{ "lane": "services", "compiled": "2026-10-16", "compiler": "research-worker", "notes": "One object per service type. Every figure carries fact, value, date and source. Figures from interested parties are labelled in the fact string. [UNVERIFIED] marks a claim carried from the vault at primary-source level but not re-derived in this run.", "service_types": [ { "service_type": "Acute / inpatient stroke unit SLT assessment", "provider": "NHS hospital stroke team (SLT)", "population": "Adults admitted with stroke requiring communication or swallowing assessment", "setting": "Hyperacute / acute stroke unit, inpatient", "access_route": "Automatic referral on admission through the stroke team; SSNAP indicator 4.5 measures SLT assessment within 72 hours of clock start", "referral_required": "No; expected as part of the admitted stroke pathway", "cost_to_user": "Free at point of use (NHS)", "national_or_local": "National standard, locally delivered", "coverage_evidence": "SSNAP audits every stroke admission; 92,414 admissions across 250 hospitals in 2024/25", "figure_facts": [ {"fact": "Stroke admissions audited by SSNAP", "value": "92,414", "date": "2024/25", "source": "[1] SSNAP State of the Nation 2025 (national audit)"}, {"fact": "SLT assessment within 72 hours of clock start [UNVERIFIED at primary source]", "value": "46.8%", "date": "2024/25 (via vault, verified Apr 2026)", "source": "[1][10] indicator definition; vault source-ssnap-apt-synthesis-2026 for value"}, {"fact": "SLT assessment within 24 hours [UNVERIFIED at primary source]", "value": "24.8%", "date": "2024/25 (via vault)", "source": "vault source-ssnap-apt-synthesis-2026"}, {"fact": "No SLT assessment for organisational reasons", "value": "7.6%", "date": "2024/25 (via vault)", "source": "vault source-ssnap-apt-synthesis-2026"} ], "sources": ["https://www.hqip.org.uk/wp-content/uploads/2025/11/SSNAP-State-of-the-Nation-2025-FINALv2.pdf", "https://www.hqip.org.uk/wp-content/uploads/2026/03/Ref.-466-SSNAP-Therapy-spotlight-report.pdf", "https://www.strokeguideline.org/chapter/communication-and-language/"] }, { "service_type": "Inpatient stroke unit SLT therapy (dose and intensity)", "provider": "NHS hospital stroke team (SLT, sometimes therapy assistants)", "population": "Adults with communication difficulty on a stroke unit", "setting": "Stroke unit, inpatient", "access_route": "Follows the SLT assessment; therapy delivered by the SLT team", "referral_required": "No; internal to the stroke team", "cost_to_user": "Free at point of use (NHS)", "national_or_local": "National guideline standard, locally delivered", "coverage_evidence": "SSNAP therapy intensity and frequency indicators; NB SLT benchmark assumes only 50% of caseload requires SLT", "figure_facts": [ {"fact": "Patients receiving the NICE target total therapy dose (128 min/day) [UNVERIFIED at primary source]", "value": "35.4%", "date": "2024/25 (via vault)", "source": "vault source-ssnap-apt-synthesis-2026"}, {"fact": "SLT benchmark caseload coverage used in SSNAP scoring", "value": "50% of patients (OT 80%, PT 85%)", "date": "2018 (audit methodology paper)", "source": "[19] BMJ Open therapy-intensity ethnography"}, {"fact": "Decline in the standard of receiving 45 minutes of therapy five days per week, in SLT specifically, since 2022/23", "value": "decline: other disciplines unchanged", "date": "2023/24", "source": "[10] SSNAP Therapy Spotlight Report; [8] Stroke Association 10 Year Health Plan response"}, {"fact": "Mean daily SLT delivered after first 72 hours (older audit cycle)", "value": "20.9 min/day", "date": "April 2018 to March 2019", "source": "[26] ICAP scoping review (metadata only; figure not re-fetched)"} ], "sources": ["https://www.hqip.org.uk/wp-content/uploads/2026/03/Ref.-466-SSNAP-Therapy-spotlight-report.pdf", "https://bmjopen.bmj.com/content/8/12/e023676", "https://www.tandfonline.com/doi/full/10.1080/09638288.2021.1964626"] }, { "service_type": "Early Supported Discharge (ESD)", "provider": "NHS specialist stroke multidisciplinary team, as part of the Integrated Community Stroke Service", "population": "Stroke survivors assessed as able to leave hospital early and rehabilitate at home at equivalent intensity", "setting": "Patient's home / community", "access_route": "From hospital at discharge, via the stroke team; ICSS can also be entered from the community", "referral_required": "Internal referral at discharge; needs-based triage", "cost_to_user": "Free at point of use (NHS)", "national_or_local": "National service model (ICSS), locally commissioned", "coverage_evidence": "SSNAP