Lincolnshire Family Hubs speech and language drop-ins (co-location model)

Moving away from traditional clinic-based pathways, the model enables families to access early advice and support in a way that is accessible locally without a need for referrals or waiting lists. Strong partnership working between health visiting, early years and speech and language teams allows for immediate triage, shared planning, and coordinated interventions. 

The approach has increased family engagement, improved parental confidence, and strengthened system integration, demonstrating an effective, accessible model for early language development support. Making the best use of resources, this improved early access to coordinated support aims to improve children’s readiness for school and trajectory towards reaching their Good Level of Development in the Reception year.

Early language acquisition plays a critical role in children’s communication, emotional development, and readiness for learning. 

In Lincolnshire, demand for speech and language support—particularly for pre-school children—highlighted limitations of traditional clinic-based pathways. There was a need to:

• improve accessibility for families
• provide earlier intervention
• strengthen partnership working across services.

Lincolnshire were part of the Start for Life and Family Hubs programme prior to the national roll-out of Best Start Family Hubs and Healthy Babies. This provided an opportunity to redesign delivery through a pilot approach initially, aligning with the 'earlier, better, together' vision.

The project aimed to:

• Increase early identification of speech and language needs.
• Improve access to support for families in community settings
• Reduce reliance on referral-based, clinic-led models.
• Strengthen integrated working across health, early years and Family Hubs.
• Build parental confidence to support children’s communication at home.

This pilot initially offered drop-in and group based speech and language support for all pre-school children. This focussed on co-locating speech and language assistant practitioners across the then 10 Family Hubs, which are all based in areas of greatest need.

This pilot approach quickly influenced the delivery of pre-school school and language therapy support model; whereby a qualified speech and language therapist also now facilitates the individual drop-in and group-based model alongside the therapy assistant.

Key elements of the current model includes:

• Establishing regular open access speech and language drop-ins (one day per week per hub) for pre-school children
• Co-locating speech and language practice assistants and speech and language therapists across the hubs
• Joint working with health visiting and early years teams to promote the drop-in model and for coordinated intervention
• Providing on-the-day triage and advice without the need for referrals or booked appointments
• Offering targeted pathways including: 
  
  • universal advice at drop-ins
  • group interventions
  • invite-only sessions for children with higher needs. 

Strong partnership structures supported delivery, including:

• Joint working with health visiting during two year checks
• Shared progress monitoring between practitioners
• Engagement with Early Years SENCo networks and parent carer forums. 

There are now plans through the new Best Start in Life and Healthy Babies funding from September 2026 to expand the reach of this approach into connected early years settings and schools to each of the now 14 Best Start Family Hubs.

Access and engagement

• high levels of attendance across hubs and sustained engagement from families 
• expanded reach through accessible, community-based delivery.

Family experience and outcomes

Evidence from family feedback demonstrates:

• increased expressive communication and confidence in children
• improved use of words and reduced frustration
• better engagement and interaction during play and routines. 

Parents reported feeling:

• easy to implement advice and support
• listened to and supported rather than judged
• more confident in understanding and supporting their child’s needs. 

Parent confidence

• Confidence increased from an average of 2.99 percent before intervention to 4.46  percent after demonstrating improved confidence in understanding and supporting their child’s communication needs.

System impact

• Redesign of pre-school SALT provision - Moving from referral based to open-access support. 
• Improved integration between services (health, early years, Family Hubs).
• Move from fragmented services to integrated, family-centred support across health, education, and local services.
• No further need for formal referrals Reduced reliance on traditional referral pathways through earlier access to advice and intervention.
• More coordinated support pathways for children and families.
• Eradication of waiting lists for Speech and language support in early years.

What worked well

• Co-location enabled immediate professional collaboration and decision making.
• Drop-in model reduced barriers to access for families.
• Partnership working strengthened service integration and consistency.

What we learned

• Early engagement opportunities (e.g. at two year checks) are critical.
• Families value informal, accessible support models.
• Workforce development and joint training are essential to sustain integration.

Challenges and what we would do differently

• Ensuring consistent staffing across all hubs required careful planning.
• Demand required ongoing monitoring to maintain capacity.
• Continued work is needed to target outreach in areas of poorer outcomes.

Future plans and sustainability

• Expansion to additional Family Hubs and drop-in provision and into connected early years settings and schools. 
• Development of targeted outreach linked to areas of lower educational outcomes. 
• Continued use of data and feedback to refine the model.
• Strengthening integrated pathways across early years, health, and SEND services.

Recommendations for other councils

• Embed speech and language support within Family Hub models for accessibility.
• Prioritise co-location to strengthen partnership working
• Use drop-in models to reduce delays in early support.
• Align with wider early years and SEND systems for maximum impact.
• Collect and use family feedback to shape service delivery.