In the last blog post, I talked about what to do whilst waiting for speech and language therapy for your child. I hope that the recommended strategies and supports will be useful but you may feel that they are an inadequate replacement for specialist speech and language therapy, personalised to your child. You’re not alone. In England, long waits for community health services - including speech and language therapy - are an ongoing source of concern for parents and professionals alike.
So, here is a guide to some steps you can take if you’re unhappy about the wait: how to advocate for your child, where to go for support, and how to raise your voice to push for change.
1. Start by Understanding the System You’re Navigating
Children’s SLT in England is usually delivered by local NHS community health trusts, commissioned by Integrated Care Boards (ICBs). Waiting times vary hugely by area and are affected by:
- Numbers of referrals
- Vacancies and/or posts not being replaced once therapists leave
- Disruption to services during the pandemic and reported levels of increasing need since then
- Service restructures and redesigns, with the Government's decision to abolish NHS England and make cuts to ICBs causing further unrest within the system.
You might be waiting for any one of the following stages:
- Triage or screening
- Initial assessment
- Treatment or intervention
- Onward referral to other services (such as neurodevelopmental assessment pathways)
- Reviews / follow-up
Knowing which stage you’re waiting for helps you ask the right questions later.
2. Contact the Service for an Update - and Be Specific
You’re entitled to know what’s happening but most parents never receive detailed updates unless they ask.
When you contact the SLT service, ask:
- Has my child’s referral been received and accepted?
- Are some referrals prioritised over others?
- What is the typical wait for children who have referrals like mine?
- Is there any interim support available?
- How can I access updates on the waiting times and support available?
If your child’s needs are changing or worsening, make this clear. Services sometimes review and re-prioritise cases when they receive new information.
3. Use the Support That Is Available While You Wait
You shouldn’t be told to “just wait.” Even if your child hasn’t been seen yet, there are often ways to access some support:
a) Local SLT webpages
Many NHS trusts publish or signpost to:
- Home practice packs
- Early language advice videos
- Speech sound development guidance
- Parent strategies
b) Advice lines / drop-ins
Some SLT services run telephone advice or drop-in sessions (on-site and/or online). These can help you access some tailored guidance while waiting.
c) School or nursery support
Every early years setting and school has a SENCO who can:
- Recommend and support the implementation of communication strategies
- Refer or re-refer to SLT
- Gather evidence of needs
- Support with transitions
If your child is at school, ask what support is already in place - many schools can start interventions before therapy begins.
4. Raise Concerns Through the Proper Channels
If waiting times are excessively long or the communication feels inadequate, you’re allowed to raise concerns.
Start informally:
- Email the SLT service or the children’s therapy manager:
- Explain your concerns
- Describe the impact on your child
- Ask what can be done to help now
This may lead to clearer information, or a review of the case.
If that doesn’t help, you can make a formal complaint.
You can make a complaint through the trust’s complaints team (often called Patient Advice and Liaison Service (PALS). This process should give you:
- A clear explanation of how the local service works
- Information about what to expect for you and your child
- A plan to address your concerns as much as possible
You’re not complaining about the therapists - you’re challenging a system that isn’t meeting your child’s needs.
5. Explore Educational Routes: SEN Support and EHCPs
If your child’s speech, language or communication needs significantly affect learning, the educational system offers additional protections.
a) SEN Support
Every school must provide support for special educational needs, even without an EHCP. This may include:
- Small-group language interventions
- Visual support
- Alternative communication methods
- Trained support staff
b) EHCP (Education, Health and Care Plan)
If your child’s needs are more complex or long-term, an EHCP may be necessary. Crucially:
- SLT written into an EHCP is a legal entitlement
- The local authority must ensure it is delivered
- Recommendations in an EHCP must be specific and quantified
If SLT is listed in the EHCP but is not being provided because “there are long waits,” the law is on your side - and you can challenge this. IPSEA is the leading charity in the field of SEND law in England and can help you navigate your next steps.
6. Document your actions
Making good notes strengthens your position if you need to escalate your concerns. Keep a record somewhere you won't lose it (on your phone, on the fridge, by your home phone), documenting:
- Dates of referrals
- Emails and phone calls
- Advice you’ve been given
- Changes in your child’s communication
- Impact on behaviour, learning or social life
Documentation is especially useful if you later apply for an EHCP or need to challenge a decision.
7. If You’re Still Struggling, You Can Go Further
If you don’t feel heard, there are additional ways to escalate your concerns:
- Healthwatch: They gather patient experiences and can raise concerns at a system level.
- Your MP: MPs can write directly to ICBs and trusts.
- Your local councillors: Can ask questions and raise concerns about local services.
- SENDIASS: Free, impartial advice on SEND rights.
- The Patient's Association: Can help you to understand your rights and advocate for improved services as part of their wider work.
8. Private Therapy: Not for Everyone, but an Option
Some families choose to seek private SLT while waiting. This can:
- Provide early assessment and intervention
- Offer targeted strategies
- Provide guidance for your child’s educational setting (with your consent)
However:
- It can be expensive
- It doesn’t replace your place on the NHS list
- It can be equally difficult to access in some areas
If you go private, choose a therapist registered with the Health and Care Professions Council and preferably a member of ASLTIP and RCSLT. Here is my guide to choosing a private speech and language therapist.
9. Most Important: You’re Not Overreacting
- It is completely reasonable to be unhappy about long waits.
- It is reasonable to want help.
- It is reasonable to advocate.
Your concerns aren’t “pushy” - they are protective. You are the expert on your child, and your voice is essential in a system that isn't working as well for everyone as perhaps it should.
Final Word
Long waiting lists for children’s speech and language therapy shouldn’t be normal - and they certainly shouldn’t be accepted as inevitable. While you can’t eliminate the wait entirely, you can take steps that:
- Get clearer answers
- May help you access support sooner
- Strengthen your child’s educational provision
- Ensure your concerns are taken seriously
Above all, you’re not alone. Many families are navigating the same challenges and concerns are also being raised by those working within services. Together, I hope our voices will help push for fairer, more responsive SLT services across England.
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