In short? Not a lot.
In the recently released 171-page NHS 10-Year Health Plan, ‘speech and language’ is mentioned just three times. Of those, only one refers directly to speech and language therapy (SLT); the other two relate to broader speech and language support. Allied Health Professionals (AHPs) fare only slightly better, with eight mentions - most of which speak in general terms about the value AHPs bring to healthcare and patient outcomes. (See all relevant excerpts below).
In contrast, there are 60 references to waiting, including 11 specific references to 'waiting lists' and 8 references to 'waiting time'. The topic is centred through the publication, evidenced in the foreword by the Prime Minister Keir Starmer who writes:
It is no exaggeration to say that we inherited an NHS facing the worst crisis in its history. Across the country, people are stuck on waiting lists for years on end. Our fabulous NHS staff let down by endless bureaucracy. And a society that is slowly getting sicker.
There is a clear emphasis on reducing hospital waiting lists and a commitment to reducing waiting, with recognition that long waits can have negative impacts, e.g.
The elective waiting list stands at 7.4 million, up from 2.3 million in 2010. Just 60% of people are seen within 18-weeks. While elective care is non-urgent, it is still important. Long waits can be anxious, leave people needlessly in pain or otherwise interrupt their lives. (page 39)
However, this focus leaves little room for services that fall outside of these categories, such as children's speech and language therapy (SLT). Anecdotally, SLT services have had variable engagement with the 18 week wait targets and despite a commitment within the NHS constitution to inform service users about healthcare services and provide accessible information (Department of Health and Social Care, 2021), service visibility and transparency has been lacking.
In fact, it wasn't until April 2023 that NHS England (2025) began releasing monthly waiting list data for community health services, including SLT — a long overdue step toward accountability. Prior to that, it was virtually impossible to compare SLT provision or waiting times across regions (Dinenage, 2020).
The Royal College of Speech and Language Therapists (2025) have cautiously welcomed the new plan, saying
Arnold et al., (2025) also identified some aspects of the plan but state that
"this is a hugely ambitious set of tasks that will have to be delivered with below-average funding growth and fewer staff than projected under the current long-term workforce plan".
They go on to argue that:
"the nation’s health cannot improve if the NHS continues to take an ever-growing share of funding at the expense of wider services that maintain and improve our health. Yet until the government is clearer about what will not be delivered or prioritised over the next ten years, the national conversation the government wants to have with the public will not be as honest as it could be."
And while the vision is bold, the implementation plan is notably absent. As reported by Alastair McLellan (HSJ, 2025), the plan was published without the critical chapter detailing how these changes will be delivered. Likewise, we are still awaiting the SLT action plan, announced earlier this year (Mikey’s Wish, 2025).
We urgently need more clarity about what action will be taken and when. In the meantime, speech and language therapy - and the children and families who rely on it - remain in limbo.
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References
Arnold, S., Wickens, C., Charles, A., Baird, B., Naylor, C., Nwasike, CJ., Wellings, D., Buck, D., Berry, N., Walsh, N. and Mistry, P. (2025) Truly fit for the future? The 10 Year Health Plan explained. The King's Fund. Available at: https://www.kingsfund.org.uk/insight-and-analysis/long-reads/ten-year-health-plan-explained [Accessed 8 August 2025]
Department of Health and Social Care (2021) The NHS Constitution for England. Available at: https://www.gov.uk/government/publications/the-nhs-constitution-for-england/the-nhs-constitution-for-england [Accessed 8 August 2025]
Dinenage, C. (2020) Speech and Language Therapy: Children. Department of Health and Social Care written question – answered on 20th January 2020. Available at: https://www.theyworkforyou.com/wrans/?id=2020-01-15.3666.h&s=%22social+care%22 [Accessed 8 August 2025]
McLellan, A. (2025) Exclusive: 10-Year Plan published without delivery chapter. HSJ. Available at: https://www.hsj.co.uk/policy-and-regulation/exclusive-10-year-plan-published-without-delivery-chapter/7039607.article [Accessed 8 August 2025]
Mikey's Wish (2025) Meeting with the Minister of Health and Social Care. Available at: https://mikeyswishfoundation.org/?blogcategory=Meeting+With+The+DHSC [Accessed 08 August 2025]
