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Reply To: Employing SLTs vs Subcontracting

Patricia Ruth Howes

That’s very astute advice from Jan. We are good as Independent practitioners in adapting and doing it quickly as happened with the online shift during the first lockdown and months after it.

When this happened before, some years ago my service (NHS) began to employ assistant practtioners. It was a lot of work but the benefits outweighed the effort put in. Different perspectives and adapted care pathways emerged. The clients and families benefited and some did indeed go on to qualify. Others stayed and developed this role. It changed again and we were easily able to recruit NQTs for some years – yet we had changed our thinking and the assistant practitioner role strengthened.

We did have some success attracting NQTs too, but we had an integrated service with adults and could offer rotational posts which were attractive to graduates. In a small practice it is difficult to do that. I do think that one of the themes I hear about in supervision is that people want flexibility in working approach – work life balance, home working some of the week, not to be scared of taking time off if their child is ill (or in my case elderly parents )and so on. In some not all NHS roles that is more difficult than it was in the past. You may find someone – hope so.

I think we overlook case sharing as a ‘therapy team’ and having a template care pathway around that. This gives work based learning and focused support (and assistants have different skillsets when they come into role). There can be joint sessions and then follow up by the assistant practitioner for X sessions and then a therapist joins again. It works really well with Cycles approach in phonology or play based support for example. I work with children but can see conversational partner role for adult clients would work here. To be clich├ęd it is peering out of the box and thinking about what we offer differently. The support needs are considerable at first but in retention and recruitment terms an assistant practitioner may stay longer in role. One of our Project group was a Band 5 Assistant leading on alternative and adapted communication for adults with learning difficulties. I am in awe of some of these colleagues and feel there is a complimentary, emerging professional role here with a skillset which links but is different to mine as a therapist.

I know of one service where the job title was changed to describe what the assistant role in schools actually covered e.g. Language and Communication practitioner – think it might even have been specialist and the educational settings were keen to work with these practitioners once the role and scope of practice was outlined.

RCSLT is just about to launch its Assistant Practitioner professional framework (APPF) for learning in role. There will be a new section of the website focusing on assistant practitioners and a Forum from the website. I’m not sure when exactly as the Project Manager left – but it is all ready to go and been out to national consultation – I’m meeting about a podcast linked to it next week.

The Framework isn’t perfect as out RCSLT Project Group put it together over an 9 month period – but it will be there as guidance and with a Toolkit of support for Assistants and therapists supporting them. The HEE (Health Ed England) Framework is already out there, but we have adapted it slightly and added a profession specific checklist for those who have done the basis competencies.

I was the Lead Author and it ended up being far more than writing a document but was a lovely experience. In fact transformative as I am just planning to launch training and support for those working with assistant practitioners. It will be an extension if my supervision services. A combination of short accessible modules (online seminars) and a longer course/program where practitioners can learn over several months, meet and gain confidence together.

There will be more info and I’ll advertise in a few weeks time. If you want to be specifically sent info then let me know at arcsupervision.com

Oh dear, I was going to wrte a few lines and got carried away – i do tend to do that on this topic. Apologies !!

Best Wishes,