ABSTRACTSpeech therapy for dysphasic patients outside hospital, using trained and supervised volunteers, group therapy and home visits from trained speech therapists, was compared with hospital out‐patient speech therapy. The cost per case (direct NHS costs only) for providing community speech therapy for 12 patients was greater than that for providing monthly hospital speech therapy for a similar number. However, when estimated costs per case for a larger group of patients are compared with fortnightly or weekly hospital therapy, community speech therapy is less costly. An assessment of the effectiveness of the speech therapy in these patients suggests that the group given community speech therapy with volunteer support made greater progress than those given therapy as hospital out‐patients.