london borough of barking and dagenham notice of meeting
TRANSCRIPT
London Borough of Barking and Dagenham
Notice of Meeting
ASSEMBLY
Wednesday, 5 January 2005 - Town Hall, Barking, 7:00 pm To: Members of the Council of the London Borough of Barking and Dagenham Chair: Councillor J Davis Deputy-Chair: Councillor W F L Barns Declaration of Members Interest In accordance with Article 1, paragraph 12 of the Council's Constitution, Members are asked to declare any direct/indirect financial or other interest they may have in any matter which is to be considered at this meeting
John Tatam
Director of Corporate Strategy
Contact Officer Valerie Dowdell Tel. 020 8227 2756 Fax: 020 8227 2171
Minicom: 020 8227 2685 E-mail: [email protected]
AGENDA
1. Apologies for Absence 2. To confirm as correct the minutes for the meeting held on 1 December
2004 (Pages 1 - 3) 3. Local Issue (for discussion): (Pages 5 - 35) Simon Sharp of PricewaterhouseCoopers will present the 2003/04 Joint Audit
and Inspection Letter
4. Final Report of the Health Scrutiny Panel's Review of Speech and Language Therapy Services (for decision) (Pages 37 - 105)
5. Report of the Director of Corporate Strategy: Policy Commissions 2004/06 (for decision) (Pages 107 - 110)
6. Appointments (for decision) (to be reported verbally) 7. Leader's Question time (for response) 8. General Question Time (for response) 9. Report of the Executive (for decision) (Pages 111 - 112) 10. Report of the Director of Education, Arts and Libraries: Governing Body
Appointments (for decision) (Pages 113 - 114) 11. Any other public items which the Chair decides are urgent 12. To consider whether it would be appropriate to pass a resolution to
exclude the public and press from the remainder of the meeting due to the nature of the business to be transacted.
Private Business
The public and press have a legal right to attend Council meetings such as the Assembly, except where business is confidential or certain other sensitive information is to be discussed. The list below shows why items are in the private part of the agenda, with reference to the relevant legislation (the relevant paragraph of Part 1 of Schedule 12A of the Local Government Act 1972). There are no such items at the time of preparing this agenda.
13. Any other confidential or exempt items which the Chairman decides are
urgent
ASSEMBLY
Wednesday, 1 December 2004
(7:00 - 7:30 pm)
PRESENT
Councillor J Davis (Chair) Councillor W F L Barns (Deputy Chair)
Councillor J L Alexander Councillor Mrs E E Bradley Councillor G J Bramley Councillor Mrs J E Bruce Councillor L A Collins Councillor A H G Cooper Councillor Mrs J E Cooper Councillor R J Curtis Councillor J R Denyer Councillor C J Fairbrass Councillor M A R Fani Councillor Mrs K J Flint Councillor C Geddes Councillor A Gibbs Councillor D Hemmett Councillor Mrs D Hunt Councillor I S Jamu Councillor T J Justice Councillor M A McCarthy Councillor M E McKenzie Councillor B M Osborn Councillor Mrs C T Osborn Councillor R B Parkin Councillor Mrs J E Rawlinson Councillor Mrs V M Rush Councillor L A Smith Councillor Miss N E Smith Councillor A G Thomas Councillor Mrs P A Twomey Councillor T G W Wade Councillor J P Wainwright Councillor L R Waker Councillor P Waker Councillor Mrs M M West
APOLOGIES FOR ABSENCE Councillor Ms M G Baker Councillor Mrs J Blake Councillor Mrs D Challis Councillor H J Collins Councillor Mrs J Conyard Councillor B Cook Councillor W C Dale Councillor F C Jones Councillor S Kallar Councillor D Kelley Councillor R C Little 60. Minutes (29 October and 3 November 2004) Agreed.
61. Petition regarding erection of Telecommunications Mast in Parsloes Avenue,
Dagenham Noted that a meeting had been held with the petitioners to discuss their concerns but
that the Council has no powers to intervene in this case.
62. Report of the Director of Corporate Strategy: Barking Town Centre - Proposed Alcohol Consumption Restriction in Designated Public Places
Agreed to use the Council’s powers under Section 13(2) of the Criminal Justice and
Police Act 2001 to make the area within Barking Town Centre identified in the report a
AGENDA ITEM 2
Page 1
designated public place under the Act.
63. Report of the Director of Education, Arts and Libraries: Council Appointed School Governors
Agreed to:
(i) re-appoint the following to serve as Representative Members on governing
bodies: Mrs L Carr Manor Infants’ School Councillor S Kallar Robert Clack Comprehensive School Mr R Moorton Grafton Infants’ School Mr D Waters Eastbury Comprehensive School (ii) appoint the following to serve as Representative Members on governing
bodies: Mr L Halls Village Infants’ School Ms L White Henry Green Primary School
64. Leader's Question Time In response to a question from Councillor Bramley as to whether the Leader thought it
appropriate for an elected Member to delegate their responsibilities to members of the public, Councillor Fairbrass stated that a Councillor cannot delegate their authority.
65. Report of the Executive Noted that the new Conditions of Tenancy will be sent to the Plain English Campaign
for Crystal Marking, and Agreed to: (i) approve the revised Conditions of Tenancy; and (ii) authorise the Director of Housing and Health to publish the ‘Plain English’
version of the Conditions of Tenancy for distribution to every tenant in the Borough, subject to the Solicitor of the Council being satisfied that the terminology in the ‘Plain English’ version does not compromise the Council’s position.
66. Report of the Standards Committee Agreed the revised Rules for Conferences, Visits and Hospitality (which are for
inclusion in Part D (Rules) of the Council’s Constitution) and, as such, the necessary amendments to the Constitution.
67. Report of the Community Forums Noted
Page 2
68. Report of the BAD Youth Forum Noted.
69. * Appointments Agreed the following appointments:
• Thames Chase Joint Committee – Councillor J Davis • London (North East) Valuation Tribunal - Mrs Eileen Keller • Personnel Board – Councillors R J Curtis, J Davis, C J Fairbrass, M A R Fani,
Mrs D Hunt, T J Justice, Mrs V M Rush, T G W Wade and P T Waker
Following the increase in the membership of the Board, agreed a subsequent amendment to the Council’s Constitution.
• Licensing Board – Councillors Mrs D P Challis, W C Dale, J R Denyer, Mrs D
Hunt, I S Jamu, D O’Brien, T G W Wade, J P Wainwright, L R Waker and Mrs M M West
* Item considered as a matter of urgency with the consent of the Chair under Section 100 (4)(b) of the Local Government Act 1972
Page 3
Page 4
This page is intentionally left blank
Go
ve
rnm
en
t a
nd
Pu
blic
Se
cto
r D
ecem
ber
2004
London B
oro
ugh o
f B
ark
ing a
nd D
agenham
2003/0
4 J
oin
t A
udit a
nd I
nspection L
etter
AGENDA ITEM 3
Page 5
Pri
cew
ate
rho
us
eC
oo
pers
LL
P
So
uth
wa
rk T
ow
ers
32
Lo
nd
on
Brid
ge
Str
ee
t
Lo
nd
on
SE
1 9
SY
Tele
phone +
44 (
0)
20 7
58
3 5
000
Fa
csim
ile +
44
(0
) 2
0 7
82
2 4
65
2
Dire
ct
Ph
on
e 0
20
78
04
35
15
T
he M
em
bers
London B
oro
ugh o
f B
ark
ing a
nd D
agenham
Civ
ic C
entr
e
Da
ge
nha
m
Esse
x
RM
10 7
BY
Dece
mbe
r 200
4
La
die
s a
nd
Ge
ntle
me
n
Jo
int
Au
dit
an
d In
sp
ecti
on
Lett
er
2003/0
4
We a
re p
leased to p
resentour
Join
t A
udit a
nd Inspection L
etter
for
2003/0
4. W
e h
ope that th
e info
rmation c
onta
ined in this
re
po
rt p
rovid
es a
usefu
lsourc
e o
f re
fere
nce for
Me
mb
ers
. T
he
Au
dit C
om
mitte
e (
the
Co
rpora
te M
onito
rin
g G
roup
) co
nsid
ere
d the L
etter
on 1
6 D
ecem
ber
2004. W
e look forw
ard
to p
resenting it to
you a
t th
e A
ssem
bly
meeting o
n 5
January
2005.
Ian H
ickm
an, th
e A
udit C
om
mis
sio
nR
ela
tionship
Manager
has b
een p
rom
ote
d in
to a
new
role
at th
e A
udit C
om
mis
sio
n. J
anette W
hitfield
will
now
fulfil
this
role
. Ian w
ould
like to p
lace o
n r
ecord
his
thanks to the o
ffic
ers
and M
em
bers
of th
e C
ouncil
for
their c
o-o
pera
tion.
Yours
faithfu
lly
Pri
cew
ate
rhou
seC
oo
pers
LL
P
Ian
Hic
km
an
Audit C
om
mis
sio
n R
ela
tionship
Manage
r
Pri
ce
wa
terh
ou
se
Co
op
ers
LL
P is a
lim
ite
d lia
bili
ty p
art
ne
rsh
ip r
eg
iste
red
in
En
gla
nd
with
reg
iste
red
nu
mb
er
OC
30
35
25
. T
he
re
gis
tere
d o
ffic
e o
f P
rice
wa
terh
ou
se
Co
op
ers
LL
P is 1
Em
ba
nkm
en
t P
lace
, L
on
do
n
WC
2N
6R
H.
Price
wa
terh
ou
se
Co
op
ers
LL
P is a
uth
ori
se
d a
nd
re
gu
late
db
y t
he
Fin
an
cia
l S
erv
ices A
uth
ori
ty f
or
de
sig
na
ted
in
ve
stm
en
t b
usin
ess.
Page 6
Conte
nts
Executive s
um
mary
................................................................................................................................................................................................................................................
4
Accounts
and G
overn
ance
........................................................................................................
............................................................................................................................
7
Perf
orm
ance m
anagem
ent..................................................................................................................................................................................................................................
16
Inspection
.............................................................................................................................................................................................................................................................2
1
Audit p
lan 2
004/0
5...............................................................................................................................................................................................................................................2
7
Appendix
A: A
udit r
eport
sis
sued in r
ela
tion to the 2
003/0
4 fin
ancia
l year
.........................................................................................................................................................2
8
Appendix
B: R
eco
mm
endations
..........................................................................................................................................................................................................................
29
Co
de
of
Au
dit
Pra
cti
ce
an
d S
tate
me
nt
of
Resp
on
sib
ilit
ies
of
Au
dit
ors
an
d o
f A
ud
ite
d B
od
ies
We p
erf
orm
our
audit in a
ccord
ance w
ith t
he A
udit C
om
mis
sio
n’s
Code o
f A
udit P
ractice (
the C
ode),
whic
h w
as last
issued in M
arc
h 2
002.
This
is s
upport
ed b
y t
he S
tate
ment
of
Responsib
ilities o
f A
uditors
and A
udited B
odie
s,
whic
h w
as last
issued in
April 2000.
Both
docum
ents
are
availa
ble
fro
m t
he C
hie
f E
xecutive o
f each a
udited b
ody.
The p
urp
ose o
f th
e s
tate
me
nt
is t
o a
ssis
t aud
itors
and a
ud
ited b
odie
s b
y e
xpla
inin
g w
here
the r
espo
nsib
ilities o
f au
ditors
beg
in a
nd
end,
an
d w
hat
is t
o b
e e
xpecte
d o
f th
e a
ud
ite
d b
ody in
cert
ain
are
as.
Our
report
s a
nd a
udit letters
are
pre
pare
d in t
he c
onte
xt
of
this
sta
tem
ent
and in a
ccord
ance w
ith t
he C
ode.
Rep
ort
s a
nd letters
pre
pare
d b
y a
ppo
inte
d a
uditors
an
d a
ddre
ssed t
o m
em
bers
or
offic
ers
are
pre
pare
d f
or
the s
ole
use
of
the a
udited b
ody,
and n
o r
esponsib
ility
is t
aken b
y a
uditors
to a
ny
Mem
ber
or
offic
er
in t
heir indiv
idual capacity,
or
to a
ny t
hird p
art
y.
Pri
ce
wa
terh
ou
se
Co
op
ers
LL
P3
Page 7
Exe
cu
tive
su
mm
ary
The p
urp
ose
of th
is r
eport
We a
re r
equired, under
the A
udit C
om
mis
sio
n's
Code
of A
udit P
ractice (
the
Code),
to issue a
n a
nnualA
udit L
etter
to the C
ouncil
on c
om
ple
tion o
f our
audit,
de
mo
nstr
ating
th
at th
e C
od
e’s
ob
jective
s h
ave
bee
na
dd
ressed
and
su
mm
arisin
g
all
issues o
f sig
nific
ance a
risin
g fro
m o
ur
work
. O
ur
repo
rt a
lso inclu
des a
sum
mary
of th
e r
esults o
f th
e inspection w
ork
undert
aken d
uring 2
003/0
4 b
y the
Audit C
om
mis
sio
n in a
ccord
ance w
ith their r
esponsib
ilities a
s d
eta
iled in s
ection
10 o
f th
e L
ocal G
overn
ment A
ct 1999.
The join
t re
port
ing o
f audit a
nd inspection w
ork
in this
form
at re
cognis
es the s
tep
s
that th
e A
udit C
om
mis
sio
nhas taken to in
tegra
te m
ore
clo
sely
audit a
nd
inspection r
egim
es, w
hils
t re
cognis
ing a
nd m
ain
tain
ing
their s
epara
te s
tatu
tory
responsib
ilities. T
he A
udit C
om
mis
sio
nhas a
ppoin
ted ‘re
lationship
managers
’ fo
r
all
local auth
ori
ties to c
o-o
rdin
ate
pla
nnin
g a
nd d
eliv
ery
of in
spection w
ork
alo
ngsid
e the s
tatu
tory
audit w
ork
.
The n
ew
appro
ach is inte
nded to p
rovid
e a
more
pro
port
ionate
and inte
gra
ted
appro
ach to p
erf
orm
ance a
udit a
nd inspection
work
.
The m
ain
are
a for
an inte
gra
ted a
ppro
ach h
as b
een in
respect of perf
orm
ance
revie
w w
ork
, based o
nth
e im
pro
vem
entpla
n d
evelo
ped b
y the C
ouncil,
follo
win
g
the
Au
dit C
om
mis
sio
n’s
Co
mp
reh
en
siv
e P
erf
orm
ance
Assessm
ent p
rocess
(CP
A).
Our
Audit P
lan s
et out th
e r
isks that w
e identified a
s p
art
of our
audit p
lannin
g,
togeth
er
with the targ
ete
d w
ork
that w
e p
lanned to p
erf
orm
in o
rder
to a
ddre
ss
the
se
ris
ks. T
he
in
sp
ectio
n w
ork
un
de
rtake
nth
is y
ea
r w
as a
resu
lt o
f th
e C
ou
ncil’
s
Impro
vem
ent P
lan.
We h
ave issued a
num
be
rof re
port
s d
uring the a
udit y
ear,
deta
iling the fin
din
gs
from
our
work
. A
lis
t of
these r
eport
s is inclu
ded a
t A
ppendix
A to this
Join
t A
udit
and Inspection L
etter.
We h
ave s
et out belo
w w
hat w
e c
onsid
er
to b
e the k
ey issues a
risin
g fro
m the
audit a
nd inspection
work
. T
hey r
eflect
the fact th
at th
e C
ouncil
has m
ade g
ood
pro
gre
ss in
ad
dre
ssin
g its
ch
alle
ng
es o
ve
r th
e p
ast 1
2 m
on
ths.
Pri
ce
wa
terh
ou
se
Co
op
ers
LL
P4
Page 8
Accou
nts
an
d G
ove
rnan
ce
In last year’s a
udit letter
we n
ote
d that du
ring 2
003 there
were
sig
nific
ant changes
in p
ers
onnelw
ithin
the F
inance d
epart
ment w
hic
h r
esulted in s
om
e a
reas o
f th
e
depart
ment’s w
ork
bein
g d
ela
yed, such
as the d
evelo
pm
ent of risk m
anagem
ent
and a
Mediu
m T
erm
Fin
ancia
l S
trate
gy (
MT
FS
). T
he d
epart
ment fa
ced a
challe
ngin
g a
genda in e
very
are
a o
f its o
pera
tion.
We a
re p
leased to r
eport
that S
enio
r finance o
ffic
ers
have m
ade tangib
le
impro
vem
ents
to the d
epart
ment’s w
ork
over
the last 12 m
onth
s. T
his
is e
vid
ent
from
the im
pro
ved s
core
s that have b
een r
ecord
ed in o
ur
Auditor
Score
d
Judg
ments
and the d
epart
ment’s r
espon
se to the fin
din
gs o
f th
e B
enefit F
raud
Inspecto
rate
.
For
the first tim
e, th
e C
ouncil
has a
lso d
evelo
ped a
MT
FS
. T
he d
ocum
en
t sets
out a fra
mew
ork
for
usin
gth
e C
ouncil’
s fin
ances to d
eliv
er
the C
om
munity
Priorities d
eta
iled w
ithin
the S
trate
gy o
ver
the n
ext th
ree y
ears
. It is
a k
ey
docum
ent as it pro
vid
es a
str
ate
gic
conte
xt fo
r pro
posed d
evelo
pm
ents
in the
Co
un
cil’
s b
udg
ets
, spe
nd
ing
pla
ns a
nd
fin
an
cia
l a
dm
inis
tra
tion
. A
s th
e d
ocu
me
nt
has n
ow
be
en
develo
ped, th
is s
hould
furt
her
enhance inte
rnal contr
ol w
ithin
the
Council
as it is
inte
nded to b
e u
sed a
s a
fra
mew
ork
for
decis
ion m
akin
g in the
futu
re. T
he C
ouncil
is p
lannin
g to u
pdate
it
annually
to e
nsure
that it r
eflects
the
most up to d
ate
fin
ancia
l po
sitio
n o
f th
e C
ouncil
and its
exte
rnal environm
en
t.
Ris
k identification a
nd m
anagem
ent is
an a
rea
of critical im
port
ance to a
ny
org
anis
ation. W
here
a C
ouncil
has identified r
isks a
cro
ss its
busin
ess, and
co
nsid
ere
d th
e c
on
tro
ls a
va
ilab
le to
man
ag
e th
ese
ris
ks, it is in
a b
ett
er
positio
n to
achie
ve its
obje
ctives, in
the s
hort
er
an
d longer
term
.
During 2
003/0
4 the C
ouncil
begun to d
evelo
p a
ris
k m
anagem
ent str
ate
gy a
nd
identify
str
ate
gic
ris
ks a
t a d
epart
menta
lle
vel. A
ris
k m
anagem
en
t polic
y a
nd
str
ate
gic
ris
k r
egis
ter
is to b
e a
gre
ed b
yth
e C
orp
ora
te M
onitoring G
roup in
Decem
ber
and
then the E
xecutive. H
ow
ever,
pro
gre
ss in e
mbeddin
g r
isk
managem
ent in
to the d
ecis
ion m
akin
g p
rocesses o
f th
e C
ouncil
has n
ot been a
s
sw
ift as inte
nded.
The n
ext sta
ge is for
the C
ouncil
to c
onsid
er
opera
tional risks a
cro
ss the
org
anis
ation, and then e
nsure
that risks
are
mapped to inte
rnal contr
ols
, budgets
,
resourc
e a
llocations a
nd indiv
idual jo
b s
pecific
ations o
r obje
ctives. P
lans h
ave
been form
ula
ted b
y the C
ouncil
to d
o this
.
The o
pera
tion o
f th
e O
racle
fin
ancia
l syste
m is s
till
causin
g p
roble
ms for
the
Council.
S
om
e k
ey r
econcili
ations a
re p
rovin
g d
ifficult to c
om
ple
te a
nd o
ur
annual
revie
ws o
f th
e s
yste
m c
ontinue to h
ighlig
ht a n
um
ber
of is
sues. O
ffic
ers
are
focused u
pon these p
roble
ms a
nd the A
udit C
om
mitte
e is m
onitoring their
pro
gre
ss.
Ensuring that th
e IT
depart
ment is
fit for
purp
ose to s
upport
the o
rganis
ation’s
bu
sin
ess n
eed
s is c
urr
en
tly a
hig
h p
riority
fo
r th
e D
irecto
r o
f F
inan
ce
. O
ffic
ers
are
aw
are
that part
icula
r attention s
hould
be g
iven to the IT
str
ate
gy, as this
should
be
the b
asis
for
all
IT r
ela
ted d
ecis
ions. T
he IT
str
ate
gy w
ill r
equire
consultation w
ith
bu
sin
ess u
nits th
roug
hou
t th
e o
rga
nis
atio
n to
en
su
re th
at it fits w
ith
th
e C
oun
cil’
s
bu
sin
ess s
trate
gy.
We issued a
n u
nqualif
ied a
udit o
pin
ion o
fth
e S
tate
ment of A
ccounts
befo
re 3
0
No
ve
mbe
r 200
4 d
ead
line
fo
r p
ub
lish
ing
the
acco
un
ts.
Pe
rfo
rma
nce
Ma
na
ge
men
t
In 2
003/0
4 the C
ouncil
ha
s c
ontinued to d
evelo
p a
nd
str
eng
then its
perf
orm
ance
managem
ent fr
am
ew
ork
. D
uring o
ur
work
this
year
we found that offic
ers
at all
levels
refe
rred to the d
evelo
pm
ent, r
eport
ing a
nd im
pa
ct of serv
ice s
pecific
score
card
s to their w
ork
.
The C
ouncil
als
o r
ecognis
es the n
eed to r
em
ain
ale
rt to the c
hanges that can
imp
act o
n its
ap
pro
ach
to
pe
rfo
rma
nce
ma
na
ge
men
t, s
uch
as th
e im
plic
ation
s
arisin
g fro
m the G
overn
ment's
Effic
iency R
evie
w (
the
Gers
hon r
evie
w).
The C
ouncil
continues to face a
challe
ngin
g a
genda, fo
r exam
ple
, w
ith r
espect to
:
Securing the b
enefits
of its r
egenera
tion a
ctivitie
s;
Imp
rovin
g th
e p
erf
orm
ance o
f its s
ocia
l ca
re s
erv
ices;
Imple
menting its
Custo
mer
First str
ate
gy s
uccessfu
lly; and
Com
ple
ting the ‘H
ousin
gF
utu
res’ activity.
We h
ave u
nde
rtaken a
range o
f ta
ilore
d r
evie
ws in 2
003/0
4. E
ach h
as r
esulted in
a n
um
ber
of re
com
mendations, w
hic
h h
ave form
ed the b
asis
of action
pla
ns.
