ABSTRACT
About 20 years ago I took on a post as the ‘chief’ of a children’s speech and language therapy team. The team were under pressure from long waiting lists, and feeling that they were spreading themselves ever thinner and thinner. As a team we tried all kinds of strategies to get this workload under control, with varying levels of success: we tried to increase the staffing levels, by systematic analysis of workloads and workforce planning techniques, prioritisation of different sections of the caseload, working with referral agencies, centralised planning for waiting lists and certain kinds of group work; and when families complained, we directed the complaints (before the new NHS complaints system) through to the upper-level managers of the health authority. Over the years, the nature of the complaints and the source of the pressure points changed, but the problem never really went away.
