Agenda item

Cabinet received a report providing:

·               a progress update on the Special Educational Needs and Disabilities (SEND) Improvement Programme since inspection.

·               a brief overview of the new SEND Inspection Framework and outcomes to date.

·               an overview of current challenges across the system and the evolving strategic plans to try to mitigate the challenges.

The local authority and the Integrated Care Board (ICB) were jointly responsible for services provided to children and young people with SEND in Buckinghamshire and were subject to inspection by Ofsted and the Care Quality Commission (CQC). Buckinghamshire, Oxfordshire and Berkshire West (BOB) was the partner ICB.  Ofsted and the CQC inspected the services provided for children and young people with SEND in Buckinghamshire between 7 March and 11 March 2022. Following the local area inspection, the Local Authority and the Integrated Care Board (formerly the Clinical Commissioning Group [CCG]) were jointly responsible for submitting an action plan to Ofsted, detailing how 3 areas of significant weakness would be addressed. The plan, submitted on 8 August 2022 was approved by Ofsted on 25 August 2022.

The 3 areas of weakness identified related to:

• The lack of a cohesive area strategy to identify and meet the needs of those children and young people requiring speech and language, communication and occupational therapy.

• Waiting times for assessments on the autism and attention deficit and hyperactivity disorder diagnosis pathways and the system-owned plans in place to address this.

• Waiting times to see a community paediatrician.

The current challenges across the SEND system related to:-

·       waits for access to diagnoses and therapy support being still too long,

·       a sharp rise in requests for EHCP assessment, together with a shortage of Educational Psychologists (This had led to a decline in performance against the statutory 20-week EHCP needs assessment measure.)

·       the number of EHCPs maintained by Buckinghamshire was also increasing

·       there were very significant financial pressures on the High Needs Block.

Buckinghamshire was not alone in facing challenges in meeting the needs of children with SEND. The local area has sought to deliver against a wider improvement programme to ensure the experience of children and families improved across all areas of SEND.

RESOLVED –

That the update from the Area SEND Partnership be NOTED.

Cabinet received a report providing:

·       a progress update on the Special Educational Needs and Disabilities (SEND) Improvement Programme since inspection.

·       a brief overview of the new SEND Inspection Framework and outcomes to date.

·       an overview of current challenges across the system and the evolving strategic plans to try to mitigate the challenges. 

The local authority and the Integrated Care Board (ICB) were jointly responsible for services provided to children and young people with SEND in Buckinghamshire and were subject to inspection by Ofsted and the Care Quality Commission (CQC). Buckinghamshire, Oxfordshire and Berkshire West (BOB) was the partner ICB.  Ofsted and the CQC inspected the services provided for children and young people with SEND in Buckinghamshire between 7 March and 11 March 2022. Following the local area inspection, the Local Authority and the Integrated Care Board (formerly the Clinical Commissioning Group [CCG]) were jointly responsible for submitting an action plan to Ofsted, detailing how 3 areas of significant weakness would be addressed. The plan, submitted on 8 August 2022 was approved by Ofsted on 25 August 2022. 

The 3 areas of weakness identified related to:

·       The lack of a cohesive area strategy to identify and meet the needs of those children and young people requiring speech and language, communication and occupational therapy.

·       Waiting times for assessments on the autism and attention deficit and hyperactivity disorder diagnosis pathways and the system-owned plans in place to address this.

·       Waiting times to see a community paediatrician. 

The current challenges across the SEND system related to:-

·       waits for access to diagnoses and therapy support still being too long.

·       a sharp rise in requests for EHCP assessment, together with a shortage of Educational Psychologists (This had led to a decline in performance against the statutory 20-week EHCP needs assessment measure).

·       the number of EHCPs maintained by Buckinghamshire was also increasing.

·       there were very significant financial pressures on the High Needs Block.

Buckinghamshire was not alone in facing challenges in meeting the needs of children with SEND. The local area had sought to deliver against a wider improvement programme to ensure the experience of children and families improved across all areas of SEND.