Info
rmation a
bout th
em
is c
onta
ined in o
ur
section o
n P
erf
orm
ance M
anagem
ent.
Pri
ce
wa
terh
ou
se
Co
op
ers
LL
P5
Page 9
CP
A S
core
card
The A
udit C
om
mis
sio
n h
as a
ssessed c
ore
serv
ice p
erf
orm
ance in the s
erv
ice
are
as d
eta
iled
in
th
e ta
ble
be
low
. E
ach
se
rvic
e is s
core
d o
n a
sca
le o
f 1
to
4, w
ith
1 b
ein
g th
e low
est a
nd
4 b
ein
g th
e h
ighe
st.
Ed
uca
tio
n a
nd
so
cia
l ca
re a
re g
ive
n
more
im
port
ance in r
eachin
g the o
vera
ll score
than o
ther
are
as.
Serv
ice
Dec
em
ber
200
2
Dec
em
ber
200
3
Dec
em
ber
200
4
Education
33
3
Socia
l care
(adults)
22
2
Socia
l care
(ch
ildre
n)
22
2
Enviro
nm
ent
32
2
Housin
g2
33
Lib
raries a
nd L
eis
ure
33
3
Benefits
22
3
Use o
f R
eso
urc
es
33
4
Inspection
Th
e C
ou
ncil
ha
s m
ad
e im
pro
ve
me
nts
in
ho
usin
g b
en
efits
, ro
ad
sa
fety
, sta
bili
ty o
f
pla
ce
me
nts
of lo
oke
d a
fte
r ch
ildre
n a
nd
fe
wer
ad
mis
sio
ns o
f o
lde
r pe
op
le to
resid
en
tia
lor
nu
rsin
g c
are
.
The C
ouncil
has c
learly a
rtic
ula
ted its
am
bitio
ns a
nd
priorities to s
upport
deliv
ery
of th
e r
evis
ed c
om
munity s
trate
gy a
nd h
as im
pro
ved its
appro
ach to p
erf
orm
ance
managem
ent.
Both
com
munity e
ngagem
ent and localin
volv
em
ent in
decis
ion m
akin
g a
re
incre
asin
g. P
hysic
al and e
lectr
onic
access to c
ouncil
serv
ices h
as b
een im
pro
ved.
Majo
r re
genera
tion p
roje
cts
such a
s B
ark
ing T
ow
nC
entr
e, B
ark
ing R
ivers
ide, and
Dagenham
Dock a
re p
rog
ressin
gw
ell.
Continued focus is n
eeded to e
nsure
de
livery
of agre
ed g
overn
ment ta
rgets
,
reduce
crim
e levels
, and to im
pro
ve c
ouncil
housin
g v
oid
s, sta
ndard
assessm
ent
test re
su
lts for
ch
ildre
n a
t th
e a
ges o
f 1
1 a
nd
14
, a
nd
waste
ma
nage
me
nt,
wh
ere
co
mpa
rative
pe
rform
ance
rem
ain
s p
oo
r.
Based o
n B
ark
ing a
nd D
agenham
’s c
urr
ent pla
ns, th
e C
ouncil
is n
ow
well
pla
ced
to im
pro
ve the w
ay it w
ork
s a
nd the s
erv
ices it pro
vid
es to local people
.
We d
iscussed the issues c
onta
ined w
ithin
this
Join
t A
udit a
nd Inspection L
etter
with the A
udit C
om
mitte
e o
n 1
6 D
ecem
ber
2004.
Pri
ce
wa
terh
ou
se
Co
op
ers
LL
P6
Page 10
Accounts
and G
overn
ance
In this
section o
f our
docum
ent w
e c
om
ment upon the r
esults o
f our
Accounts
an
d
Govern
ance
work
. In p
art
icula
r:
Accou
nts A
udit O
pin
ion a
nd A
ccounting Issues;
A
ccounting
Develo
pm
ents
;
Go
ve
rna
nce
CP
A –
auditor
score
d judge
ments
;
F
inancia
lsta
ndin
g;
Syste
ms o
f in
tern
al financia
l contr
ol;
Sta
nd
ard
s o
f fin
an
cia
l con
du
ct a
nd
th
e p
reve
ntio
n a
nd
de
tection
of fr
au
d
and c
orr
uption; and
The legalit
y o
f financia
l tr
an
sactions.
We a
lso p
rovid
e s
om
e info
rmation a
bout our
work
on c
ert
ifyin
g g
rant cla
ims.
Accounts
The p
urp
ose
of our
accounts
work
is to p
erf
orm
an a
udit o
f th
e fin
al accounts
of
the C
ouncil,
in
accord
ance w
ith a
ppro
ved A
uditin
g S
tandard
s.
Audit O
pin
ion a
nd A
ccounting Issues
The A
ccounts
and A
udit R
egula
tions 2
003
bro
ught fo
rward
the tim
eta
ble
for
the
pro
duction a
nd p
ublic
ation
of th
e a
ccounts
. In r
esponse to this
we w
ork
ed w
ith
offic
ers
to identify
the b
arr
iers
and p
ossib
le s
olu
tions to the a
ccounts
bein
g
pre
pare
d e
arly. T
his
work
inclu
ded o
rganis
ing, jo
intly w
ith the H
ead o
f F
inancia
l
Serv
ices, a w
ork
shop for
offic
ers
fro
m thro
ughout th
e F
inance d
epart
ment w
here
these m
atters
were
dis
cussed.
We a
re p
leased to r
eport
that th
e 2
003/0
4 fin
ancia
l sta
tem
ents
were
appro
ved b
y
Council
befo
re the 3
1 A
ugust 2004 d
eadlin
e. T
he d
eadlin
e w
ill b
e b
rought fo
rward
by a
month
for
2004/0
5, and for
2005/0
6, w
here
the a
ccounts
will
need to b
e
appro
ved b
y 3
1 J
uly
2005, and 3
0 J
une 2
006, re
spectively
.
We r
equeste
d a
num
ber
of adju
stm
ents
to the fin
ancia
l sta
tem
ents
subm
itte
d for
audit, all
of w
hic
h w
ere
accepte
d b
y o
ffic
ers
, and a
n u
nqualif
ied a
udit o
pin
ion h
as
been issued.W
e a
re p
leased to n
ote
managem
ent in
stigate
d a
num
ber
of
changes d
uring the y
ear
whic
h r
esulted in s
ignific
ant im
pro
vem
ents
in the q
ualit
y
of w
ork
ing p
apers
that are
pro
duced b
y t
he C
ouncil,
although w
e b
elie
ve that
furt
he
r im
pro
ve
me
nts
co
uld
be
ma
de
in
ce
rta
in a
reas, su
ch
as e
xp
lan
atio
ns fo
r
year
on y
ear
movem
ents
in b
ala
nces w
ithin
the C
onsolid
ate
dR
evenue A
ccount
bein
g r
eadily
availa
ble
. T
his
should
im
pro
ve the e
ffic
iency o
f th
e a
udit p
rocess
and a
lso e
nhance the q
ualit
y o
f m
anagem
ent
info
rmation that is
availa
ble
.
Pri
ce
wa
terh
ou
se
Co
op
ers
LL
P7
Page 11
We a
lso w
elc
om
e m
anagem
ent’s initia
tive in facto
ring tim
e into
the c
losedow
n
pro
cess to a
llow
for
a d
eta
iled r
evie
w o
f th
e fin
ancia
l sta
tem
ents
by s
enio
r offic
ers
.
In a
dditio
n, th
e c
orp
ora
te fin
ance team
is b
ein
g r
eorg
anis
ed a
nd s
trength
ened,
whic
h s
hould
result in furt
he
r im
pro
vem
ents
next year.
As a
uditors
we a
re r
equired to issue a
Sta
tem
ent of A
uditin
g S
tandard
s 6
10 (
SA
S
610)
repo
rt, w
hic
h c
om
munic
ate
s to those c
harg
ed w
ith g
overn
ance (
the
Corp
ora
te M
onitoring G
roup
), the follo
win
g issues, w
here
applic
able
, arisin
g fro
m
our
audit:
Expecte
d m
odific
ations to the a
udit r
eport
;
Unadju
ste
dm
issta
tem
ents
, i.e. th
ose m
issta
tem
ents
identified a
s p
art
of th
e
audit that m
anagem
ent have c
hosen n
ot to
adju
st oth
er
than those
that are
cle
arly triflin
g;
Ma
teria
lw
eakn
esses in
th
e a
cco
un
tin
ga
nd
in
tern
al co
ntr
ol syste
ms id
en
tifie
d
as p
art
of th
e a
udit;
Ou
r vie
ws a
bo
ut th
e q
ua
lita
tive
asp
ects
of th
e C
ou
ncil’
s a
ccou
ntin
gp
ractices
and fin
ancia
lre
port
ing; and
Any o
ther
rele
vant m
atters
rela
ting to the a
udit.
Our
SA
S 6
10 r
eport
was p
resente
d to the C
orp
ora
te M
onitoring G
roup o
n 2
5
Novem
ber
2004. T
he m
ain
issue d
iscussed in the r
eport
is d
escribed b
elo
w.
Bank R
econcili
ation
As p
art
of our
audit w
ork
ea
ch y
ear,
we c
onsid
er
the r
econcili
ation b
etw
een the
Council’
s b
ank s
tate
ment as a
t 31 M
arc
h, and the c
ash fig
ure
within
the g
enera
l
ledger
at th
at date
. T
his
“bank r
econcili
ation”
is c
onsid
ere
d to b
e a
fundam
enta
l
contr
ol w
ithin
any o
rganis
ation.
Fo
r th
e last th
ree
and
a h
alf y
ea
rs th
e C
ou
ncil
ha
s b
een
un
ab
le to
reco
ncile
th
e
bank a
ccount w
ith the O
racle
genera
l le
dger.
In
2001/0
2 this
pro
ble
m a
rose a
s
managem
ent w
ere
unable
to m
atc
h the to
tal bala
nce
on the p
ayable
s s
yste
m to
the g
enera
l le
dger.
Alth
ou
gh
pro
gre
ss h
as b
ee
n m
ad
e a
s th
e 2
001
/02
pro
ble
m h
as n
ow
bee
n
resolv
ed, fo
r 2003/0
4 the C
ouncil
continued
to e
xperience d
ifficultie
s w
ith c
ash
reconcili
ations, as s
ince A
pril 2003 it has n
ot been p
ossib
le to m
atc
h the tota
l
bala
nce o
n the r
eceiv
able
s s
yste
m to the g
enera
l le
dger.
The im
ple
men
tation o
f th
e a
ccoun
ts r
eceiv
able
module
of th
e O
racle
genera
l
led
ger
accoun
tin
g s
yste
m r
esu
lte
d in
pro
ble
ms w
ith
re
ve
rsin
g e
ntr
ies to
cash
receip
ts. T
he e
ntr
ies w
ere
corr
ect on R
adiu
s (
the
cash r
eceip
ting s
yste
m)
but
the
y d
id n
ot co
rre
ctly in
terf
ace
with
Ora
cle
wh
ich
resu
lte
d in
cash
be
ing
ove
rsta
ted
on O
racle
by a
ppro
xim
ate
ly £
2.5
m a
t th
e s
tart
of th
e a
udit. M
anagem
ent has
inve
stig
ate
d th
e d
iffe
rence
be
twee
n th
e tw
o s
yste
ms a
nd
has r
edu
ce
d th
e
unre
con
cile
ddiffe
rence to a
round £
400k.
Fro
m the w
ork
that offic
ers
have u
ndert
aken o
n this
we h
ave b
een a
ble
to b
e
satisfied r
egard
ing the c
ash fig
ure
s in the S
tate
ment of A
ccounts
. H
ow
ever,
it has
been a
concern
that such a
fundam
enta
l contr
ol had n
ot been in o
pera
tion for
such
a lo
ng
tim
e a
nd
th
at th
e C
ou
ncil
has lim
ite
d a
ssura
nces o
ve
r its c
ash
bala
nce.
Offic
ers
have a
gre
ed to c
ontinue to a
ttem
pt to
reconcile
the c
ash fig
ure
for
2003/0
4 a
nd w
ill p
ut pro
cedure
s into
pla
ce a
nd e
nsure
these a
re im
ple
mente
d to
enable
cash to
be r
econcile
d o
n a
tim
ely
basis
in the futu
re.
We n
ote
that a furt
her
reconcili
ation is a
lso u
ndert
aken w
hic
hensure
s that cash
receip
ted b
y the C
ouncil
is a
ctu
ally
receiv
ed into
the b
ank a
ccount. T
his
fully
reconcile
d thro
ughout 2003/0
4 p
rovid
ing a
contr
ol over
the C
ouncil’
s c
ash.
Accounting d
evelo
pm
ents
A n
um
ber
of new
accounting a
nd r
eport
ing d
evelo
pm
ents
were
required to b
e
adopte
d this
year.
T
hese a
re o
utlin
ed b
elo
w.
Fin
ancia
l R
eport
ing S
tandard
(F
RS
) 17
: R
etire
ment B
enefits
2003/0
4 w
as
the first year
of fu
ll im
ple
menta
tion o
f F
RS
17. T
he F
RS
is
concern
ed w
ith identify
ing the r
eal underlyin
g fin
ancia
l positio
n o
f an
auth
ority
with
regard
to its
part
icip
ation in p
ensio
n s
chem
es.
Pre
para
tion o
f th
e d
isclo
sure
s h
as
required the C
ouncil
to c
om
mis
sio
n e
xpert
advic
e fro
m a
ctu
arie
s a
nd
pre
sent m
ore
info
rmation a
bout th
e C
oun
cil’
s longer-
term
fin
ancia
l positio
n than r
equired u
nder
pre
vio
us a
ccounting tre
atm
ents
.
Th
e a
va
ilab
ility
of in
form
atio
n a
s r
eq
uired
un
der
FR
S 1
7 h
as p
rovid
ed
th
e C
ou
ncil
with a
dvance
info
rmation a
bout th
e lik
ely
im
pact on e
mplo
yer’s c
ontr
ibution
rate
s
of th
e n
ext fu
ll valu
ation o
f th
e C
ouncil’
spensio
nschem
e. R
ecent tr
ends in the
Pri
ce
wa
terh
ou
se
Co
op
ers
LL
P8
Page 12
sto
ck m
ark
et suggest th
at th
e v
alu
ation m
ay c
onfirm
a w
ors
enin
gpositio
n in the
fund that w
ould
require a
n incre
ase in c
ontr
ibution
rate
s in the futu
re.
Sta
tem
ent of
inte
rnalcontr
ol
The A
ccounts
and A
udit R
egula
tions 2
003 inclu
ded a
requirem
ent th
at th
e
sta
tem
ent of accounts
pre
pare
d b
y a
n a
uth
ority
in E
ngla
nd s
hould
conta
in a
sta
tem
ent on inte
rnalcontr
ol (S
IC)
from
2003/0
4. T
hese s
tate
ments
refe
r to
much
wid
er
syste
ms o
f contr
ol th
an p
ure
ly fin
ancia
lsyste
ms a
nd r
equire the C
ouncil
to
ha
ve
in
pla
ce s
uch
syste
ms o
f co
ntr
ol.
Au
tho
rities a
re r
eq
uired
to
con
duct a
nn
ua
l
revie
ws o
f th
e e
ffectiveness o
f th
e s
yste
m o
f in
tern
alcontr
ol,
whic
h w
ill p
rovid
e
the fin
din
gs to s
upport
the S
IC.
The C
ouncil
pro
duced a
com
pre
hensiv
e S
IC, w
hic
h d
isclo
sed thre
e s
ignific
ant
inte
rnal contr
olis
sues:
Ris
k m
anagem
ent arr
angem
ents
;
The C
ouncil’
s B
enefits
Serv
ice; and
Syste
m r
econcili
ation p
roble
ms.
We c
om
ment upon the first tw
o o
f th
ese issues late
r in
this
docum
en
t and h
ave
com
mente
d u
pon the s
yste
m r
econcili
ation p
roble
ms
above.
Govern
ance
Au
dit R
ep
ort
ing
Arr
an
gem
en
ts
The r
ole
of an a
udit c
om
mitte
e inclu
des
overs
eein
g the fin
ancia
l aspects
of
corp
ora
te g
overn
ance o
f th
e C
ouncil.
D
uring 2
003/0
4 the C
ouncil
furt
her
develo
ped the r
ole
of th
e C
orp
ora
te M
onitoring G
roup
(C
MG
) to
pe
rform
som
e o
f
the
fu
nctio
ns
of a
n a
ud
it c
om
mitte
e. It n
ow
rece
ives p
rogre
ss r
ep
ort
s fro
m
Inte
rnal A
udit a
nd m
onitors
offic
ers
’ pro
gre
ss in im
ple
menting a
ccepte
d inte
rnal
and e
xte
rnal audit r
ecom
mendations.
Recently, C
MG
’s r
ole
as a
n a
udit c
om
mitte
e h
as b
een
enhanced b
y the d
ecis
ion
to a
dd a
third m
em
ber,
who is fro
m a
n independent polit
ical gro
up, to
those
meetings w
here
CM
G is fu
lfill
ing the r
ole
of an a
udit c
om
mitte
e. T
his
develo
pm
ent should
str
ength
en furt
her
the inte
rnal financia
l contr
ols
of th
e
Council.
Com
pre
hensiv
e P
erf
orm
ance A
ssessm
ent – a
uditor
score
d judgem
ents
As p
art
of th
e A
udit C
om
mis
sio
n’s
Co
mpre
hensiv
e P
erf
orm
ance A
ssessm
ent
(CP
A)
pro
cess, auditors
have b
een r
equired to c
om
ple
te a
n a
ssessm
ent of th
e
corp
ora
te g
overn
ance a
rrangem
ents
of th
e C
ouncil
in lin
e w
ith o
ur
Code
obje
ctives.
As in p
revio
us y
ears
we invited the F
inance
Directo
r and h
er
sta
ff to c
om
ple
te a
self a
ssessm
ent, r
ating the C
ouncil
again
st
the v
arious fin
ance c
rite
ria inclu
ded
in
the
Au
dit C
om
mis
sio
n’s
Au
dito
r S
co
red
Ju
dg
me
nts
exe
rcis
e. W
e th
en
eva
lua
ted
the s
elf a
ssessm
ent in
the lig
ht of our
cum
ula
tive k
now
ledge o
f th
e C
ouncil
and
sought evid
ence fro
m o
ffic
ers
where
ratings w
ere
judged a
s h
avin
g im
pro
ved
co
mpa
red
with
th
e p
revio
us y
ea
r.
We a
re p
leased to r
eport
that in
alm
ostall
are
as o
f th
e fin
ancia
l aspects
of
corp
ora
te g
overn
ance the C
ouncil
has im
pro
ved d
uring the y
ear
or
main
tain
ed the
hig
hest score
possib
le. T
he r
esults a
resum
marised
as follo
ws (
score
s fro
m 1
to
4,
4 b
ein
g th
e h
igh
est)
:
Area
Ov
era
ll A
ssessm
en
t
2003
Ov
era
ll A
ssessm
en
t
2004
Fin
ancia
l S
tan
din
g3
4
Inte
rnal F
inancia
l C
ontr
ol
33
Sta
ndard
s o
f financia
l co
nd
uct
and
the p
revention a
nd d
ete
ction o
f fr
aud
& c
orr
uptio
n
34
Fin
ancia
l S
tate
ments
23
Leg
alit
y o
f sig
nific
ant
fina
ncia
l
transactions
44
The a
ppro
valof a tre
asury
managem
ent
str
ate
gy a
nd im
pro
vem
ents
in the
tim
elin
ess, qualit
y a
nd s
upport
ing
record
s o
f th
e fin
ancia
lsta
tem
ents
contr
ibute
d
to a
n im
pro
vem
ent in
the s
core
s for
sta
ndard
s o
f financia
l conduct and the
Pri
ce
wa
terh
ou
se
Co
op
ers
LL
P9
Page 13
pre
vention a
nd d
ete
ction o
f fr
aud &
corr
uption a
nd fin
ancia
lsta
tem
ents
,
respectively
.
Within
the c
ate
gory
of In
tern
al F
inancia
lC
ontr
ol th
e a
rea o
f risk identification a
nd
managem
ent is
still
score
d a
s a
2. W
e c
om
ment on this
furt
her
belo
w.
Ris
k identification a
nd m
anagem
ent
Ris
k identification a
nd m
anagem
ent is
an a
rea
of critical im
port
ance to a
ny
org
anis
ation. W
here
a C
ouncil
has identified r
isks a
cro
ss its
busin
ess, and
co
nsid
ere
d th
e c
on
tro
ls a
va
ilab
le to
man
ag
e th
ese
ris
ks, it is in
a b
ett
er
positio
n to
achie
ve its
obje
ctives, in
the s
hort
er
and longer
term
. A
s p
art
of our
work
on the
CP
A a
uditor
score
d judgem
ents
, w
e w
ere
asked to s
core
the C
oun
cil
again
st a
num
ber
of le
vels
of com
pete
ncy in this
are
a. T
o a
chie
ve the top s
core
availa
ble
,
the C
ouncil
would
need to d
em
onstr
ate
that it h
as the follo
win
g p
rocesses in
pla
ce:
Form
al id
entification a
nd a
ssessm
ent of risks (
both
insura
nce a
nd n
on-
insura
nce),
and d
ocum
enta
tion o
f th
ose r
isks o
n a
ris
k r
egis
ter.
The r
egis
ter
should
be r
egula
rly r
evie
wed a
nd u
pdate
d;
Mappin
g o
f risks to inte
rnal contr
ols
, and to b
udgets
and r
esourc
eallo
cations;
Monitoring the e
ffectiveness o
f th
e inte
rnal contr
ols
thro
ugh k
ey indic
ato
rs; and
Com
parisons / b
enchm
ark
ing w
ith c
om
para
ble
auth
orities a
nd o
rganis
ations.
These p
rocesses r
epre
sent best pra
ctice
for
local auth
orities, and indic
ate
the
direction in w
hic
h the C
ouncil
should
be h
eadin
g.
The C
ouncil
accepts
that risk m
anagem
ent is
not yet em
bedded into
the d
ecis
ion
makin
g p
rocesses o
f th
e C
ouncil
and h
as d
isclo
sed this
as a
sig
nific
ant in
tern
al
contr
ol is
sue in
the S
IC.
Du
rin
g 2
00
3/0
4 th
e C
ou
ncil
co
mm
issio
ne
d its
in
tern
al a
ud
ito
rs to
de
ve
lop
a r
isk
managem
ent str
ate
gy a
nd identify
str
ate
gic
risks a
t a d
epart
menta
lle
vel. A
ris
k
managem
ent polic
y a
nd s
trate
gic
ris
k r
egis
ter
is to b
e a
gre
ed b
y the C
orp
ora
te
Monitoring G
roup in D
ecem
ber
and then
the E
xecutive.
