Setting speech and language therapy priorities: theory and practice

Within speech and language therapy (SLT) systems for prioritising treatment waiting lists are emerging in response to demand exceeding resources and difficult decisions having to be made. This study evaluates the theoretical issues, the methods and criteria SLTs use to prioritise caseloads and the relationship between priority setting at the clinical, provider and purchaser levels. The results indicate that there is consensus about the priority criteria SLTs use and that the criteria can be ethically defended. Consensus is also found between SLTs and the purchasers and provider interviewed regarding the priority criteria that are valued but the relatively 'sophisticated' systems that exist at the clinical level are not reflected at these levels of the organisation. Three criteria are identified as being of relatively more importance and a framework for good practice is proposed.