Joint Working for Quality Improvement and Integration around SEND

• Engaging with reality – children and young people with SEND and their families have complex lives; their needs cross traditional service boundaries

• CYP with SEND are also more likely to belong to other groups that need support

• The policy context – the Children and Families Act and duties around joint working

• The financial context – may seem to make joint working harder, but integration has the potential to reduce pressures on families and professionals

Why we need a focus on joint working

A complex web of inter-relating and intersecting vulnerabilities

SEND 1,244,255

Young offenders

sentenced 25,700

LAC

72,670

SEN support 45%28% EHCPs

6%52%*

57.3%

Learning disability

23-32%

Dyslexia 43-57%

Communicationdisorder

60-90%

ADHD 12%

ASD 15%

Young Offenders**

26%

Children needing support

SEND

LAC

CiN

Poverty

Alternative provisionYoung

offenders

Excluded

Mental health needs

Troubled families

Engaging with reality

Current figures for LAC, children with SEND and children in custody

• The number of pupils with special educational needs (SEN) was 1,244,255 in January 2017 (DfE, Special Educational Needs in England, 2017)

• At 31 March 2017 there were 72,670 looked after Children (DfE, Children Looked After in England, 2017 )

• In 2016/17 25,700 children and young people received a sentence in court (Youth Justice Board/MoJ, Youth Justice Statistics 2016/17)

Intersection between vulnerabilities

• 57.3% of LAC have a SEN identified by the end of KS2 (DfE, Children Looked After in England, 2017)

• 52%* of young offenders asked for a 2014-15 study said they were or had been in care (Youth Justice Board, Children in Custody 2014–15, 2015)

• 45% of young offenders sentenced in 2014 at the end of KS4 were recorded as having SEN without a statement, and 28% as having SEN with a statement (DfE and MoJ, Understanding the educational background of young offenders, 2016)

• 26% of boys held in YOIs in 2014-15 who said they had been in local authority care also reported having a disability (Youth Justice Board, Children in Custody 2014–15, 2015)

*This is the percentage who said they were or had ever been in care. The official figures are much lower and only represent children currently looked after.

**Prevalence rates of neurodevelopmental disorders among young people in custody (Howard League What is Justice? Working Papers 17/2015)

Context and sources

The policy context

• Rising demand and falling resources

• A complex system

• Pressures on professionals

• National policy and programme requirements against a backdrop of financial pressures, reorganisations, rising demand

• Pressures on parents and carers

• Many parents doing a lot of the ‘joining up’ themselves – creating inequality of access/experience?

The financial context

• Early intervention and the graduated approach• Low intensity support, e.g. West Berks Emotional Health

Academy• Starting in the early years, e.g. Northants Specialist SEND

Support Services

• Sharing resources and expertise locally

• Collaboration between specialist settings, e.g. Lincolnshire Special Schools, to deliver support closer to home

• Building skills and knowledge in universal settings, e.g. Therapies in Schools, Whole School SEND

What’s working well?

• Shared outcomes and strategy

• Hertfordshire Outcome Bees

• Bedford’s shared outcomes

• Meaningful co-production and participation

• Working with forums and families from the start e.g. St. Helens ND pathway, Rotherham Charter

• Empowering young people’s groups e.g. Suffolk Young Person’s Network

What’s working well?

Key challenges for 2019?

Links with youth justice

system

Inclusion (and exclusion)

Identifying and supporting children and young people with

autism only

What’s happening nationally?

• SEND Leadership Board

• NHS Long Term Plan• Key worker role• Expanded mental health services and support • Information and training on LD and autism• Integrated Care Provider Contract and ICS Accountability and

Performance Framework

• Changes to Ofsted framework and exclusions review

• SEND inspections and revisits ongoing

• Autism review and strategy to include children (Autumn 2019)

Opportunities for support

Support to local areas through the DBOT partnership

• Audit tool

• Regional events

• Local support

• DMO/DCO forum

• Children’s Commissioners Forum

Can you help us?

• Survey on joint commissioning

https://www.surveymonkey.co.uk/r/27NWPXC

Leadership is the most important factor in enabling (or hindering!) integration – leaders can unite services and agencies around a whole system approach to SEND and centrally agreed outcomes.

Good leaders drive integration by:

• Setting a clear, strategic vision across agencies, including shared outcomes that different agencies can unite around;

• Setting an organisational culture that supports collaboration.