discharge destination measure; guideline requires treatment at home within 24 hours of discharge", "figure_facts": [ {"fact": "Patients discharged to a stroke/neurology specific ESD and/or CRT service", "value": "66.6%", "date": "2024/25", "source": "[1] SSNAP State of the Nation 2025"}, {"fact": "Of those, proportion transferred to a combined ESD-CRT service", "value": "23.1%", "date": "2024/25", "source": "[1] SSNAP State of the Nation 2025"}, {"fact": "Growth in ESD/CRT discharge over the audit series", "value": "41% (2013/14) to 66.5% (2024/25)", "date": "2013/14 to 2024/25", "source": "[1] SSNAP State of the Nation 2025"}, {"fact": "Hospitals in England, Scotland and Wales said not to offer an ESD service (charity claim, cited to a 2020 evidence review; not verified)", "value": "around one fifth", "date": "stated 2025", "source": "[8] Stroke Association 10 Year Health Plan response"} ], "sources": ["https://www.hqip.org.uk/wp-content/uploads/2025/11/SSNAP-State-of-the-Nation-2025-FINALv2.pdf", "https://www.england.nhs.uk/publication/national-service-model-for-an-integrated-community-stroke-service/", "https://www.stroke.org.uk/10-year-plan-response"] }, { "service_type": "Community Rehabilitation Team / ICSS community therapy", "provider": "NHS community stroke rehabilitation teams (ICSS model)", "population": "Stroke survivors with ongoing rehabilitation needs after discharge", "setting": "Home and community; intended to be 7 days per week", "access_route": "Discharge from hospital or referral from community; needs-based", "referral_required": "Yes, from hospital teams, GP or community services depending on local pathway", "cost_to_user": "Free at point of use (NHS)", "national_or_local": "National ICSS service model; commissioned locally by ICBs", "coverage_evidence": "SSNAP community measures plus 2021 Post-acute Organisational Audit of 664 services; only 17% have appropriate access to all core disciplines", "figure_facts": [ {"fact": "Community services participating in SSNAP", "value": "195", "date": "2024/25", "source": "[1] SSNAP State of the Nation 2025"}, {"fact": "Community-based services with appropriate access to all core disciplines (PT, OT, SLT)", "value": "17%", "date": "1 April 2021 snapshot", "source": "[8][11] Stroke Association response; SSNAP Post-acute Organisational Audit 2021"}, {"fact": "Community-based services meeting recommended staffing levels per patient", "value": "fewer than one third", "date": "1 April 2021", "source": "[11] SSNAP Post-acute Organisational Audit 2021"}, {"fact": "Recommended SLT establishment in community teams", "value": "0.4 WTE per unit", "date": "1 April 2021", "source": "[11] SSNAP Post-acute Organisational Audit 2021"}, {"fact": "Post-acute services participating in the organisational audit (591 England, 42 Wales)", "value": "664 services; over 6,700 WTE staff", "date": "1 April 2021", "source": "[11] SSNAP Post-acute Organisational Audit 2021"} ], "sources": ["https://www.hqip.org.uk/wp-content/uploads/2026/03/Ref.-296-SSNAP-2021-Post-acute-Organisational-Audit-National-Report-Final.pdf", "https://www.england.nhs.uk/publication/national-service-model-for-an-integrated-community-stroke-service/", "https://www.stroke.org.uk/10-year-plan-response"] }, { "service_type": "Outpatient / clinic-based SLT", "provider": "NHS community or hospital SLT teams; also independent therapists where the NHS route is exhausted", "population": "Adults with aphasia or other communication/swallowing needs not on an inpatient or home pathway", "setting": "Community clinic, hospital outpatient department", "access_route": "Referral from GP, stroke team or community services; local self-referral routes vary; NHS community health services waiting lists apply", "referral_required": "Yes (usually)", "cost_to_user": "Free (NHS); paid if taken privately", "national_or_local": "Locally commissioned; no ringfenced central SLT funding", "coverage_evidence": "NHS England Community Health Services Waiting Lists (monthly); whole adult SLT, not aphasia-specific", "figure_facts": [ {"fact": "Adults waiting for speech and language therapy in England", "value": "23,590", "date": "end November 2024", "source": "[7] House of Commons Library CDP-2025-0010, citing NHS England Community Health Services Waiting Lists"}, {"fact": "Of those, waiting more than 12 weeks", "value": "7,281 (30.9%)", "date": "end November 2024", "source": "[7] House of Commons Library CDP-2025-0010"}, {"fact": "Waiting over 12 weeks, London", "value": "37.8%", "date": "November 2024", "source": "[7] House of Commons Library