Saving NHS Sheffield's adult service

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How we used our voice to keep the NHS Sheffield adult stammering service open.

Summary

When it was announced that the NHS speech & language therapy service for adults who stammer in Sheffield was closing, STAMMA and our members fought the decision by advocating and playing a key role in a task group. It was overturned following a review.

Outcome: Over 18s in Sheffield can carry on accessing NHS support for stammering.

Background

In April 2021, we learnt that the NHS Trust in Sheffield was no longer accepting adults who stammer to its speech & language therapy (SLT) service. 

Isabel O'Leary, a speech & language therapist, raised the alarm – Isabel was retiring just when the news was announced and, being a passionate advocate for the service, was keen for us to know about it.

Unsurprising, it came down to funding. There wasn't a devoted provision for over 18s, so the Sheffield Children's Foundation Trust had been accepting referrals from adults. Concerns were raised about its ability to deliver both effectively, so a decision was made to stop accepting adults, without any consultation.

Closure would be a huge blow for those in Sheffield seeking help for their stammer, with the only other option being to pay for professional support, which isn't cheap, or to go without. 

Fighting for the service

In July 2021, Kirsten Howells, STAMMA's Director of Services, travelled to Sheffield to join forces with Isabel and other therapists, as well as adults who stammer, to argue the case for keeping the specialist stammering service open. 

Kirsten attended and spoke at a Social Care Scrutiny and Policy Development Committee meeting, explaining to councillors how stammering — and society's responses to it — can impact on a person's self-esteem, mental health, sense of career prospects and relationships.

What are adults like me supposed to do when they reach out for help... and all they get is a rejection letter saying 'sorry, there is simply no support for you here'? (Dean Ridge)

Sheffield-based Dean Ridge, who founded the STAMMA Striders walking group, sent a powerful letter that was read out at the meeting. It read: 

"For all of my adult life I would only say what I could fluently and now I say what I want to, regardless of whether I stammer. This is such a massive difference for me in a world where communication is so important. None of this would have happened without access to SLT as an adult. I know the stammering service made a very important difference to my life and I am concerned to hear this is no longer available.

'What are adults like me supposed to do when they reach out for help, perhaps due to concerns that have been building up over time or because they hit a crisis point, and all they get is a rejection letter saying 'sorry, there is simply no support for you here'?"

Review, survey… and silence

Having listened to Kirsten and Dean's words, the committee expressed concern over the way the service had been closed to adults before a full consultation was carried out. They recommended that they review the case and reopen the service to new adult referrals in the meantime.

The local Clinical Commissioning Group (CCG) then set up a Task & Finish Group to create a survey. The aim of this survey was to explore and understand the views and experiences of service users. Kirsten was STAMMA's representative in this group and she attended multiple meetings, and spent lots of time commenting on and refining the wording of the survey so that the questions were relevant and appropriate.

The survey was made public, and the NHS Trust sent it out to past and current service users, including parents of children who stammer who might use the adult stammering service in the future. STAMMA sent a message to all our members in Sheffield, letting them know about the survey and asking them to give their views if they were willing to. Findings were then reviewed.

Then everything went quiet. Really, really quiet, for ages.

We learnt that there was a whole restructuring of Clinical Commissioning Groups going on. The Sheffield CCG was dissolved and then re-emerged as the 'South Yorkshire Integrated Care Board' (ICB). We chased them intermittently for updates, but it was difficult to get a clear picture of what was happening.

Final decision

Then, in January 2024, Isabel spotted that there was a meeting of the Council Scrutiny Committee THAT morning. No-one had told any of the external stakeholders from the Task & Finish Group about it.

We were then informed that a decision had been made. The Committee confirmed that the Sheffield Children's service would continue taking referrals from adults and that they had no intention of reviewing this decision in the near future. Result!

Having reviewed the survey results and listened to the voices of service users, colleagues and stakeholders, the Committee said that they recognised that those who stammer are best supported on a continual and consistent basis. Although capacity remained a significant issue for the service as a whole, the ICB acknowledged that ceasing the adult stammering service would have little effect.

Making our voice heard

Local Healthwatch commented in an email to Isabel that she and Kirsten, by representing STAMMA, had played a vital role and that: 

"...it makes such a difference when people bring public questions to the Committee; your advocacy and challenge definitely helped bring focus to the questions being asked."

You can download the pdf summarising the decision on the Sheffield County Council website. You can also watch a webcast of that section of the meeting. There's an interesting discussion towards the end of the segment too (about 60 minutes in).