Fruitful NHS and independent SLT collaboration yields benefits

Can blending NHS and independent speech and language therapy transform the service user experience? Speech and language therapist Richard Talbot shares his experiences.

Throughout my years in the NHS, I had fruitful collaborations with independent therapists. I once worked alongside a private therapist while supporting several adults with developmental language disorder (DLD). We would share group and client meet-up opportunities, ideas, and importantly – time.

Now, as an independent SLT myself, I work alongside a wonderful, creative NHS therapist called Laura Beynon. Laura and I work jointly with Pete, a man living with primary progressive aphasia (PPA) – a language led dementia. PPA is a rare condition, and it can be difficult to find a specialist SLT to help. Working with Pete has enabled me to put my clinical skills in PPA and telehealth to good use, but the real addition to this work is being able to work alongside Laura.

“I started private speech and language therapy sessions with Richard over Zoom in September and then face-to-face NHS speech and language therapy sessions with Laura in December. Laura and Richard have liaised from the start, effectively joint-working, and bringing a coordinated approach to my sessions.”

– Peter Somers, service user

Following the evidence base, we began script therapy. Script therapy is where the person with aphasia and the SLT work together to create and practice short pieces of talk based on their interests and functional needs. It is an evidenced-based treatment for aphasia that has been clinically proven as effective.

“Working alongside Richard to support Pete has made it clear that joint working in this way can bring skill mixes and patterns of working together in a way that can really benefit our service users.”

– Laura Beynon, NHS therapist

Laura then facilitated carryover of scripts and strategies into real world settings. Laura has also led on monitoring Pete’s swallow, trickier to do effectively on-line.

Pete benefits from the ongoing review system and monitoring the NHS offers, and I offer advice on input, and changes to therapy direction, such as an emerging focus on conversation partner training. Our respective reports complement each other’s, and are shared, with Pete’s consent. It is a benefit to the therapy to work in this way.

During the pandemic, I worked remotely on a stroke community pathway, seeing service users across a wide area via telehealth. Several people on the caseload were concurrently receiving charitably funded, private speech and language therapy face-to-face. Working collaboratively with the charity and independent therapist, we maximised carryover or real-life use and practice of remotely delivered therapy gains, closer to home. This time, it was a third sector-independent-NHS collaboration which facilitated generalisation. In all my experiences, the independent-NHS partnership has led to better client care, and has been an invaluable experience for me.

My managers have been supportive of collaborations with independent therapists. Anything that would be to the service users’ benefit was on, while remaining mindful of information governance and role boundaries. The RCSLT guidance on such collaboration is clear: all SLTs should work in partnership with colleagues in the best interest of service users, and collaborative working is key to providing an effective service.

With pressures on services, this model of blending face-to-face and remote input, mixing skills and raising capacity through independent-NHS collaboration could become an increasingly important solution, particularly for underserved populations like people with PPA, and adults with DLD.