CDP-2025-0010"}, {"fact": "Waiting over 12 weeks, East of England", "value": "18.7%", "date": "November 2024", "source": "[7] House of Commons Library CDP-2025-0010"}, {"fact": "Ringfenced central funding for speech and language therapy", "value": "none; ICBs and local authorities decide spend", "date": "January 2025", "source": "[7] House of Commons Library CDP-2025-0010"} ], "sources": ["https://researchbriefings.files.parliament.uk/documents/CDP-2025-0010/CDP-2025-0010.pdf"] }, { "service_type": "NHS aphasia group therapy (community/outpatient)", "provider": "NHS community or hospital SLT teams (SLT-led or SLT-supervised groups)", "population": "Adults with post-stroke aphasia", "setting": "Clinic, community venue, occasionally hospital", "access_route": "Via the treating SLT; availability varies by local service", "referral_required": "Yes, via SLT caseload", "cost_to_user": "Free (NHS)", "national_or_local": "Local; not separately audited by SSNAP", "coverage_evidence": "No national count of NHS aphasia groups located; qualitative evidence that provision varies markedly between areas", "figure_facts": [ {"fact": "SLT-reported view that addressing social participation is part of their role", "value": "99% (survey n=124)", "date": "2016", "source": "[25] Northcott et al. UK SLT survey"}, {"fact": "SLTs who considered 70-100% of their clients with aphasia experience psychological difficulties", "value": "50% of respondents (n=124)", "date": "2016", "source": "[25] Northcott et al. UK SLT survey"}], "sources": ["https://openaccess.city.ac.uk/id/eprint/14907/11/FURTHER%20REVISED%20SLT%20on-line%20survey%20paper%20AS%20RESUBMITTED.pdf", "https://www.strokeguideline.org/chapter/communication-and-language/"] }, { "service_type": "Third-sector aphasia drop-in groups (e.g. Say Aphasia)", "provider": "Aphasia charities and local support groups, run by and for people with aphasia", "population": "Adults with aphasia after stroke, brain injury or brain tumour, and their families/carers", "setting": "Community venues and online; drop-in format", "access_route": "Open access drop-in; no clinical referral required; signposted by the NHS and by charities", "referral_required": "No", "cost_to_user": "Free to the user (donation funded)", "national_or_local": "Local and regional; Aphasia Alliance is a signposting network with no central office", "coverage_evidence": "Provider websites and Charity Commission records; no national audit of aphasia group coverage", "figure_facts": [ {"fact": "Say Aphasia charity number and objects", "value": "CIO 1169933; relief of persons with aphasia including provision of therapy, support and information", "date": "current registration", "source": "[23] Charity Commission register"}, {"fact": "Say Aphasia drop-in group frequency and format", "value": "weekly to monthly groups across the UK plus a weekly online group", "date": "accessed October 2026", "source": "[5] Say Aphasia About us; Say Aphasia drop-in groups"}, {"fact": "Illustrative Say Aphasia donation levels", "value": "£10 communication tools per group; £20 volunteer aphasia communication training", "date": "accessed October 2026", "source": "[5] Say Aphasia"} ], "sources": ["https://www.sayaphasia.org/about-us", "https://register-of-charities.charitycommission.gov.uk/en/charity-search/-/charity-details/5089928", "https://aphasiaalliance.org/members/"] }, { "service_type": "Charity peer befriending, communication support and local co-ordinators (Stroke Association, Aphasia Re-Connect)", "provider": "Stroke Association; Aphasia Re-Connect; regional aphasia charities", "population": "Stroke survivors with communication difficulty and their families; long-term and lonely or isolated", "setting": "Home visits, community, telephone, online; local support services", "access_route": "Self-referral, helpline, or referral from NHS/community teams; some services commissioned by local systems", "referral_required": "No (self-referral available), though local services may accept clinician referral", "cost_to_user": "Free to the user (charity funded)", "national_or_local": "Mix: UK-wide (Stroke Association), regional/local (others)", "coverage_evidence": "Charity self-reported reach (interested party, not independent)", "figure_facts": [ {"fact": "People reached through all Stroke Association support services in 2024-25 (charity self-reported)", "value": "over 66,000", "date": "2024-25", "source": "[22] Stroke Association Annual Report 2024-25 landing page"}, {"fact": "People reached through Stroke Association local support services (charity