The n
ext sta
ge is for
the C
ouncil
to c
onsid
er
opera
tional risks a
cro
ss the
org
anis
ation, and then e
nsure
that risks
are
mapped to inte
rnal contr
ols
, budgets
,
resourc
e a
llocations a
nd indiv
idual jo
b s
pecific
ations o
r obje
ctives.
The C
ouncil
inte
nds to a
ddre
ss this
contr
ol is
sue b
y u
ndert
akin
g the follo
win
g
actions d
uring 2
004/0
5:
Com
ple
te a
com
pre
hensiv
e tra
inin
g p
rog
ram
me for
senio
r m
anagers
and
leadin
g m
em
bers
prio
r to
the a
ppoin
tment of a full
tim
e r
isk m
ana
ge
r;
Pre
pare
co
mp
rehe
nsiv
e o
pe
ration
al a
nd
str
ate
gic
ris
k r
eg
iste
rs a
nd
in
tro
duce
a p
rocess to
en
su
re th
at th
e a
re r
eg
ula
rly r
evie
we
d a
nd
up
da
ted
;
All
com
mitte
e r
eport
s w
ill h
ave to inclu
de r
efe
rence to r
isk im
plic
ations inhere
nt
within
their p
roposals
; and
Ris
k m
anagem
ent w
ill b
e in
tegra
ted
into
the C
ouncil’
s p
erf
orm
ance
managem
ent syste
m.
We r
eco
mm
en
d t
hat
the C
ou
ncil d
eve
lop
s its
ris
k m
an
ag
em
en
t p
rocesses,
in lin
e w
ith
best
pra
cti
ce
, to
meet
the
need
s o
f th
e o
rgan
isati
on
. T
his
sh
ou
ld
invo
lve
th
e d
eve
lop
men
t o
f an
org
an
isati
on
wid
e r
isk r
eg
iste
r, d
eta
ilin
g
risks, co
ntr
ol acti
vit
y a
nd
sp
ecif
ic i
nd
ivid
uals
to
ch
am
pio
n e
ach
ris
k. K
ey
risks s
ho
uld
be c
ollate
d a
nd
co
nsid
ere
d b
y t
he m
an
ag
em
en
t te
am
.
Pru
dential F
ram
ew
ork
for
Capital E
xpenditure
Fro
m 1
April 2004, each a
uth
ority
has h
ad to p
lan its
capital expenditure
under
the
new
Pru
dential F
ram
ew
ork
, w
hic
h focuses o
n the a
uth
ority
’s a
bili
ty to a
fford
the
co
nseq
uen
ces o
f sp
en
din
g d
ecis
ions fro
m fu
ture
ye
ars
’ re
ve
nu
e a
cco
un
ts a
nd
allo
ws it to
set its o
wn lim
its o
n the b
orr
ow
ing n
eeded
to a
chie
ve a
n a
fford
able
capital str
ate
gy.
We u
ndert
ook a
hig
h level re
vie
w o
f th
e s
teps the C
ouncil
took in 2
003/0
4 to
pre
pa
re fo
r th
e im
ple
men
tatio
n o
f th
e P
rud
en
tia
l F
ram
ew
ork
, in
clu
din
g th
e p
rocess
for
settin
g lim
its a
nd indic
ato
rs u
nder
the C
IPF
A P
rudential C
ode. W
e found that
the C
ouncil
esta
blis
hed e
ffective a
rrange
ments
for
the P
rudential F
ram
ew
ork
.
The r
evis
ed a
rrangem
ents
required o
nly
a s
mall
num
ber
of changes to the
Council’
s e
xis
ting p
rocesses. T
he m
ost sig
nific
ant change
was the inclu
sio
n o
f
Pru
dential C
ode lim
its a
nd indic
ato
rs in the 2
004/0
5 b
udget str
ate
gy r
eport
to
Mem
bers
.
Pri
ce
wa
terh
ou
se
Co
op
ers
LL
P10
Page 14
Fin
ancia
l sta
ndin
g
In this
section w
e c
om
ment upon the C
ouncil’
s g
enera
l financia
l sta
ndin
g takin
g
into
account both
its
perf
orm
ance d
uring t
he last year
and its
abili
ty to m
eet know
n
financia
l oblig
ations. S
pecific
ally
we c
om
ment on the follo
win
g:
Overa
ll financia
l perf
orm
ance in 2
003/0
4;
Housin
g R
evenue A
ccount financia
l perf
orm
ance in 2
003/0
4;
Pe
rfo
rma
nce
of tr
ad
ing
opera
tio
ns;
Colle
ction fund;
Bala
nces a
nd r
eserv
es;
The 2
004/0
5financia
l year
and o
utlook; and
The C
ouncil’
s p
ensio
n fund.
Overa
ll financia
l perf
orm
ance in 2
003/0
4
For
2003/0
4a tota
l of £200.3
m w
as s
pent
on s
erv
ices a
gain
st a r
evis
ed b
udgete
d
tota
l of £204.2
m, w
hic
h h
as r
esulted in
a n
et unders
pend o
f £4m
again
st th
e
budgete
d tota
l. T
he m
ain
reasons for
the C
ouncil
spendin
g less than a
nticip
ate
d
were
as follo
ws:-
Additio
nal in
tere
st in
com
ere
ceiv
ed d
ue to s
lippage o
n the c
apital pro
gra
mm
e
and h
igher
inte
rest ra
tes than e
xpecte
d; and
Under
spends in E
nvironm
enta
l S
erv
ices, S
ocia
l S
erv
ices a
nd H
ousin
g
Benefits
.
Again
st th
ese u
nder
spends the C
ouncil
incurr
ed a
dditio
nal expenditure
within
som
e a
rea
ssuch a
s E
ducation, w
here
the b
udgets
not dele
gate
d to s
chools
overs
pent by £
1m
. W
e u
nders
tand t
hatth
e C
ouncil
ha
s c
om
mis
sio
ned the
inte
rnal audit s
ection to e
sta
blis
h the r
easons for
this
overs
pend a
nd m
ake
recom
mendations o
n h
ow
budget m
onitoring a
nd c
ontr
ol can b
e im
pro
ved in this
are
a.
The fin
al outturn
for
capital expenditure
in 2
003/0
4 w
as £
89.3
m c
om
pare
d to a
n
origin
al appro
ved p
rogra
mm
e o
f £96.7
m. In 2
002/0
3 there
was a
lso s
om
e
slip
page in the c
apital schem
e a
s a
tota
l of £92.2
m w
as s
pent again
st a b
udgete
d
figure
of £96.0
m. W
e u
nders
tand that th
e m
ain
cause o
f th
e s
lippage is d
ue to the
actu
alscale
of th
e c
apital pro
gra
mm
e a
nd the d
ifficultie
s that can b
e e
ncounte
red
with p
roje
ctm
anagin
g a
pro
gra
mm
e o
f th
is s
cale
. W
e w
elc
om
e the C
ouncil’
s
initia
tive in d
evelo
pin
g a
pro
ject m
anagem
ent tr
ain
ing p
rogra
mm
e for
offic
ers
to
addre
ss this
.
Ho
usin
g R
eve
nu
e A
ccou
nt p
erf
orm
ance in
20
03
/04
The H
ousin
gR
evenue A
ccount (H
RA
) re
cord
ed
a d
eficit o
f £1.5
m for
2003/0
4 in
com
parison w
ith a
surp
lus o
f £2.6
m for
the p
revio
us
year.
T
he m
ain
reason for
the d
iffe
rence b
etw
een the tw
o y
ears
is b
ecause a
paym
ent of £3.8
m w
as m
ade
to the L
ondon B
oro
ugh o
f R
edbridge in 2
003/0
4 a
s a
fin
al ‘o
ne-o
ff’ tr
ansaction
pa
ym
en
t fo
llow
ing
th
e b
oun
da
ry tra
nsfe
r o
f h
ousin
g s
tock in
19
94
.
There
were
no
oth
er
sig
nific
ant cost in
cre
ases
within
the H
RA
com
pare
d to the
pre
vio
us y
ear,
and w
ith a
carr
y forw
ard
bala
nce o
f £2.0
m w
ithin
the H
RA
, th
e
Council
will
need to e
nsure
that adequate
resourc
es a
re a
vaila
ble
in the m
ediu
m
term
to
en
su
re th
e C
oun
cil
ca
n m
ee
t e
xp
ecte
d e
xpe
nditu
re p
ressure
s in
are
as
such
as h
om
ele
ssne
ss. T
he
Cou
ncil
has n
ote
d th
is in
its
Me
diu
m T
erm
Fin
ancia
l
Str
ate
gy.
Pe
rfo
rma
nce
of tr
ad
ing
opera
tio
ns
There
is a
sta
tuto
ry r
equirem
ent fo
r LocalA
uth
orities to
report
on the p
erf
orm
ance
of th
eir tra
din
g o
pera
tions, w
hic
h a
re d
efined b
y the B
est V
alu
e A
ccounting C
ode
of P
ractice (
BV
AC
OP
).
The C
ouncil
opera
tes 1
7 tra
din
g o
pera
tions, tw
o o
f w
hic
h h
ave r
ecord
ed
sig
nific
ant deficits in r
ecent years
:
Com
munity H
alls
record
ed
a d
eficit o
f £750k in 2
003/0
4 (
£723k in 2
002/0
3);
an
d
Ea
stb
ury
Ho
use
(m
use
um
an
d h
isto
ric s
ite
) re
cord
ed
a d
eficit o
f £
20
2k in
2003/0
4 (
£225k for
2002/0
3).
A s
trate
gy is in
pla
ce to a
ddre
ss the d
eficit that has p
ers
iste
d o
n the p
rovis
ion o
f
Com
munity H
alls
. P
lans a
re in p
lace to tra
nsfe
r th
e m
anagem
ent of th
e h
alls
to
the local C
om
munity A
ssocia
tions b
y S
epte
mber
2006, and 2
1-y
ear
leases a
re to
be g
ran
ted. W
here
Com
munity A
ssocia
tions
cann
ot, o
r are
unw
illin
g to, m
eet th
e
Pri
ce
wa
terh
ou
se
Co
op
ers
LL
P11
Page 15
runnin
g c
osts
of th
e H
alls
, and the C
ouncil
is u
nable
to
run this
serv
ice o
n a
bre
ak-e
ven b
asis
, th
ey a
re to b
e c
losed d
ow
n o
r dis
posed o
f.
A d
eficit o
n the o
pera
tional m
anagem
ent of
Eastb
ury
House is to b
e e
xpecte
d a
s it
is a
museum
and h
isto
ric s
ite. T
he C
ouncil,
as p
art
of th
e a
nnual budget settin
g
round, is
consid
ering
ways to im
pro
ve the e
conom
y o
f th
e s
erv
ice.
Colle
ction F
und
The C
olle
ction
Fund r
ecord
ed a
deficit o
f £2.6
m for
2003/0
4 (
£0.3
m d
eficit for
2002/0
3).
T
he d
eficit w
as
prim
arily
due to the C
ouncil
havin
g a
short
fall
on its
Council
base
for
2003/0
4 a
s a
result o
f its tre
atm
ent of sin
gle
pe
rson d
iscounts
.
This
reduced the a
mount of gra
nt in
com
e that th
e C
ouncil
receiv
ed
fro
m the
govern
ment in
this
are
a. It is
pla
nned that
the a
ccum
ula
ted d
eficit o
f £2.1
m a
s a
t
31 M
arc
h 2
004 (
surp
lus o
f £0.5
m a
s a
t 31 M
arc
h 2
003)
will
be r
ecovere
d in futu
re
years
.
The p
erc
enta
ge o
f C
ouncil
Tax c
olle
cte
d in 2
003/0
4 w
as 9
2.0
% (
91.8
% in
2002/0
3).
A
lthough this
is a
n im
pro
vem
ent on the p
revio
us y
ear,
the targ
et w
as
92.5
% a
nd the 2
002/0
3 top q
uart
ile L
ondon fig
ure
was 9
6.0
%. S
imila
rly the
NN
DR
colle
ction r
ate
im
pro
ved fro
m 9
8.4
% to 9
9.4
% w
hic
h w
as a
bove the
Council'
s targ
et fo
r th
e y
ear
of 98.6
% a
nd a
lso w
ithin
the 2
002/0
3 top q
uart
ile
London fig
ure
of 98.9
%.
Bala
nces a
nd R
eserv
es
The C
ouncil
main
tain
s e
arm
ark
ed r
eserv
es s
et asid
efo
r specific
polic
y p
urp
oses
and g
enera
l re
serv
es for
pu
rposes s
uch a
s c
ontingencie
s a
nd c
ash flo
w
managem
ent. T
he g
enera
lfu
nd r
eserv
es a
re n
ow
£48.5
m, (£
46.8
m a
t 31 M
arc
h
2003),
and s
chools
’ re
serv
es s
tood a
t £0
.8m
(£1.8
m a
t 31 M
arc
h 2
003).
The C
ouncil
continues to b
enefit fr
om
a s
trong
reserv
es p
ositio
n. H
ow
ever,
it als
o
continues to face s
ignific
ant re
venue a
nd c
apital com
mitm
ents
. T
he C
ouncil
recognis
es the im
port
ance o
f re
gula
rly m
onito
ring the level of re
serv
es to e
nsure
that th
ey r
em
ain
appro
priate
. It is
sta
ted w
ithin
the M
ediu
m T
erm
Fin
ancia
l
Str
ate
gy that th
e level of in
div
idual re
serv
es a
nd the p
olic
y o
n r
eserv
es w
ill b
e
revie
wed a
nnually
as p
art
of th
e b
udget settin
g p
rocess.
The 2
004/0
5financia
l year
and o
utlook
For
2004/0
5 the C
ouncil
set its o
vera
ll spendin
g b
udget at £220.2
m, consis
ting o
f
£115.0
m for
Education, £61.3
m for
Socia
l S
erv
ices a
nd the r
em
ain
der
for
oth
er
serv
ices p
rovid
ed b
y the C
ouncil.
The late
st fo
recast at N
ovem
ber
2004 is that
there
will
continue to b
e p
ressure
s w
ithin
Education w
hic
h is fore
cast to
overs
pend b
y £
0.2
m, how
ever
it is a
nticip
ate
d that oth
er
Council
serv
ices w
ill
meet budget by the y
ear
end.
Over
half the tota
l spend o
f th
e C
ouncil
is for
education a
nd the 2
004
/05 b
udget
was s
et based u
pon E
ducation s
pendin
g a
t F
orm
ula
Spendin
g S
hare
. H
ow
ever
within
Education, th
e D
epart
ment fo
r E
ducation a
nd S
kill
s h
as e
ffectively
capped
centr
ally
funded ite
ms s
uch a
s s
pecia
leducation n
eed
s w
hic
h c
ould
result in
sig
nific
ant budgeta
ry p
ressure
s c
ontinuin
g into
the futu
re.
Socia
l S
erv
ices a
ccounts
for
a s
ignific
ant pro
port
ion
of th
e b
udget, a
nd this
is a
n
are
aw
here
there
is c
ontinuin
g d
em
and u
pon s
erv
ices in
additio
n to u
ncert
ain
ties
over
fundin
g. T
he C
ouncil
will
need to c
ontinue to m
onitor
the b
udge
t in
Socia
l
Serv
ices c
are
fully
, as there
is a
ris
k t
hat changes in G
overn
ment priorities m
ay
arise w
hic
hcould
result in s
pecific
gra
nts
bein
g d
iscontinued a
nd r
edirecte
d
tow
ard
s n
ew
serv
ices.
For
the m
ediu
m term
, it is fore
cast th
at spendin
g for
2005/0
6 w
ill b
e £
236.5
m a
nd
this
is fore
cast to
incre
ase to
£250.8
m d
uring 2
006/0
7.T
he C
ouncil
will
need to
ensure
it continues to m
onitor
the p
ositio
n g
oin
g forw
ard
clo
sely
, part
icula
rly if
there
are
pla
nned
changes in the level of spendin
g o
n c
urr
ent serv
ices, in
additio
n
to a
ny p
roposed s
tatu
te c
hanges w
hic
h m
ay h
ave a
n a
dvers
e im
pact upon the
Co
un
cil’
s fin
an
ces.
The C
ouncil
is p
lannin
g to m
ake
savin
gs in futu
re y
ears
. It is
fore
cast in
the
MT
FS
that savin
gs o
f £3.5
m w
ill b
e m
ade for
2004/0
5 w
ith furt
her
savin
gs o
f
£3.0
m p
roje
cte
d for
2005/0
6 a
nd a
furt
her
£2.3
m for
2006/0
7. T
he s
avin
g levels
will
be r
evis
ed w
hen the M
TF
S is u
pdate
d a
s p
art
of th
e 2
005/0
6 b
udget settin
g
pro
cess. T
hese s
avin
gs w
ill m
ain
ly b
e c
oncentr
ate
d o
n a
reas w
ithin
the
Environm
enta
l, P
rote
ctive a
nd C
ultura
l S
erv
ices, although, as d
eta
iled in the
Mediu
m T
erm
Fin
ancia
l S
trate
gy, pro
tection w
ill b
e g
iven to s
erv
ice p
rovis
ion that
deliv
ers
the ‘cle
aner,
gre
ener,
safe
r’ C
oun
cil
priority
.
The C
ouncil
is w
ell
pla
ced
to fund its
pla
nned
capitalpro
gra
mm
es in the m
ediu
m
term
, w
here
by it is
inte
nded that th
e p
rog
ram
me w
ill b
e funded o
ut of capital
receip
ts, re
venue r
esourc
es a
nd e
xte
rnal fu
ndin
g.
Co
un
cil
Pe
nsio
n F
un
d
The C
ouncil’
s p
ensio
n fund p
rovid
es p
ensio
ns a
nd o
ther
benefits
for
form
er
em
plo
yees o
f th
e C
ouncil
and a
dm
itte
d b
odie
s. It is
a s
tatu
tory
defined b
enefit
Pri
ce
wa
terh
ou
se
Co
op
ers
LL
P12
Page 16
schem
e o
pera
ted u
nder
regula
tions issued b
y C
entr
al G
overn
ment. T
he
investm
ents
of th
e fund a
re a
dm
inis
tere
d b
y the C
ouncil
and p
resently investe
d b
y
exte
rnal fu
nd m
anagers
. In
com
mon w
ith
many o
ther
UK
pensio
n funds, th
e fund
is in d
eficit m
ain
ly d
ue to the e
ffect of
falli
ng s
tock m
ark
ets
. T
he n
ext tr
iennia
l
actu
arial valu
ation w
ill b
e b
ased o
n info
rmation a
s a
t 31 M
arc
h 2
004
and c
urr
ent
expecta
tions
are
that contr
ibutions w
ill h
ave to incre
ase.
Fo
r th
e p
urp
oses o
f th
e fin
an
cia
l sta
tem
en
ts, th
e C
oun
cil’
s a
ctu
aries h
ave
estim
ate
d, by r
olli
ng forw
ard
their a
ssum
ptions fro
m the last fo
rmal tr
iennia
l
valu
ation, th
at th
e o
vera
ll positio
n o
f th
efu
nd a
t 31 M
arc
h 2
004
was a
n e
xcess o
f
liabili
ties o
ver
assets
of £60.5
mill
ion (
£93.6
mill
ion in 2
002/0
3),
whic
h is e
quiv
ale
nt
to the s
chem
e b
ein
g 8
3%
funded (
72%
in
2002/0
3).
There
will
need to b
e a
recovery
pla
n a
risin
g fro
m the fort
hcom
ing triennia
l
valu
ation a
nd this
is lik
ely
to r
equire
incre
ased c
om
mitm
ents
fro
m the C
ouncil’
s
Genera
l F
und a
nd H
ousin
g R
evenue A
ccount as the le
vel of em
plo
yer’s
contr
ibutions
incre
ases. T
his
is taken a
ccount of in
the M
TF
S.
It h
as b
ecom
e incre
asin
gly
im
port
ant fo
r th
e C
ouncil
to m
onitor
the o
vera
ll positio
n
of th
e s
chem
e r
egula
rly a
nd to e
nsure
that pensio
n fin
ancia
l com
mitm
ents
are
not
ove
rlo
oked
wh
en
eva
lua
ting
fu
ture
ch
ang
es in
se
rvic
es a
nd
pa
rtn
ers
hip
arr
angem
ents
.
Syste
ms o
f in
tern
al financia
l contr
ol
Ora
cle
Fin
ancia
l S
yste
m
In o
ur
2001/0
2 a
udit letter,
we e
xpre
ssed s
ignific
ant concern
s o
ver
the
imple
men
tation o
f th
e O
racle
applic
ation a
cro
ss the C
ouncil
and in 2
002/0
3 w
e
un
dert
ook a
no
the
r d
eta
iled r
evie
w o
f th
e O
racle
syste
m, w
hic
h r
ais
ed
27
new
recom
mendations, 13 o
f w
hic
h w
ere
consid
ere
d to b
e “
hig
h p
riority
”.
For
2003/0
4w
e u
ndert
ook a
furt
her
revie
w o
f th
e O
racle
syste
m, w
hic
h inclu
ded
a
deta
iled r
evie
w o
f th
e R
evenues &
Receiv
able
sC
ycle
as the C
ouncil
imple
mente
d
a n
ew
Accoun
ts R
eceiv
able
module
during the y
ear.
Our
work
identified a
num
ber
of is
sues
and w
e a
re c
urr
ently in the p
rocess o
f
agre
ein
g o
ur
findin
gs w
ith o
ffic
ers
and d
evelo
pin
g a
naction p
lan. W
e w
ill m
onitor
pro
gre
ss a
gain
st th
is p
lan d
uring the n
ext audit y
ear.
We a
ckn
ow
led
ge t
hat
the p
ast
year
has b
een
on
e o
f tr
an
sit
ion
for
the IT
dep
art
men
t. T
he H
ead
of
IMT
reti
red
in
th
e s
pri
ng
an
d a
n in
teri
m m
an
ag
er
has b
een
in
po
st.
H
ow
eve
r, n
ow
that
a n
ew
Head
of
IMT
has r
ecen
tly jo
ine
d
the C
ou
ncil, sen
ior
man
ag
em
en
t sh
ou
ld e
nsu
re t
hat
the issu
es id
en
tifi
ed
as
“h
igh
pri
ori
ty” a
re a
dd
ressed
as a
ma
tter
of
urg
en
cy a
nd
th
at
ad
eq
uate
reso
urc
es a
re g
iven
to
reso
lvin
g t
he issu
es r
ais
ed
by o
ur
wo
rk.
