Interventions designed to improve communication environments and the quality of adult–child interactions in early years (EY) settings are an important part of facilitating children’s communication skills both for children with identified Speech, Language and Communication Needs (SLCN) and children without SLCN. One such intervention devised and delivered by speech and language therapists (SLTs) in Nottinghamshire is the Language Lead Approach (LLA), where SLTs deliver a formalized but flexible package of support and training to EY practitioners who go on to become Language Leads (LLs) for their setting. Nine SLTs delivering the LLA were interviewed to explore their perspectives on the implementation and impacts of the LLA. Interviews were analysed thematically. Three key themes were identified, the first of which related to factors internal to the setting and included aspects relating to the nature of initial and sustained engagement with an LL and the setting manager, time pressures and the impact of different setting organizational cultures. The second theme which emerged related to the individual qualities and characteristics of the LL, as SLTs noted that the response of LLs to the role varied considerably and was influenced by their confidence, experience and leadership capacity, as well as the degree of autonomy in the role. The final theme, external influences on implementation, reflected the SLTs own working practices and workload. Overall, SLTs felt the LLA was effective and could be implemented alongside their daily workload. SLTs reflected on their lack of training to implement such interventions, the challenges to sustaining the LLA at the setting and County level, and the challenges of evidencing effectiveness. This research has implications for those designing and evaluating training and mentoring approaches as well as for those SLTs who are seeking to develop the effectiveness of their consultative working with Early Years Educators (EYEs).