self-reported)", "value": "nearly 38,000", "date": "2024-25", "source": "[22] Stroke Association Annual Report 2024-25 landing page"}, {"fact": "Stroke Support Helpline enquiries (charity self-reported)", "value": "around 15,000", "date": "2024-25", "source": "[22] Stroke Association Annual Report 2024-25 landing page"}, {"fact": "Stroke Association research investment (charity self-reported)", "value": "£2.4 million", "date": "2024-25", "source": "[22] Stroke Association Annual Report 2024-25 landing page"}, {"fact": "Stroke Association support groups and people reached (metadata-level, from Charity Commission filing description; not fetched)", "value": "434 groups; around 13,000 people; interpreting support for 480 people in 17+ languages", "date": "year ending 31 March 2025", "source": "[22] context; Charity Commission annual report description (metadata only)"} ], "sources": ["https://www.stroke.org.uk/about-us/annual-report", "https://aphasiareconnect.org/", "https://aphasiaalliance.org/members/"] }, { "service_type": "Online / digital peer-led aphasia support groups", "provider": "Aphasia Re-Connect; Say Aphasia; regional charities", "population": "Adults with aphasia able and willing to use online groups", "setting": "Online (video platform)", "access_route": "Self-referral or charity signposting; no clinical referral", "referral_required": "No", "cost_to_user": "Free to the user (charity funded)", "national_or_local": "National reach from local charities", "coverage_evidence": "Provider statements; useful in reducing isolation but digital exclusion is a documented barrier", "figure_facts": [ {"fact": "Say Aphasia online drop-in group", "value": "weekly, Wednesdays 10am", "date": "accessed October 2026", "source": "[5] Say Aphasia"}, {"fact": "Digital inclusion risk: aphasia itself is a barrier to digital inclusion, particularly for older people with lower education", "value": "qualitative finding", "date": "2023-2024 studies", "source": "[16] FATE-A / Hilari telehealth work"} ], "sources": ["https://aphasiareconnect.org/", "https://www.sayaphasia.org/about-us", "https://openaccess.city.ac.uk/id/eprint/31858/10/Intl%20J%20Lang%20%20%20Comm%20Disor%20-%202023%20-%20Hilari%20-%20Telehealth%20practice%20in%20aphasia%20%20A%20survey%20of%20UK%20speech%20and%20language%20therapists_.pdf"] }, { "service_type": "Telerehabilitation / remotely delivered SLT", "provider": "NHS SLT teams; independent therapists; commercial platforms", "population": "Adults with aphasia who can engage with remote delivery; guideline says not an alternative to in-person", "setting": "Home, using video platforms (Zoom, Microsoft Teams, Attend Anywhere)", "access_route": "Via the treating SLT service; availability uneven across England and the UK", "referral_required": "Yes, via SLT", "cost_to_user": "Free (NHS) or paid (private)", "national_or_local": "Locally implemented; inconsistent across England (per the studies cited)", "coverage_evidence": "Survey and review evidence of feasibility and acceptability; national audit does not report remote SLT delivery volumes", "figure_facts": [ {"fact": "UK SLTs who used telehealth during the COVID-19 pandemic", "value": "more than 80%", "date": "survey 2021", "source": "[16] Hilari et al., telehealth practice in aphasia survey"}, {"fact": "UK SLTs planning to continue telehealth after the pandemic", "value": "more than 90%", "date": "survey 2021", "source": "[16] Hilari et al."}, {"fact": "Guideline position on telerehabilitation for aphasia", "value": "should be personalised, monitored, supplemented with face-to-face reviews, and NOT used as an alternative to in-person rehabilitation", "date": "2023 guideline", "source": "[4] National Clinical Guideline for Stroke 2023, communication and language chapter"} ], "sources": ["https://openaccess.city.ac.uk/id/eprint/31858/10/Intl%20J%20Lang%20%20%20Comm%20Disor%20-%202023%20-%20Hilari%20-%20Telehealth%20practice%20in%20aphasia%20%20A%20survey%20of%20UK%20speech%20and%20language%20therapists_.pdf", "https://www.strokeguideline.org/chapter/communication-and-language/"] }, { "service_type": "Private / self-funded independent SLT", "provider": "Independent HCPC-registered SLTs listed by ASLTIP and similar directories", "population": "Adults (and children) able to pay, or with insurance cover; commonly stroke survivors with aphasia", "setting": "Clinic, home or online", "access_route": "Direct contact with the therapist; no referral required; insurance claims may need GP confirmation", "referral_required": "No (unless claiming on insurance)", "cost_to_user": "Self-funded; therapist-set