Offic
ers
are
aw
are
that part
icula
r attention s
hou
ld b
e g
iven to the IT
str
ate
gy, as
this
should
be the b
asis
for
all
IT r
ela
ted d
ecis
ions. T
he IT
str
ate
gy w
ill r
equire
consultation w
ith b
usin
ess u
nits thro
ughout th
e o
rganis
ation to e
nsure
that it fits
with the C
ouncil’
s b
usin
ess s
trate
gy.
As a
result o
f th
e d
ifficultie
s e
xperienced b
y the C
ouncil
in im
ple
menting O
racle
,
we c
onclu
ded that th
e o
pera
tion o
f th
e C
ouncil’
ssyste
ms w
as insuffic
ient to
support
fully
our
pla
nned a
udit a
ppro
ach for
2003/0
4 a
nd w
e h
ave a
gain
had to
perf
orm
a s
ignific
ant le
vel of deta
iled testing this
year.
Mediu
m T
erm
Fin
ancia
l S
trate
gy
We a
re p
leased to r
eport
that th
e C
ouncil
has d
evelo
ped a
Mediu
m T
erm
F
inancia
l S
trate
gy (
MT
FS
) covering
the
period 2
004/0
5 to 2
006/0
7. It w
as
appro
ved b
y the A
ssem
bly
in M
arc
h 2
004
at th
e s
am
e tim
e a
s the 2
004/0
5 b
udget
and a
revis
ed c
apital str
ate
gy. T
he d
ocum
ent sets
out a fra
mew
ork
for
usin
g the
Council’
s fin
ances to d
eliv
er
the C
om
munity P
riorities d
eta
iled
within
the S
trate
gy
over
the n
ext th
ree y
ears
. It is
a k
ey d
ocum
ent as it pro
vid
es
a s
trate
gic
conte
xt
for
pro
posed d
evelo
pm
ents
in the C
ouncil’
s b
udgets
, spendin
g p
lans a
nd fin
ancia
l a
dm
inis
tra
tion
. A
s th
e d
ocu
me
nt h
as
now
be
en
de
ve
lop
ed
, th
is s
ho
uld
fu
rth
er
enhance inte
rnal contr
ol w
ithin
the C
ouncil
as it is
inte
nded to b
e u
sed a
s a
fr
am
ew
ork
for
decis
ion m
akin
g in the futu
re. T
he C
ouncil
is p
lannin
g to u
pdate
it
annually
to e
nsure
that it r
eflects
the m
ost up to d
ate
fin
ancia
l po
sitio
n o
f th
e
Council
and its
exte
rnal environm
en
t.
Fin
ance T
eam
In last year’s a
udit letter
we n
ote
d that du
ring 2
003 there
were
sig
nific
ant changes
in p
ers
onnelw
ithin
the F
inance d
epart
ment w
hic
h r
esulted in s
om
e a
reas o
f th
e
depart
ment’s w
ork
bein
g d
ela
yed, such
as the d
evelo
pm
ent of risk m
anagem
ent
and a
Mediu
m T
erm
Fin
ancia
l S
trate
gy (
MT
FS
).
Senio
r finance o
ffic
ers
have m
ade tangib
le im
pro
vem
ents
to the d
epart
ment’s
work
over
the last 12 m
onth
s. T
his
is
evid
ent fr
om
the im
pro
ved s
core
s that have
been r
ecord
ed in o
ur
Auditor
Score
dJudgm
ents
and the d
epart
ment’s r
espon
se
to the fin
din
gs o
f th
e B
enefit F
raud Inspecto
rate
. W
e a
lso n
ote
that th
ere
has b
een
a s
ignific
ant im
pro
vem
ent in
the q
ualit
y o
f w
ork
ing p
apers
that w
ere
supplie
d for
audit p
urp
oses c
om
pare
dw
ith the p
revio
us y
ear.
Pri
ce
wa
terh
ou
se
Co
op
ers
LL
P13
Page 17
Sta
ndard
s o
f financia
l conduct and the p
revention a
nd d
ete
ction o
f fr
aud a
nd
corr
uption
Th
e p
rim
e r
esp
on
sib
ility
fo
r th
e p
reve
ntio
n a
nd
de
tectio
n o
f fr
au
d a
nd
irr
eg
ula
ritie
s
rests
with the C
ouncil’
s m
anagem
ent. It is the r
esponsib
ility
of th
e C
ouncil
to
en
su
re th
at its a
ffa
irs a
re m
an
age
d in
acco
rda
nce
with
pro
pe
rsta
nd
ard
s o
f
financia
l conduct and to p
revent and d
ete
ct fr
aud a
nd c
orr
uption. It is
our
responsib
ility
to c
onsid
er
wheth
er
the
Council
has p
ut in
pla
ce a
dequate
arr
an
ge
me
nts
to
ma
inta
in p
rope
rsta
nda
rds o
f fin
an
cia
l co
nd
uct a
nd
to
pre
ve
nt
and d
ete
ct fr
aud a
nd c
orr
uption. It is
not th
e a
uditors
function to p
revent or
dete
ct
bre
aches o
f pro
per
sta
ndard
s a
nd o
ur
work
does n
ot re
move the p
ossib
ility
that
fra
ud
or
corr
up
tio
n h
as o
ccu
rre
d a
nd
rem
ain
ed
un
de
tecte
d.
Our
work
in r
espect of th
e s
tandard
s o
f financia
l conduct and the p
revention a
nd
dete
ction o
f fr
aud a
nd c
orr
uption focussed o
n a
n a
ssessm
ent of th
e c
ontr
ol
environm
entat th
e C
ouncil
and the m
onito
ring c
ontr
ols
in o
pera
tion d
esig
ned to
pre
vent and d
ete
ct fr
aud a
nd c
orr
uption.
We a
ssessed the s
tandard
s o
f financia
l conduct and the p
revention a
nd d
ete
ction
of fr
aud a
nd c
orr
uption in o
ur
auditor
score
d judgem
ents
as a
4.
Benefit F
raud Inspecto
rate
The C
ouncil’
s r
evenue s
erv
ices d
epart
ment w
as s
ubje
ct to
inspection b
y the
Benefit F
raud Inspecto
rate
(BF
I) in N
ovem
ber
2003. T
he p
urp
ose o
f th
eir v
isit w
as
to inspect th
e s
ocia
l security
benefit adm
inis
tration a
nd c
oun
ter-
fraud a
ctivity a
t
the
Co
un
cil.
Th
eir fin
al re
po
rt h
igh
ligh
ted
th
e fo
llow
ing
are
as o
f w
ea
kne
ss:
Str
ate
gic
managem
ent;
Counte
r fr
aud; and
Overp
aym
ents
.
The C
ouncil
responded p
rom
ptly a
nd c
om
pre
hensiv
ely
to the fin
din
gs o
f th
e
inspection a
nd w
as p
roactive in s
eekin
gsupport
fro
m the B
FI to
help
it im
pro
ve.
This
appro
ach h
as b
een
successfu
l be
cause the q
ualit
y o
f serv
ices is n
ow
rate
d
by the B
FI as L
evel 3 (
Level 4 is the h
ighest)
com
pare
d to L
evel 1 follo
win
g the
inspection.
There
are
no
oth
er
matters
with r
espect to
the s
tandard
s o
f financia
l conduct and
the p
revention a
nd d
ete
ction o
f fr
aud a
nd
corr
uption
to b
ring to m
em
bers
’
attention.
The legalit
y o
f financia
l tr
ansactions
In o
rder
to m
eet our
obje
ctives in this
are
a, w
e h
ave:
Re
vie
we
d th
e a
rran
ge
me
nts
in
pla
ce
with
in th
e C
ou
ncil
for
ensuring
th
e
legalit
y o
f financia
l tr
ansactions;
Revie
wed the m
inute
s o
f th
e C
ouncil
an
d r
ele
vant C
om
mitte
es;
Dis
cussed
key issues a
nd c
oncern
s w
ith m
anagem
ent;
Had r
egard
to the C
ouncil’
s im
ple
menta
tion o
f sig
nific
ant new
legis
lative/s
tatu
tory
requirem
ents
;
Revie
wed the local applic
abili
ty o
f re
levant national is
sues;
Taken a
ccount of advic
e issued b
y the A
udit C
om
mis
sio
n; and
Had r
egard
to m
atters
com
ing to the a
uditor’s a
ttention w
here
legalit
y, lo
sses
or
de
ficie
ncie
s m
ay b
e a
n issu
e.
We a
ssessed the legalit
y o
f sig
nific
ant financia
l tr
ansactions in o
ur
auditor
score
d
judgem
ents
as a
4. T
here
are
no m
atters
with r
espect to
the legalit
y o
f financia
l
transactions to
bring to m
em
bers
’ attention.
Data
Pro
tection A
ct
In o
ur
2002/0
3 L
etter
we r
ais
ed the issu
e that th
e C
ouncil
has n
ot undert
aken a
n
assessm
ent of its level of
com
plia
nce w
ith the D
ata
Pro
tection A
ct. T
his
was a
lso
rais
ed a
s p
art
of our
2001/0
2 L
etter
where
we r
ecom
mended that th
e C
ouncil
sh
ou
ld u
nd
ert
ake
a form
ala
ssessm
en
t o
f th
e le
ve
l o
f th
e C
ou
ncil'
s c
om
plia
nce
with the D
ata
Pro
tection A
ct, a
nd that
action p
lans s
hould
be d
evelo
ped a
t both
corp
ora
te a
nd d
epart
menta
l le
vels
to a
ddre
ss a
ny issues that ari
se.
The C
ouncil
agre
ed to d
o this
by M
arc
h 2
004 thro
ugh the w
ork
of th
e C
orp
ora
te
Info
rmation M
anagem
entW
ork
ing P
art
y, w
hic
h h
as r
epre
sen
tatives fro
m e
ach
depart
ment. H
ow
ever,
fro
m d
iscussio
n w
ith
offic
ers
, w
e u
nders
tand that th
e focus
over
the p
ast 12 m
onth
s h
as b
een o
n p
repara
tions for
the im
ple
menta
tion o
f th
e
Fre
edom
of In
form
ation A
ct fr
om
January
2005. A
s a
result there
has b
een little
Pri
ce
wa
terh
ou
se
Co
op
ers
LL
P14
Page 18
develo
pm
ent w
ith r
espect to
the D
ata
Pro
tection A
ct over
the last year.
We r
eit
era
teo
ur
reco
mm
en
dati
on
fro
m 2
001/0
2 t
hat
a f
orm
al assessm
en
t o
f
the level o
f th
e C
ou
ncil’s
co
mp
lian
ce w
ith
th
e D
ata
Pro
tecti
on
Act
sh
ou
ld b
e
perf
orm
ed
. A
cti
on
pla
ns s
ho
uld
th
en
be d
eve
lop
ed
at
bo
th c
orp
ora
te a
nd
dep
art
men
tal le
ve
ls t
o a
dd
ress a
ny is
su
es t
hat
ari
se.
Lo
ca
l G
ove
rnm
en
t E
lecto
rs
During the y
ear,
we h
ave r
eceiv
ed a
num
ber
of le
tters
fro
m m
em
bers
of th
e p
ublic
in r
ela
tio
n to
th
e C
ou
ncil’
sse
rvic
es. W
e h
ave
ad
dre
sse
d th
e issu
es r
ais
ed
in
these letters
in
lin
e w
ith o
ur
sta
tuto
ry d
uties a
s a
uditors
to the C
ouncil
and in lin
e
with g
uid
ance issued b
y the A
udit C
om
mis
sio
n. T
here
are
no s
pecific
matters
in
rela
tion to these issues to b
ring to y
our
attention.
Gra
nts
In 2
003/0
4 the A
udit C
om
mis
sio
n intr
oduced a
more
str
eam
lined
pro
cess for
cert
ifyin
g g
ran
t cla
ims. O
nly
gra
nts
wh
ere
the a
mount cla
imed is g
reate
r th
an
£100,0
00 a
re s
ubje
ct to
the full
cert
ific
ation p
roced
ure
s. C
laim
s b
etw
een £
50,0
00
and £
100,0
00 a
re s
ubje
ct to
lim
ited t
ests
and c
laim
s b
eneath
£50,0
00 n
o longer
require
cert
ific
ation b
y the a
uditor.
It is a
nticip
ate
d that th
is s
hould
reduce the
am
ount of gra
nt cla
im w
ork
required
of auditors
and C
ouncils
alik
e.
The C
ouncil
continues to r
eceiv
e a
sig
nific
ant am
ount of fu
ndin
g that is
subje
ct to
deta
iled g
rant cla
ims c
ert
ific
ation p
rocedure
s. In m
ost in
sta
nces the d
eadlin
e for
this
is 3
1 D
ecem
ber
follo
win
g the fin
ancia
l year
end to w
hic
h the c
laim
rela
tes.
Last year
we
recom
mended that th
e C
ouncil
take s
teps to im
pro
ve the q
ualit
y o
f
the p
repara
tion a
nd r
evie
w p
rocess for
gra
nts
. W
e a
re p
leased to r
eport
that
pro
gre
ss h
as b
een m
ade in the q
ualit
y a
nd e
ffic
iency o
f th
e g
rants
pre
para
tion
pro
cess.
In J
une 2
004
we o
rganis
ed a
join
t w
ork
shop w
ith the H
ead o
f F
inancia
l S
erv
ices
for
offic
ers
involv
ed in p
reparing g
rant cla
ims. A
s a
result o
f th
is o
ffic
ers
have a
cle
are
r u
nde
rsta
nd
ing
of th
e w
ork
ing
pa
pe
rs r
eq
uire
d to
fa
cili
tate
a s
mo
oth
runnin
g a
udit. T
his
has b
een c
om
ple
mente
d b
y the intr
oduction o
f a c
hecklis
t th
at
is c
om
ple
ted
by the o
ffic
er
responsib
le fo
r th
e c
laim
and then s
ubje
ct to
revie
w b
y
a m
ore
senio
r offic
er.
These d
evelo
pm
ents
ha
ve b
egun to r
educe the tim
e r
equirem
ent on b
oth
auditors
and C
ouncil
sta
ff w
hic
h h
as r
esulted
in a
more
effic
ient cert
ific
ation p
rocess.
Furt
her
impro
vem
ents
are
anticip
ate
d n
extyear
as a
result o
f th
e p
rocess b
ein
g
em
bedded m
ore
fully
.
Pri
ce
wa
terh
ou
se
Co
op
ers
LL
P15
Page 19
Perf
orm
ance m
anagem
ent
This
section o
f th
e r
eport
covers
:
The C
ouncil’
s P
erf
orm
ance M
anagem
ent F
ram
ew
ork
;
Ongoin
g w
ork
associa
ted w
ith the C
ouncil’
sC
PA
Action P
lan;
Our
audit o
f th
e 2
004/5
Best V
alu
e P
erf
orm
ance P
lan a
nd 2
003/4
Best
Valu
e P
erf
orm
ance Indic
ato
rs;
Targ
ete
d a
udit w
ork
in the a
reas o
f P
art
ners
hip
Managem
ent
Arr
angem
ents
, P
ensio
ns A
dm
inis
tration
and the u
se b
ein
g m
ade o
f th
e
Ora
cle
syste
m; and
Follo
w u
p w
ork
tie
d to p
revio
us a
udit a
ctivity.
Pe
rfo
rma
nce
ma
na
ge
men
tfr
am
ew
ork
Th
e C
ou
ncil'
s c
orp
ora
te a
ssessm
en
t in
20
02
ide
ntified
th
at th
e C
ou
ncil
had
intr
od
uced
th
e B
ala
nce
d S
co
re C
ard
(B
SC
) syste
m to
su
pp
ort
and m
on
ito
r
pro
gre
ss in
resp
ect o
f its c
orp
ora
te p
rio
ritie
s. W
hils
t th
e a
pp
roach
wa
s
acknow
ledged a
s b
oth
inno
vative a
nd a
ppro
priate
to the n
eeds o
f th
e C
ouncil,
it
was h
ow
eve
r, h
igh
ligh
ted
th
at th
e s
yste
m w
as n
ot w
ide
ly u
nd
ers
too
d a
nd
th
at th
e
Council
needed to d
evelo
p s
kill
s in s
om
e k
ey a
reas to
im
ple
ment it fully
.
Ove
r re
cen
t ye
ars
th
e C
oun
cil
has
co
ntin
ue
d to
assess its
ap
pro
ach
to
perf
orm
ance
managem
ent in
ord
er
to b
ring a
bout gre
ate
r consis
tency a
nd e
nsure
that perf
orm
ance im
pro
vem
ent is
an in
tegra
l part
of th
e C
ouncil’
s w
ork
pro
gra
mm
es. T
his
work
has a
lso e
xte
nded to s
haring
key p
erf
orm
ance
managem
ent skill
s w
ith the local prim
ary
care
tru
st to
assis
t w
ith join
t w
ork
ing a
nd
the d
evelo
pm
ent of th
eir p
erf
orm
ance m
anagem
ent arr
angem
ents
.
The C
ouncil
has focussed o
n d
eliv
ering its
identified c
om
munity p
riorities a
nd its
bala
nced s
core
card
fra
mew
ork
is b
ein
gused c
onsis
tently to m
anage a
nd m
onitor
its p
erf
orm
ance in d
eliv
ering s
erv
ices in its
priority
are
as. T
his
appro
ach
en
co
mp
asses th
e C
ou
ncil’
s w
ork
with
the
Lo
ca
l S
tra
teg
ic P
art
ne
rsh
ip a
nd
ha
s
been
com
plim
ente
d b
y the G
overn
ment O
ffic
e for
London.
Du
rin
g o
ur
wo
rk th
is y
ea
r, p
art
icu
larly in
re
spe
ct o
f o
ur
revie
w o
f p
art
ne
rsh
ip
managem
en
t arr
angem
ents
, w
e found that offic
ers
at all
levels
refe
rred to the
de
ve
lop
me
nt,
re
port
ing
and
im
pa
ct o
f se
rvic
e s
pe
cific
score
ca
rds
to th
eir w
ork
.
How
eve
r, th
e C
ou
ncil
als
ore
co
gn
ises the
ne
ed
to
rem
ain
ale
rt to
th
e c
ha
nge
s th
at
can im
pact on
its
appro
ach to p
erf
orm
ance m
anagem
ent, s
uch a
s the im
plic
ations
for
the C
ouncil
arisin
g fro
m the G
overn
ment's
Effic
iency R
evie
w (
the G
ers
hon
Pri
ce
wa
terh
ou
se
Co
op
ers
LL
P16
Page 20
revie
w).
T
he C
ouncil
continues to face
a c
halle
ngin
g a
genda, fo
r exam
ple
, w
ith
respect to
:
Securing the b
enefits
of its r
egenera
tion a
ctivitie
s;
Imp
rovin
g th
e p
erf
orm
ance o
f its s
ocia
l ca
re s
erv
ices;
Imple
menting its
Custo
mer
First str
ate
gy s
uccessfu
lly; and
Com
ple
ting the ‘H
ousin
gF
utu
res’ exerc
ise.
We w
ill m
eet w
ith the n
ew
Chie
f E
xecutive a
nd h
is team
of directo
rs in o
ur
audit
pla
nnin
g m
eetings, to
unders
tand
how
the C
ouncil
will
respond to these
challe
nges.
Socia
l S
erv
ices
The D
epart
ment of H
ealth’s
2004 s
tar
rating a
ssessed S
ocia
l S
erv
ices a
s 1
sta
r.
The table
belo
w d
ispla
ys the C
ouncil’
s r
esu
lts for
the last 3 y
ears
. It show
s that
the r
ating h
as r
em
ain
ed the s
am
e thro
ughout th
at period a
lthough the c
apacity for
impro
vem
ent has im
pro
ved o
ver
tim
e.
Year
Se
rvin
g
ch
ild
ren
well?
Cap
acit
y f
or
imp
rove
me
nt
in
ch
ild
ren
’s
serv
ice
s?
Se
rvin
g
ad
ult
s
well?
Cap
acit
y f
or
imp
rove
me
nt
in
ad
ult
s’
serv
ice
s?
Perf
orm
an
ce
Ra
tin
g
200
2S
om
eU
ncert
ain
Som
eU
ncert
ain
1sta
r
200
3S
om
eP
rom
isin
gS
om
eU
ncert
ain
1sta
r
200
4S
om
eP
rom
isin
gS
om
eP
rom
isin
g1
sta
r
Ove
r th
e p
ast 1
2 m
on
ths the
re h
as b
ee
na
co
mp
lete
ch
an
ge
in
sen
ior
managem
ent support
ing the D
irecto
r of S
ocia
l S
erv
ices. N
ow
that a full
team
is in
pla
ce the C
ouncil
expects
that, this
couple
d w
ith the fact th
at th
e C
ouncil
continues to b
udget fo
r th
e d
epart
ment to
be funded in p
rincip
le a
t th
e F
orm
ula
Spendin
g S
hare
(F
SS
) fo
r S
ocia
l S
erv
ices, th
e d
epart
ment has e
very
opport
unity
to im
pro
ve its
perf
orm
ance s
ubsta
ntially
.
The C
om
mis
sio
n for
Socia
l C
are
Inspection w
ill b
egin
an inspection o
f th
e
Council’
s s
ocia
l care
serv
ices for
Child
ren s
hort
ly. It is
hoped that th
is w
ill g
ive the
Co
un
cil
the
op
po
rtun
ity to
de
mo
nstr
ate
th
at se
rvic
es in
th
is a
rea
have
im
pro
ve
d
sin
ce the last in
spection, w
hic
h w
as r
eport
ed in M
ay 2
002. H
ow
ever,
the
depart
ment re
cognis
es that im
pro
vem
ents
in the s
erv
ices it pro
vid
es to a
ll clie
nt
gro
up
s, i.e
. ch
ildre
n, a
du
lts a
nd
old
er
pe
op
le a
like
, are
req
uire
d.
Com
pre
hensiv
e P
erf
orm
ance A
ssessm
ent (C
PA
)
The a
nnual C
orp
ora
te P
erf
orm
ance A
ssessm
ent undert
aken b
y the A
udit
Com
mis
sio
n c
ontr
ibute
sto
the
wid
er
Com
pre
hensiv
e P
erf
orm
ance A
ssessm
ent,
whic
h w
ill n
ext be r
eassessed/p
ublis
hed
in 2
005 (
the o
rigin
al assessm
ent w
as in
2002).
T
he C
ouncil
is c
urr
ently r
ate
d a
s ‘fa
ir’.
Our
involv
em
ent in
the C
PA
pro
cess for
2003/0
4 h
as
been to u
pdate
our
assessm
ent of th
e c
orp
ora
te g
overn
ance a
rrangem
ents
of th
e C
ouncil,
in lin
e w
ith
our
Code o
bje
ctives. T
he r
esults o
f th
is w
ork
are
inclu
ded in the A
ccounts
and
Govern
ance
section o
f th
is L
etter.
