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AAC Commissioning (England)

This page contains important information, updates and links to relevant specifications, legislation and other documents on the commissioning of AAC services and equipment in England.

See also 

National Standards for Specialised AAC Services.

New Guidance for Commissioning on AAC Services and Equipment (PDF) - March 2016

New Service Specification for AAC (PDF) - March 2016

New Specialised AAC Referral Criteria Document (PDF) - March 2016


January 2015

A list of Hub centres offering Specialised AAC Services is now available:

> See list of Specialised AAC Services (Hub centres)

June 2014

Updated Guidance on Commissioning AAC Services & Equipment in England

A ‘Hub and Spoke’ model of AAC provision is being commissioned across England.

A Clinical Reference Group (CRG) is responsible for Complex Disability Equipment in England (see more details here). This CRG has an AAC Sub-Group that has now updated a short, easy-to-read guidance document which explains the ‘Hub and Spoke’ model, and gives useful contact details for Directors for Specialised Commissioning, AAC Sub-Group members, and identifies a number of specialised AAC services.

> Download 'How to access an AAC Assessment and Equipment - updated June 2014' (pdf)

Eligibility, Exclusion and Prioritisation Criteria - Specialised AAC Services

Acceptance criteria:

An individual who would access a specialised AAC service would have both of the following:

  • a severe/complex communication difficulty associated with a range of physical, cognitive, learning, or sensory deficits;
  • a clear discrepancy between their level of understanding and ability to speak.

In addition, an individual must:

  • be able to understand the purpose of a communication aid;
  • have developed beyond cause and effect understanding;

and may:

  • have experience of using low tech AAC which is insufficient to enable them to realise their communicative potential.

Exclusion criteria:

  • preverbal communication skills; 
  • not having achieved cause and effect understanding; 
  • have impaired cognitive abilities that would prevent the user from retaining information on how to use equipment.

Prioritisation criteria:

  • Priority will be given to referrals received for assessments / reviews / QA of patients’ resident within the specialised commissioning region of the service
  • Priority will also be given to patients with a rapidly degenerative condition, e.g. MND and efforts will be made to ensure these patients are assessed and / or provided with equipment as soon as is practically possible.
  • Priority will be given to patients who have communication aid equipment currently but that has ceased to be functional or is significantly unreliable, in order to meet their communication needs.
  • Priority will be given to patients facing a transition to a new sector / school / college / workplace environment or currently in rehabilitation provision.
  • Priority will be given to patients who are at risk of developing significant psychological / challenging behaviour as a consequence of their inability to communicate without a communication aid.
Quality Assurance of 'Equipment only' requests for individuals who meet the eligibility criteria for Specialised AAC services

It is recognised that there will be some instances where it will not be necessary for commissioned specialised AAC services to undertake an assessment of an individual meeting the eligibility criteria within the service specification D01 S/b and funding may be sought for equipment provision only.  Read more...

Update on Commissioning of Specialised AAC Services

In April 2014, NHS England confirmed the allocation of £15 million per year for the development of specialised AAC Services in England. Thirteen AAC services have been identified as partly meeting the service specifications for a specialised service. The information about the services was as a result of the mapping exercise within the Communication Matters Research Matters Project (2010-3), and the Department of Education AAC Grant (2012-3).

These services have been invited to submit business cases to their NHS Area Teams, responsible for commissioning specialised services under NHS England. These business cases are currently been reviewed; it is hoped a decision, in relation to which services have been successful in their bids, will be made in July 2014.

There is a recognised gap in specialised service provision in the East of England. NHS England and the AAC subgroup (advisory group feeding into the Complex Disability Group within NHS England) are meeting with AAC services within this region to ensure that needs are met during this transitional stage. The Service Specifications have been revised recently: 

> Download 'Specialised AAC Services Specifications - updated June 2014' (pdf)

SEND Code of Practice & Regulations - Government Response:

The availability of the Code, Regulations and information about transitional arrangements will help local authorities and their partners, early years providers, schools, colleges and those working with children, young people and parents in further developing their plans for implementing the reforms from September 2014 onwards. The Government’s response to the latest consultation was published on 12 June 2014 and includes specific references to the commissioning of local AAC services, equipment and requirements within the Local Offer. Read more...

April 2014

Update of Local AAC Services

In April 2013, 'Liberating the NHS' changes came into effect with most local health services in England provided by Clinical Commissioning Groups (CCGs).

Specialised AAC Services are to be funded by NHS England and will provide assessment, review and equipment for those with the most complex communication needs, and/or those who require a high tech powered communication aid. Part of the remit of the specialised services will be to establish services where there are none, and further develop services where they exist. Read more...