A bold package of reforms: Is it working for children and young people with communication and swallowing needs?

Yesterday NHS England celebrated treatment waiting lists dropping to a 26-month low, making reference to "a bold package of reforms to help drive down NHS waiting lists". The Secretary of State for Health and Social Care, Wes Streeting, stated "This is not a coincidence – it is because this government has delivered on the Plan for Change and put in the work to finally get our NHS moving in the right direction." 

So what does this mean for children and young people waiting for speech and language therapy support?

Since March 2023, NHS England have published monthly data on waiting lists and waiting times for community health services, providing some long-awaited external transparency to these areas. During this time the total number of children and young people waiting for speech and language therapy support has ranged from 61,739 (August 2023) to 76,331 (May 2024). The latest available data indicates that 68,185 children and young people were waiting for support in May 2025. (Figure 1)

Whilst it's useful to look at the total number of children and young people waiting, we also need to consider the length of the wait. We might consider it acceptable for 70,000 people to be on a waiting list if they only had to wait a few weeks for support. Unfortunately that is not the case for children's speech and language therapy services.

In May 2025, 6,923 children and young people had been waiting over 52 weeks, compared to 6,053 children in May 2024 and 3,766 in May 2023 (Figure 2). So whilst we've seen a reduction in the total number of children and young people who are waiting, there are still significant issues in the length of wait that some are experiencing.

43,130 (63%) of those waiting were waiting up to 18 weeks, whereas 25,055 (37%) were waiting more than 18 weeks (Figure 3).  

Whilst this is broadly in line with NHS England's (2025) statement that 60.9% of people on waiting lists are waiting 18 weeks or less for planned care, the situation is not quite as straight forward as it may initially seem because:

1. We can reasonable predict that many of those currently waiting up to 18 weeks will continue to wait past the 18 week mark.
2. It is not clear at what point the 'clock stops' in relation to speech and language therapy waiting lists. If families receive a telephone call and receive some initial advice, does that count as treatment, even if further support is required? If a child or young person is seen for an initial assessment and therapy recommended, does the clock stop or do the weeks continue to be counted?

In their response to Mikey Akers' petition on the need to Increase investment in speech and language therapy, the Department for Health and Social Care stated that they "recognise the impact that long waits to access speech and language therapy can have on the individual, their families and carers." They further wrote:

"Addressing waiting times for community health services, including Speech and Language Therapy, is a priority for the NHS and this Government. Published on 27 March 2024, the NHS England 2024/25 priorities and operational planning guidance asked local systems to develop a comprehensive plan by June 2024 to reduce the overall waiting times for community services. This includes reducing waits over 52 weeks for children’s community services. NHS England will work with Integrated Care Boards and providers of these services to set a specific ambition and improve data capture. NHS England is also working to understand what more can be done to reduce waits for Speech and Language Therapy."

This plan did not materialise, or at least was not shared openly. 

Throughout campaigning and following the General Election in July 2024, the new Government made a clear commitment to improving the NHS and to addressing waiting lists and waiting times. In his statement on 5 July 2024, Wes Streeting stated that the policy of the Department for Health and Social Care was "that the NHS is broken" and that they were committed to working with NHS to "deliver the shortest waits and highest patient satisfaction", saying "we did it before, and together we will do it again". 

Recognition of these issues within speech and language therapy specifically was reaffirmed during the 27 January 2025 House of Commons debate on Speech and Language Therapy. Members of Parliament shared their own personal accounts as well as experiences of their constituents, highlighting the need for more timely support and improved access to specialist speech and language therapy services. In his response, Minster Stephen Kinnock acknowledged the issue of waiting, stating:

"Our children and young people are stuck on waiting lists, some for more than two years. More than 65,000 children and young people were on a waiting list for speech and language therapy in November 2024. We know that more than 23,000 have been on those waiting lists for longer than 18 weeks. That is simply too long."

A broad commitment to addressing waiting lists has been reinstated through the Government's 10 Year Health Plan for England but as noted by the Royal College of Speech and Language Therapists (RCSLT, 2025), this vision needs to be "backed with the right resources, leadership and planning". Change at this scale, managed well, takes time but we cannot lose sight of the fact that this is a long-standing issue that has received limited attention for far too long. We need action urgently to end the postcode lottery to ensure that all children, young people and families can access the support that they need and the support that they have long deserved.

References

NHS England (2025) NHS delivers record numbers of treatments as waiting list drops to 26-month low. 10 July 2025. Available at: https://www.england.nhs.uk/2025/07/nhs-delivers-record-numbers-of-treatments-as-waiting-list-drops-to-26-month-low/ [Accessed 11 July 2025]

RCSLT (2025) RCSLT responds to NHS 10 Year Plan. Available at: https://www.rcslt.org/news/rcslt-responds-to-nhs-10-year-plan/ [Accessed 11 July 2025]

About WAIT-UP SLT

WAIT-UP SLT is a research project focused on understanding the experiences of waiting within children's speech and language therapy (SLT) services in England. The project aims to explore these experiences from the perspectives of speech and language therapy teams, parents, caregivers, and children and young people, specifically addressing the gap in knowledge about the subjective experiences of those waiting for and within SLT services. Follow our work and find out more via Linktree: https://linktr.ee/waitupslt