NHS England (2025) Community Health Services Waiting Lists. Available at: https://www.england.nhs.uk/statistics/statistical-work-areas/community-health-services-waiting-lists/ [Accessed 8 August 2025]
Royal College of Speech and Language Therapists (2025) RCSLT responds to NHS 10 Year Plan. Available at: https://www.rcslt.org/news/rcslt-responds-to-nhs-10-year-plan/ [Accessed 8 August 2025]
UK Government and NHS (2025) Fit for the future: 10 Year Health Plan for England. Available at: https://assets.publishing.service.gov.uk/media/6888a0b1a11f859994409147/fit-for-the-future-10-year-health-plan-for-england.pdf [Accessed 8 August 2025]
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Excerpts from the NHS 10 Year Plan relating to speech and language therapy (SLT) and/or allied health professionals (AHPs):
- "The NHS will remain stuck in the past unless its staff are freed up to shape the future. This profound change in culture will mean embracing reforms to skill mix and training to allow more clinical tasks to be performed by nurses and allied health professionals - backed by AI - liberating doctors to work to the top of their license." (page 24)
- "There are already innovative models demonstrating what a neighbourhood approach can look like in rural and coastal areas - demonstrating the wide applicability of its principles. Whitstable Medical Practice is a single GP practice primary care network with 300 staff, including 32 GPs, 27 allied health professionals and a range of community multi-disciplinary teams. The practice works across 3 sites, serving nearly 45,000 patients. It delivers a wide range of services, including many traditionally found in hospitals, such as day surgery, integrated urgent treatment centres, pharmacy, physiotherapy, specialist clinics and outreach services." (page 37)
- "Through local commissioning, we will ensure that Neighbourhood Health Services work in partnership with family hubs, schools, nurseries and colleges to offer timely support to children, young people and their families including those with Special Educational Needs and Disabilities (SEND). Start for Life services will be extended to the whole conception to age 5 range, enabling additional health visitor and speech and language support for children and their families." (page 39)
- "In the autumn, we will bring forward a schools white paper, which will detail the government’s approach to SEND reform, ensuring joined-up support for children and young people. Building on the successes of programmes such as Early Speech and Language for Every Child, that prioritise early intervention ensuring, where possible, needs do not escalate, we will ensure that education and healthcare providers work together with other local services to plan and deliver evidence-based early interventions for children. Reforms will focus on ensuring allied health professionals, such as speech and language or occupational therapists, who are vital for supporting children and young people with SEND, are more effectively deployed spending time supporting children not on bureaucracy and admin. Early evidence suggests these approaches have the potential to reduce pressure on referrals and make it easier to secure a sufficient supply of these key specialists." (page 70)
- "Building on these foundations, we will develop advanced practice models for nurses, midwives, and allied health professionals (AHPs) that are aligned to the delivery of our 3 shifts, reflecting their essential leadership roles in a range of settings, including community and public health services. In parallel, we will work closely with the Nursing and Midwifery Council (NMC), the professions, and employers to ensure that effective systems of accreditation and regulation for advanced practice roles are introduced as quickly as possible. As part of this, we will support the NMC to consult on advanced practice standards in 2027 to 2028. This regulatory framework will provide clarity for patients and the public, enhance patient safety, and strengthen career pathways thereby enabling nurses, midwives, and AHPs to continue delivering direct patient care with increased autonomy." (page 103)
- "We will open more research opportunities for nurses, midwives and AHPs. Their role in research is already expanding: 13% of National Institute for Health and Care Research (NIHR) money now goes to studies where nurses or AHPs are the lead researchers, but we want to go further. The NIHR Academy is supporting more dedicated funding opportunities for these professional groups across both its programme and fellowship funding. It will work closely with the NIHR Research Nursing Office and NIHR Research Support Service to provide academic and research leadership support and training to more nurses, midwives and AHPs." (page 103)
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