The Cabinet Member reported that all eligible children had to have an Education, Health and Care Plan and there was a strict legal framework around this, which meant there was no flexibility in provision of services. There had also been a radical change in demand; in 2022 there were 6000 young people and this year there was 7000. There were also staff shortages. There was a restructuring of therapists and also a restructure of the SEND workforce. 

The Leader introduced Rachael Corser, Chief Nursing Officer with the Integrated Care Board. She reported that the partnership working across the sectors was strengthening. There had been some financial and people investment in the service area but there was still further work to be undertaken. The Inspection had been undertaken following a new area SEND inspection framework and also was mindful of problems being experienced in neighbouring authorities such as Oxfordshire. One of the advantages of having a wider integrated care system was that Councils could ensure that any learning from past experience was taken on board.  There were some significant workforce challenges with up to a third of vacancies and it was important to work with partners in terms of streamlining referral processes and maximising the workforce in conjunction with parent and carer forums and children to ensure their needs were met as much as possible. Partnership working with providers was strengthening with Oxford Health Foundation Trust and Buckinghamshire Healthcare Trust, who were working with the ICB in strengthening those referrals and getting better access to community paediatrics pathways (and had been cited as a national exemplar). They were also working with speech and language therapists and occupational therapists. Whilst improvements were being made, there were still areas to progress which were being monitored by the ICB Chief Executive monthly personally. The Corporate Director for Children’s Services also referred to the Delivering Better Value Programme to redesign and introduce early support to children and families due to the increasing demand. The recommissioned Therapies Service would further support delivery of this when the new contract goes live in 2024.

During discussion the following points were noted:-

• With regard to EHC needs assessment requests these had increased from 680 in 2016 to 1,365 in 2022 which showed an increase of 107%. 7,000 ECHP’s would need to be processed, which was a significant workload in terms of assessments and provision of service. The Chief Nursing Officer reported that whilst children were waiting for assessments early help was provided using a variety of tools including Artificial Intelligence and digital platforms as often children responded well to those mechanisms. The Corporate Director reported that ECHPs were dependent on Educational Psychologists who were difficult to recruit and during the Summer they had used Associate EP’s to complete parts of the ECHP (Appendix D) to help alleviate workloads. EP’s had also been asked to prioritise ECHPs but that had taken them operationally from schools. 
• A Cabinet Member referred to ICB investment as £4.6m had been invested from the ICB in April to support additional specialist/clinical capacity across the pathways. Recruitment against this investment had commenced but the impact had not yet been realised. The Chief Nursing Officer reported that recruitment was a challenge, but they were looking at how they skill mix qualified occupational therapists and qualified speech and language therapists with support and associate roles and looking at other collaborative platforms bringing in groups of children, parents and carers together to make collective assessments. This was working well and they were looking to build on that investment. In terms of recruitment they were looking wider with internationally educated therapists. There were challenges but benefits of that investment were being realised.
• In response to another question, the Corporate Director reported that they were involving parent groups in the Strategy and they have also had a Shout out for SEND Session with young people which he attended, along with the Cabinet Member, where young people with SEND had discussed their experiences of being involved in processes and working with schools. The child was always involved in a ECHP as it was their plan.
• Reference was made to the transformation scheme implementation plan which dovetailed into the SEND programme. The aim was to encourage children and families to identify issues at a young age so that needs could be met at an early stage, which should avoid any escalations later in their school life. Schools also had a budget for higher needs and were taking part in accessing local therapy and dealing with issues to avoid any further escalation.
• In terms of best practice, the Chief Nursing Officer reported that they had been looking at models used by Hampshire and Isle of Wight, which was an advantage of having wider partnerships and networks. Implementation Plans used by other Councils who had been through challenging times were also being looked at.

RESOLVED – 

That the update from the Area SEND Partnership be NOTED.