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Access to Communication and Technology

Referral information

ACT works with people with complex disabilities to enable them communicate and interact, assisted by the use of electronic equipment.

Referring to ACT

ACT is commissioned by NHS England to accept all referrals that meet the national AAC and/or EC referral criteria.


ACT operates within the NHS England priority criteria as follows:



Priority criteria for AAC

  • Priority will be given to patients with a rapidly degenerative condition, eg. MND and effort 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.



Priority criteria for EC

  • A prioritisation system will be in place to ensure that individuals with a rapidly deteriorating condition are assessed and equipment provided (where appropriate) within a clinically appropriate time.  Other reasons for prioritisation may also be appropriate and will be considered on a per-case basis from referral information.



The ACT referral and advice helpline will provide a first point of contact to access:

  • specialist assessment held in an appropriate setting
  • detailed advice and signposting to other services, including support to move your client forward towards meeting the NHS England referral criteria


An experienced clinician will be available to take calls on this number from 9am till 4pm, Wednesday and Friday and also on a Monday from February 2024 on 0121 466 3028.


ACT Clinicians will work with callers to identify the best way to support clients based on identified skills and needs. As highlighted above, when appropriate the ACT clinician will offer an appointment date at the time the referral is made. This will depend on the NHS England prioritisation criteria.  (Please note that you will need to confirm this date with the client and team around them and notify ACT within ten working days).


This telephone service is the initial point of contact for new clients for the service including: environmental controls, alternative computer access and augmentative and alternative communication.


For activity around clients with ACT we are currently working with, please call our main office number 0121 466 3050 which is open business hours Monday to Friday.


In order to accept a referral, ACT will need information on:

  • Client: GP, date of birth, diagnosis, address and contact details, physical/cognitive abilities and impairments
  • Goals: Identified by the patient to ensure their motivation and engagement.
  • Environments: details of schools, day centres etc, information on the team supporting the client and what on-going support is available.
  • Please note that referrals will not be accepted without full information.



Guide to commissioning AAC services 

 NHS England has produced a guide to explain how Augmentative and Alternative Communication (AAC) services for those with difficulty with speech are organised and commissioned, with signposts for how to access the support the services provide.



Augmentative & Alternative Communication (AAC) Referral Criteria:

A decision flow chart has been developed and agreed nationally by the AAC Subgroup (of the NHS England Clinical Reference Group for Complex Disability Equipment) which patients can be accepted by specialised services, and which patients should be the responsibility of the local AAC (SLT) service:


Referral criteria decision flow chart


This is in the context of the service specification document for AAC which says:

“Specialised AAC services will work with their local AAC teams to build their capacity to manage directly the needs of 90% of the region’s AAC population and to jointly manage the needs of the 10% of the region’s population that require powered communication aids or specialised AAC assessment.”

For further information please view the NHS England document.



Environmental Controls (EC) Referral Criteria

“Environmental Controls assessment and provision will be for people who meet the following criteria: 

  • Profound and potentially complex physical disability, such that they are unable to operate standard (remote) controls for functioning independently in the home
  • Cognitively and physically able to operate EC equipment consistently
  • Able to demonstrate sustained motivation to use the EC equipment
  • Individuals who require multiple control functions integrated into a single means of access and for whom multiple devices, each with separate function, are inappropriate
  • Where individuals have a variable condition (e.g. progressive neurological condition), the above criteria can be applied with regard to the person’s anticipated, as well as current needs”

 The specification for Environmental Control System is available from NHS England.



Computer Access Referral Criteria

“The specialised service will assess and provide equipment for a patient who meets the above criteria and who:

  • Is unable to access their computer through standard means (mouse, keyboard etc) but would be expected to be able to use the equipment with the provision of suitable aids or adaptations
  • Demonstrates an intention to require access to IT to support independence and daily living
  • Does not have computer access difficulties solely related to sensory difficulties (i.e. visual or hearing difficulties)
  • Does not intend to use the computer primarily for educational or work situations or environments
  • Has a level of literacy adequate for the tasks they wish to be able to achieve, or have ongoing access to adequate training and support to achieve this”



Assessment appointment

This is the initial meeting in a series of appointments where ACT offers extended face to face support.  Assessment appointments are carried out in the most appropriate setting; this is likely to be the client’s home, school or day centre. It is likely that provision of equipment will be considered and trialled.


If you are unsure whether your client meets the referral criteria, please call the ACT referral and helpline 0121 466 3028 to discuss this as we offer telephone support and advice. 


If you are a family member, carer or potential service user please call us for initial advice and support but we will need to contact professionals for further information.



ACT Film and Booklet

ACT have made a  22 minute film to guide those working towards or thinking about, a specialist  NHSE Augmentative and Alternative Communication AAC assessment for a child or young person (YP).


The film is to help you, the team around the child or YP, work together to think about;

  • Your joint goals for the child/YP
  • The child or YP’’s own goals
  • How the team are going to work together to achieve those goals,
  • Evidence based ways of supporting someone to use language in the form of AAC
  • How you all might use and model AAC into your everyday life
  • How the child or YP is going to access (use scanning, point to) their AAC system


Helping a child or YP become proficient at using AAC involves a lot of effort and is reliant on the skills, knowledge and attitudes of the adults, and perhaps other young people,  around them supporting them to succeed. This is why we would like you to watch this film as a team including family, teaching staff, Speech and Language Therapist and any other professionals who will be involved, so that you can build your knowledge and understanding together.


An accompanying workbook is available for you to fill in together. Filling in your answers and thoughts or further questions will help you prepare for the assessment. As you will be able to tell the ACT team more about why a voice output communication aid is important for the child or YP and how you will be supporting them to become successful communicators using AAC.


ACT would like to thank the families who have been involved in helping us to make this film. Some of the photos and videos are of vulnerable young people and we ask that you do not share this film outside of your close team around the child or YP you are thinking about at the moment.


If you are ready to watch this film as a team please phone the ACT referral and helpline between 9.00 am and 4.00 pm on a Wednesday or Friday and also on a Monday from February 2024 to open a referral /helpline enquiry relating to the child or young person.


You may be asked to watch the film and look at the accompanying workbook before the referral is accepted, in line with NHSE AAC Specialised Services criteria.


If you are ready to watch this film as a team please phone the ACT referral and helpline on a Wednesday or Friday between 9.00 am and 4.00 pm to open a referral /helpline enquiry relating to the child or young person.


Our number for referrals and advice is 0121 466 3028.

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