Specialised AAC services

Also called NHS England specialised AAC, AAC hubs, Specialised AAC hub services, Regional AAC services

The NHS England hub services that assess for and provide powered communication aids, who is eligible, and why most people are not.

What it is

Specialised AAC services are the regional hub services that NHS England has commissioned since 2016 to assess for, provide and maintain powered communication aids for people with the most complex needs. There are about a dozen hubs covering England, each taking referrals from the local services in its region. They are England only. Scotland provides AAC through health boards, with CALL Scotland as the national centre; Wales and Northern Ireland have their own arrangements through health boards and trusts.

The hubs exist because the most complex assessments, involving eye gaze, switch access, mounting and integration with other technology, need equipment and expertise no local team can hold.

Who it can help

The NHS England service specification sets the eligibility criteria, and they are narrow on purpose. In broad terms the person must have a severe or complex communication difficulty with a wide range of needs, must be able to understand the purpose of a communication aid, must have had a local assessment first, and must need a powered aid that the local service cannot provide. A person who needs a simpler device, a low-tech board or an app on a tablet is meant to be served locally, not by the hub.

That means most people who use AAC never go near a hub, and are not supposed to. If you are told you do not meet the hub criteria, that is not the end of the road; it is a pointer back to local AAC services and to the other routes in funding a communication aid.

How it works

The local speech and language therapy or assistive technology team makes the referral, with evidence that the criteria are met and a local assessment has been done. The hub assesses, usually over more than one visit and including a loan period, and if it recommends a device it provides it, funds it, and maintains it for as long as the person needs it, including replacement. The hub also trains the local team and family.

The hub does not usually provide the ongoing therapy or day-to-day support. That stays with the local team, which is why the local team must be involved from the start.

Getting started

Ask the local SLT service whether the person meets the specialised criteria and, if the therapist thinks so, ask them to make the referral and to tell you which hub covers your area. If the therapist is not sure, ask them to contact the hub for advice; hubs would rather answer a question early than reject a referral later.

Collect the evidence: what has been tried, video of the person using it, and evidence that they understand cause and effect and can make choices. Where the answer is that the person does not meet the criteria, ask for that in writing with reasons, and then pursue the local route.

Where to get help

NHS England publishes the specialised AAC service specification. Communication Matters lists the hubs and explains the criteria in plain language. ACE Centre and Barnsley Assistive Technology Team are two of the hubs and publish their referral routes. In Scotland, CALL Scotland.