A Model for Spoke Services? The AAC Service for Adults in Gloucestershire



Practice Report

  • Katherine Broomfield (Gloucestershire Care Services NHS Trust)
  • Louise Walters (Gloucestershire Care Services NHS Trust)


In Gloucestershire, a well-established AAC service is in practice providing a local, specialist service to meet the needs of most adults in the county who require AAC. Anecdote, experience and recent research indicate that such a local AAC service continues to be a rarity nationally. New commissioning arrangements should address this phenomena in England and sharing examples of good practice in local AAC provision can facilitate the transition to increased availability of and clinical expertise in spoke services.

This presentation aims to provide delegates with a model for a ‘spoke’ AAC service. By sharing our model of service delivery on a national platform we intend to initiate a discussion about what spoke services could and should look like; support other local services to develop as AAC spokes; and support regional hubs to develop local spoke services.


The Gloucestershire AAC team has established a care pathway for local AAC assessment and provision; budget for providing some AAC equipment; process and database for managing local AAC resources and equipment; training workshop to support SLTs working within the adult service to develop basic AAC competencies; and a service user group to support implementation of AAC.


The local AAC service in Gloucestershire compares favourably to the Communication Matters National Service Standards, despite lacking the full range of professional and clinical resources of larger, regional organisations.


Gloucesterhire has an established local AAC team that has gained positive recognition from service users, local managers and people working within the AAC industry for its clinical standards and its provision of services to people who require AAC. Access to specialism in AAC and support, both clinical and financial, from local SLT managers has enabled the continued development of the service and its governance structures. The service continues to innovate and strives to improve the experience for people using AAC via support groups and patient-involvement research.

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