In 2015, NHS England began to directly commission augmentative and alternative communication (AAC) services as a specialised service. Assessment and provision in England is provided through one of 16 regional AAC hubs, with support provided locally by speech and language services.

For an individual to be eligible for the service, there must be a clear discrepancy between their level of understanding and their ability to speak, associated with a range of physical, cognitive, learning or sensory deficits. They must also be able to understand the purpose of a communication aid, and have cognitive skills beyond cause and effect understanding.

Following assessment, the specialised service will typically provide a communication device and specialised access solutions (a switch or joystick, for example) to enable the user to use the device in the most efficient and appropriate way. A key objective is to facilitate communication when and where the client needs it. This often involves mounting the device for use in a range of environments.

Of course, many clients will use either manual or powered mobility. It is important for AAC service providers to communicate effectively with wheelchair services so that everyone involved in providing kit knows who is doing what, and to ensure that those mounting assistive technology to wheelchairs are competent, and fully understand the implications of their activities.

A working party has recently developed assessment and risk management documentation which is used by AAC services when mounting assistive technology. The Mounting Assistive Technology Documentation (MAT-DOC) is a useful and open tool to document decisions taken when providing mounting solutions. This is available online by clicking here.

For clients who have particularly complex needs, there is an opportunity for services to work together to integrate technology, particularly if they use powered mobility. While there are challenges, it can lead to simpler, more effective solutions for the client. It can also help to reduce overall cost by avoiding duplication.

I hope this gives a useful overview of how AAC services currently work. More information on the regional services can be found on the Communication Matters website, available here.