Best V
alu
e
The L
ocal G
overn
ment A
ct 1999 r
equires a
uth
orities to
pro
duce a
Best V
alu
e
Perf
orm
ance
Pla
n (
BV
PP
) and a
s a
uditors
we
are
required to c
ert
ify that w
e h
ave
carr
ied o
ut our
audit a
nd to s
tate
wheth
er
we b
elie
ve that th
e C
ouncil’
s p
lan h
as
been p
repare
d a
nd p
ublis
hed in a
ccord
ance
with the r
ele
vant sta
tuto
ry g
uid
ance.
We r
eport
ed u
pon o
ur
audit w
ork
in r
ela
tion to the B
VP
P issued in J
une 2
003 a
s
part
of our
prio
r year
audit letter.
We p
rovid
ed initia
l advic
e to the C
ouncil
in
rela
tion to its
dra
ft 2
004/5
BV
PP
and h
ave issued a
n u
nqualif
ied o
pin
ion o
n the
final pla
n.
We r
eport
ed the r
esults o
f our
audit w
ork
on the a
ccura
cy a
nd c
ontr
ols
associa
ted
with
th
e C
ou
ncil’
ssyste
ms
for
co
llectin
ga
nd
record
ing s
pecifie
d p
erf
orm
ance
info
rmation to the A
udit C
om
mis
sio
n in lin
e w
ith the d
eadlin
e o
f 6 S
epte
mber
2004.
In o
vera
ll te
rms, th
e C
ouncil
com
plie
dw
ith the r
equ
irem
en
t to
colle
ct and r
eport
on s
pecifie
d p
erf
orm
ance in
form
ation.
We r
eport
ed
a r
eserv
ation o
n o
nly
one
sta
tuto
ry B
V indic
ato
r due to the r
eport
ed
perf
orm
ance b
ein
g b
ased o
n a
pro
jecte
d, ra
ther
than a
ctu
al outturn
fig
ure
(tw
o in 2
002/0
3).
Ta
rge
ted
audit w
ork
Under
the A
udit C
ode, th
ere
is a
sta
tuto
ry r
esponsib
ility
for
auditors
to s
atisfy
Pri
ce
wa
terh
ou
se
Co
op
ers
LL
P17
Page 21
the
mse
lves th
at a
Co
un
cil
ha
s p
ut in
pla
ce
ade
qua
te a
rra
nge
me
nts
to
secure
econom
y, effic
iency a
nd e
ffectiveness in
its u
se o
f re
sourc
es. A
uditors
are
required to m
eet th
is r
esponsib
ility
by r
evie
win
g a
nd, w
here
appro
priate
,
exam
inin
g e
vid
ence that is
rele
vant to
aspects
of th
ese a
rrangem
ents
, in
clu
din
g
the u
se o
f re
sourc
es in s
pecific
serv
ices
and functions. O
ur
work
is targ
ete
d o
n
are
as o
f ke
y r
isk o
r p
rio
rity
to
th
e C
ou
ncil,
ba
se
d o
n a
ris
k a
ssessm
en
t d
iscu
ssed
and a
gre
ed w
ith r
ele
vant offic
ers
and p
resente
d to M
em
bers
.
The r
esults o
f our
audit w
ork
are
sum
marised b
elo
w.
Revie
w o
f P
art
ners
hip
Managem
ent A
rrangem
ents
The C
ouncil
has m
ade s
ign
ific
ant pro
gre
ss in d
evelo
pin
g p
art
ners
hip
s a
nd there
ha
s b
ee
n a
ma
rke
d incre
ase
in
th
e e
xte
nt
of co
-ope
ratio
n a
nd
co
-work
ing
wh
ich
is
now
ne
cessary
betw
een the C
ouncil
an
d m
any o
ther
agencie
s, org
anis
ations a
nd
sta
kehold
er
bodie
s. T
his
is n
ot necessarily
a n
ew
phenom
enon, but over
the last
few
years
the a
mount of tim
e d
evote
d to s
uch m
atters
has incre
ased
consid
era
bly
. In r
esponse
to this
the C
ouncil
has p
art
icula
rly fo
cu
se
d o
n its
part
icip
ation in
the L
ocal S
trate
gic
Part
ners
hip
and the p
roduction o
f th
e
Com
munity S
trate
gy.
The c
oncept of part
ners
hip
is s
ubje
ct to
diffe
ring d
efinitio
ns, in
terp
reta
tions a
nd
expecta
tions. In
additio
n a
num
ber
of com
mon r
isks a
re p
erc
eiv
ed in
respect of
the
va
rio
us fo
rms o
f p
art
ners
hip
in
clu
din
g w
he
the
r th
e p
urp
oses o
f th
e p
art
ne
rsh
ip
are
cle
ar
an
d w
he
the
r p
art
ne
rs a
reco
mm
itte
d to
th
e a
ch
ieve
me
nt o
f its o
bje
ctive
s.
Th
e C
ou
ncil
is in
vo
lve
d in
an
exte
nsiv
e r
an
ge
of p
art
ne
rsh
ips a
nd
th
e m
ain
ris
ks
of th
e C
ouncil’
s involv
em
ent in
part
ners
hip
s c
an b
e fin
ancia
l, p
erf
orm
ance r
ela
ted
e.g
. not achie
vin
g o
bje
ctives a
nd/o
r re
puta
tional. T
he a
im o
f th
e R
evie
w o
f
Pa
rtn
ers
hip
Ma
na
ge
men
t A
rra
ng
em
en
ts w
as
to a
ssess th
e C
oun
cil’
s p
art
ne
rsh
ip
arr
angem
ents
and e
nsure
that adequate
pro
cesses a
re in p
lace to a
ddre
ss the
risks o
utlin
ed
above a
nd a
s s
uch inclu
ded a
n a
ssessm
ent of th
e:
Str
ate
gy d
ocum
enta
tion a
nd a
lignm
ent
with the C
ouncil’
s o
vera
ll aim
s a
nd
obje
ctives;
Str
uctu
re o
f th
e p
art
ners
hip
and c
larity
of ro
les a
nd r
esponsib
ilities o
f each
part
ner;
Fin
ancia
l contr
ols
;
Cla
rity
of re
port
ing p
roto
cols
;
Monitoring a
rrangem
en
ts a
gain
st sta
ted o
bje
ctives; and,
Legal aspe
cts
of th
e p
art
ners
hip
.
Follo
win
g d
iscussio
ns w
ith o
ffic
ers
thre
e h
igh p
rofile
part
ners
hip
s fro
m d
iffe
rent
secto
rs w
ere
se
lecte
d a
nd
co
mpa
red
aga
inst e
ach
oth
er:
London R
ivers
ide;
Early Y
ears
Part
ners
hip
; and
Th
e C
om
mu
nity H
ou
sin
g P
art
ners
hip
s.
We a
re c
urr
ently d
iscussin
g o
ur
findin
gs w
ith o
ffic
ers
and d
ete
rmin
ing w
ith them
wh
eth
er
bro
ad
er
co
nclu
sio
ns c
an
be
dra
wn
fro
m o
ur
wo
rk p
rio
r to
ag
ree
ing
an
actio
n p
lan
.
Revie
w o
f P
ensio
ns A
dm
inis
tration
The P
ensio
ns S
ection w
ithin
Busin
ess S
erv
ices p
rovid
es the m
ajo
rity
of
the
adm
inis
trative s
erv
ices that th
e C
ouncil
is r
equired to u
ndert
ake a
s the
Adm
inis
tering A
uth
ority
of th
e L
ondon B
oro
ugh o
f B
ark
ing a
nd D
agenham
Supera
nnuation F
und (
the
“Fund”)
.
The F
und is a
Local G
overn
ment P
ensio
n S
chem
e (
“LG
PS
”) e
sta
blis
hed u
nder
sta
tute
and h
as o
ver
10,0
00
mem
bers
of w
hic
h a
ppro
xim
ate
ly h
alf a
re m
akin
g
contr
ibutions
to e
arn
benefits
. T
he tota
l em
plo
yer
and m
em
ber
contr
ibutions w
ere
£11.7
m a
nd the F
und a
ssets
were
£292m
in the y
ear
endin
g 3
1 M
arc
h 2
003.
The o
bje
ctive for
the P
ensio
ns S
ection r
evie
w w
as to identify
issues for
the
Council
to a
ddre
ss, to
im
pro
ve the s
erv
ices to c
usto
mers
, th
rough incre
ased
effic
iency a
nd the c
ontr
ol of risk.
Our
work
was in thre
e m
ain
are
as:
Opera
tional M
anagem
ent;
Custo
mer
nee
ds; a
nd
Serv
ice D
eliv
ery
.
In p
art
icula
r, the s
cope o
f th
e r
evie
w d
id n
ot in
clu
de a
ny a
spect of F
und
investm
ent.
The k
ey m
essages fro
m the r
evie
w o
f pensio
ns a
dm
inis
tration w
ere
that th
e
Co
un
cil
sh
ou
ld m
ake
an
assessm
en
t o
f h
ow
it w
ill m
an
ag
e th
e fo
llow
ing
co
nflic
tin
g
Pri
ce
wa
terh
ou
se
Co
op
ers
LL
P18
Page 22
dem
ands o
n the P
ensio
ns S
ection:
Main
tain
ing the low
cost of th
e P
ensio
ns S
ection;
Ad
dre
ssin
g the
Co
un
cil’
s e
xp
osure
to
th
e p
rocessin
grisks ide
ntified
in
ou
r
revie
w;
Imple
menting the fort
hcom
ing c
hanges to
the L
GP
S; and
Main
tain
ing c
urr
ent and futu
re s
erv
ice levels
during the p
eriod o
f change.
The k
ey r
evie
w fin
din
gs in r
ela
tion to r
isk c
an b
e c
ate
gorised in the follo
win
g
bro
ad g
roups:
Mem
ber
event pro
cessin
ghas a
hig
h level of m
anual in
terv
ention w
ith few
form
al contr
ol pro
cedure
s;
Sch
em
e e
ve
nt p
rocessin
gu
sin
g p
ensio
ne
r d
ata
an
de
mp
loyer
contr
ibu
tio
ns
are
not re
gula
rly r
econcile
d;
A s
ingle
pers
on, th
e P
ensio
ns M
anager,
is r
esponsib
le for
a s
ignific
ant
pro
port
ion o
f th
e c
om
ple
x s
chem
e e
vents
pro
cessin
g;
Investm
ent in
sta
ff d
evelo
pm
ent is
low
; and
Investm
ent to
incre
ase the a
uto
mation o
f pro
cesses h
as b
een lim
ited.
These p
rocessin
g r
isks a
recurr
ently m
itig
ate
d, to
som
e e
xte
nt, b
y a
sm
all
Pensio
ns S
ection team
that in
clu
des in
div
iduals
with long s
erv
ice a
t th
e C
ouncil
and w
ho a
re e
xperienced
at pro
cessin
g the c
urr
ent LG
PS
benefits
.
We m
ade s
ix h
igh p
riority
recom
mendations a
ll of w
hic
h o
ffic
ers
were
quic
k to
respond to.
Ora
cle
Op
tim
al B
enefits
Revie
w
In 2
003/0
4 the C
ouncil
com
ple
ted the im
ple
men
tation
of th
e O
racle
e-B
usin
ess
suite. It p
rovid
es a
n inte
gra
ted fin
ancia
l m
anagem
ent syste
m inclu
din
g p
ers
onnel,
supply
chain
and fin
ance b
usin
ess p
rocesses w
hic
hare
core
to the C
ouncil’
s
opera
tions.
The im
ple
men
tation o
f O
racle
has r
esulted in fundam
enta
l changes to these
pro
cesse
s for
the
Co
uncil
an
d h
as r
equ
ire
d s
ign
ific
an
t in
ve
stm
en
t in
th
e n
ew
techno
logy, a s
yste
m s
upport
function a
nd in tra
inin
g C
ouncil
em
plo
yees to
ensure
they a
re a
ble
to u
se
the s
yste
m e
ffectively
.
Ou
r re
vie
w w
as in
itia
ted
to e
va
lua
te th
e e
ffe
ctive
ness o
f co
re b
usin
ess
pro
cesses
an
d th
e C
ou
ncil’
s u
se
of th
e O
racle
syste
m to
en
sure
op
tim
um
bene
fits
are
derived fro
m u
tilis
ing the n
ew
syste
m.
The k
ey fin
din
g fro
m o
ur
revie
w w
as that th
e c
urr
ent fu
nctionalit
y o
f th
e O
racle
syste
m h
as in g
enera
l only
repla
ced the C
oun
cil’
s legacy fin
ance s
yste
m. W
hils
t
Ora
cle
has p
rovid
ed a
more
inte
gra
ted fin
ance a
nd o
pera
tional syste
m, allo
win
g
better
vis
ibili
ty o
f activitie
s a
cro
ss t
he C
ouncil,
gre
ate
r benefits
and e
ffic
iencie
s
can b
e a
chie
ved thro
ugh the im
ple
menta
tion
of m
odule
s s
uch a
s H
R s
elf s
erv
ice
and inte
rnet pro
cure
ment w
hic
h w
ill tra
nsfe
r adm
inis
tration a
ctivitie
s b
ack to the
users
. M
anagem
ent has n
ote
d this
within
the c
urr
ent e-p
rocure
ment str
ate
gy a
nd
pro
posal.
The r
evie
w n
ote
d that, for
the m
ost part
, fu
nctionalit
y a
vaila
ble
thro
ugh the O
racle
e-B
usin
ess S
uite is a
vaila
ble
and b
ein
gused. H
ow
ever,
the d
egre
e to w
hic
h it is
bein
g e
ffectively
used a
cro
ss the C
ouncil
varies b
y d
epart
ment/fu
nction. W
ithin
every
Council
depart
ment w
e n
ote
d a
relu
cta
nce to u
tilis
e the O
racle
syste
m a
nd
change legacy b
usin
ess p
rocesses. T
his
has r
esulted in ineffic
iencie
s a
nd
bottle
necks w
ithin
key a
reas o
f th
e b
usin
ess. D
epart
ments
must ta
ke a
join
t
responsib
ility
for
makin
g c
hanges to k
ey a
ctivitie
s, w
hic
h w
ill e
nable
the C
ouncil
to
fully
utilis
e the O
racle
syste
m. W
hils
t th
e fin
ance d
epart
ment m
ay lead these
initia
tives, depart
ments
must fo
llow
and take a
ctions to a
ddre
ss these s
hort
falls
as
a m
atter
of priority
.
Pro
gre
ss o
n P
revio
us T
arg
ete
d a
udit w
ork
Each y
ear
our
perf
orm
ance m
anagem
en
t audit p
rogra
mm
e inclu
des follo
w u
p
work
to c
onsid
er
the C
ouncil’
s p
rogre
ss o
n the a
gre
ed a
ction p
lans a
risin
g fro
m
pre
vio
us p
erf
orm
ance m
anagem
ent re
po
rts. T
his
can take a
num
ber
of fo
rms
inclu
din
gcolle
cting furt
her
data
for
the A
udit C
om
mis
sio
n’s
nationalfo
llow
up
indic
ato
rs, undert
akin
g furt
her
targ
ete
d w
ork
ours
elv
es,
or
revie
win
g the C
ouncil’
s
ow
n fo
llow
up p
roce
dure
s.
During the y
ear,
we h
ave c
ontinued to lia
ise w
ith o
ffic
ers
and m
onitor
the
Council’
s a
rrangem
ents
on a
gre
ed a
ction p
lans a
risin
g fro
m a
udit w
ork
un
dert
ake
n in p
revio
us y
ears
, w
hic
h h
ave
in
clu
de
d the
Co
un
cil’
s d
eve
lop
men
ts
with r
egard
to:
Pri
ce
wa
terh
ou
se
Co
op
ers
LL
P19
Page 23
Revie
w o
f H
om
e c
are
Follo
win
g o
n fro
m o
ur
pre
vio
us r
evie
w o
f hom
e c
are
during 2
003
we d
iscussed
the issues a
risin
g fro
m o
ur
work
with the A
udit C
om
mitte
e o
n 2
5 N
ovem
ber
2004.
We p
lan to u
ndert
ake m
ore
deta
iled fie
ld w
ork
to follo
w u
p o
n k
ey issues d
uring
early 2
005.
Pri
ce
wa
terh
ou
se
Co
op
ers
LL
P20
Page 24
Inspection
This
section o
f th
e r
eport
covers
:
The A
udit C
om
mis
sio
n’s
assessm
ent of th
e C
ouncil’
s D
irection o
f T
ravel;
an
d
The C
PA
Score
card
.
Direction o
f T
ravel A
ssessm
ent
Priorities, fu
ture
pla
ns a
nd a
mbitio
n
The C
ouncil
art
icula
tes its
am
bitio
n thro
ugh the r
evis
ed c
om
munity s
trate
gy a
nd
its L
PS
A w
ith g
overn
ment. S
even c
om
munity p
riorities a
nd 1
2 k
ey targ
ets
have
been a
gre
ed
with p
art
ners
and incorp
ora
ted w
ithin
the r
evis
ed c
om
munity
str
ate
gy. T
he s
trate
gy a
lso
now
incorp
ora
tes b
oth
the n
eig
hbourh
ood
renew
al
str
ate
gy a
nd the r
egenera
tion s
trate
gy.
The C
ouncil’
s p
riority
action
s lin
k to longer
term
actions in the c
om
munity s
trate
gy.
LP
SA
targ
ets
for
the C
ouncil
support
deliv
ery
of th
e c
om
munity s
trate
gy p
riorities,
with p
art
icula
r fo
cus o
n im
pro
vin
g the e
nvironm
ent, e
ducation a
ttain
ment, a
nd
com
munity s
afe
ty. O
vera
ll th
e targ
ets
are
achie
vable
, th
ough those for
open
spaces, re
-lettin
g o
f vacant pro
pert
ies a
nd e
ducational attain
ment of lo
oked a
fter
ch
ildre
n n
ow
lo
ok p
art
icu
larly a
mb
itio
us c
on
sid
erin
g r
ece
nt p
erf
orm
an
ce
.
The C
ouncil’
s fin
ancia
l and s
erv
ice p
lannin
g h
ave b
een inte
gra
ted a
t a h
igh level
thro
ugh p
roduction o
f th
e m
ediu
m te
rm fin
ancia
l str
ate
gy (
MT
FS
) 2004/0
5 –
2006/0
7. T
his
sets
out th
e p
riority
are
as
for
fundin
g. E
xecutive p
ort
folio
hold
ers
have p
roduced
sta
tem
ents
of th
eir a
ims w
hic
h feed into
and a
lign w
ith c
orp
ora
te
pla
ns. T
he a
nnual budget pro
cess e
nsure
sth
at in
div
idual savin
gs a
nd g
row
th
decis
ions m
ade a
t serv
ice
level are
in lin
e w
ith the M
TF
S. R
esourc
es h
ave b
een
moved a
way fro
m low
pri
ority
are
as s
uch
as n
on-c
ore
socia
l serv
ices s
upport
and
in-h
ouse c
om
munity p
rovis
ion to s
upport
hig
h p
riority
are
as, such a
s s
erv
ices
de
live
ring
th
e C
lea
ne
r, G
ree
ne
r an
d S
afe
r p
rio
rities.
Str
ate
gic
be
st va
lue
re
vie
w a
reas a
re c
lea
rly r
efle
cte
din
th
e C
ou
ncil’
s 2
004
/5
str
ate
gic
ob
jective
s a
nd
fo
cu
s o
n th
e r
ege
ne
ratio
n, p
rocure
me
nt a
nd
‘custo
mer
firs
t’ p
riorities.
Th
e “
Ho
usin
g F
utu
res”
sto
ck o
ptio
ns a
ppra
isa
l h
as b
ee
n in
form
ed
by th
e ‘L
an
dlo
rd
Serv
ices’ re
vie
w. A
Housin
g F
utu
res F
oru
m h
as b
een
esta
blis
hed for
this
purp
ose.
The C
ouncil
is a
lso im
ple
menting the r
ecom
mendations o
f its e
xte
rnal auditor’s
scru
tiny o
f C
om
munity H
ousin
g P
art
ners
hip
s a
nd P
art
ner
work
ing. R
ais
ing
attain
ment at K
ey S
tage 3
is a
national priori
ty a
nd is s
upport
ed b
y P
riority
5 o
f th
e
Council’
s E
ducation
Develo
pm
ent P
lan. R
estr
uctu
ring to d
eliv
er
LA
C1 p
lans is
aim
ed a
t im
pro
vin
g S
ocia
l S
erv
ices
to b
ecom
ing a
tw
o s
tar
serv
ice.
1 L
AC
– L
ocal auth
ority
circula
r
Pri
ce
wa
terh
ou
se
Co
op
ers
LL
P21
Page 25
Fo
cus
Th
e C
ou
ncil
is fo
cusse
d o
n d
eliv
ering
th
e c
om
mu
nity p
rio
rities a
nd
its
ba
lanced
score
card
fra
mew
ork
is b
ein
g u
sed e
ffectively
to m
an
age a
nd m
onitor
its
perf
orm
ance in
deliv
ering p
riority
actions a
nd targ
ets
. T
his
now
incorp
ora
tes 2
3
str
ate
gic
ob
jective
s a
nd
45 p
erf
orm
ance in
dic
ato
r m
ea
sure
s. T
arg
ets
an
d
measure
s fro
m the C
PA
im
pro
vem
ent
pla
n a
nd L
PS
A h
ave b
een in
tegra
ted to
en
su
recle
ar
focus. T
he
ro
le o
f th
em
atic
sco
recard
s is b
ein
g s
tre
ng
the
ned
to
le
ad
rath
er
than follo
w s
erv
ice s
core
card
s a
nd
furt
her
work
is r
equired to im
pro
ve
alig
nm
en
t b
etw
een
serv
ices.
Ste
ps taken to e
nsure
that priorities
run
cle
arly thro
ugh
all
pla
ns inclu
de:
dis
trib
uting the “
Managin
g the C
ouncil”
fold
er
to a
ll M
em
bers
and s
enio
r offic
ers
to
make
cle
ar
the lin
ks b
etw
een top level am
bitio
n a
nd p
riorities a
nd indiv
idual
targ
ets
; re
vis
itin
g th
e s
tra
teg
ic o
bje
ctives in
th
e C
ou
ncil
Sco
recard
to
pla
ce
a
str
ong
er
em
ph
asis
on
de
ve
lop
ing
th
e o
rga
nis
atio
na
lcu
ltu
re; a
nd
ensu
rin
g th
at
serv
ice s
core
card
s lin
k a
nd c
om
ple
ment each o
ther.
LP
SA
targ
ets
are
bein
g
regula
rly m
onitore
d a
nd r
em
edia
l action taken w
here
necessary
.
