Fed up with local SALT provision (or lack thereof...)

[mm22bys]

DS2 sees the local SALT provision once in a blue moon, and now I have received an email saying that his next appointment has been put off again.

His regular SALT told us in November that she would be leaving in December to work closer to home. Fair enough...they said though that provision would be for emergencies only till they found a replacement.

HE was supposed to be seen by the other one (who we've met before) on Feb 18 but she's cancelled because she's on school holidays.

So they rescheduled for Feb 25. Now that one's been cancelled because that's when they are doing interviews for the SALT who they knew at least as late as November would be leaving. Why does it take 3 months to organise interviews?

So he will be seen on March 2nd

AIBU to think this is really not acceptable, and that patient / client time should not be taken up with interviewing...

I would lodge a complaint but we are leaving this god-forsaken borough in about six weeks. The way I'm feeling now, I can't get out of here soon enough...

Firstly, that your appointment has been put off is crappy.

Secondly, interviews are always conducted during office hours. As SALTs don't work weekends, there's no such thing as protected "patient time". Everything is up for grabs.

Also, the reason it takes so long is because they cannot advertise the post until the current post holder has actually left (at least where I work). The post holder has to give 1-2 months notice (longer notice period is required for more senior grades).

The job is usually advertised internally for 2 weeks before going onto NHS jobs (website) with a closing date three weeks later. This is potentially now 3 months since the SALT handed in her notice.

And then when you get an interview date it has to suit everyone on the interview panel.

And then when you find a new therapist she/he has to give 1-2 months notice.

I agree it's not great but can't think of a way around it (I'm a senior SALT myself). The wider NHS makes those decisions and I can assure you it's frustrating (and expensive in locum costs where you can get agreement to pay for one!).

I don't honestly think you'd get anywhere with a complaint other than a reply stating what I just said. The staff are "following procedure" and I don't think that would stand up as grounds for complaint.

YANBU! Lack of SALT provision really, really pisses me of! (sorry for swearing, we have been where you are now and ended up waiting for ten months.)

If you weren't moving I would suggest writing to manager of the service and chief exec of the pct.

It just isn't good enough is it? Our therapist left and whilst there was a massive gap in the service the funding had been stopped so no replacement for nearly a year.

I hope you have more success when you move.

We had a SALT once that went on her honeymoon and never came back - but problems/glitches happen in all professions I suppose.

It would be good if people DID write to the chief exec of the trust.

They usually write to the SLT services manager, who is powerless in this situation because she's usually been told she's not allowed the funding to backfill the post.

And it's not something we pass on to the chief executive.

Complain away but complain about lack of locum cover not just "the system". A more specific complaint with a solution (locum cover) will be more successful.

She left before Christmas, I would have thought before they put on someone permanently they would appoint a locum in the best interests of the childeen,, but it is obviously down to the money, maybe they don't want to be able to appoint a new one till April 6....

I actually knew of a private OT who was forced to leave the country (she was Anti-podean ) because the govt's deemed her profession is not in "demand".

Crazy crazy country we live in...

I wrote to the chief exec and our MP. I think that my main point was actually that there seemed to be no triage type system. The children with severe needs, (and for ds this included eating and drinking) were not seen any quicker than those that needed less help.

To be fair once in place the new speech therapist quickly discovered the main root of his problem and I will be forever grateful to her. She spotted on the second visit that he had a submucus cleft palate. He was 4 years old.

mm22bys, your qutite right - it is crazy. Whilst doing all this complaining I did some research and discovered that newly qualified SALT's were unable to find work, whilst children were waiting and waiting... Crazy!

I do wonder how much of the therapists' time is actually taken up with seeing patients - by the time you factor in report writing, meetings, time taken to get to home / school visits, etc, there mustn't be much time to see patients left!

In which case, why is it patient time that is the first to be sacrificed?

Case in point - one time one of Max's physios rang me to tell me she would be late, public transport was up sh*t creek without a paddle. I could not believe that the PCT values that profession's time so cheaply that they think it's acceptable to have them waiting around for a bus...I gladly would have put my hand in my pocket to pay for a taxi for her to get here.

