Meeting documents

Olga Hamer was confirmed as Co-Chair of the Autism Partnership Board.

Apologies for absence were received from Robin Greenfield, Clare Samways, Sally Slade, Polly Wilkinson, Ian King and Zita Calkin.

To confirm the minutes of the meeting held on 13 August 2014.

The minutes of the meeting held on 13 August 2014 were agreed as a correct record.

Matters Arising

Item 4 – Carers Bucks/Young Carers

Questions about the issue of Young Carers and depression are to be taken back to Young Carer Managers for comments and feedback.

Action: Ann Whiteley

Item 5 – Diagnostic Pathway for Adults

The possibility of details of the Pathway being publicised in the SUCO bulletin is to be discussed with CCGs.

Action: Zita Calkin

Item 7 – update from Working Groups

Funding has been agreed for the development of an E-learning module.  It is hoped that the information will also be available on an external website.  The feedback received from Richard Maguire and Lisa Burridge has been invaluable.

Item 8 – Innovation Fund

A presentation about the Innovation Fund was made at the Assistive Technology Board meeting.  Adam Willison, Assistive Technology Joint Commissioning Manager is keen to discuss how Assistive Technology can be used to support those with autism and learning difficulties.  A bid for funding from the Department of Health has been submitted.

Gill Shurrock, Head of SEN

Gill Shurrock, Head of SEN, Suzy Paylor, SEN Manager/Service Development, Stephen Stych, NICE Guidelines Autism Pathways and Sue Butt, Operations Manager Commissioning, were welcomed to the meeting.

Gill Shurrock explained that the report included in the agenda pack is an update of the progress since the last Special Educational Needs and Disabilities (SEND) Board meeting.

In terms of the background to the SEND Reforms, three years ago the Government announced a change to the way Local Authorities address the SEN processes.

Young people with more complex needs used to have a Statement of SEN.  This is a legal document which sets out the needs of the child, the objectives and the provision to be put in place to meet their needs in school.  This could be a local school or one with additional provision.  The statutory process of an SEN Statement was 26 weeks.

In accordance with the Children and Families Act 2014, the Local Authority has to publish information for parents and carers of children and young people with special educations needs or who have a disability about local provision and support in the form of the Local Offer.  The Local Offer has two clear purposes;

·         To provide clear, comprehensive and accessible information about provision available and;

·         To make provision more responsive to local needs and aspirations by directly involving children and young people with SEN, parents, carers and service providers in its development and review.

The statutory deadline for publication is the 1 September 2014.

It has also been announced that the Statement Process following a statutory assessment has changed.  Education Healthcare Plans (EHC) will be introduced across England and Wales from September 2014. The EHC Plans will cover the education, health and social care needs of the child.  In Bucks work is taking place in partnership with parents and carers and in conjunction with FACT Bucks to put the family at the centre of the new processes. EHC Plans are predominately education based and are a co-production approach to write down the education needs for each child.

Changes to the process include;

·       The process now has a 20 week deadline

·       Older young people (16+) in college who had a learning disability assessment had a Section 139a/ Learning Difficulty Assessment (LDA) to identify a young their learning difficulties and/ or disabilities as they move on to post 16 education, training or higher education and to identify suitable provision to meet their needs.  The process was having an SEN prior to the age of 16 followed by a LDA at college. These were two different process and two different documents. There is now the opportunity to apply for an EHC Plan which gives a continuation of the process. 

·       Parents and carers can appeal against an EHC Plan

·       An EHC Plan assessment is required for any new requests. Effectively, there are two processes taking place at the same time.  The Government has advised that all Local Authorities are required to convert existing Statements into EHC Plans between September 2014 and  ...  view the full minutes text for item 5.

Update on membership, Lead/Chair and governance between SEND Board and Autism Board.

Sue Butt, Operations Manager, Commissioning

Gill Shurrock, Head of SEN

Suzy Paylor, SEN Manager explained that she has been a teacher for 9 years in ASD and set up an ASD provision prior to joining BCC.  In 2005 a Co-ordination Group was set up in response to the National Autism Plan for children.  The membership of the Co-ordination Group was quite prescriptive.  It included representation from parents of children with autism and organisations from the north and south of the county.  The Group looked at the diagnosis of autism in GP Practices and schools and how to become more autism friendly.

Gill Shurrock reported that there are a lot of work-strands currently taking place around SEN Review that took place in 2001 and the SEND Reforms.

There has been an increase in the number of young people being diagnosed with Autism Spectrum Disorder.  A piece of work was carried out in conjunction with the Head of Specialist Teaching to look at services available and provision.

It is being proposed that following on from a recent ASD review, a Working Group is set up to focus on ASD and the recommendations from the review and action to be undertaken. The Working Group will include representation from professional organisations.  Expressions of interest in joining the work group were requested were requested from members of the Autism Partnership Board.

Action: All

Olga Hamer and Paulette Hunn expressed an interest in becoming members of the Working Group.

During discussions, the following questions were asked.

