NHS reforms ‘open door to better communication services’

A new project could improve augmentative and alternative communication (AAC) services “for a generation”, by taking advantage of the government’s major reforms of the NHS, according to a prominent disabled activist.

The Department for Education project aims to improve provision of AAC services – communication aids such as picture boards, communication charts, sign-supported speech, and electronic speech devices – across England.

AAC-users have been campaigning for years for successive governments to improve services, and address the regional variation in quality.

Simon Stevens, the disabled consultant and activist who is consulting stakeholders across the midlands and east of England as part of the project, and an

AAC-user himself, said services were currently “patchy”, particularly for adults, while sourcing funding “has always been hard”.

He said the project provided a “unique opportunity” for people “to have a say in how AAC is commissioned under the new NHS arrangements”, and added: “Since this is a time of change, it is a time of opportunity.”

He hopes AAC-users and carers will now “have the opportunity to say what they want from any new services, starting from a blank sheet to highlight current strengths and weaknesses of current services to help see what is really needed”.

Some AAC services are currently provided through “specialised health commissioning” arrangements, but only in the west midlands.

The health reforms have provided an opportunity to spread these NHS services to other parts of England, from April this year, under the new NHS Commissioning Board.

Stevens said the project was not just looking at high-tech solutions.

He said: “While people think AAC can just be high-tech, it can be as simple as a piece of paper with yes or no on it, or an alphabet board.

“People who have a high-tech solution also often need a low-tech one as a backup.”

Stevens is now coordinating a survey of current and potential AAC-users, families and carers that aims to find out how services could improve.

A quarter of respondents to a survey for a Scope report in 2009 said their equipment had not been funded by a statutory organisation, while the report found “many agencies (particularly education, health and social care) refer people on to other agencies, claiming that the responsibility for funding lies with another body”.

Stevens said: “I would personally say this is still the case from my understanding, and this is certainly a great opportunity to change this for a generation and this is why this survey is so important.”

Anna Reeves, the government’s national AAC coordinator, said: “It is widely recognised that AAC provision is variable across the country and for different ages.

“Some areas in the country have local AAC services and/or AAC equipment budgets for children, some for adults, some for both, some areas have nothing in place.”

The project aims to map existing provision of AAC services and compare it with national standards, and develop good practice guidelines for developing local services.

The project will also assess whether it is feasible to use technology to deliver AAC services remotely, allowing changes to be made to computers or communication aids without the need for home or hospital visits.