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22/125 Improving access and use of services for people with speech, language, and communication needs - commissioning brief


Published: 18 August 2022

Version: 1.0 - August 2022

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The Health and Social Care Delivery Research (HSDR) Programme is interested in receiving high-quality research applications evaluating initiatives to reduce health inequalities and to improve access to or experiences of care for people with speech, language, and communication needs (SLCNs). These research applications may include individuals diagnosed with intellectual disabilities, degenerative conditions (e.g. motor neurone disease, dementia), acquired conditions (e.g. brain injury, stroke), neurodevelopmental conditions (e.g. autism), developmental and congenital conditions (e.g. speech sound disorders, language disorders, social communication disorders, cleft palate, stammering, deafness, hearing impairment). Applications are welcome that focus on any stage across the lifespan and across any health and social care settings.

Research priorities to understand the experiences and barriers encountered by individuals with SLCNs from various causes have been identified by priority setting partnerships (PSPs) conducted by the James Lind Alliance (JLA) and the Royal College of Speech and Language Therapists (RCSLT). Links to these priorities are listed in the supporting information.

Identified research need

Several NICE Guidelines, which have considered SLCNs as part of a broader neurodevelopmental condition e.g. intellectual disabilityautism, and cerebral palsy, have made recommendations for longer-term support for anticipated periods of additional needs. Examples of anticipated periods of additional needs include during the transition between primary and secondary school, during adolescence, and when managing social demands, such as leaving home or in finding and thriving in work. NICE Guideline (NG42), for acquired disorders such as motor neurone disease, highlights variation in the provision and use of communication interventions, and other Guidelines, e.g. NICE Guideline (CG162) on stroke rehabilitation in adults, recommends key components of speech and language therapy. Health and social care services often find it difficult to deliver these recommendations because of lack of training about specific conditions, lack of understanding of individual needs, staff shortages, limited resources, or absence of targeted support pathways. Further research is needed to support the implementation of effective and reasonably-adjusted interventions and services for people with SLCNs.

The HSDR Programme is interested in funding mixed-methods research applications of complex interventions and of high-quality participatory research. An example application is the evaluation of a staff training intervention to improve communication between people living with dementia and health care professionals in hospitals (HSDR 13/114/93). The HSDR Programme has also funded relevant, participatory research in this area, such as the HSDR study -14/70/153, identifying symbol communication aids for children and adults who are non-speaking.

Areas of interest

Some areas of interest are listed below but these are not exhaustive. Applicants can also refer to the full JLA and RCSLT priorities in the supporting information or consider other relevant initiatives that fall within the scope of this brief.

Services and systems

  • Appropriate models of support, including adjustment/s to services for longer-term (life-span) care of children and/or adults with acquired conditions and stepped-care service delivery models to accommodate different needs over time (e.g. transitioning from childhood to adulthood).
  • Implementation of evidence-based services that provide tailored, individualised care for people with SLCNs, including how care might be provided equitably across different geographical areas, particularly, in more remote locations and how services can be configured to reduce health inequalities.
  • Approaches to how social care support services can be improved to sustain existing social networks for people with communication difficulties. For example, peer-support networks and/or psychoeducation programmes for people with SLCNs and for their families/carers/advocates.
  • Identification of good practice for organisations in deploying specialist staff and sharing skills across a wide range of staff.


  • Evaluation and embedding of interventions to improve staff awareness and skills in caring for a range of people with SLCNs. For example, communication partner training in aphasia, motor neurone disease and in Parkinson’s disease.
  • Models of multidisciplinary and multi-agency working to improve access to services for people with communication difficulties.

Patients, families, and carers

  • Participatory research looking at the experiences of individuals with SLCNs when engaging with health and social care services, the impact of these experiences and how they relate to health inequalities.
  • Interventions to improve information for families/carers of individuals with SLCNs to enable them to access appropriate interventions/education/employment support and services.
  • Identifying barriers to access and engagement with services for individuals with SLCNs across any stage of their lifespan. 

Equality, diversity and inclusion

The NIHR is committed to actively and openly supporting and promoting equality, diversity and inclusion (EDI). All NIHR applications need to demonstrate that they have met the requirements of the Equality Act (2010) by embedding EDI throughout their research proposal, ensuring that there is no discrimination across the following domains: age; disability; race (including colour, nationality, ethnic or national origin); religion or belief; sex; sexual orientation; gender reassignment; being married or in a civil partnership; and being pregnant or on maternity leave. Applicants are expected to pay attention to populations that have been underserved, to conduct research in locations where the need is greatest, and to promote the inclusion of diverse participants.

General guidance

The HSDR Programme supports applied research with the aim of improving both health and social care services across the nation and is open to any appropriate methodology to answer the proposed research question; this must be fully explained and justified. In order to enhance the success of a proposal, a clear theory of change and pathway to impact, with links into the NHS and social care services delivery process, is suggested. It is useful to consider in the research study design how outcomes could be scaled up to maximise impact and value for money across the NHS and social care services – the focus is on applied research with tangible impacts that improve the quality, accessibility and organisation of health and social care services. This includes stakeholder engagement and the development of processes, tools, and guidelines to strengthen workforce capacity. Further general information can be found on the HSDR Programme webpage.

Research proposals should be co-produced with national organisations, professional bodies, health and social care service professionals, and service users. Links with health and social care planners and professional bodies are required to ensure impact and scaling up of research findings to benefit the wider health and social care system.

The COVID-19 pandemic is having a significant impact across the health and social care system. As this research may be conducted during the COVID-19 response and recovery period, applicants should consider how the impact of the COVID-19 response and recovery may affect the deliverability of their research.