment and retention: IASLT will continue to advocate alongside our colleagues in ISCP, AOTI, PSI, IASW for changes in Children’s Disability Services. The professional bodies' primary concerns are focused on, clinical governance, scope of practice, risk management, and clinical supervision. These foundation stones are essential to ensure that HSCPs are enabled to deliver care in a way that is safe for patients and to reassure HSCPs that they are operating in a way that ensures that risk is minimised and that their professional code of conduct and ethics and CORU registration is not compromised. Clarity around these issues will also enhance staff recruitment and retention, supporting comprehensive service provision to children and their families.
• Clinical Specialist posts: IASLT continues to advocate for appropriate clinical specialist posts in line with agreed job descriptions and appropriate governance, competency development and supervision. These posts are required to support and develop specialist areas of practice in Ireland, namely FEDS and AAC initially.
• IASLT will advocate for changes to support recruitment. This includes fully funded professional development and research opportunities up to and including MSc and PhD studies in relevant areas. The implementation of a Location Allowance to act as compensation for the high cost of living in larger cities where the standard cost of living and cost of rent is higher than the national average. The promotion of family friendly working policies incorporating flexibility for all professional HSCPs to form part of an ongoing HSCP strategic review. IASLT also advocates for changes in the visa system to support international recruitment. HSCPs should be able to relocate to Ireland with their families similar to medics.

During meetings concern in relation to the high fees for accessing private SLT was highlighted and also the challenge of finding therapists with specialist skills. IASLT does not set fees for clinical practice. We will share concerns with Independent Speech and Language Therapists of Ireland (www.isti.ie) in relation to high costs and recent increases.

There were also a further number of discussion areas for future consideration:

IASLT must consider the accessibility of its communications and consider producing easy to read/accessible versions. This is a focus of IASLTs current strategic plan.

IASLT were also asked to consider how they might support competency development in the form of mentoring/supervision for SLTs in specialist roles.

We wish to thank everyone for their time and the opportunity to engage.

We will continue to advocate for children and their families and look forward to meeting again later in 2024 to review actions and identify future priorities.