Auditory Verbal Therapy

Maria Caulfield Excerpts

Tuesday 12th December 2023 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

It is a pleasure to serve under your chairmanship, Dame Maria. I start by congratulating my constituency neighbour and hon. Friend the Member for Hastings and Rye (Sally-Ann Hart) on securing the debate on this important topic. I reassure her and all Members today that the Government are committed to improving outcomes and experiences for all children and young people with special educational needs and disabilities, including children with hearing loss.

As I am sure colleagues are aware, figures from the National Deaf Children’s Society show that there are more than 50,000 deaf children and young people across the UK. Between one and two babies in every thousand are born with permanent hearing loss in one or both ears, and we know that early and effective support is crucial for these children and their families. My hon. Friend pointed out how important it is that help and support is there as soon as possible. She also pointed out that, without intervention, children with speech and language needs are at higher risk of facing longer-term challenges, including in education. It is vital that we intervene at birth, which is why we are investing in hearing screening for newborns to identify babies who have permanent hearing loss as early as possible, so that we can intervene as quickly as possible.

We know that language is linked to social, emotional and learning outcomes. From birth through to childhood, children and young people with hearing loss might need a range of therapy, such as speech, language and auditory verbal therapies. As we have heard today, however, those children are not always receiving the help they need. It is important that we start by pointing out that the commissioning of many of these services, including the provision of therapies for children with hearing loss, happens at the local level. This now sits with our 42 integrated care boards, which means that the responsibility for meeting the needs of a local community of non-hearing children lies with local NHS commissioners.

The National Institute for Health and Care Excellence has issued guidance on the topic of cochlear implants for children and adults with severe to profound deafness. When it comes to commissioning and providing services for children with hearing loss, we have been crystal clear with those ICBs and NHS trusts that they must take those relevant guidelines into account. As yet, however, there are no NICE guidelines on hearing loss for children in general, and until now NICE had not made any specific recommendations on auditory verbal therapy.

I am pleased that NHS England has met with Auditory Verbal UK this year and discussed the need for more high-level research evidence, for the intervention and for evaluations of impact to be developed. NICE will not make recommendations without that evidence base, and getting that information absolutely must be the priority now, so that decisions and recommendations can be made. It is right that Auditory Verbal UK was invited to join the chief scientific officer’s audiology stakeholder group; I am sure it will have a lasting impact on the decisions being made. I am very happy to work with my hon. Friend and Auditory Verbal UK to ensure that progress is happening.

The Government will continue to prioritise investment into the NHS, and we have seen record levels in cash terms, rising to £165 billion in the coming year. We are using that money to support ICBs to make informed decision about the provision of hearing loss services, so that they can provide consistent high-quality integrated care to children with hearing loss. In 2016, NHS England published “Commissioning Services for People with Hearing Loss: A framework for clinical commissioning groups”, which also supports NHS commissioners to address inequalities in access and outcomes between hearing services.

With input from the National Deaf Children’s Society, NHS England produced a guide for commissioners and providers who support children and young people with hearing loss. That guide provides practical advice on ensuring that children with hearing loss receive the necessary support. More recently in May, the NHS service specification for cochlear implant services for adults and children recognised AVTs as part of multidisciplinary teams’ decision-making processes, enabling them to provide rehabilitation services alongside a range of healthcare professionals providing other services.

I fully recognise my hon. Friend’s point that we are not where we want to be in improving access to therapies for children with hearing loss. The limiting factor, as she pointed out, is the number of therapists working in the NHS—the SNP spokesperson, the hon. Member for Motherwell and Wishaw (Marion Fellows), also raised that issue in Scotland. We are increasing the numbers and have seen a 17% increase in speech and language therapists since 2018.

That is also why we are undertaking the biggest nursing, midwifery and allied health professional recruitment drive in decades with our long-term workforce plan, which includes the recruitment of speech and language therapists. AHP training places will increase by 13% to 17,000 in the next five years, with an 8% increase just next year, and by 25% to over 18,800 in the next 10 years. I am very happy to speak to the Minister responsible for the long-term workforce plan to particularly focus on the AVT element of that. Recruiting speech and language therapists is important, but I have clearly heard the point in this debate about the added training required to ensure that more therapists are available across England.

As committed to in the SEND implementation plan, we are exploring options to commission research to understand the health needs of children and young people through the National Institute for Health and Care Research. As I said previously, without NICE recommendations and the evidence base to inform those recommendations, we will not make progress as quickly as we would like. We are therefore working to improve access to speech and language therapy through service innovations.

We are including Early Language and Support for Every Child projects in our £70 million change programme, in partnership with NHS England. That programme is funding innovative workforce models to identify and support children and young people with speech, language and communication needs at an early stage. That will reduce exacerbation of need that might lead to a referral for specialist speech and language therapy or for an education, health and care plan. I welcome the work of Auditory Verbal UK on its plans to upskill health professionals to deliver AVT. Whether that is through speech and language therapists or upskilling other healthcare professionals, I am very keen to hear about its work and to see what more we can do to get those skills in place to help children and young people.

My hon. Friend the Member for Hastings and Rye spoke powerfully about the importance of early identification and intervention for children with hearing loss. The shadow Minister, the hon. Member for Dulwich and West Norwood (Helen Hayes), touched on schools in particular. She will know that teachers of deaf children have to hold the mandatory qualification in sensory impairment. There are currently six providers of that, and a seventh will come on stream next year. I am working closely with the Minister for children, and I will absolutely take her points to him to make sure there is a joined-up approach. This issue is not just about health, but about education—it is a cross-Government issue. We are committed to joining up the dots and working together to get children help and support wherever they need it, whether in healthcare or in school.

My hon. Friend the Member for Hastings and Rye and I share the same ICB. I recommend that all local MPs lobby their ICBs on the importance of commissioning these services. I recognise that we have to do more nationally to train practitioners who teach AVT, but we need local commissioners to commission those services and upskill their own local workforce. I have heard that message very powerfully and look forward to working with my hon. Friend and all Members across the House to deliver for children with hearing problems in the months ahead.