But a lack of support from senior leaders can act as a barrier to integration.

The importance of leadership

“We’ve been looking at integrating our service with our colleagues in the community… this is a project

that’s been ongoing for five years and I find it very difficult to get senior management to

focus on any change …I get the sense that people all think it’s a good idea but we’re not high enough on the priority level for it to be actually

actioned. There’s always something else more pressing.”

“...the clear strategy, around being child friendly, around the voice of the child, it’s given us some real value bases that we can collectively work together around… it supports the conversation between what’s the health element, what’s the care element, what’s the education element, because we’re coming at it from the same outcome base.”

The importance of leadership

Good quality data and effective information sharing processes should aid integration at both strategic and individual care level, supporting areas to look at the ‘big picture’, respond together as a system and achieve strategic outcomes.

However areas are held back both by practical challenges and by service-specific focus/mindset.

*Leadership has a role to play in promoting work to overcome these barriers.

Data and information sharing

Population data:

• Availability and quality of population level data not great.

• Where available data was often used to support infighting over funding.

Performance data:

• Can track performance of specific services but harder with bigger outcomes.

• This is still an aim for all areas!

Information sharing processes:

• Information sharing is difficult due to differing systems, processes and governance arrangements between agencies and services.

• Where in place, multi-agency information sharing processes had been difficult to establish and required cross-agency buy-in/commitment to be successful.

Data and information sharing

Range of external factors influence decisions locally, sometimes driving and sometimes hindering integration.

*Leadership has a role to play in ensuring national programmes are aligned at local level and in promoting collaborative approaches to funding pressures.

National policy and programmes – within SEND:• Can help drive integration in some cases, where national policy

and directives are clearly aligned: “…the outcomes and what health and social care have to sign up to do [for the Transforming Care Programme], I think are going to be really helpful … it makes people focus on it …it becomes a top priority.”

• However national directives can also be seen as unhelpful where tight timescales risk compromising quality or national bodies are not aligned in their approach/demands on local areas.

External factors

National policy – universal services:

• Different priorities and incentives for universal services which don’t speak to SEND or promote inclusion make join-up with these services very difficult, particularly in education.

• “[Schools have] got their remit and that’s what they’re focused on… so it can feel very much like separate entities… The knock on is that we have children in special schools that shouldn’t be in special schools.”

Resource constraints and increasing demand:

• Integration can potentially support areas under financial pressure by reducing duplication – some areas were trying this.

• However in most cases funding pressures were seen as hindering integration as organisations sought to protect their own funds and became focussed on internal cost-saving activities, e.g. service reorganisation.

External factors

There are a number of things that have been shown to support integrated working. *These are most effective where they are supported by leadership.

• Joint commissioning arrangements make integration ‘harder to walk away from’ and therefore increase commitment to joint working.

• Joint working arrangements, e.g. co-location helps teams to understand each other’s perspectives and develop their work in a more integrated way; multi-agency panels cut out some of the complexity by coming together to resolve complex cases.

• Effective involvement of children, young people and parents/carers, both at strategic and individual level, helps bring agencies together around holistic outcomes and shifts the focus away from individual services.

Cutting through the complexity – what’s working

Embedding the Children and Families Act 2014

across a local area –

Progress and challenges

Knowsley 15 February 2019

André Imich, SEN and Disability Professional Adviser, DfE

Children and Families Act 2014

The Act and the statutory SEND Code of Practice introduced major changes

including:

• 0-25 system

• EHC plans

• Much stronger role for families in planning and commissioning

• Local Offer

• Joint commissioning

• SEN support replaced ‘school action’ and ‘school action plus’

• Young Offenders duties

• Personal budgets

• Review of disagreement resolution

What we have achieved so far

The Children & Families Act 2014 set an ambitious agenda for SEND –

an outcomes-focused, person-centred and collaborative system.

The 2014 reforms remain the right ones, and the Department is

committed to seeing them through.

We are encouraged by the early evidence of the impact of their

implementation in improving the lives of children and young people with

SEND.

Completing the statutory transition of statements to EHC plans was an

important milestone.

We know there is much more to do to embed the reforms and achieve

consistency across the country.

Now we are moving from statutory compliance to improving quality, and

continuing to invest in sharing best practice and driving improvements.

