Direct access to speech and language therapists: where do we stand in 2026?
Direct access to speech and language therapists in 2026: generalized framework since 2023, coordinated practice, conditions, and coordination with the doctor. The framework and its impact on written reports. Checklist to download.
Countries covered : France
In speech and language therapy, direct access is no longer an experiment: it has been generalized since July 2023 for speech and language therapists practising in a coordinated care structure. Patients can consult without first seeing a doctor, and coordination remains the rule.
This page reviews the conditions, limits, and impact on your written reports, with a checklist available for download.
The framework: generalized since 2023, in coordinated practice
Direct access to speech and language therapists was introduced by the Rist law (Article 4) and specified by Amendment 20 to the national agreement. It has applied since July 26, 2023, across the entire country, for speech and language therapists practising within a coordinated care structure: primary or specialized care teams, multi-professional health centers, health centers, or health, social, and medico-social institutions.
Important point: this is neither an experiment nor a scheme limited to a few departments (this restriction applies to other professions), and no session limit is attached to direct access itself.
Special case of CPTS: direct access is possible provided that the community's health project explicitly allows for it.
If you have any doubts about your situation, the FNO, your URPS, and your ARS can confirm the framework applicable to your structure.
The principles
What this changes for your practice
Direct access strengthens the responsibility of the speech and language therapist and the value of their written reports: the assessment report and traceability become even more crucial, in a context where checks are often conducted retrospectively (see the removal of the DAP with Amendment 21).
Direct access checklist to download
Conditions, coordinated practice, coordination with the doctor. Access the PDF by entering your email:
The impact on your written reports
More autonomy means more written documents to secure: assessments, session notes, letters to the referring doctor. Start with a fixed template, standardise your phrasing, and dictate right after the session.
This is exactly what Delta does: you capture your observations through live note-taking or post-session dictation, and the tool generates your structured assessments and notes based on your template, with a longitudinal patient memory from one session to the next. HDS certified hosting, GDPR compliant.
Frequently asked questions
Can you consult a speech and language therapist without a prescription in 2026?
Yes, since July 26, 2023, when the speech and language therapist practices within a coordinated care structure (ESP, MSP, health centre, institution). This is not an experiment and is not limited to certain departments.
Does direct access apply to all speech and language therapists?
No: it requires practising within a coordinated care structure. A speech and language therapist in a solo practice, outside of a coordinated structure, is not affected. For CPTS, the health project must provide for it.
Is the speech and language therapy assessment still necessary?
Yes. The assessment retains its full place: it forms the basis of the care and billing.
Is coordination with the doctor required?
Yes: the assessment report is sent to the primary care physician, who remains informed of the care.
Where can I check the applicable framework?
With the FNO, your URPS, and your ARS, which specify the scope and procedures in your territory.
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