What services need to be represented on the Working Group? The previous Board included representation from Paediatrics, CAHMS, Social Care, Educational Psychology and Specialist Teaching Services.

Does the Working Group need to be separate to the Autism Partnership Board?  Yes the Working Group needs to be separate to the Autism Partnership Board as previous set up was cumbersome which we do not want to replicate.  The Working Group will not report to the Autism Partnership Board but to the SEND Board. An update on the work being carried will be given to the Autism Partnership Board.

Will timeframes be set for outcomes of work carried out by the Working Group? Feedback from meetings is very valuable. Representation from Specialist Schools could provide the vehicle for training and for further development.

What are the objectives and outcomes for the Working Group? The objectives and outcomes will be included in the Terms of Reference.  The Working Group will also have tasks and actions to carry out. A list of objectives and outcomes will be compiled and sent members of the Autism Partnership Board.

Action: Suzy Paylor

The following comments were also made;

·       It is important for the Working Group to include representation from mainstream schools, SENCO, CAHMS, Occupational Therapy and Speech and Language Therapy.

·       It is important that key pieces of work are prioritised by the Working Group and there are key areas of focus.  There is also the possibility of networking opportunities and wider engagement.

·       Key areas of focus should include the diagnostic pathway as well as the post diagnosis pathway  ...  view the full minutes text for item 6.

Update Amy Moore, Joint Commissioner, Transitions

Amy Moore, Joint Commissioner, Transitions was welcomed to the meeting.

Amy gave the following update;

·       Gill Shurrock has provided an overview of the EHC Plans, which from the adult side, can be started from age 11 onwards. 

·       Safeguarding training is key for colleagues in Adult Services.  Training needs to be mapped against the Safeguarding Board pathway. 

·       The welfare of the child is paramount

·       There has been a cap on Adult Social Care funding.

·       In terms of the Local Authority being ready for the changes to the Care Act and reforms to the assessment of Adult Social Care Provision, specialist teams have been put in place.  The expectation is the rest of the teams will pick up cases as work progresses.

·       Assessments have been taking place for those ages 16+. There needs to be an awareness that assessments need to start at an early age.

·       School lists and referrals are being received.

·       Proactive contact needs to be made with schools making referrals as some children are approaching the age of 17.

·       The possibility of having an Educational Worker in the team is being discussed who would predominately look at out of county referrals.  There needs to be clarification of children coming back into the county.

·       The Local Authority has been approached by a provider who would like to convert an existing building into a 10 bedroom unit and flat for the manager.  The accommodation would be for those aged between 18-25 eligible for social care services who are in transition. The accommodation is not prescriptive i.e. for learning disabilities or mental health. It is about outcomes of supported living and getting individuals ready to live independently as the provision of the accommodation is not long term.  A manager has been recruited who has a background in both autism and mental health provision.  The accommodation will be part of three step programme which is to be confirmed.

·       A post 16 college resource has been commissioned.  This is a bespoke programme which can be continued over holiday periods.

·       A small pilot is taking place over 18 months to determine if a cognitive support technology intervention could lead to increased independent living skills and to reduce the likelihood of requiring future services. This includes help with travel, training cooking and task scheduling to possibly access employment (use of a smartphone). Five young people were identified who did not meet the Fair Access to Care Services eligibility thresholds but could do in the future without some form of intervention were identified. Most had Autism or behavioural problems, were not accessing education, training or employment and needed support regarding independent living skills.

During the update, the following questions were asked.

What is the eligibility criteria for the supported accommodation i.e. FACS or service needs? The Local Authority has a limited say in who is able to stay at the accommodation as it has not commissioned the service.

Is the accommodation suitable for individuals with substantial needs who require a level in independence?  The young people are  ...  view the full minutes text for item 7.

Update from Debi Game, SUCO

Debi Game, Bucks Service User and Carer Organisation (SUCO), gave the following update.

Bucks SUCO is a small organisation which has been commissioned by the Local Authority to recruit and support and promote Service User and carers engagement in Buckinghamshire around adult services. Carers Bucks has been employed to host SUCO.

SUCO participates in the work of the Partnership Boards, the mechanism the Local Authority uses to engage formally with Service Users and Carers.

SUCO meets the travelling expenses for Service Users and Carers to attend meetings of the Partnership Board. It also provides induction training and information about the skills and qualities to bring to the Partnership Board meetings. Service Users and Carers are empowered to speak up for the communities they represent. It is important for the voice of those who access services to be put across in a constructive way.

Work undertaken by SUCO includes;

·       Involvement in contracts and commissioning of services

·       Working with the Local Authority on the Access to Information

·       The set up and hosting of a group to discuss issues of importance to Service Users and Carers

·       Involvement in the establishment of the Autism Partnership Board and Dementia Partnership Board.

Amy Moore explained that an organisation called Talkback runs information and advice sessions about reforms.  There is good participation from adults, carers and families. The voice of Young People is missing from the information sessions.  The possibility of the creation of a Young Peoples Board to fit into with the Learning Disability Board is looked at tentatively.