Th
e C
ou
ncil
ha
s e
sta
blis
he
d a
nu
mbe
ro
f b
oa
rds to
en
ha
nce
co
rpora
te d
ecis
ion
makin
g inclu
din
g: R
egenera
tion B
oard
, C
usto
mer
First B
oard
and
the
Pro
cure
mentG
roup. T
here
is c
ontinued
focus o
n e
nsuring that equa
litie
s a
re p
art
of all
Council
activity in o
rder
to a
chie
ve r
ace e
qualit
y s
tandard
s, com
munity
cohesio
n a
nd tackle
dis
crim
ination. A
Com
munity C
ohesio
n p
lan a
nd a
n A
nti-
Dis
crim
ina
tion
Ch
art
er
we
re a
gre
ed
in
Ja
nu
ary
20
04
. W
ork
pro
gra
mm
es a
re
driven b
y the 3
year
str
ate
gy o
n e
qualit
ies a
nd d
ivers
ity a
nd 5
year
em
plo
ym
ent
str
ate
gy. T
he C
ouncil
ha
sconcentr
ate
don the c
om
mun
ity e
ngagem
ent aspect of
the e
qualit
ies a
genda a
nd is m
akin
g g
ood
pro
gre
ss w
ith a
num
ber
of exclu
ded
gro
ups a
gain
st th
is. In
additio
n, im
pro
ve
ments
to c
usto
mer
access
(tele
phone, e-
mail,
inte
rnet, p
ublic
access to C
ouncil
facili
ties)
and d
evelo
pm
ent of one s
top
conta
ct centr
es a
re im
media
te p
riorities
and a
re p
rogre
ssin
g w
ell
(see
Achie
vem
ent section).
The S
cru
tiny M
anagem
en
t B
oard
(S
MB
)overs
ees p
oor
perf
orm
ance a
s p
art
of its
rem
it. T
he C
ouncil
has
set up 8
scru
tiny p
anels
and c
om
ple
ted a
polic
y
com
mis
sio
n o
n c
om
munity e
mpow
erm
ent in
April 2004.
Ca
pa
city
The C
ouncil’
s fin
ancia
l situation r
em
ain
ssound. It c
ontinues to b
e d
ebt fr
ee a
nd
ha
s a
re
aso
na
ble
le
ve
l o
f re
serv
es. P
revio
usly
id
en
tifie
d c
ap
acity issu
es a
re b
ein
g
addre
ssed thro
ugh the o
rganis
ational de
velo
pm
ent pla
n ‘P
eople
Ma
tter,
’ and
pro
cure
men
t str
ate
gy to
ensu
re r
esou
rces a
nd
pro
cure
me
nt su
pp
ort
de
live
ry o
f
corp
ora
te p
rio
rities.W
ork
to d
evelo
p c
om
munity c
apa
city h
as p
rog
ressed. A
pro
gra
mm
e to d
evelo
p M
em
bers
’ le
aders
hip
capacity is u
nderw
ay b
ut th
is is a
n
are
a that re
quires furt
her
develo
pm
ent.
Capacity h
as b
een incre
ased to s
upport
com
munity s
afe
ty initia
tive
s. F
or
exam
ple
an A
nti-S
ocia
l B
ehavio
ur
Coord
inato
r and C
om
munity S
afe
ty O
ffic
er
(Yo
uth
Dis
ord
er)
ha
ve
be
en
re
cru
ited
and
th
e C
oun
cil
is in
th
e p
roce
ss o
f
recru
itin
g a
Dom
estic V
iole
nce C
o-o
rdin
ato
r. T
hro
ugh the L
PS
A, a C
om
munity
Safe
ty A
dvis
or
(Burg
lary
) ha
s b
een r
ecru
ited to h
elp
reduce d
om
estic b
urg
lary
,
and the C
ouncil
has o
bta
ined a
gre
em
ent fo
r a P
olic
e O
ffic
er
to b
e s
econded to the
Com
munity S
afe
ty team
. S
uccessfu
l lo
bb
yin
g for
an in
cre
ase in the n
um
ber
of
Polic
e O
ffic
ers
within
the B
oro
ugh n
ow
sees n
um
bers
at an a
ll tim
e h
igh.
Str
ate
gic
managem
ent capacity is b
ein
g s
tre
ng
thened
to d
evelo
p the C
ouncil’
s IT
str
ate
gy a
nd r
eorg
anis
e the IT
depart
men
t to
support
deliv
ery
of corp
ora
te
priorities. T
he C
orp
ora
te fin
ance function
has a
lso b
een
str
ength
ened
to e
nsure
,
for
exam
ple
, tighte
r contr
ol on c
apital expenditure
.
A C
orp
ora
tep
rocure
men
t g
roup
has b
ee
n fo
rmed
and
pro
cure
men
t h
as b
ee
n
incorp
ora
ted w
ithin
the b
ala
nced s
core
card
fra
mew
ork
. H
ow
ever,
the a
bsence o
f
a c
om
ple
te c
orp
ora
teco
ntr
acts
reg
iste
rm
ea
ns th
ere
is n
o c
lea
r base
line
to
identify
priority
are
as for
action. T
here
are
als
o n
o c
lea
r assessm
ent crite
ria for
options a
ppra
isals
to b
e u
sed in a
ny m
ajo
r serv
ice r
evie
w o
r pro
cure
ment,
pro
mo
tin
g m
od
els
of g
oo
dp
ractice
such a
s p
art
ne
rsh
ips a
nd
con
sort
ia.
Th
e C
ou
ncil
is w
ork
ing
with
th
e ID
eA
to
de
ve
lop
th
e m
ea
ns to
en
ha
nce
Me
mbe
rs’
Leaders
hip
Capacity. A
ll m
em
bers
have b
een o
ffere
d the o
pport
unity to h
ave a
Pers
onalD
evelo
pm
ent P
lan a
nd o
ver
50 p
er
cent have a
ccepte
d. T
his
is a
n a
rea
that re
quires furt
her
develo
pm
ent.
The C
ouncil
has s
et up the B
ark
ing T
ow
n C
entr
e P
art
ners
hip
and d
evelo
ped
pro
gra
mm
em
anagem
ent syste
ms a
nd s
oftw
are
to d
eliv
er
the tow
n c
entr
e
pro
gra
mm
e w
ith p
art
ner
agencie
s.
Are
a foru
ms
are
enablin
g im
pro
ved r
esid
ent in
volv
em
ent w
ith the C
ouncil
and
local m
em
bers
thro
ugh d
evelo
pm
ent of com
munity a
ction p
lans. C
om
munity
capacity is b
ein
g d
evelo
ped
by s
ponsoring r
esid
ents
and c
om
munity
repre
senta
tives to a
ttend tra
inin
g e
vents
. T
he A
bbey, G
ascoig
ne, T
ham
es
Pri
ce
wa
terh
ou
se
Co
op
ers
LL
P22
Page 26
Com
munity T
rust has b
een d
evelo
ped a
nd a
Com
munity C
ham
pio
ns tra
inin
g
pro
gra
mm
e in
troduced. T
he v
olu
nta
ry s
ecto
r have a
ppoin
ted a
Com
munity
Em
pow
erm
ent N
etw
ork
coord
inato
rw
ho h
as s
et up a
support
netw
ork
, tr
ain
ing
events
and is in the p
rocess o
f in
troducin
g a
n e
lection s
yste
m for
repre
senta
tives
to foru
ms a
nd the B
ark
ing a
nd D
agenham
Part
ners
hip
. S
ix C
om
munity h
ousin
g
pa
rtn
ers
hip
sh
ave
be
en
deve
lop
ed
to
ena
ble
gre
ate
r te
na
nt p
art
icip
atio
n in
makin
g local decis
ions a
round their h
ousin
g n
eeds.
Pe
rfo
rma
nce
Ma
na
ge
men
t
As d
eta
iled a
bove, th
e b
ala
nced s
core
card
appro
ach h
as b
een s
trength
ened to
ensure
effective p
erf
orm
ance m
anagem
ent of th
e C
ouncil
in d
eliv
ering its
contr
ibution to
com
munity p
riorities.
Each H
ead o
f S
erv
ice h
as
an a
nnual assessm
ent w
ith M
em
bers
to r
evie
w d
eliv
ery
again
st th
eir S
erv
ice S
core
card
, and futu
re p
riorities for
impro
vem
ent. A
nnual
appra
isals
for
em
plo
yees b
elo
w this
level are
yet to
be fully
em
bedded C
ouncil-
wid
e. P
rog
ress a
ga
inst th
e C
oun
cil
Sco
recard
str
ate
gic
ob
jective
s a
nd
spe
cific
targ
ets
are
mo
nito
red
qu
art
erly b
y th
e E
xe
cu
tive
of th
e C
oun
cil
an
d s
om
e c
ase
s
month
ly b
y T
he M
anagem
ent T
eam
(T
MT
). T
he C
ouncil
ha
sw
ork
ed to furt
he
r
em
bed the s
core
card
s, in
clu
din
g e
nsuring that th
e s
core
card
is c
overe
d d
uring
induction o
f all
sta
ff, but additio
nal w
ork
is r
equired to im
pro
ve c
oord
ination a
cro
ss
se
rvic
es.
Sin
ce D
ecem
ber
2003, th
e C
ouncil
has im
ple
mente
dm
onth
ly m
onitoring o
f
appro
priate
PIs
to e
nsure
maxim
um
attention to im
pro
ve p
erf
orm
ance. E
xecutive
Mem
bers
monitor
PIs
quart
erly in a
specia
l m
eeting d
evote
d to this
. O
nly
one
BV
PI (B
VP
I157)
was r
eserv
ed in 2
003/0
4 a
nd the C
ouncil
is r
evie
win
g c
olle
ction
pro
cesses for
this
indic
ato
r.
In O
lder
People
’sserv
ices a
new
monitoring
syste
mhas b
een intr
oduced to h
elp
incre
ase the p
roport
ion o
f old
er
people
receiv
ing a
care
pla
n. T
he q
ualit
y o
f th
e
care
pla
n is a
lso a
ssessed a
s p
art
of th
is n
ew
arr
angem
ent.
There
has b
een a
ctive w
ork
with m
ana
ge
rs to m
onitor,
report
and r
espond
appro
priate
ly to s
ickness a
bsence. W
ith t
he a
id o
f a r
evis
ed S
ickness A
bsence
Managem
en
t P
olic
y a
nd the intr
oduction o
f a n
ew
Str
ess P
olic
y, th
e C
ouncil
hopes to furt
her
impro
ve its
good p
erf
orm
ance.
The C
ouncil
has b
een
com
mended b
y G
OL for
its w
ork
on the L
SP
and
Com
munity S
trate
gy p
art
icula
rly in term
s o
f th
e involv
em
ent of part
ners
and the
com
munity, and the d
evelo
pm
ent of an e
ffective p
erf
orm
ance m
anagem
ent
fram
ew
ork
to d
rive im
ple
menta
tion o
f th
e c
om
munity s
trate
gy. T
his
fra
mew
ork
is
fully
lin
ke
d to
th
e c
orp
ora
te a
nd
serv
ice
sco
recard
s.
Learn
ing
Th
e C
ou
ncil
is u
sin
g a
rang
e o
f a
ctivitie
s to
be
co
me
a m
ore
ou
tward
fo
cused
and
learn
ing o
rganis
ation. It h
as e
ngaged ID
eA
in the p
rocure
ment re
vie
w to p
rovid
e
additio
nal challe
nge a
nd m
em
bers
ha
ve v
isited b
est pra
ctice p
rovid
ers
, fo
r
exam
ple
Am
ste
rdam
to look a
t housin
gdevelo
pm
ent, a
nd L
eeds
City C
ouncil
to
dis
cuss
corp
ora
te p
are
nting. T
he C
ouncil
is s
trength
en
ing n
etw
ork
ing a
nd
corp
ora
te learn
ing b
y r
egula
rly c
ontr
ibuting a
t national confe
rences a
nd w
ork
ing
gro
ups. T
here
is a
new
score
card
indic
ato
r fo
r th
e p
erc
enta
ge o
f m
anagers
sh
arin
g b
estp
ractice
so
tha
t th
is is e
mbe
dd
ed
with
in th
e c
ultu
re o
f th
e
org
anis
ation. T
he C
ouncil
is m
akin
g p
rog
ress o
n Investo
rs in P
eople
with four
de
part
me
nts
ach
ievin
g a
ccre
dita
tio
n. In
sp
ection
re
po
rts a
nd
im
pro
ve
me
nt p
lans
dem
onstr
ate
learn
ing fro
m e
xte
rnal audit a
nd inspection.
Investm
ent
Inve
stm
en
ts s
upp
ort
de
live
ry o
f co
mm
un
ity p
rio
rities a
nd
are
ad
dre
ssin
gca
pa
city
issues. T
he C
ouncil
has a
lso b
een s
uccessfu
l at le
vering in e
xte
rnal fu
nds to
support
regenera
tion initia
tives. E
xam
ple
s inclu
de:
Th
e C
ou
ncil
ha
s s
ecu
red
£8
mill
ion
in
go
ve
rnm
en
t a
nd
Eu
rope
an
fu
nd
ing
fo
r
Dagenham
Dock, £3 m
illio
n fro
m S
usta
inable
Com
munitie
s F
und for
the
Lifelo
ng L
earn
ing C
entr
e to
be b
uilt
on the s
ite o
f B
ark
ing lib
rary
, and £
2
mill
ion for
public
realm
im
pro
vem
ents
;
Successfu
l bid
s to the L
ondon r
ecyclin
gfu
nd w
ill e
xte
nd k
erb
sid
ecolle
ctions to
a furt
her
22,0
00 p
ropert
ies, a d
oor
knockin
g e
ducation e
xerc
ise to incre
ase
part
icip
ation, and g
reen w
aste
colle
ction;
Work
ha
s n
ow
be
gu
n o
n th
e p
erm
ane
nt b
uild
ing
fo
r Jo
Ric
ha
rdson
Co
mm
un
ity
School and the r
edevelo
pm
ent of E
astb
ury
Com
pre
hensiv
e S
choolon to a
sin
gle
site a
s p
art
of th
e e
ducation P
rivate
Fin
ance Initia
tive (
PF
I) c
ontr
act;
£3 m
illio
n h
as b
een m
ade a
vaila
ble
for
refu
rbis
hm
ent of re
sid
ential, r
esourc
e
and d
ay c
are
facili
ties;
A c
hild
ren’s
str
ate
gy h
as b
een p
roduced
acro
ss S
ocia
l S
erv
ices, education
and the N
HS
that re
vie
ws a
ll serv
ices for
child
ren in the B
oro
ugh.T
he
Pri
ce
wa
terh
ou
se
Co
op
ers
LL
P23
Page 27
child
ren’s
com
mis
sio
nin
gstr
ate
gy is b
ein
g u
pdate
d a
nd the n
um
ber
of socia
l
work
ers
incre
ased
. S
ignific
ant w
ork
has
been u
ndert
aken o
n L
ocalA
uth
ority
Circula
rs a
nd m
oney h
as b
een r
edirecte
d to s
upport
this
;
Fundin
g h
as b
een m
ade a
vaila
ble
for
the r
evis
ed s
trate
gic
pro
cure
ment
se
rvic
e s
tructu
re;
£100k h
as b
een a
gre
ed to fund c
ritical P
I im
pro
vem
ent fo
r 2004/0
5;
The first ‘C
usto
mer
First’ c
all
centr
e o
pened in O
cto
be
r 2004 c
overing
Environm
enta
l S
erv
ices; and
The r
edevelo
pm
ent of th
e B
roadw
ay T
heatr
e.
Achie
vem
ent
Th
e C
ou
ncil
ha
s m
ad
e im
pro
ve
me
nts
in
se
ve
ral serv
ice
are
as d
uri
ng
200
3/0
4,
inclu
din
g e
nviro
nm
en
t, s
ocia
l se
rvic
es, h
ou
sin
g a
nd
ed
uca
tio
n (
sum
me
r 2
00
3
results).
Overa
ll, p
erf
orm
ance a
gain
st 71 p
er
cent of perf
orm
ance indic
ato
rs h
as
impro
ved. T
here
has b
een v
ariable
pro
gre
ss o
n a
chie
vin
g the L
PS
A targ
ets
-
de
tails
are
inclu
de
d u
nd
er
the
ap
pro
priate
su
b-h
ead
ing
s. T
here
ha
ve
be
en
co
nsid
era
ble
imp
rove
me
nts
in
th
e a
rea
of cu
sto
me
rca
re d
ue
to
th
e fo
cus p
laced
on the C
usto
mer
First pro
gra
mm
e a
nd e
qua
litie
s a
nd d
ivers
ity. A
chie
vem
ents
inclu
de
up
gra
din
g p
ub
lic a
nd
co
mm
una
l a
reas o
f D
age
nh
am
Civ
icC
en
tre
an
d
Bark
ing T
ow
n H
all
and 8
1 p
er
cent of C
ouncil
build
ings n
ow
bein
g a
ccessib
le to
dis
able
d p
eop
le. T
here
has b
een a
substa
ntial in
cre
ase in the p
erc
enta
ge o
f
transactions that can b
e u
ndert
aken e
lectr
onic
ally
(77 p
er
cent com
pare
d to 4
6
per
cent la
st year)
although this
fig
ure
cannot be v
alid
ate
d a
s the indic
ato
r has
been q
ualif
ied.
Socia
l S
erv
ices
Socia
l serv
ices h
ave s
how
n a
n im
pro
vem
ent
in p
erf
orm
ance in 4
0 p
er
cent of key
socia
l care
indic
ato
rsw
ith o
nly
one indic
ato
r in
the w
ors
t bandin
g.S
ocia
l care
serv
ices h
ave r
eceiv
ed a
one s
tar
rating
overa
ll fr
om
CS
CI w
ith b
oth
adults’ and
child
ren’s
serv
ices a
ssessed a
s ‘serv
ing s
om
e p
eople
well’
with ‘pro
mis
ing
pro
sp
ects
for
imp
rove
me
nt’. T
he
re h
as
be
en
im
pro
vem
en
t in
th
e s
tab
ility
of
pla
cem
ents
of lo
oked a
fter
child
ren inclu
din
g foste
ring a
nd a
doptions, and the
em
plo
ym
ent, e
ducation a
nd tra
inin
g for
care
leavers
.H
ow
ever,
only
15 p
er
cent of
those a
ged 1
6+
leavin
g c
are
did
so w
ith a
t le
ast 1 G
CS
E a
t gra
de A
* to
G, m
akin
g
achie
vem
entof th
e C
ouncil’
s P
SA
targ
et appear
part
icula
rly c
halle
ngin
g.
Th
ere
ha
ve
be
en
fe
we
r a
dm
issio
ns o
f o
lde
r p
eo
ple
to
re
sid
en
tia
l or
nu
rsin
gcare
as m
ore
are
help
ed to liv
e a
t hom
e. In
tensiv
e h
om
e c
are
has b
een
used to
su
pp
ort
th
is a
nd
has m
ain
tain
ed
its
5 b
lob
pe
rform
ance
ra
ting
ove
r th
e la
st ye
ar.
Tw
o h
om
es for
eld
erly p
eople
have b
een r
epla
ced b
y tw
o h
igh q
ualit
y h
ousin
g
with e
xtr
a c
are
schem
es.
Th
e O
lde
r P
eo
ple
’s s
erv
ice
s in
sp
ection c
om
ple
mente
d the c
om
mis
sio
nin
g o
f
serv
ices fro
m the independent secto
rand the im
pro
ved r
ange a
nd q
ualit
y o
f
serv
ices. T
he n
um
bers
of serv
ice u
sers
who u
se
Direct P
aym
ents
to m
anage their
ow
nca
re p
acka
ge
s h
as incre
ase
d.
Education
Pe
rfo
rma
nce
imp
roved
ag
ain
st 6
8 p
er
ce
nt o
f E
du
ca
tion
in
dic
ato
rs d
urin
g
2003/0
4. A
t G
CS
E level th
e C
ouncil
was the 6
th h
ighest im
pro
ver
in the c
ountr
y
and the s
econd h
ighest in
London for
5 o
r m
ore
A*-
C g
rades in s
um
mer
2003.
49.3
per
centof pupils
achie
ved fiv
e m
ore
GC
SE
s g
raded A
* to
C, a s
even
perc
ent im
pro
vem
ent fr
om
2002. H
ow
ever,
pro
vis
ional figure
s for
2004 indic
ate
a
4 p
er
cent decre
ase in the n
um
ber
of pupils
achie
vin
g this
level. K
ey S
tage 3
SA
Ts r
esults
show
ed im
pro
vem
ent in
the thre
e c
ore
subje
cts
(E
ng
lish,
Math
em
atics
and S
cie
nce)
but m
uch m
ore
still
needs to b
e d
one a
s r
esults levels
fell
within
the w
ors
t quart
ile. T
here
was a
4 p
er
cent declin
e in p
upils
achie
vin
g
level 4 o
r above in K
ey S
tage 2
Math
s tests
and o
nly
a 1
per
cent im
pro
vem
ent in
respect of E
nglis
h tests
.
Although there
have b
een s
mall
impro
vem
ents
to a
ttendance levels
at prim
ary
and s
econdary
schoo
ls, attendance is s
till
an issue w
ith r
ela
tively
hig
h levels
of
absence. T
his
is a
noth
er
LP
SA
targ
et. T
he C
ouncil
perf
orm
s w
ell
in p
reparing
sta
tem
ents
of specia
l educational needs w
ithin
18 w
eeks.
Ho
usin
g
Th
e C
ou
ncil’
s h
ou
sin
g s
tra
teg
y a
nd
busin
ess p
lan
are
de
em
ed
‘fit fo
r p
urp
ose
’.
Perf
orm
ance
impro
ved a
gain
st 70 p
er
cent
of in
dic
ato
rs last year.
The o
uts
ourc
ed
repairs c
ontr
act has b
rought som
e e
arly
successes. T
he p
erc
enta
ge o
f specifie
d
repairs c
om
ple
ted o
n tim
e h
as im
pro
ved to 9
5 p
er
cent (f
rom
89 p
er
cent)
and the
nu
mb
er
of re
pa
ir a
pp
oin
tme
nts
ma
de
and
ke
pt im
pro
ve
d. T
he
Cou
ncil
has
achie
ved r
eductions in the n
um
ber
of
days h
om
ele
ss fam
ilies w
ith c
hild
ren a
re
accom
modate
d in b
ed a
nd b
reakfa
st fr
om
an a
vera
ge o
f 48 d
ays to 3
6 d
ays, and
in h
oste
l accom
modation fro
m 3
8 d
ays to
35 d
ays. H
ow
ever,
the turn
round tim
es
and r
e-lettin
gof vacant pro
pert
ies d
ete
rio
rate
d fro
m 4
2 d
ays to 4
7 d
ays a
nd this
is
Pri
ce
wa
terh
ou
se
Co
op
ers
LL
P24
Page 28
well
short
of th
e P
SA
targ
et of 25 d
ays. In
additio
n, 55 p
er
cent of th
e C
ouncil’
s
housin
gsto
ck d
oes n
ot m
eet th
e d
ecent hom
es s
tandard
(w
ors
t quart
ile).
