How Speech

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How Speech Language Therapists ensure equality
of childrens services across Wales.

• Learning Outcomes for the workshop attendees
• To have an insight into the process of the SLT
  service redesign in Wales.
• To understand the achievements of joint working
  together developments in Wales
• To be aware of problems/ barriers of redesign of
  services
• To have opportunity to consider how to take
  forward similar projects within your own areas
• Christine Graham
• Wen Hayton 11th October 2007

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How Speech Language Therapists ensure equality
of childrens services across Wales.

• Study Day Future Perfect
• New Ways of Working Across Wales
• Working Together
• Speech Language Project
• Christine Graham
• Wen Hayton 11th October 2007

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How Speech Language Therapists ensure equality
of childrens services across Wales

• Background to Working Together Project in Wales
  
• Outline of two regional project developments
• Achievements gained

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How Speech Language Therapists ensure equality
of childrens services across Wales

• Question and Answer Time

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Background to Working TogetherSpeech Language
Project in Wales
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Background to Working TogetherSpeech Language
Project in Wales

• July 2000 Jointly commissioned research
• August 2002 Speech and Language Therapy Action
  Group (SALTAG) established in Wales
• June 2003 Working Together Speech and
  Language Services for Children and Young People
  joint consultation document

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Background to Working TogetherSpeech Language
Project in Wales

• December 2004 invitation from Welsh Assembly
  Government inviting interest in becoming a pilot
  project
• April 2005 initial funding awarded to 4 pilot
  projects Ceredigion, Conwy/Denbighshire, Gwent
  and Bro Morgannwg Nhs Trust
• Now all but 1 region across Wales have projects
  established

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Working TogetherSpeech Language Project

• Study Day Future Perfect
• New Ways of Working Across Wales
• 11 October 2007
• 4.10 pm 4.50 pm
• Presentation by
• Christine Graham, Deputy Head with responsibility
  for School Services
• Speech Language Therapy Dept, Bro Morgannwg NHS
  Trust

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Outline of Presentation

• Background
• Management Structure
• Communication Forums
• Training Packages
• Speech and Language Therapy Intervention Packages
  
• BTEC in Speech and Language Support
• Evaluation
• Overcoming problems/ barriers

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Background Management Structure

• Developing joint working with LEA colleagues
• Tiered management structure

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Communication Forums

• Joint location-with a Project Administrator
• 2 LEAs Bridgend Neath / Port Talbot each with a
  Communication Forum
• Members of the Forums
• Joint Referral form for schools
• Joint management of the referrals

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Training Packages

• Speech Link
• Language Link
• Social Use of Language Programme (SULP)-Bridgend
• Talkabout Social Skills NPT
• Elklan

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Speech Link

• Progress to date
• ½ Day Training to ALL schools in Bridgend and in
  NPT
• Return to training for new school staff
• Training to all SALTs and SALT Assistants in
  Trust
• Follow up school visits
• One Twilight session in each LEA -Answer
  Questions
• Speech Language Therapy Helpline
• Available Thursday 330 to 430pm
• E-mail contact with Christine Graham/Delyth Lewis
  

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Language Link

• In Bridgend launched at School Conference in
  February 2007
• - All schools to be trained by the end of
  September 2007
• In NPT launched in September 2007
• - 10 schools to be trained by the end of
  September 2007

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Social Use of Language Programme (Wendy Rinaldi)

• Progress to date
• 3 courses, Part 1 SULP provided
• SULP groups provided by LEA Out Reach Officers
• School based support April-July 2007
• Training Part 1
• September 2007-December 2007

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Talkabout- Alex Kelly

• 1 day course to examine examples of social
  communication programmes
• Commenced January 2007 -waiting list for 1 day
  per term training
• Core materials used Talkabout by Alex Kelly
• Assessment of social skills
• Activities to run groups
• Loan of Resources
• Follow up support in school

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Elklan

• Progress to date
• 2 day teacher overview
• 10 week ½ day training to support staff
• Whole school training has commenced

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• Speech and Language Therapy Intervention
  Packages
• (SALTIPs)
• Defining the type of intervention each referred
  child requires
• Stating who should provide that intervention
• Stating how that intervention should be delivered

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BTEC Level 3 Speech Language Support

• Progress to date
• Completion of first year Sept 2006 2007
• Trained SLT assistants and school support from
  both LEAs
• Sept 2007 2008 intake 6 support staff from
  NPT LEA and 4 SLT assistants from neighbouring
  Trusts will be trained.

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Working TogetherSpeech Language Project
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Conwy DenbighshireIntegrated Communication
Service
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Integrated Communication Strategy

• Wen Hayton, Principal Speech Language
  Therapist, Conwy Denbighshire NHS Trust
• Diane Evans, Primary Education Officer,
  Denbighshire
• Cathy Rogers, Educational Psychologist, Conwy

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Background..

• We reviewed our current services
• (Oct 2005 March 2006)

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Background..

• We highlighted good practice
• - Joint working in Denbighshire in
• Mainstream Schools (Joint Flexibilities)
• - Communication Forum in Ysgol y
• Gogarth
• - Partnership working with Surestart in
• Conwy

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Background..

• We identified areas to develop
• - Better information about Services
• - Better information about speech
• language difficulties and how to
  help
• - Better access to services
• - Better training
• - Clearer entry / exit criteria

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Background..

• We asked stakeholders what they thought
• - Questionnaires to Parents
• - Questionnaires to key frontline staff
• - Questionnaires to staff in Education
• - Consultation day March 24th, Oriel House

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Background..

• Stakeholders wanted..
• - More training
• - Better information
• - Clearer understanding of services
• - To know what to do to help

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Background..

• We all agreed..
• - Services work best where there is
• consistency in personnel, enabling
• good relationships

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Background..

