Doncaster – Speech and Language Service Integration

Background

In 2019 Doncaster Council received £250,000 from the Department for Education Early Years Outcomes Fund to improve speech, language and communication assessments and interventions. This project is known as ‘Talking Together’.

The Covid-19 pandemic put significant pressure on Doncaster’s early years sector. Practitioners observed children developing social skills slower than would have been expected pre-pandemic. Children were less confident interacting with others, taking turns and building relationships with adults and other children. This is likely due to having fewer opportunities to develop their social and emotional skills during the pandemic.

Talking Together

Talking Together worked alongside the NHS Speech and Language service to provide targeted support for children who no longer met criteria for the NHS specialist service. 

Those consulted when setting up the service included regional local authority partners, health services and parents. 

The Talking Together team includes a speech and language therapist working for the NHS and Doncaster Council. This approach allowed the therapist to attend NHS Speech and Language Therapy team meetings, maintain close working relationships with the NHS team and ensure NHS and Talking Together services are aligned. Other benefits of this approach include: 

  • It ensures consistent and effective movement of children between specialist and targeted services. 
  • It enables information and knowledge sharing between NHS speech and language therapists and Talking Together Practitioners.  
  • It ensures NHS staff are up to date with the Talking Together programme. 
  • It prevents crossover of work, as therapists can access health records of children on the Talking Together pathway (with their consent).  
  • It facilitates informal discussions between NHS therapists and the Talking Together team to decide which pathway would be most suited for individual children. 

More information on South Yorkshire Talking Together can be found on the programme website.

Work with Doncaster Arts

Doncaster Arts is a charity aiming to improve local people’s life, learning and health through art. 

Their focus aligns closely with Talking Together’s aims, opening up opportunities to collaborate. Doncaster Arts completed research with the Early Years Inclusion Team and Doncaster-based early years practitioners. This showed: 

  • 47% of early years practitioners believe children’s vocabulary is below the expected level of development. 
  • 48% said children’s listening skills are not where they should be. 
  • 45% felt children’s confidence in speaking was below the expected level for their age. 

This research indicates a need for work to continue. 

A consortium was formed to seek Arts Council funding to support it. This led to the development of Tuneful Chatter – a service to improve children’s language and communication skills through creative play, movement and music. 

Further work is now taking place to embed Tuneful Chatter within the Home Learning Environment (HLE) focus of the Family Hubs and Start for Life programme. More information about Tuneful Chatter can be found on the darts website. 

Feedback from professionals on Talking Together

NHS practitioners reported that Talking Together reduced demand for specialist services, enabling them to “use [their] capacity to the best of its ability”. They also highlighted the Talking Together team’s “wealth of knowledge” and the “smooth transition between the two services”.

“The clinic environment is not always appropriate for the children I see in clinic and therefore I think it is fantastic that Talking Together are able to support these families […].I believe that parents will find it more useful to see this done at home and in the groups where they are more settled and have their own resources and toys.”

Family case study

A Community Nursery Nurse referred a child to Talking Together following their two-year progress check on concerns regarding his use of language.

At the time of the referral, the child was reported to use two words, with most of his communication being non-verbal. The child was reported as having limited opportunities for interaction with individuals outside the family home.

On the initial visit, parents reported that the child was very shy, although will interact with others once he feels confident. In the initial assessment, parents reported that the child understood 59 words and used seven.

A Talking Together practitioner (TTP) worked with the family over the course of two months, with four home visits.

Visits focused on modelling communication strategies with parents and encouraging them to access universal services to increase the child’s opportunities for communication. These strategies included offering choices, commenting on what the child is interested in and copying the child’s phrases with an extra word added.

Both parents implemented the strategies during the session, allowing the TTP to observe, praise and address any concerns or issues as they happened. The child’s confidence increased each session. During the final session the child engaged in play with the TTP and talked freely with parents. This child had English as an additional language, so strategies were modelled to parents in English, then carried out by parents in their first language.

In the end of block assessment, parents indicated the child now understood 142 words and used 141, regularly combining three and four-word phrases.

How were challenges overcome?

The initial project launched in 2019. Since then, the project has evolved based on what the Talking Together team has learned and the challenges they identified. These challenges include:

  • the time it takes to set up a project with different services
  • competing priorities
  • different funding and commissioning requirements
  • separate systems that don’t communicate with each other
  • a perceived threat to specialisms
  • limited time to commit
  • risk aversion
  • limited and differing existing knowledge.

Having completed the project, the team has the following tips:

  • Form close working relationships with all key stakeholders.
  • Create a culture of mutual respect – you will all approach issues from different disciplines and understandings. Taking the time to acknowledge this will help in the long run.
  • Establish a mutual understanding of what each partner hopes to achieve, and what they can and cannot offer in line with their policies and commissioning. Agree a set of common goals.
  • Ensure each member of the steering group has ownership over key elements relevant to their disciplines. Shared ownership of the project can help sustain momentum.
  • Ensure you have executive leadership buy-in. Share updates and insights every step of the way so that the focus remains high on policy agendas.
  • Be clear from the start what time commitment is expected from each partner. Is the expectation realistic and achievable? Is additional capacity needed?
  • Be willing to adapt, change processes and grow. Identifying potential barriers and challenges from the start will ensure success.

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