fees", "national_or_local": "National market, locally variable", "coverage_evidence": "Directory listings and commercial guidance; no authoritative fee schedule or volume data", "figure_facts": [ {"fact": "ASLTIP fee model", "value": "therapists set their own fees; ASLTIP takes no commission and is free to search", "date": "accessed October 2026", "source": "[14] ASLTIP FAQ"}, {"fact": "Private SLT session cost (commercial-directory estimate, NOT authoritative)", "value": "about £70 to £150 per session; initial assessment up to about £250", "date": "2025-2026 listings", "source": "[14] ASLTIP FAQ context; commercial directory guides (Bark, STAMMA, guides) - third-party estimates"}, {"fact": "Stroke survivors paying for rehabilitation out of their own funds (charity claim)", "value": "reported, not quantified", "date": "2025", "source": "[8] Stroke Association 10 Year Health Plan response"} ], "sources": ["https://asltip.com/faqs/", "https://www.stroke.org.uk/10-year-plan-response"] }, { "service_type": "Six-month review / long-term follow-up", "provider": "NHS community stroke services / ICSS (often coordinated with voluntary sector)", "population": "All stroke survivors at six months; SSNAP measures against applicable patients", "setting": "In person, telephone, post, online", "access_route": "Coordinator- or service-led tracking after discharge; not patient-triggered in most services", "referral_required": "No; should be automatic where a service runs it", "cost_to_user": "Free (NHS)", "national_or_local": "National expectation (National Stroke Programme), locally delivered", "coverage_evidence": "SSNAP six-month follow-up measure; Stroke Association campaign; PLOS ONE ethnicity analysis", "figure_facts": [ {"fact": "Applicable patients receiving a six-month review", "value": "35.1%", "date": "2024/25", "source": "[1] SSNAP State of the Nation 2025"}, {"fact": "Six-month review rate the previous year", "value": "39% in 2023/24", "date": "2023/24", "source": "[1] SSNAP State of the Nation 2025"}, {"fact": "Six-month review delivery by mode", "value": "14.7% in person, 18.8% telephone, 0.4% post, 0% online", "date": "2024/25", "source": "[1] SSNAP State of the Nation 2025"}, {"fact": "Patients reporting moderate to severe mood issues at six months", "value": "approximately one fifth", "date": "2024/25", "source": "[1] SSNAP State of the Nation 2025"}, {"fact": "National Stroke Programme target for six-month reviews", "value": "from 29% to 90%", "date": "Long Term Plan commitment", "source": "[13] NHS England stroke programme page"}, {"fact": "Discrepant Stroke Association figure for the same measure (source anomaly, not to be reused)", "value": "\"39% of stroke survivors received a six-month review in 2024-25\"", "date": "2025", "source": "[8] Stroke Association 10 Year Health Plan response (contradicts [1] and [2])"}, {"fact": "Six-month review attendance rate in SSNAP-linked analysis (inception to Aug 2023)", "value": "80,413 of 307,054 (26.2%)", "date": "inception to August 2023", "source": "[15] PLOS ONE ethnicity and six-month care"} ], "sources": ["https://www.hqip.org.uk/wp-content/uploads/2025/11/SSNAP-State-of-the-Nation-2025-FINALv2.pdf", "https://www.england.nhs.uk/ourwork/clinical-policy/stroke/", "https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0354353", "https://www.stroke.org.uk/10-year-plan-response"] }, { "service_type": "Care-home resident stroke/aphasia provision", "provider": "NHS community services in-reach; care-home staff; some voluntary sector", "population": "Stroke survivors living in care homes; may be older and more disabled than the community average", "setting": "Care home", "access_route": "Depends on local in-reach arrangements; not a distinct national pathway", "referral_required": "Usually via GP or community therapy service", "cost_to_user": "NHS element free; care costs separate", "national_or_local": "Local; recognised as a separate access problem in the 2021 organisational audit (Section 4.5)", "coverage_evidence": "SSNAP Post-acute Organisational Audit 2021 has a dedicated care-home section; specific figures not extracted in this run", "figure_facts": [ {"fact": "Care-home treatment examined in the post-acute organisational audit", "value": "dedicated section (4.5) exists; figures not extracted", "date": "1 April 2021", "source": "[11] SSNAP Post-acute Organisational Audit 2021 [UNVERIFIED figure level]"} ], "sources": ["https://www.hqip.org.uk/wp-content/uploads/2026/03/Ref.-296-SSNAP-2021-Post-acute-Organisational-Audit-National-Report-Final.pdf"] } ] }