This
is
bein
g a
ddre
ssed b
y the H
ousin
g F
utu
res
exerc
ise. T
enant in
volv
em
ent in
this
pro
cess m
ay tu
rn r
ou
nd
resu
lts o
f 2
00
3/4
su
rve
ys s
ho
win
g p
oor
sa
tisfa
ction
with
opport
unitie
s to p
art
icip
ate
in h
ousin
g m
anagem
ent decis
ions.
Le
isu
re a
nd
lib
raries
Overa
ll 67 p
er
cent of lib
raries a
nd leis
ure
indic
ato
rs im
pro
ved s
ince 2
002/3
.
DC
MS
has a
ward
ed the s
erv
ice the h
ighest possib
lescore
for
its p
ositio
n
sta
tem
ent re
spondin
g to the g
overn
ment’s p
olic
y a
nd s
trate
gy for
libra
ries. S
erv
ice
perf
orm
ance
again
st th
e p
ublic
lib
rary
sta
ndard
s is r
ate
d a
s g
ood.P
hysic
al vis
its
incre
ase
d a
lth
ou
gh
th
e C
ou
ncil’
s ta
rge
t w
as n
ot m
et.
2 n
ew
lib
raries o
pen
ed
at
Sue B
ram
ley c
entr
e (
Tham
es M
ead)
an
d M
ark
yate
. A
ll th
e b
oro
ugh’s
lib
raries
have n
ow
receiv
ed U
K o
n lin
e s
tatu
s a
nd 1
20 p
ublic
in
tern
etcom
pute
rs h
ave
been insta
lled.
Vala
nce H
ouse M
useum
was a
ward
ed N
ational B
ronze
Win
ner
for
the N
ationa
l
Civ
ic P
ride A
ward
s 2
004 a
nd the n
um
ber
of vis
its incre
ased b
y 5
000. E
astb
ury
Ma
nor
Hou
se in
Ba
rkin
g h
as r
eop
ene
d follo
win
gre
furb
ish
men
t, a
nd
Gre
en
fla
g
aw
ard
s h
ave
be
en
ga
ine
d fo
r E
astb
rooke
nd
Co
un
try P
ark
an
d D
age
nh
am
Parish
Churc
hyard
contr
ibuting to a
chie
vem
entof LP
SA
targ
ets
. H
ow
ever,
there
is s
till
poor
resid
ent satisfa
ction
with p
ark
s a
nd o
pen s
paces.
Ho
usin
g B
enefits
The B
enefit F
raud Inspecto
rate
(B
FI)
recently r
eassessed b
enefits
serv
ices a
s
bein
g ‘fa
ir’. M
any a
reas identified for
impro
vem
ent la
st year
have o
r are
bein
g
addre
ssed, fo
r exam
ple
, counte
r fr
aud o
pera
tions. 56 p
er
cent of in
dic
ato
rs
impro
ved
and the C
ouncil
achie
ved
top q
uart
ile p
erf
orm
ance in thre
e a
reas,
pro
cessin
g r
enew
al cla
ims
on tim
e, perc
enta
ge o
f cases p
rocessed a
ccura
tely
,
an
d s
atisfa
ctio
n w
ith
th
e c
larity
of fo
rms
an
d le
afle
ts. T
he
re r
em
ain
ed
de
lays fo
r
pro
cessin
g n
ew
cla
ims
(ave
rag
ing
46
days a
ga
inst th
e s
tan
da
rd o
f 3
6 d
ays).
Perf
orm
ance
for
pro
cessin
g n
otifications o
f change in c
ircum
sta
nces im
pro
ved
sig
nific
antly b
ut fe
ll w
ell
belo
w the s
tan
da
rd o
f 9 d
ays a
nd c
om
pare
s p
oorly w
ith
oth
er
boro
ughs. T
hese issues m
ay c
ontr
ibute
to p
oor
user
satisfa
ction w
ith H
B
serv
ices. R
epla
cem
ent of th
e R
evenues a
nd B
enefits
syste
m is p
lanned.
En
viro
nm
en
tal S
erv
ices
Although 8
4 p
er
cent of E
nvironm
ent in
dic
ato
rsshow
im
pro
vem
ent, a
num
ber
of
the
se
are
fro
m a
lo
w b
ase. R
ecyclin
g p
erf
orm
ance
ha
s im
pro
ve
dco
nsid
era
bly
(fro
m 1
.96 p
er
cent to
5.7
7 p
er
cent)
but is
still
som
e w
ay s
hort
of th
e C
ouncil’
s
sta
tuto
ry r
ecyclin
g targ
et. T
here
is p
oor
accessib
ility
to the k
erb
sid
e c
olle
ction
recyclin
gsche
me
an
d a
ltho
ug
h th
ere
ha
s b
ee
n a
sig
nific
an
t re
ductio
n in
th
e
am
ount of household
waste
colle
cte
d, th
e b
oro
ugh is s
till
a h
igh w
aste
pro
ducer.
The b
oro
ugh a
lso p
erf
orm
ed p
oorly o
n s
treet cle
anlin
ess
(BV
PI1
99)
with 4
7 p
er
cent of re
levant la
nd found to b
e litte
red t
o a
sig
nific
ant or
heavy e
xte
nt (w
ors
t
quart
ile).
Road
safe
ty h
as im
pro
ved
furt
her
with the c
ontinued r
eduction in r
oad
casualtie
s a
nd the C
ouncil
is w
ell
pla
ced to
deliv
er
its P
SA
targ
et in
this
are
a. T
he
Co
un
cil
als
op
erf
orm
sw
ell
for
co
nd
itio
n o
f n
on
-princip
al ro
ads, a
nd
th
e
pe
rce
nta
ge
of cro
ssin
gs w
ith
fa
cili
tie
s fo
rth
e d
isab
led
,b
ut p
oo
rly fo
r fo
otw
ay
conditio
n. E
nvironm
enta
l H
ealth a
nd T
radin
g S
tandard
s indic
ato
rs r
em
ain
excelle
nt (1
00 p
er
cent)
. P
erf
orm
ance a
gain
st all
pla
nnin
g s
tandard
perf
orm
ance
ind
ica
tors
has im
pro
ve
d b
y o
ve
r 1
0 p
erc
en
tag
e p
oin
ts a
s a
resu
lt o
f re
cen
t
investm
ent de
cis
ions, although p
erf
orm
ance h
as s
till
not re
ached the g
overn
men
t
targ
ets
.
Re
ge
nera
tio
n
There
has b
een p
rogre
ss o
n a
num
ber
of m
ajo
r pro
jects
. F
or
exam
ple
, in
rela
tion
to p
lans for
Ba
rkin
g T
ow
ncentr
e, th
e B
loom
field
s, W
akerings a
nd C
levela
nds
site
was s
old
and the e
sta
te d
ecante
d to e
nable
dem
olit
ion a
nd n
ew
build
ing w
ork
in
2004; th
e S
t. A
nne’s
resid
ential develo
pm
ent schem
e featu
ring 1
25 o
ne a
nd tw
o
bedro
om
fla
ts in a
thre
e a
nd four
sto
rey s
chem
e w
as b
uilt
on the s
ite o
f th
ree
dem
olis
hed tow
er
blo
cks (
the G
ascoig
ne E
sta
te);
and p
lannin
g p
erm
issio
n w
as
gra
nte
d for
ne
w h
ousin
g o
n A
bbey R
oad. T
he C
ouncil
has s
uccessfu
lly lobbie
d
the O
DP
M for
inclu
sio
n o
f B
ark
ing w
ithin
the T
ham
es G
ate
way. T
his
ensure
s that
resourc
es fro
m the G
overn
ment’s S
usta
inable
Com
munitie
s P
lan c
an b
e m
ade
availa
ble
to s
upport
regenera
tion o
f th
is t
ow
n c
entr
e.A
join
t ventu
re c
om
pany h
as
been
set up to s
hare
the c
ost of build
ing 1
0,7
00 n
ew
hom
es a
t B
ark
ing R
ivers
ide
and m
aste
r pla
nners
ha
ve b
een a
ppoin
ted.
The C
ouncil
esta
blis
hed the G
ate
way to H
ealth a
nd
Socia
l C
are
to p
rom
ote
care
ers
for
local people
in the h
ealth s
ecto
r, s
ecure
d fundin
g for
a fu
rther
two
ye
ars
for
We
lfa
re to
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fo
r D
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d e
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blis
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d a
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l E
nte
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ork
in the B
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ncoura
ge local econom
icin
itia
tives.
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mm
un
ity S
afe
ty
Co
mm
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ity s
afe
ty in
dic
ato
rssh
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an
incre
ase
in
dom
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bu
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s, ro
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and v
iole
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he incre
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akes the P
SA
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more
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here
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num
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of th
efts o
f/fr
om
moto
r vehic
les to
Pri
ce
wa
terh
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se
Co
op
ers
LL
P25
Page 29
the p
revio
us
year.
The intr
oduction o
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eet w
ard
ens in V
illage, R
iver
&
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resbro
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rds h
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ese
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um
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ssessed c
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4
Pri
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P26
Page 30
Audit p
lan 2
004/0
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Audit P
lan 2
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We h
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lan for
2004/0
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nd w
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resente
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udit
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mitte
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Corp
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onitoring G
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) at its m
eeting in A
pril 2004.
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nvironm
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ithin
whic
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ou o
pera
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e h
ave r
evis
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lan to e
nsure
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s a
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for
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5 fin
ancia
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e
can
confirm
that sin
ce the C
ouncil
ha
s n
ot ra
dic
ally
changed a
ny o
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lans s
ince
we p
repare
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lan in M
arc
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posals
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2002 u
ntil 31 M
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fees c
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Ap
pe
nd
ix A
: A
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it r
ep
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sis
sued in r
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tion t
o t
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2003/0
4 f
inancia
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ancia
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tem
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SA
S 6
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eport
.
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Ap
pe
nd
ix B
: R
eco
mm
en
da
tio
ns
This
table
sum
marises the r
ecom
mendations that w
e h
ave m
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t
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nd Inspection L
etter.
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mm
en
dati
on
Man
ag
em
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t
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po
ns
e
We r
ecom
mend that th
e C
ouncil
develo
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its r
isk m
anagem
ent pro
cesses, in
lin
e
with b
est pra
ctice, to
meet th
e n
eeds o
f
the o
rganis
ation. T
his
should
involv
e the
develo
pm
ent of an o
rganis
ation w
ide r
isk
regis
ter,
deta
iling r
isks, contr
ol activity
and s
pecific
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iduals
to c
ham
pio
n e
ach
risk. K
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isks s
hould
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colla
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consid
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anagem
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.
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k M
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he p
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des
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mew
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s. O
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tional
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eg
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re in
th
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bein
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ine M
anagers
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escale
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– H
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it
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Reco
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dati
on
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po
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cknow
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e p
ast year
has
been o
ne o
f tr
ansitio
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depart
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sp
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nag
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has b
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in p
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ow
ever,
now
that a n
ew
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of IT
has r
ecently join
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ouncil,
se
nio
r m
an
age
me
nt sho
uld
en
sure
th
at
the issues identified a
s “
hig
h p
riority
” are
addre
ssed a
s a
matter
of urg
ency a
nd
tha
t a
de
qua
te r
esou
rces a
re g
ive
n to
resolv
ing the issues r
ais
ed
by o
ur
work
.
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agre
e w
ith the
recom
mendations a
nd w
ill p
urs
ue the
recom
mendations m
ade, prioritise,
co
nsu
lt a
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fo
r re
so
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re
appro
priate
.
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escale
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During 2
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6
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le O
ffic
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f IM
&T
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eitera
te o
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recom
mendation fro
m
2001/0
2 that a form
al assessm
ent of th
e
level of th
e C
ouncil’
scom
plia
nce w
ith the
Data
Pro
tection A
ct should
be p
erf
orm
ed.
Action p
lans
should
then b
e d
evelo
ped
at
bo
th c
orp
ora
te a
nd
dep
art
me
nta
l le
ve
ls to
addre
ss a
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ha
s b
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un
on
re
vie
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record
s m
anagem
ent. A
revie
w o
f
our
degre
e o
f com
plia
nce w
ith the
Act w
ill b
e c
om
ple
ted b
y the e
nd o
f
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rch
200
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nd
an
actio
np
lan
pre
pare
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eal w
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fall.
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escale
s –
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h 2
005
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on
sib
le O
ffic
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– H
ead
of
Dem
ocra
tic S
erv
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Pri
ce
wa
terh
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se
Co
op
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Page 35
Page 36
This page is intentionally left blank
THE ASSEMBLY
5 JANUARY 2004
REPORT OF THE HEALTH SCRUTINY PANEL
REPORT ON THE SPEECH AND LANGUAGE THERAPY (SALT) REVIEW
FOR DECISION
This report provides a summary of the Health Scrutiny Panel’s review of Speech and Language Therapy (SALT) services provided in the borough. The full review report is attached. Final reports of scrutiny panels are presented to the Scrutiny Management Board (SMB), the Executive and the Assembly, as required by Paragraph 11 of Article 5b of the Council’s Constitution. The Assembly, together with any members of the public, may ask questions. It will be asked to formally adopt the report and its recommendations. It may move changes to the recommendations in which case the Lead Member (or representative) will be given the opportunity to respond before a vote is taken. Summary 1. Health Scrutiny Since January 2003, Councils have had the power to look into local health services on residents’ behalf and recommend improvements - this is called ‘health scrutiny.’ The Council set up a special members’ panel to carry out this work locally. The panel is led by Councillor Marie West and meets in public session.
A key aspect of health scrutiny is in-depth reviews on issues of local concern. These involve seeking stakeholders’ views, looking at relevant documents, visiting services and, at the end of the process, producing a report including recommendations for improvement. The National Health Service (NHS) bodies responsible for the area being reviewed then have to say, within a set period, what action they will take in response.
2. The Review
Local people were asked to suggest key topics for in-depth health scrutiny reviews in the Spring of 2003. The first of these, Access to Primary Care, has been completed. The second priority topic was Speech and Language Therapy and this review has been carried out over the period May to September 2004. The review method included researching the local provision and the establishment of best practice from experience elsewhere. It carried out substantial enquiries with stakeholders, including two stakeholder meetings and various visits. In addition a number of organisations and individuals submitted written evidence. This included many letters from individual parents.
AGENDA ITEM 4
Page 37
3. Findings The Panel found that the supply of speech and language therapy services had been insufficient to meet demands over many years. This had been recognised by operational managers, both of the service provided by the NHS and also by that provided by the Council’s own Education Service. In the latter case there has been substantial new investment during the last few years. In the case of the NHS it appears that the service has suffered from increasing demand with no increase in budget and has responded by targeting the service to younger children. It appears to the Panel that individual therapists have been working tirelessly to provide the best service within limited resources. Nevertheless, with regard to the NHS, the service seems to have suffered from repeated reorganisation. The change from Barking and Havering Health Authority to the Barking and Dagenham Primary Care Trust and Havering Primary Care Trust has led to changes in commissioning arrangements. On the provider side the original unitary service provided by the Barking, Havering and Brentwood NHS Trust is now provided by one PCT (Barking and Dagenham) to its own population and also to the populations of Havering Primary Care Trust and the Billericay, Brentwood and Wickford Primary Care Trust. This has meant that the three PCTs as commissioners have had to decide on what services they wish to have supplied by the lead provider, the Barking and Dagenham PCT and these arrangements are described in local Service Level Agreements. There is now a greater understanding of the under funded position. At present there is an apparent substantial shortfall within the Barking and Dagenham PCT budget for the Speech and Language Therapy Service. This shortfall represent approximately one third of the current expenditure. One serious deficiency lies in the failure to deliver speech and language services to statemented children and the almost total absence of any service to mainstream schools. Another major concern has been the fact that many parents have had to use the private sector for the assessment and treatment of their children because of the inadequacies of the publicly funded speech and language therapy services. In order to meet current demand the service managers have proposed a staged increase in staff numbers and a staged set of developments. 4. Recommendations (the relevant sections of the report are indicated in square brackets) A: The Health Scrutiny Panel recommend to the Council and to the PCT that:
A1) More resources should be targeted at parents. These should include training, support and the provision of materials [6.2]. A2) They review their existing policies for supporting key workers and formulate and implement an action plan to improve the recruitment and retention of speech and language professionals in Barking and Dagenham, looking at issues including pay, work/life balance, benefits and affordable housing. It is also recommended that both organisations
Page 38
acknowledge the exceptional contribution made by existing staff who have worked hard to provide a high standard service with inadequate resources [6.9].
A3) They ensure that future complaints are fully recorded and monitored and that reports are discussed within both organisations and also at the joint working groups with responsibility for children, adults and those with learning disabilities [6.11].
A4) They make increased provision in their 2005-6 budgets for the treatment and support of children with hearing problems including those identified by the Neonatal Screening Programme [6.8]. A5) They formally acknowledge their responsibility for providing services to statemented children in cases where it is written into Part 3 of the child's Statement of Special Educational Needs as an "educational provision", and they make public how this is to be funded. In the absence of public provision the Council should make clear its policy on the reimbursement of parents whose children have been assessed and treated in the private sector [6.3].
A6) Adequate arrangements are made to ensure that proposals in the report are implemented and monitored through existing joint strategy groups (for example, for children, the Children’s Services Strategy Group) [6.4]. B: The Health Scrutiny Panel recommend to the PCT that: B1) Barking & Dagenham PCT fund the gap between current budget and spend where it relates to services for the Barking & Dagenham population, and that Havering and Billericay Brentwood and Wickford Primary Care Trusts and Barking Havering & Redbridge Hospital Trust are asked to fund the service at the current level provided [6.13].
B2) It accepts the long-term plan to increase Speech and Language Therapy establishments across, children, adults and those with learning disabilities [6.13].
B3) It includes the implementation of Stage 1 of the expansion plan, prepared by its own operational staff, in the local delivery plan, in particular the training post, the two speech and language therapists and the two speech and language therapy assistants for maintained schools and that this plan is implemented at the beginning of the year 2005-2006 [6.13].
B4) It re-profiles its future budgets so that appropriate resources are made available for children, adults and those with learning disabilities who have speech and language difficulties [6.13]. C: The Health Scrutiny Panel recommend to the two local PCTs that receive services from Barking and Dagenham PCT that:
C1) They consider as a matter of urgency whether they wish the lead arrangement and shared arrangements to continue. The Scrutiny Panel recommended that these organisational arrangements be confirmed so that they can be operational by the onset of the year 2005-2006 [6.12].
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D: The Health Scrutiny Panel recommend to the Director of Public Health of Barking and Dagenham that:
D1) The Director of Public Health confirms the need for increased speech and language therapy services for children, adults and those with learning disabilities as a matter of urgency [6.1, 6.6 and 6.7]. 5. Conclusion The scrutiny has been shown much that is good about the current service and the dedication of those working in the service. It recognises that many new developments have been funded and introduced by the Council. At the same time the NHS service has been stationary. The Panel believes it is now time for the NHS to expand the service to meet the very real needs of this disadvantaged group. 6. Next steps Once the report has been agreed by the Assembly, the Council will ask the various organisations to respond to the recommendations. It will also be asking the North East London Strategic Health Authority, which has responsibility for performance managing the primary care trusts, to review the progress of the Barking and Dagenham Primary Care Trust in implementing the Scrutiny Panel’s recommendations. At a local level we propose that the existing joint committees with responsibility for children, adults and those with learning disabilities should receive reports every six months on the implementation plan and that they report back to the Health Scrutiny Panel at six months and at one year. Recommendation The Assembly is recommended to agree the Health Scrutiny Panel’s recommendations as set out in the report. Councillor Marie West John Barry
Lead Member, Barking & Dagenham Health Scrutiny Panel Democratic Support Officer
020 8592 5071 (telephone) e-mail: [email protected] 020 8227 2352 (telephone) 020 8227 2171 (fax number) 020 8227 2685 (minicom) e-mail [email protected]
Background papers used in the preparation of this report: Health Scrutiny Panel minutes and papers
Page 40
London Borough of Barking and Dagenham Speech and Language Therapy Scrutiny Review
Page 41
Foreword by the Health Scrutiny Panel We have pleasure in presenting the Report of the Barking and Dagenham Health Scrutiny Panel on Speech and Language Therapy Services. Since January 2003, councils have had the power to look in depth at local health services on residents’ behalf and recommend improvements – this is called ‘health scrutiny’ and its main aim is to act as a lever to improve the health of local people. Before choosing to undertake a review of Speech and Language Therapy Services, we consulted local people on what they think the key health issues are in Barking & Dagenham. This included consultations through the Community Forums, the Barking & Dagenham Forum for the Elderly, the BAD Youth Forum, the Barking & Dagenham Partnership and ‘The Citizen’. We also met representatives from local NHS bodies and other organisations involved in health. It was clear from this that many people across the Borough had strong concerns about the provision of Speech and Language Therapy Services. We believe this report has confirmed those concerns and, through the recommendations it outlines, will make a significant contribution towards addressing the problems. Decisions on issues of resources are the responsibility of others, but we hope that multi-agency working will be endorsed and look forward to a positive and constructive response from the Barking & Dagenham Primary Care Trust. We should like to place on record our thanks to all those who provided views and evidence during the review, in particular those members of the public who have first-hand experience of using the service and who expressed their concerns with such clarity and force.
