An Update on the West Midlands AAC Care Pathway

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An Update on the West Midlands AAC Care
Pathway Julie Atkinson (SLT) Victoria Lundie
(SLT) Helen Whittle (SLT) West Midlands AAC Care
Pathway SIG Access to Communication
Technology 0121 627 8235 www.actwmids.nhs.uk
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History of the AAC Care Pathway

• No clear process to meet the needs of AAC Users
  within the West Midlands
• Model of service delivery within the regional
  centre not meeting the needs of local services in
  an efficient manner
• The person with AAC needs and their carers not
  knowing what to expect from local and regional
  services
• Huge differences within local services in
  awareness of how to work with people with AAC
  needs
• Lack of an identification of a co-ordinator
• No agreed assessment documents resulting in
  important information not being recorded or
  elicited
• Inconsistent recording of treatment objectives,
  making it difficult to judge the success of
  interventions

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In the beginning

• Concern from the West Midlands SLT about
  equality of service for AAC. This lead to
  consultation between ACT and West Midlands SLT
  Managers.
• Funding was secured for a project worker to
  co-ordinate the writing of the documentation.
• A working party was put together to support the
  project and to ensure regional needs were met.
  The working party consisted of a range of
  professionals from across the West Midlands. The
  working group received advice from an independent
  Care Pathway specialist.
• Two documents available to download from ACT
  website
• http//www.actwmids.nhs.uk/AAC/care-pathway/aac-
  care-pathway-documentation
• AAC Care Pathway Documentation
• AAC Care Pathway Documentation Guide

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Mission Statement

• The AAC Care Pathway aims to achieve the
  delivery of high quality services for people with
  AAC needs in the West Midlands region

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Aims of the Care Pathway

• To increase awareness and understanding of how an
  AAC Care Pathway can improve the care and service
  received by individuals within the West Midlands
  region
• To identify and evaluate current pathways of care
  for people with AAC needs
• To identify key areas for improvement within the
  current pathways of care
• To clarify roles and responsibilities in
  multidisciplinary, inter/intra agency working
• To improve consistency of service delivery to an
  individual based upon evidence and best practice
• To define an agreed, anticipated course of
  action, whilst allowing for variation, based upon
  need

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Aims continued

• To provide streamlined and standardised
  documentation
• To monitor service delivery against agreed
  standards
• Reduce waiting times for ACT intervention for
  those complex clients who are referred.
• Alter ACTs services to better meet the needs and
  wishes of service users clients, their carers
  and clinicians

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Areas to Assess using the AAC Care Pathway
Documentation

• Background Information
• Communication
• Use of Language
• Understanding of Language
• Equipment and Positioning Checklist
• AAC Environment
• Identification of Multi-disciplinary team members
• Allocation of Co-ordinator
• Co-ordinators checklist
• Action Checklist
• Outcome of Actions
• Request for Support from ACT
• Implementation Checklist
• Review Form
• Recording Variances

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Process Map
1 AAC Needs Identified
2 Multi Disciplinary Team
3 Co-Ordinator
Branch A A.C.T.
Branch B Other Agency
4 AAC Introduced
5 Review and Exit
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Special Interest Group

• Started to support and update the AAC Care
  pathway Documentation in 2005
• Way of sharing information and best practice
  across the region
• Meets 3 times per year
• Details of past meetings on the ACT website
• http//www.actwmids.nhs.uk/AAC/care-pathway/aac-si
  g
• Funding CM places for SIG members
• Meeting content
• Case presentations
• Journal reviews
• Funding issues
• Equipment updates
• Manufacturers presentations

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ACT Training Strategy

• Run as a project funded by Commissioners to write
  a training programme to support the AAC Care
  Pathway
• Looked at what was happening across the U.K.
• Consulted West Midlands SLT Managers
• Explored what was happening across the U.K.
• Explored formats of training
• Ended up with 9 X 1day courses
• Now a rolling programme
• Courses run at ACT
• But all run with one ACT clinician and a member
  of a local team
• Courses available to be run in alternative venues
  by other teams with the support of the SIG

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9 x One Day courses developed

• AAC An Introduction
• Text to speech
• Developing switching skills making it
  Successful
• Using Symbol based VOCAs
• Successful AAC the impact of environments and
  Communication partners
• Meeting communication needs- low tech AAC from
  single message to complex Communication
• Assessing and developing emerging communication
• AAC and acquired communication disorders
• Alternative access to computers

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AAC Care Pathway Achievements

• Improved skills of local teams increased
  awareness of AAC
• More clients AAC needs being met locally
• Shorter waiting times for assessment provision
  at ACT for complex clients
• Tertiary service has developed more flexible
  working patterns e.g. Helpline, Consultation
• Packages of training developed
• Video case studies on website
• User consultation
• AAC Care Pathway documentation now on Version 4
  (October 2008) regional input to this.
• AAC Care Pathway SIG for SLTs, OTs, teaching
  staff others
• Recognised at a national level - CQ3, Bulletin,
  EAT document

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The Future of the AAC Care Pathway

• Used consistently at a local level across the
  region as an information gathering tool
• Ultimate aim to run courses at local venues
• Continue to update the documentation to meet the
  needs of clients and local teams Version 4
  (October 2008)
• Promote use at a national level, in line with the
  Bercow report recommendations

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References Resources

• Development of a Regional AAC Care Pathway
  (2005) Glendinning, C Hampson, J. Presentation
  at CM 2005
• Communicating Quality 3 RCSLT's guidance on
  best practice in service organisation and
  provision (2006) ISBN 0-947589-55-4
• Improving AAC Intervention RCSLT Bulletin Feb
  2008 Pg 20
• What is an Integrated Care Pathway? Middleton,
  S Barnett, J Reeves, D (Vol3 No3)
  www.evidence-based-medicine.co.uk
• Getting Started with Integrated Care Pathways
  (2001) www.hsurc.sk.ca
• The Bercow review Children, young people
  speech, language communication
  www.dcsf.gov.uk/bercowreview
• www.communicationmatters.org.uk/downloads/governan
  ce/response_to_bercow_final_report.pdf
• www.communicationmatters.org.uk/downloads/news/200
  8_bercow_summary_aac_rec.pdf
• ACT website www.actwmids.nhs.uk
• FAST ttp//fast.isledev.co.uk/atcommunity/orgview.
  php?id63