Challenges for local authorities

LA capacity:

Staff turnover and training needs

Challenge of delivering the culture of the 2014 reforms

Pressures on places:

Increasing demand for special school places

Accountability system does not reward mainstream schools for

inclusion

Challenge of managing a complex and autonomous range of providers

Importance of parental preference; statutory right to appeal to Tribunal

Financial pressures:

Increasing spend on high needs provision and impact of ring-fencing

the schools block

Growing pressure for provision for young people aged 16-25

Pressure on wider LA budgets (e.g. social care, transport)

Challenges for local authorities Strategic planning and commissioning

Join up with health and social care, esp. for complex needs

Building local services: role of local offer

Post-19 provision and focus on supporting YP into employment

Relationships with schools

SEN support

Support from wider services

Relationships with parents

Developing/ maintaining co-production

Wider context

Exclusions and Timpson Review

Alternative provision

Children & young people’s mental health

Embedding the SEND reforms:

What the data says

Data – the SEN system and EHCPs

Total number of EHCPs held – Increase of 11.3% (2016 to 2017)

LAs agreed to more EHC needs assessments following requests

(78% agreed).

16.8% more new EHC plans issued in 2017 than in 2016

93.3% of all EHC needs assessments led to a EHC plan

2017 has the highest number of EHC plans held by LAs –

319,819 (2.9% of 5-16 population)

2017 – 11.7% of school population on SEN Support

Improvement in 20 week timeliness of assessments – from 59% in

2016 to 65% in 2017 (38 LAs over 90%; 8 LAs achieved 100%)

Tribunal Appealable Rate – 1.5%

DO YOU KNOW WHERE KNOWSLEY STANDS

ON EACH OF THESE DATA-SETS?

Data – the SEN system and EHCPs

Total no of EHCPs held – Increase of 11.3% (2016 to 2017) –

Knowsley 16%

LAs agreed to more EHC needs assessments following requests (78%

agreed). Knowsley 95.6%

16.8% more new EHC plans issued in 2017 than in 2016 - Knowsley 33%

93.3% of all EHC needs assessments led to a EHC plan - Knowsley 100%

2017 has the highest number of EHC plans held by LAs – 319,819 (2.9%

of 5-16 population) Knowsley 3.9%

2017 – 11.7% of school pop on SEN Support - Knowsley 15.3%

Improvement in 20 week timeliness of assessments – from 59% in 2016

to 65% in 2017. Knowsley: 92.5% in 2016, 90.8% in 2017

38 LAs over 90% including Knowsley; 8 LAs achieved 100%

Tribunal Appealable Rate – 1.5%. Knowsley 0.3%

The local area

SEND inspection process

Local Area SEN Inspections

All local areas to be inspected, over five years, from May 2016.

Inspection teams include a HMI, a CQC inspector and a local

authority inspector.

Covers education, health and social care services and providers

for SEND

Visits are made to providers, but not an inspection of the

provider.

Parents, children and young people are interviewed

A notice period – 5 days.

Written Statement of Action (WSoA) required where areas of

serious weaknesses are identified

For WSoA local areas, a revisit 18 months later.

The focus of inspection

The aim is to hold local areas to account and champion the

rights of children and young people with SEND

Inspectors consider how effectively the local area:

identifies need;

meets need; and

improves the outcomes

of the wide range of different groups of children and young

people who have SEND.

Local area SEND inspections are a key part of

holding local areas to account

As at 31 January 2019:

79 local areas inspected

and letters published

38 local areas require

Written Statement of

Action (WSoA)

30

No52%

Yes48%

WSoA Requested from Inspections (%)

SEND inspections – common areas of strength

Strong strategic leadership that has led to

established joint working between education, health

and care services.

Early Years services – good levels of parental

satisfaction

Co-production - parents, professionals, children and

young people are working effectively together to

devise and implement improvements

Strong health engagement, inc DCO/ DMO in place

WSoAs – common areas of serious weaknesses

0%

10%

20%

30%

40%

50%

60%

70%

80%

Leadership/Governance/

Strategy

Jointcommissioning

Co-production EHC plans Managementinfo/ data

Implementation of the SEND reforms:

What we are learning about good

practice in local areas

Implementation of the SEND reforms –

Our indices of success

1. Co-production

with children, young

people and parents

2. All parties meet their

statutory duties3. Increased satisfaction

with access to local

services

4. Accurate and

timely identification

of SEN and disability

5. Improved attainment

and narrowing of gap

for CYP with SEND 6. Strong focus on

those at SEN Support

7. More YP go on to

post-16 education,

training & employment

8. Improved parental

confidence

Wiltshire (2018) - Staff have taken on board the need to

involve parents and CYP fully in the co-production of these

plans to improve their effectiveness and quality…… The local

area wants every parent carer to be satisfied with its

information offer and is currently working with parent carers to

redesign its local offer website.

