Agenda item

For the Select Committee to receive a report detailing the outcome of the Ofsted and Quality Care Commission inspection of the local area SEND provision, carried out between 28^th February and 11^th March 2022.

Contributors:

Cllr Anita Cranmer, Cabinet Member for Children’s and Education

Simon James, Director of Education

Councillor Dormer welcomed Tracey Ironmonger, Service Director; Gayle Porter and Tina Charlton from Buckinghamshire NHS Trust; Sue Hadwin from Oxford Health NHS Trust and Niki Cartwright from NHS Berkshire West CCG who attended the meeting to speak on this item.

Councillor Cranmer, Cabinet portfolio holder for Children’s Services and Education introduced the report. It was noted that a thorough investigation of the local area SEND provision had taken place between 28^th February and 11^th March this year involving staff, service users and parents. The work had included a significant analysis of reported information from over 1000 parents.  The review was the first of its kind on this service carried out jointly by the Care Quality Commission and Ofsted.

Councillor Cranmer noted that in the report was good overall and  that the service was reported to know its area of work well and was aware of the areas that needed to improve as highlighted in the inspection report.  These areas were already subject to improvement by both the council and the healthcare services who were working in partnership. The areas included the need for a  cohesive area strategy on therapies, waiting times for autistic/ADHD reports and waiting times for appointments with community paediatricians.

Richard Nash noted that this was a local area inspection involving the health, education and departmental services which would work together to address the highlighted issues and ensure that all children requiring the services would receive what they required.

Simon James noted that there was a whole system approach to addressing the highlighted issues.  The focus of the review of services had been on identifying needs; assessing and meeting needs and thirdly, identifying what the positive outcomes were for children and young people in the area. FACT (Families and Children Together) Bucks had taken evidence from parents and carers as well as  speaking to parents within schools and this evidence was taken very seriously and was documented in the response letter from Ofsted and the Care Quality Commission.

Much work had commenced on the three areas of work recommended for improvement which would be responded to in the written statement of action. The statement would be submitted to Ofsted via the Department for Education and NH S England no later than 8^th August.

The  strengths currently found  in the SEND service were detailed in the response  letter as follows:-

-             good SEND governance which included the Board co-chaired by Simon Jones and the chair of FACT Bucks,

-          good leadership in local authority, health, social care and schools

-          co-production was embedded in terms of strategic work

-          effective joint commissioning especially relating to children’s mental health needs

-          Children are well prepared for school

-          EHCPs are provided in a timely manner

-          The independent board provided an added level of scrutiny

-          Fortnightly planning meetings occurred to ensure the written statement of action was on track

-          All elements formed the planned ongoing journey for the service

-          Work would continue with parents to aid improvements

Tracey Ironmonger, noted that the overall responsibility for funding the SEND service lay with the CCGs. The council’s integrated commissioning team undertake the procurement and contract monitoring of services via a section 75 partnership agreement and this was particularly useful where services are provided jointly. The area is complex with a wide range of providers delivering joined up services to children which included:

-          Children’ s integrated therapies; delivered by Bucks Healthcare Trust and including community speech and language therapy, physiotherapy and occupational therapy to children registered with GP in or resident in Buckinghamshire

-          The neurodevelopment pathway delivered with Oxford Health Foundation Trust and Bucks Healthcare Trust which provides pre-assessments for diagnostic assessment of autism and ADHD and post diagnostic support. This service provides a single point of access managed by Oxford Heath. BHT is responsible for 0-11 year olds and Oxford Health is responsible for 11-18 year olds.

-          The community paediatrics service which is provided by Bucks Healthcare Trust and which gives a specialist medical service from prevention through to identification, assessment, diagnosis and case management for children and young people with moderate and severe disabilities, special educational needs and those looked after or going through the adoption process.    

-          It was considered important to maintain a strong relationship with parents and carers through FACT Bucks

-          Plans were developing via a system wide approach and co-production between services providers

-          The written statement for action would be an opportunity to accelerate the service’s progress 

-          From 1^st July the CCGs for Buckinghamshire, Oxfordshire and Berkshire West, would merge and become an integrated care board which would look at the challenging area of improving consistency of service provision across the areas.

In response to questions from Councillors it was noted that:

-          There is an existing improvement plan already in progress which included preparation for adulthood and early identification of children moving from primary to secondary school; and ensuring the quality of EHCPs remains high and that the experience of annual reviews of EHCPs remains good

-          Care plans are a national issue. Both Berkshire West and Oxfordshire also have long wait times to access services. We have funding for a CAMHS academy and the service was assessing how to develop roles to supplement the workforce.                            

Action: Niki Cartwright to report back to committee with information on  waiting times

-          A different approach was required and as such, schools’ meetings have discussed embedding health professionals in schools. Some schools are already employing specialists directly. The recommendation was for a hub and spoke model with expertise based in geographical regions so that specialists would get to know a particular school’s culture more thoroughly and therefore be able to respond to the children’s needs more effectively.  Recommissioning as a whole system over the next 2-3 years was being assessed.

-          The committee’s attention was drawn to consider Birmingham and Camden which were areas with strong service level agreements and were good models to examine.

-          The issues noted by the review were long-standing ones and the focus now was on mitigating the long wait times and secondly how to avoid these issues again in the future.

-          Service level agreements  were very detailed and the specifications would be reassessed to ensure that the whole system would work as well as possible

-          The expertise for making a difference to children and young people once needs were identified, should be based in schools

-          Waiting lists were being prioritised on the basis of clinical needs and measures were brought in to relieve pressure on the system

-          Reports from private practitioners commissioned by parents were accepted as part of EHCPs and quality assured to save time in the assessment process

-          Diagnoses were not the only requirement for assessment of a school place. Assessments were based on the needs of the child

-          Specialists helping in schools, enabled the upskilling of staff in schools and this would be developed further as part of the whole school approach, with oversight from specialists in place.

-          It was suggested that a task and finish group of councillors could be formed to look into a SEND related area.

Action: Simon James to look at possible areas for a SEND task and finish group

-          Richard Nash noted that with regards to supported living, work was underway with the housing and commissioning teams to try to match young people to accommodation appropriately, taking into account their needs and wishes. Much progress had been made in this area so far and it would be business as usual to ensure the correct level of support here.

-          John McCoughlin chaired the Improvement Board which would monitor progress and would also discuss potential solutions.  The written statement of actions would go to the next meeting on 11^th July for comment and approval. The board would have an on-going remit to monitor progress of this. Board work would dovetail with the other improvement work which was on-going.

-          There is a requirement to report back to the Department of Education within 4-6 months.

-          The CQC would return to reinspect the service within the next three years.

-          All three areas for improvement were already in the improvement plan prior to inspection. Measures had already been put in place to make improvements such as the introduction of Speak Link in schools, and commissioning services from Helios -a partnership around diagnostic support and an evidence-based provider.

-          Feedback from parents was sought via FACT, or via the feedback button on the local offer, via “You Said We Did” and analysis via any complaints.

Action: Data from Helios to be brought back to Select committee

-          The plan would give details of aims and when targets would be expected to be met and what the hoped impact would be for families.

Action: The Directors noted that they could consider areas that would be helpful to be reviewed by a task and finish group including areas of good practice.

-          Further to new legislation relating to the development of multi-academy trusts, schools were already considering potential structures and it was noted that the local authority would still have the same level of statutory oversight with a key role in engaging and ensuring strong outcomes for children in the future.

-          The Side by Side project would also be used to help develop improvements