• We all agreed what the desired outcomes of
• Communication Service should be..
• For
• - Each Child and Young Person
• - Each Parent
• - Each member of the Communication
  including Speech Language Therapists
• - The wider community

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Mission Statement
It is everybodys human right to be able to
communicate with people in their
environment.   We endeavour to deliver a single
integrated service to provide timely
comprehensive and cohesive support across all
phases of development.   The service will involve
and empower all those in contact with children
and young people to deal effectively with
communication needs
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Our Philosophy

• Communication is
• everybodys business
• Right person in the right
• place, at the right time, doing
• the right thing

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Philosophy of Integrated Communication Service
Communication service to PreSchool Children
Child
The priority of the service is to empower those
who have daily contact with each child to
maximise communication skills.
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Philosophy of Integrated Communication Service
Communication service to Children of School Age
Child
The priority of the Communication service is to
empower those who have daily contact with the
child to maximise communication skills.
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Parties Involved..
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Integrated frontline communication services are
delivered across Conwy Denbighshire via a
network of Integrated Communication Forums

• These Forums
• Work within the agreed Communication Policy
• Ensure Services are delivered within a Clinical
• Governance Framework

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CONWY COMMUNICATION FORUMS
Conwy (Strategic) Management Communication Forum
Secondary Mainstream Support Communication Forum
PreSchool Communication Forum
Specific Speech Language Impairment Communicatio
n Forum
Special Schools Communication Forum
Mainstream Support Communication Forum
Bro Cernyw Cluster
Old Colwyn/ Colwyn Bay
Kinmel Bay/ Towyn/ Abergele
Llandudno/ Conwy/ Penmaenmawr
Glan conwy Cluster
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DENBIGHSHIRE COMMUNICATION FORUMS
Denbighshire Management Communication Forum
PreSchool Communication Forum
Mainstream Support Communication Forum
Secondary Mainstream Support Communication Forum
Tir Morfa
Plas Brondyffryn
Rhyl Schools
Llangollen / Corwen
Denbigh / Ruthin
Prestatyn / St Asaph
Welsh Medium School Head Teachers
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The Communication Service will achieve the
desired outcomes for service users by delivering
services as agreed in the 6 Key Service
Descriptions. These descriptions define our
standards.
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They are

• PreSchool
• Primary Mainstream Support
• Secondary Schools
• Specific Speech Language Impairment
• Special Educational Needs
• Follow up Specialist Services

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• Development of Service Descriptions
• Workshop 20th July 2006
• Workshop 29th September 2006
• Final Consultation 14th November 2006

• Focussed on
• Agreed Screening Tools
• Agreed Integrated Assessment
• Training Strategy
• Service Pathways
• Crucial ICP

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• Training Strategy Identifies Training packages
  for
• Speech Language Therapists / Educational
• Psychologists
• Teachers
• Assistants
• Parents
• Specifies roles responsibilities in delivering
  training

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Parents Parents Parents Parents Parents Parents
Parents Parents Parents
Pre School Teams
Teaching Assistants Teaching Assistants Teaching
Assistants Teaching Assistants Teaching Assistants
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Parents Parents Parents Parents Parents Parents
Parents Parents Parents
Pre School Teams
LSAs LSAs LSAs LSAs LSAs LSAs LSAs LSAs LSAs LSAs
LSAs LSAs LSAs LSAs LSAs LSAs LSAs LSAs LSAs
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SLT
Health Team
Educational Psychologist
Training Officers
Suggested Communication Forum Membership
Senior Management Team of School or Centre
Parent / Carer
Social Services
Governor
Voluntary Body
Service User
Front-Line Key Staff
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Each Forum has

• Register of Members
• List of schools / services covered
• Standardised agendas and notes of meetings
• Local SALT reports
• Communication policy framework

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Each Forum will have

• Service specification
• Risk register
• Audit details plan
• PPI details plan

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Parental Role on Forums

• Represent parental views opinions
• Give opinion on leaflets
• Advocate for parental involvement
• Group other parents and seek opinions
• Question processes / services

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Conwy DenbighshireIntegrated Communication
Service
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• Achievements Gained
• Finding Solutions

Ymddiriedolaeth GIG Siroedd Conwy a Dinbych Conwy
Denbighshire NHS Trust
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Evaluation

• 2 Stage evaluation
• Pilot project activities achievements -service
  redesign
• Evaluation of the process
• Guidance to be published by Welsh Assembly
  Government with Service standards

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Achievements Finding Solutions 1

• Co-location
• Advantages
• Increased communication between SLT/ Education
  Staff
• Shared resources
• Sharing of expertise
• Pooled administration
• Challenges
• Large geographical area-access for some staff
• Ownership
• Size
• Not base for all the week

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Achievements Finding Solutions 2

• Achieved integrated models of care SALTIPs-
  what, who and how?
• Evidence based recommendations for skill mix
  within the work force
• Adapting to change

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Achievements Finding Solutions 3

• Children Services Committee
• Established as a sub-committee of All Wales
  Speech and Language Therapist Managers Committee
  (AWSLTMC)
• Work Plan tasks completed e.g.
• All Wales Referral Form
• Case Note standards

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Finding Solutions 4

• Practical issues requiring strategic solutions
• Information Technology including networks
• Different personnel operating procedures / terms
  and conditions.
• Sharing of information and record management
• Finance / pooled budgets
• Different (conflicting) organisational targets
  set by "Government"
• Commissioning
• Embedding an All Wales approach 

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Exit Strategy

• What can continue without funding - just on the
  basis of partnership working and agreement-
  Funding ends March 2008
• Continue Communication Forum development
• Continue training packages
• Continue development of joint management
• Evaluation