Wigan - CYP and their families are at the heart of the local

area SEND strategy. Effective joint working between health,

education and social care leaders, managers and frontline

staff is breaking down professional boundaries. The local

parent carer forum is a valued partner.

1. Co-production with children, young

people and parents

St Helens - Leaders and managers ensure that the

statutory duties…..are at the heart of the work of services

working with CYP who have SEND. Senior leaders,

managers and frontline staff have embraced the spirit of

the reforms, putting CYP and families at the heart of their

plans.

West Berkshire - EHC plans are of good quality and

completed on time. Professionals and members of the

PCF regularly check the quality of EHC plans. EHC plans

include precise and relevant educational outcomes.

Suitable provision is clearly identified.

2. All parties meet their statutory duties

3. Increased satisfaction with access to

local services

Southend - Young people up to the age of 18 years

with SEND are now able to access emotional well-

being and mental health service (EWMHS) specialist

support. A parenting group that offers a six-week

support to parents has also been established.

Parents are appreciative of this provision.

Sheffield – Consistently strong early identification

and support for children and young people who are

deaf or have a hearing impairment. Well-planned

support enables these children to make a positive

start in developing their communication skills. 37

N Somerset - Early years leaders provide training in

autism and downs syndrome to support the work of staff

on the ground. This effective training ensures that there is

a common understanding and approach to the care,

education and support of these children and their families

and carers.

Stockport - New EHCPs, and those that have been

transferred from statements of SEN, are completed in a

timely manner. There are effective systems in place to

ensure that plans are agreed within the expected

timescales.

4. Accurate and timely identification of SEN

and disability

5. Improved attainment for CYP with SEND

Rochdale Revisit - “There are clear improvements

in SEN support pupils’ outcomes in the early years,

KS1 and KS2. Pupils’ outcomes are on an improving

trend since 2016.”

Kingston - Learners who have LDD at ages 16 to

18 and 19+ achieve well in relation to their peers

overall. There is also clear evidence of improving

outcomes for young people who are aged from 16 to

25 years old, e.g. independent travel training,

supported internships to paid employment

39

Swindon - Parents have confidence in the work of the

school SENCos who provide strong support to their

children. These professionals are having a positive

impact in meeting the needs of children and young

people in education settings.

Northumberland - SENCos in some schools are a

trusted point of contact for parents and carers of CYP

with SEND. Children and young people with SEND told

inspectors that they are well supported and feel heard.

6. Strong focus on those at SEN Support

Southwark - Examples of successful work in commissioning

services that help young people who have SEND who are

18+. This includes helping them to gain entry into

employment and/or to take part in work experience……..

effective case studies of appropriate preparation for

adulthood, including through supported internships.

Staffordshire - More young people with SEND are accessing

education, employment and training. Inspectors met with

young people with SEND who are accessing a range of

programmes of study in college. Families and young people

told inspectors that the education, training and work

experience on offer was very much valued.

7. More YP go on to post-16 education,

training & employment

Milton Keynes - Many parents are highly appreciative

of the support their children receive across education,

health and social care. They say that practitioners

frequently ‘go the extra mile’ to offer additional help.

Lincolnshire - The most recent PCF survey of parent

satisfaction with the Liaise service was very

favourable…. Parents appreciate the speedy response

of social care services to concerns that are raised about

CYP….The number of tribunals to resolve disputes

between the LA and parents has reduced in the last

year.

8. Improved parental confidence

Implementation of the SEND reforms –

Evidence of impact across Knowsley?

1. Co-production

with children, young

people and parents

2. All parties meet their

statutory duties3. Increased satisfaction

with access to local

services

4. Accurate and

timely identification

of SEN and disability

5. Improved attainment

and narrowing of gap

for CYP with SEND 6. Strong focus on

those at SEN Support

7. More YP go on to

post-16 education,

training & employment

8. Improved parental

confidence

The focus of inspection of SEND in

Knowsley

Inspectors will consider how effectively the local area:

identifies need;

meets need; and

improves the outcomes

of the wide range of different groups of children and

young people who have SEND.

WHAT WILL THEY REPORT IN KNOWSLEY?