Audit of service provision for adults and children with fluency disorders
Authors: WATSON DIANE , PRESTON BARBARA , RICHES JUDY 
Published: April 2011

ABSTRACT  The Association of Speech and Language Therapy Managers (NI) has agreed that there is a need to review the current service provision for fluency disorders in Northern Ireland. The fluency specific interest group (SIG), which was formed in the autumn of 1992, had as one of its aims to look at the outcomes of the current service provision. However, the SIG found that there was nothing to compare performance against and no objective way of recording improvements in service delivery. SIG has been attempting to collect figures about referral patterns and therapy time, discharge policies, outcomes, etc. The initial information suggests that there are disparities between Units and Trusts about the numbers of referrals and about discharge policies, but we have no reliable or complete data to confirm this. In order to review service provision, it was necessary to establish dataseis for this client group. Communicating Quality (RCSLT, 1991), the College of Speech and Language Therapists' standard comments on the need for accessible specialist centres in order to offer an equitable service. A paper in the Journal of Fluency Disorders states ‘recent efficacy studies in fluency treatment have stressed the need for a reliable database for both quantitative and qualitative measures of outcomes’. The aims of the audit were to (1) Review the current service provision for adults and children with fluency disorders in Northern Ireland; (2) Establish a dataset for future service planning/provision; (3) Establish the dataset necessary for the measurement of therapy outcomes. In order to review the current service provision and to establish a dataset, information collected would include (a) referral patterns over the last two years, of various age groups; (b) service provision in each Unit/Trust, including prioritisation policy, mode of therapy, duration of therapy, discharge policy/information; (c) description of the overall management from the point of referral to the discharge of individual clients; (d) re‐referral patterns and policies on acceptance of re‐referrals; (e) Unit/Trusts' written policies on the management of this specific client group; (f) parents' expectations before therapy; (g) parents' and therapists' perceptions of service provision for children currently receiving therapy. The audit was to be undertaken through (1) The collection and analysis of information throughout all Area Boards (many of the figures needed for the dataset can be obtained from returns such as LCID. The details needed include age, sex, referral agent, geographical area, therapy time, mode of therapy (i.e. group/individual, intensive/weekly), reason for discharge, population by age range in Unit/Trust; (2) A review of existing policies and protocols throughout all Area Boards. It appears that some Units/Trusts have written policies for this specific group. With some age groups of dysfluent children, Units/Trusts may have unwritten policies on prioritisation; (3) Random sampling of individual client treatments: because this will require access to the files of discharged patients, it will be necessary to ask managers for their permission to staff to randomly sample individual clients' treatment histories province‐wide, the authors hope for access to a minimum of 30 files; (4) Questionnaires: it is envisaged that scaled questionnaires will be needed to obtain information about parents' perceptions of fluency therapy before its start, during and at the end of treatment and to obtain therapists' perceptions of the effectiveness and efficiency of the present model of service delivery. Questionnaires have been devised by the Royal College of Speech and Language Therapists and are available in the College's audit manual. The perceived outcomes/benefits of the audit will be (A) To give providers of speech and language therapy more information on caseloads of this client group; (B) To identify areas which may require further development in order to provide a more equitable and accessble service of high quality; (C) To increase knowledge and information to the public of the service available; (D) To understand parents' perceptions and expectations of service provision for their children; (E) To establish the dataset necessary for the development of service delivery and subsequent therapy outcomes. There are no results available at the moment. The audit is due to be completed in July 1995.