This website places cookies on your device to help us improve our service to you. To find out more, see our Privacy and Cookies statement.

Skip to page content


National Quality Improvement Award for NHS Lanarkshire SLCN Project


A NHS Lanarkshire project aimed at improving the confidence and competence of health visiting staff in identifying speech, language and communication needs and concerns in young children has won the National Children and Young People Improvement Collaborative (CYPIC) Quality Improvement Award in the category, Co-production with Families and Our Services. 

Speech language and communication need (SLCN) is identified as the highest concern affecting children’s development at 27 months of age across Lanarkshire. (NHS Information Services Division, 2018). A team of health visitors and speech and language therapists worked in partnership to improve the early language intervention and prevention information provided as part of the universal health visiting pathway to reduce the risk of a concern escalating, impacting wellbeing and the need to access specialist support. The work was co-produced across services utilising the model for improvement, iterative testing with PDSA cycles.

The team developed and tested the ‘SPEECH TOOL’ (Setting Early Language Goals in Partnership) to help health visitors and families actively intervene in promoting and accelerating their child's speech, language and communication development. The Tool’s development included testing out the essential early intervention messages linked to the key areas of early communication development:

  • attention and listening
  • play and interaction
  • receptive language
  • expressive language and speech sounds 

The tool’s structure linked directly with the NES Speech, Language and Communication (SLC) resource: Giving Children the Best Possible Start in Life and thereby ensured that learning gained from the resource carried through to practice. 

Using Quality Improvement strategies, the team were able to demonstrate that use of the ‘SPEECH TOOL’ alongside the NES resource had a positive impact on the confidence and ability of health visitors to detect early signs of SLC concerns and needs of young children. 

Michelle Scott, health visitor and practice teacher, and Sandra MacInnes, health visitor and service improvement coordinator were both involved in the development of the ‘SPEECH TOOL’ and the NES SLC resource. They said that the opportunity to be part of the multi-professional team actively involved in developing the NES SLC resource contributed greatly to their own professional learning, the development of the ‘SPEECH TOOL’ and the shared learning of local health visiting staff.

The local project team also linked with Joanne Gibson, speech and language therapist, who was the project lead for the NES SLC digital resource. This was key to establishing a strong link between the two resources and ensured a consistent and cohesive message to all health visitors regarding speech, language and communication development in children.

The work has positively influenced health visiting staff and their relationship with allied health professionals and colleagues in specialist services. In addition, it has had a key role in addressing the huge issue of language inequality facing children. 

Development of the ‘SPEECH TOOL’ has involved taking expert knowledge from different professional groups and combining it to provide an early language intervention bundle and standardised process for an influential workforce in the child’s early journey. Involving parents and carers as the child's primary educator was integral to its success. The project has already had a positive impact on health visiting practice and, in time, should support favourable outcomes for children as they journey through life. 

To learn more about the SPEECH TOOL and how it helped health visitors to enhance speech, language and communication development in young children please contact:

Sandra MacInnes, Health Visitor and Service Improvement Coordinator, NHS Lanarkshire: 

The NES digital speech language and communication resource: Giving Children the Best Possible Start in Life can be access from:


NHS Education for Scotland, 2018. Giving Children the Best Possible Start In Life
Accessible from:

NHS Information Services Division 2018. Child Health 27-30 Month Review Statistics Scotland 2016/17.
Accessible from: 

Project Team
Lucy Scott Muir, (Team leader South Lanarkshire Health and Social Care Partnership Speech and Language Service), Sandra Ferrie, (Speech and Language Therapist) Elizabeth Miller, (Health Visiting Team leader South Lanarkshire Health and Social Care Partnership), Michelle Scott, (Health Visitor/Practice Teacher) Karen Kershaw, (Health Visitor) Sandra MacInnes (Improvement Coordinator), Vivian Boxall (Improvement Advisor)

Project Award Category: Co-Production with Families and Our Services 

Project Title: Breaking the intergenerational cycle of speech, language and communication deficit for children and young people.