And while I know and acknowledge that we are very fortunate indeed that we are mobile and that public transport is relatively easy from where we live to get to the clinic, why in our case do they offer home visits anyway? Surely that in itself is a waste of resource of a therapist. I do acknowledge though that for some people it is very difficult to get around and in those circumstances I do not begrudge home visits in the slightest....

yes the new graduates in 2006/2007 were in a pickle - the NHS froze loads of jobs so there was nothing for them when they graduated.

Sadly many of them left the profession. The ones that were prepared (or able) to work for no pay did volunteer work as SLTs and eventually got jobs through having the right experience.

Very sad.

Mogwai, approximately how much time is taken up actually seeing patients?

Oh I should say that one day of every week is taken up by one of Max's therapists to study at university.....

what are the consequences of sacrificing non-patient contact?

Only last week there was a thread on here written by a lady who's son had been seen and assessed but she still hadn't had the report. A report I wrote on tuesday (for a tribunal) was so complicated it took me five hours without a break.

And that report was being written because the parents wanted the tribunal (against the LEA).

There's much more to our jobs that just seeing patients and it's hard to know which to prioritise at any one time.

Your original post is about lack of SLT because your SLT left. I'd say gettting a new one interviewed was a top priority to you?

I ought to add that I also work privately.

For every hour of therapy in someone's home it takes me at least 30 minutes travel time and an hour preparation beforehand and half an hour afterwards.

The parents, of course, think I earn £65 per hour but that's way off the mark when you look at it.

The reason I work privately is frustration with the NHS system.

mogwai Do you know if anything happened with the bercow report? Have any improvements been made at all?

The Bercow report has promised a lot but so far the jury's out on what it will actually offer.

It will certainly highlight speech and language.

There's lots of money promised but none of it seems to be for more SLTs!

More training for professionals - brilliant! - but so far no word on WHAT training or WHO will deliver it.

As SLTs are stretched, I wonder where they will find the time

I want them to look at the time available and prioritise the time (eg sacrificing home visits for the most mobile would be a good start, but then that time would be wasted by those who don't bother to turn up....)

I don't want my son's scarce-enough-as-it-is contact with a SALT sacrificed for job interviews that could have been undertaken a month ago.

Nor do I want other patient's time sacrificed.

Other professions do have to work anti-social hours (nights or weekends). I guess that's a perk of working in the public sector....

Oh, I don't want them to necessarily work "anti-social" times as the norm, but for extra-ordinary events like job interviews, what's wrong with doing that?

I've had job interviews in the past after 4.30pm...

Mogwai, approximately how much time is taken up actually seeing patients?

there's no way I'm going to work beyond 5pm. I have small children who have to be collected from nursery.

I also work 35 miles from home as they wanted my skills and I was prepared to travel.

In a predominantly female profession you'll find people voting with their feet into the private sector (as I did) at any suggestion of working unsocial hours.

Then only the least experienced SLTs will be left in the NHS (those without children).

The government know this. It's why they haven't suggested it.

Approximately how much time is taken up seeing patients?

Or is it so low that you don't want to tell me?

the other thing to remember is that I give my time and advice on mumsnet for free. I won't be drawn into an argument over an issue over your specific case when I am not personally responsible for (a) your issue or (b) the failings of the NHS.

You have repeatedly asked me the question abotu how much time is taken up in seeing patients. I honestly dont know the answer but you are starting to remind me of Mr Paxman

That's fine, that's all I wanted to know!

You're going to defend using up patient time so you don't have to work after 5pm, and I'm going to say that's not acceptable.

We'll have to agree to disagree, and accept we're coming from different perspectives.

guess what we have to remember salts do hae a life outside work and often famlies of their own and before im yelled at i do have ds with severe speech delay so can understand the frustrations

Feel I should point out here that I do not have a problem with how our SALT divides her time, and I was/am extremely grateful for the in depth report she gave to enable DS2 to obtain a full statement. I do have a major problem with the system and the general attitude of the NHS toward funding for speech therapy services.

yep that bit i agree on imlucky as we just got a new salt after month break without and previous was no good but new one seems proative even though she admit has been tod to scale back on the sever cases ie my son they want her doing quick fi ones