Young People and those going through the Transitions process can help shape and influence Assistive Technology, Equipment Services and Digital Platforms etc.  It would have been good for young people to be involved in the development of the equipment catalogue.  Amy advised that Jack Workman has been appointed as Assistive Technology Officer for Children and Young People for a period of 18 months.  Jack has been tasked to look at the needs of young people and draft relevant proposals and suggestions of areas of work to be undertaken.

Update on the diagnostics pathway, focus on CAHMS and the Resource joint post.

Sue Butt, Operations Manager, Commissioning

Sue Butt, Operations Manager, Commissioning explained that the current CAMHS contract expires in 2015 and is currently out for re-tender. The timeline for the tender process is progressing.

In terms of resourcing, Stephen Stych is carrying out a piece of work to specifically look at the Health diagnostic pathway for autism from a commissioning perspective.  The mapping exercise of the pathway and the GP Practice Model are also being undertaken. Work is also taking place with partners to look at those who do not achieve a diagnosis and setting up training and support for parents.

The National Institute for Health and Care Excellence (NICE) published clinical guidelines on the diagnostic pathway several years ago.  Hampshire County Council has published an example of work they carried out, results, evaluation and key learning points on the NICE website.

https://www.nice.org.uk/guidance/cg128/resources/type-and-title-of-submission

During discussion, the following questions were asked.

What are the timescales in terms of this piece of work fitting in with the tendering process and the Working Group? In terms of current resources and pathways, key areas of work are looking at how the diagnostic pathway needs to be reconfigured under the new arrangements and how the pathway interfaces with the re-commissioning process.

25% of the work carried out by Oxford Health is around ASD. It is important to highlight this figure.  This can be looked at in more detail as well as the impact on the re-commissioning process.

Zita Calkin, Lead Commissioning Manager

This item was deferred to the December meeting

Zita Calkin, Lead Commissioning Manager

This item was deferred to the December meeting

Update from Paulette Hunn

Paulette Hunn, Senior Adult Social Care Training Consultant gave the following update;

The Autism Strategy advises there should be three tiers of training;

·       Tier 1 - E-Learning (basic awareness of Autism and introduction to Autism

·       Tier 2 – a one day course to understand the key features of the Autism Spectrum Condition (should this include and end of course assessment?)

·       Tier 3 – one/two day course for those who have permanent contact with individuals on the Spectrum – the course includes the development of support systems, interventions and strategies, signposting to services, understanding behaviour, the history, development of theories and legislation, positive recording and reflective practice.

In terms of feedback, individuals can participate in training but we don’t know what they take away from then training and put into practice.

It is difficult to have an outcome for Autism training because of the vast spectrum.  There needs to be a person centred approach.

During discussion, the following comments were made;

·       The suggestion was made of contacting Lori Williamson, Carers Development Officer BCC, as work has been taking place on the development of an e-learning module for carers in conjunction with the Carers Partnership Board. 

·       There needs to be a feedback process in place to show that training has been effective.

·       Participants on Drug and Alcohol courses are advised that they will be contacted six months after the course to give an update i.e. have any outcomes been identified?  The response rate is usually about 50%.

·       Could participants be asked to fill in an outcome measure prior to the training course?

·       In terms of the E-Learning course, participants could be asked to demonstrate progress made since they attended the course.

·       It needs to be made clear that there is a reason for training sessions.  They are not just a day out of the office.

·       Could there be a pre-test and post-test i.e. the participant gives a brief overview of current knowledge before the course and an overview what they have learnt during the course.

·       The training needs to be balanced.  If it is too prescriptive and too onerous, participants will feel like they are back at school taking a test.

·       It is the responsibility of the individual to undertake training or the service area as a commissioning measure of a framework and expected standards to be in place.

·       Some cases are monitored by the goals with young people.

·       An example is a school in London where teachers knew they didn’t have an understanding of autism but they were doing their best.  After training took place, the teachers reported they felt more confident and fewer children were disciplined in class.

·       The cornerstone has to be a proactive approach to training.  So much could have been pre-empted if there has been better knowledge and understanding.

·       The number of hours of the Tier Two course needs to be advised.

·       The courses need to interactive i.e. information on the senses and an understanding of the difficulties those with Autism experience.

·       There needs to be a  ...  view the full minutes text for item 12.

Meeting dates for 2015 are to be sent to Board Members.

Action: Sharon Griffin

Terms of Reference for the Partnership Board and Project Board are to be circulated to Board Members.

Action: Sharon Griffin

Agenda items for December meeting;

·       Update on the Bucks Joint Autism Plan

·       Buckinghamshire Autism Training Plan

·       Care Act

·       Update and review of the Action Plan and overview of the Autism Strategy

The next meeting of the Board will take place on Wednesday 3 December 2014, 10am, Mezzanine 1, County Hall, Aylesbury.

Proposed meeting dates for 2015

The next meeting of the Board will take place in Wednesday 3 December 2014, 10am, Mezzanine1, County Hall, Aylesbury.

Meeting Dates for 2015

11 February     2 September

15 April            14 October

24 June           9 December