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The Speech and Language Therapy Services Health Scrutiny Panel Panel Membership Councillor Mrs D Challis Councillor Len Collins Councillor Mohammed A R Fani Councillor Mrs Dee Hunt Councillor Mrs Val Rush Councillor Mrs Marie West Policy and research support Steve Foster, Democratic Support Officer Pat Brown, Democratic Services, Corporate Strategy, External support Stephen Farrow, Public Health Direct Ltd Jolanta McCall, Public Health Direct Ltd Lianne Van de Merwe, Public Health Direct Ltd
Page 43
Table of contents Executive summary Section Title Page 1. Introduction 91.1 Background to scrutiny of health service 91.2 Background to speech and language services 91.3 Review method 9 2. Description of current services 112.1 Children’s services provided by the NHS 112.1.1 Caseload review and priority setting 112.1.2 Caseload 122.1.3 New demands 142.2 Children’s Services provided by the Education Authority 152.2.1 Funding 152.2.2 Provision 152.2.3 Summary of parents’ and staff comments in 2001 162.2.4 Recommendations from the LBBD review 172.2.5 Working in schools 182.2.6 Working with parents 192.2.7 Situation in 2004 192.2.8 Special Educational Needs, Review and Assessment Team 192.2.9 Multi Agency Work 202.2.10 Joint professional training programme 202.2.11 Education staffing levels 202.2.12 Future: 222.3 Complaints about the existing service 222.3.1 Parents’ views 222.3.2 Staff views 252.3.3 Voluntary sector views 262.4 Adult services 282.4.1 Local provision 282.4.2 National recommendations 292.4.3 Contacts 302.4.4 Adult caseload 302.4.5 Local provision of services for those with difficulty
swallowing 31
2.4.6 Audit for adult inpatients and outpatients at St George’s Hospital December 2003 with difficulty swallowing
32
2.4.7 Audit of tracheotomy patients - January 2004 322.4.8 An analysis of time spent by therapists on different activities 322.4.9 The planning process 332.4.10 Complaints of the adult service 342.5 Learning disabilities 352.5.1 Children’s services 35
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3. Costs 363.1 Current costs of the service 363.1.1 Current costs of the children’s service 363.1.2 Current costs of the adult service 373.1.3 Current costs of the service for adults with learning
disabilities 38
3.1.4 Summary of current costs and budget for all three services 393.2 Future costs 393.2.1 Future costs of the children’s service 393.2.2 Future costs of the adult service 403.2.3 Future costs of the adult learning disabilities service 413.2.4 Total costs to Barking and Dagenham for ideal future
service 41
3.3 Expansion plan 423.3.1 Staged expansion plan for new posts for children’s service 423.3.2 Expansion plan for new posts for adult service 42 4. Comparison with other services 43 5. NHS plans 45 6. Key issues 466.1 Caseload and waiting lists 466.2 Communication and involvement of parents 466.3 SEN statementing issues 466.4 Multi-agency working 476.5 Service delivery to children with speech difficulties 476.6 Service delivery to adults 476.7 Service delivery to those with learning disabilities 496.8 Early identification and intervention 496.9 Recruitment and retention 496.10 Service evaluation 516.11 Complaints 516.12 Problems arising from lead PCT responsibilities across
several PCTs 51
6.13 Budget issues 51 7 Action plan 52 8 References 54 9 Glossary 56 Appendices 57 Appendix 1 List of written evidence 57 Appendix 2 List of oral evidence 60 Appendix 3 Information provided during visits 61
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Executive summary Background Local people were asked to suggest key topics for in-depth health scrutiny reviews in the Spring of 2003. The first of these, Access to Primary Care, has been completed. The second priority topic was Speech and Language Therapy and this review has been carried out over the period May to September 2004. The review method included researching the local provision and the establishment of best practice from experience elsewhere. It carried out substantial enquiries with stakeholders, including two stakeholder meetings and various visits. In addition a number of organisations and individuals submitted written evidence. This included many letters from individual parents. Findings We found that the supply of speech and language therapy services had been insufficient to meet demands over many years. This had been recognised by operational managers, both of the service provided by the NHS and also by that provided by the Council’s own Education Service. In the latter case there has been substantial new investment during the last few years. In the case of the NHS it appears that the service has suffered from increasing demand with no increase in budget and has responded by targeting the service to younger children. It appears to the Panel that individual therapists have been working tirelessly to provide the best service within limited resources. Nevertheless, with regard to the NHS, the service seems to have suffered from repeated reorganisation. The change from Barking and Havering Health Authority to the Barking and Dagenham Primary Care Trust and Havering Primary Care Trust has led to changes in commissioning arrangements. On the provider side the original unitary service provided by the Barking, Havering and Brentwood NHS Trust is now provided by one PCT (Barking and Dagenham) to its own population and also to the populations of Havering Primary Care Trust and the Billericay, Brentwood and Wickford Primary Care Trust. This has meant that the three PCTs as commissioners have had to decide on what services they wish to have supplied by the lead provider, the Barking and Dagenham PCT and these arrangements are described in local Service Level Agreements. There is now a greater understanding of the under funded position. At present there is an apparent substantial shortfall within the Barking and Dagenham PCT budget for the Speech and Language Therapy Service. This shortfall represent approximately one third of the current expenditure. One serious deficiency lies in the failure to deliver speech and language services to statemented children and the almost total absence of any service to mainstream schools. Another major concern has been the fact that many parents have had to use the private sector for the assessment and treatment of their children because of the inadequacies of the publicly funded speech and language therapy services. In order to meet current demand the service managers have proposed a staged increase in staff numbers and a staged set of developments.
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Recommendations The Health Scrutiny Panel recommended to the Council and to the PCT that: A1 More resources should be targeted at parents. These should include training, support and the provision of materials [6.2]. A2 They review their existing policies for supporting key workers and formulate and implement an action plan to improve the recruitment and retention of speech and language professionals in Barking and Dagenham, looking at issues including pay, work/life balance, benefits and affordable housing. It is also recommended that both organisations acknowledge the exceptional contribution made by existing staff who have worked hard to provide a high standard service with inadequate resources [6.9]. A3 They ensure that future complaints are fully recorded and monitored and that reports are discussed within both organisations and also at the joint working groups with responsibility for children, adults and those with learning disabilities [6.11]. A4 They make increased provision in their 2005-6 budgets for the treatment and support of children with hearing problems including those identified by the Neonatal Screening Programme [6.8]. A5 They formally acknowledge their responsibility for providing services to statemented children in cases where it is written into Part 3 of the child's Statement of Special Educational Needs as an "educational provision", and they make public how this is to be funded. In the absence of public provision the Council should make clear its policy on the reimbursement of parents whose children have been assessed and treated in the private sector [6.3]. A6 Adequate arrangements are made to ensure that proposals in the report are implemented and monitored through existing joint strategy groups (for example, for children, the Children’s Services Strategy Group) [6.4]. The Health Scrutiny Panel recommended to the PCT that: B1 Barking & Dagenham PCT fund the gap between current budget and spend where it relates to services for the Barking & Dagenham population, and that Havering and Billericay Brentwood and Wickford Primary Care Trusts and Barking Havering & Redbridge Hospital Trust are asked to fund the service at the current level provided [6.13]. B2 It accepts the long-term plan to increase Speech and Language Therapy establishments across, children, adults and those with learning disabilities [6.13].
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B3 It includes the implementation of Stage 1 of the expansion plan, prepared by its own operational staff, in the local delivery plan, in particular the training post, the two speech and language therapists and the two speech and language therapy assistants for maintained schools and that this plan is implemented at the beginning of the year 2005-2006 [6.13]. B4 It re-profiles its future budgets so that appropriate resources are made available for children, adults and those with learning disabilities who have speech and language difficulties [6.13]. The Health Scrutiny Panel recommended to the two local PCTs that receive services from Barking and Dagenham PCT that: C1 They consider as a matter of urgency whether they wish the lead arrangement and shared arrangements to continue. The Scrutiny Panel recommended that these organisational arrangements be confirmed so that they can be operational by the onset of the year 2005-2006 [6.12]. The Health Scrutiny Panel recommended to the Director of Public Health of Barking and Dagenham that: D1 The Director of Public Health confirms the need for increased speech and language therapy services for children, adults and those with learning disabilities as a matter of urgency [6.1, 6.6 and 6.7]. Conclusion The scrutiny has been shown much that is good about the current service and the dedication of those working in the service. It recognises that many new developments have been funded and introduced by the Council. At the same time the NHS service has been stationary. The Panel believes it is now time for the NHS to expand the service to meet the very real needs of this disadvantaged group. Next steps The Council will ask the various organisations to respond to the recommendations. It will also be asking the North East London Strategic Health Authority, that has responsibility for performance managing the primary care trusts, to review the progress of the Barking and Dagenham Primary Care Trust in implementing the Scrutiny Panel’s recommendations. At a local level we propose that the existing joint committees with responsibility for children, adults and those with learning disabilities should receive reports every six months on the implementation plan and that they report back to the Health Scrutiny Panel at six months and at one year.
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1. Introduction 1.1 Background to scrutiny of health services Since January 1st 2003 Local Authorities have had the power to extend their scrutiny activities to wider issues of health and health services. In the Spring of 2003 the Council’s Health Scrutiny Panel asked local people to suggest key topics for in-depth health scrutiny reviews. The first of these, Access to Primary Care, has been concluded and the Panel decided to carry out a Speech and Language Therapy review. 1.2 Background to speech and language services Currently speech and language therapy is provided by Barking and Dagenham PCT. This is complicated by the fact that there are service level agreements with two other PCTs, Havering PCT and Billericay, Brentwood and Wickford PCT; as well as an acute Trust, Barking, Havering and Redbridge NHS Trust; and two mental health trusts, North East London Mental Health Trust and the South Essex Mental Health and Community Care NHS Trust. The acute trust arrangements inevitably include patients from outside the Borough. At the heart of the scrutiny is a review of the current service, a description of the different organisations roles and how they influence the overall strategy and a proposal on how the services could be improved. It was agreed that the review of speech and language therapy services would be carried out in four stages. 1.3 Review method Stage 1 Research local provision and establish best practice in the field This was carried out by reviewing local information systems and by discussion with key stakeholders. Information was gathered from other NHS districts and the published literature on best practice in the UK was reviewed. Stage 2 Consult stakeholders Consultation with stakeholders has taken place in several different forms. These have included formal sessions in the Council Chamber when key individuals have been asked to make a presentation; visits to health centres and schools and meetings with parents and carers. Officers from the Council, from the local PCT and from the North East London Strategic Health Authority have provided information. Attempts have been made to maintain a sense of a joint review between the NHS and the Council. The purpose of the Scrutiny has been to establish the gaps and to find ways of filling the gaps through the development of appropriate policies and action plans. A number of organisations and individuals have made written submissions. Stages 3 and 4 These stages were essentially concerned with the preparation and delivery of the draft report. Meetings of the Scrutiny Panel were held on August 19th and September 9th to finalise the report. The appendices to this report itemise the written evidence that was submitted (Appendix 1) and the oral evidence (Appendix 2) that was presented during
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the two stakeholders meetings. Appendix 3 provides information that was obtained during the visits.
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2. Description of current services
2.1 Children’s services provided by the NHS
In addition to the presentations at the two stakeholder meetings visits were organised to health settings and schools. These included the Julia Engwell Health Centre, Valence Nursery, Vicarage Fields Health Centre and St Georges Hospital. The school visits were to Five Elms Primary School, Eastbury Secondary Comprehensive School and Hunters Hall Primary School and its Language Resource Base. For a detailed account of these visits see Appendix 3.
2.1.1 Caseload review and priority setting
When the community caseload (covering pre-school and mainstream school children) was reviewed in autumn 2001 it was recognised that the service could only give one third of the level of therapy that was felt to be appropriate.
In 2001, given that there was no increase in numbers of staff it was decided to design a formula for prioritising demand.
For preschool children School age children (from reception upwards)
Priority 1 One six session block of therapy per year (individual or group) plus home/school programmes and up to three review appointments
Two visits to school each term, with a programme for home and /or school as appropriate
Priority 2 One six session block of therapy per year (group only) plus home/school programmes and up to three review appointments.
One visit to school each term, with a programme for home and /or school as appropriate
For preschool children School age children (from reception upwards)
Priority 3 Four review appointments per year, plus home/school programmes
Two visits to school each year with a programme for home and /or school as appropriate
Priority 4 Two review appointments per year. One visit to school each year, with a programme for home and /or school as appropriate.
From 2001 the caseload numbers continued to increase and it was not possible to fill staff vacancies. This meant that the service was unable to meet the requirements for all the children. Due to the vacancies in the Speech and Language Therapy Service it was agreed that the service should be focused on providing the stated level of service for pre-school children only and could see school-age children for initial assessments only.
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2.1.2 Caseload
Caseload figures as at December 2003
Barking and Dagenham
Havering Brentwood
Pre-school 100 60 38Nursery 120 140 61Reception 165 205 79Total 385 405 178% of total 39.7% 41.2% 18.4%
The number of new referrals and the number of children discharged influenced the size of the caseload. The figures for referrals and discharges for the calendar year 2003 are shown below.
Average number of referrals and discharges per month for the calendar year 2003
Barking and Dagenham
Havering Brentwood
New referrals per month Screening 22 23 9Full assessment 20 10 3Total 42 33 12 Discharges per month Total 7.3 13.8 1.3
One of the difficulties for the speech and language service is to match the number of therapists (supply) to rising demand. In December 2001 a business case was prepared for the development of community resources. It followed an assessment that had concluded that the current children’s speech and language service was insufficient to meet the needs of the local population of Barking, Dagenham and Brentwood. From June 2001 the department had undergone an extensive change programme to ensure that services were focused with the most efficient use of staff. The North Thames Managers published a paper (Campbell et al, 1998) that detailed appropriate levels of speech therapy input based on a caseload weighting system. By December 2001 it was clear that the service being provided was substantially less than that being recommended. The service faced constant criticism from stakeholders within social services and education as well as from the service users. During the twelve-month period from January to December 2001 there were 18 formal complaints regarding the paediatric speech and language therapy service. All except one of these related to access or to delayed delivery.
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As a result of the change programme it was agreed that services to school age children would be provided within an educational setting from January 2002. The establishment provided for 70 sessions of speech therapy time to the community each week. An establishment of 19.5 wte speech and language therapists was required to meet this need. The key objective of the business case was to gain approval for the development of 12.5 speech and language therapy posts. In addition a further 1.5 whole time equivalent posts were needed for administrative support.
By December 2003 it was estimated that the number of sessions each month to cover new referrals and existing caseload (for pre-school and reception year children only) was:
Number of sessions each month to cover existing caseloads and new referrals
Barking and Dagenham
Havering Brentwood
Nursery and preschool
17.50 16.25 7.75
Reception 7.00 9.00 4.00Total 24.40 25.25 11.75
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2.1.3 New demands
In addition to the general upward trend in demand there was a specific new initiative that would put further strain on the speech and language service. The Department of Health recommended the introduction of neonatal hearing screening programme that was designed to detect hearing loss at a much earlier date. Historically, therapists working in hearing impaired bases would see preschool children on initial referral, usually around three years. These children would then be placed on a monitoring and advisory caseload, where Teachers of the Deaf (TOD) would bring any concerns to the therapist’s attention, and occasional appointments were arranged where possible within the therapist’s timetable. These children would be transferred onto the therapists’ ongoing therapy caseload if they received a placement in the local resource base for hearing impaired children (Five Elms School). Funding for four extra sessions to work with deaf children was provided by Education until March 2004. This enabled the therapy service to allocate one session per fortnight to work with pre-school deaf children. However, since the funding ceased there has been no provision in place for this caseload.
Implications of the neonatal hearing screening programme The government initiative for screening all newborn infants’ hearing started in Barking & Dagenham in January 2004. Children with a hearing loss are now identified within the first two weeks of birth and referred to the Hearing Impaired Services at this time. This service has referred children to Speech and Language Therapy as young as five months old, where traditionally children were referred at around 3 years. Research has shown that support and intervention for families of deaf children from professionals in the field, is crucial in the early stages of diagnosis. It has also highlighted that direct work with families is important for developing early communication skills, rather than just an advisory and monitoring role. This has significant implications for the Speech and Language Therapy service. In 1999 the NDCS asked parents about the effects of late diagnosis, and in 2000 a questionnaire was distributed to parents to gather their views on newborn hearing screening. The outcome of this research showed that parents identified the following issues as being of primary importance for the provision of quality services for deaf children and their families. These included: time with professionals to understand the implications of deafness; early follow-up appointments; well-trained and qualified staff who are deaf aware and who have empathy with, and an understanding of the child and their family; long-term, local quality services and support. With no current funding available for preschool deaf children, the Speech and Language Therapy service is unable to provide this support. In order to provide an adequate service for this caseload of children specific funding is required for preschool deaf children. The demands of this caseload would merit 0.5wte Speech and Language Therapist. Their time would be divided between home visits for families; intervention for the children within their preschool setting (e.g. toddler group, playgroup, nursery); joint working with other professionals (teachers of the deaf, audiology, social workers,
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nursery staff, health visitors etc) and training and advice for other professionals, and parents/carers.
2.2 Children’s Services provided by the Education Authority
In 2001 the London Borough of Barking and Dagenham (LBBD) commissioned a review to investigate the level of speech and language therapy input for children within the borough. The principal author of the report was Debbie Reith, now Acting Team Leader for paediatrics in the PCT. The aims of the review were threefold:
• To provide a full picture of the level of input at the present time • To outline what provision should be available, and • To discuss how such provision might be made available within the
borough The process of the review involved consultation with a large number of people including those working within the Department of Education, Arts And Libraries (DEAL), teachers, parents and SLTs working both for the LEA and for Barking and Dagenham NHS Primary Care Trust (B&D PCT). In order to gain a full picture of the need across the borough, and people’s ideas for change, three main strategies were employed. A number of ‘interviews’ were held. Questionnaires were sent to every school in the borough and more in-depth interviews were carried out at two infant, two junior and two primary schools in the borough. As many parents as possible were contacted. The voluntary organisations ‘Carers’, Parents of Autistic Children Together (PACT) and Parents Liaison Group sent round letters of invitation to two specially arranged meetings held at Valence House. 2.2.1 Funding Pooling health and education budgets to provide services for a specific purpose or client group is one of the new partnership arrangements offered by the 1999 Health Act. The act aimed to produce flexible frameworks for organisations to improve inter-agency working. In the Thames Gateway, a partnership board manages the pooled money. There are three main new flexibilities available under the provision of the Health Act. These include lead commissioning; integrated provision; and pooled funds. The money can only be used on the agreed services set out in the partnership arrangement. This gives pooled budgets a unique flexibility, while being bounded by agreed aims and outcomes (DoH, 2000). This type of funding, as well as an exploration of possible Standards Fund money, may provide an increase in the current levels of funding. 2.2.2 Provision Government Working Groups have sought to investigate the difficulties surrounding SLT funding and provision. Information was obtained from four areas (Hackney, Harrow, Newham and Oldham). There is a need for joint strategic planning to enable SLTs to work in mainstream schools in a way that effectively supports the children, whether statemented or not. A difficulty for the profession is the national shortage of SLTs that has made recruitment
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difficult locally. There is also a problem of staff retention. Within LBBD however (as in the other boroughs served by the SLT department), there are also issues with Early Years provision and with support for children in the special schools and bases, where the level of SLT provision is insufficient to meet the needs of the children. The primary and secondary Learning Bases, and the Early Intervention Project at The Acorns had no allocated therapy provision. The sessions allocated to the Nursery Assessment Bases at Godwin and Valence schools and to the Speech and Language Base at Hunters Hall School were about 50% lower than is needed. There were two part-time SLTs employed by the LEA at Trinity school and this should be supplemented by another 12 sessions of therapy provided by health. However it was not been possible for B&D PCT to fill those vacancies, leading to frustration felt by school and parents alike. 2.2.3 Summary of parents and staff comments made in 2001 Positive comments Schools were very appreciative of support when therapists were able to provide it. The move by B&D PCT to work in mainstream schools was seen as a very positive one. The six-week blocks of therapy worked well when it happened. The service to the Hearing Impaired Bases was working well. Parents were very appreciative of the support given by the Child Development Centre at Orchard View, St George’s Hospital, Hornchurch. Negative comments There was a severe shortage of staff and the therapists’ caseloads were too large. Those that came to work in B&D PCT did not stay very long as the career prospects were not good in the department and the stress levels were high. Parents did not like the programmes they were given. They were not user friendly and were of poor quality. Schools did not like the programmes. They were hard to implement, the quality of the photocopying was poor and they were not linked to the curriculum. Schools did not know accurately who was on the speech and language therapy list. Some parents missed their appointments, so children were discharged when this should not have happened. This was a problem at pre-school level and may lead to behaviour problems later. When children were seen in clinics they were not at their best, as they were not in a familiar environment. There were not enough Specialist SLTs, both to support children and less experienced colleagues.
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2.2.4 Recommendations from the LBBD review An increase in staffing levels was essential. Mainstream schools
Early Years
Speech and Language Base
Portage Service
Nursery Assessment Bases
Learning Bases and The Acorns
12 wte therapists working in schools, with each therapist having a designated patch of schools to support.
1 wte therapist has been bid for in Marks Gate SureStart. At least another 3 wte would be needed for the rest of the borough.
2 wte (including the new ‘Outreach’ post that has been proposed), providing therapy for a maximum of 20 children in total. [7.13].
2 sessions (i.e. one full day per week)
4 sessions each (i.e. 2 days per week each)
It is estimated that at least 1 wte would be needed across these bases.
This gave a total of 20 wte therapists and did not include any SALT input that would be recommended for ‘Outreach’ for children on the autistic spectrum or the sessions that were currently in place (though largely unfilled), at Trinity. Given the shortage of SALTs and the funding implications this level may be difficult to achieve. One way of addressing that difficulty might be to employ a number of SALT Assistants to work in any of the settings outlined above. Such a skill mix would give flexibility, and provided the Assistants are well trained, perhaps by encouraging them to study for NVQ level 3, they could give care of a ‘high and measurable standard’ (McArdle, 2000). It was also considered important for the professional development of the SLTs to have a department structure that allowed for career progression and provided high quality professional support. The ideal provision would be to have one department that manages all the SLTs across the borough. One way of providing career progression within a department, and which also provided a quality service, was to have a number of specialists. These therapists could provide specialist therapy where needed and they could support more junior colleagues. Specialists in SLI, autism, hearing impairment, emotional and behavioural difficulties, dysfluency, bilingualism, written language disorders and early years would all be very helpful for the borough and colleagues. It would also be necessary to have a therapist whose area of interest and expertise was in the whole area of training, both for the department’s own staff, particularly assistants, and for those in schools etc.
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The Directorate made a bid for £300,000 to fund this increase in staff through the PCT/LDP process but this was not successful. However, this increase would have been for all three boroughs and would still have left Barking and Dagenham Borough with a shortfall. Law (2000) emphasised the importance of collaboration between local education authorities and health at a managerial level in the strategic planning of services if inclusion was to be successful. He referred to the recent Standards Fund money which services should actively bid for as a means of improving speech and language therapy provision in mainstream schools. 2.2.5 Working in schools The move towards supporting children in their school environment was acknowledged. Therapists needed to become familiar with the demands of the curriculum and learn how to adapt their activities accordingly, so that therapy targets could be included in a child’s normal day wherever possible. It would also be very helpful for all therapists working in mainstream schools to have a clear understanding of the borough’s Primary English Project and to see how therapy aims can be fitted into it. Therapists also need to be able to provide on-going training for all staff in every school that will help them to: • Better understand the needs of children with a speech, language or
communication difficulty • Understand what strategies they can use to support the children • Be more aware of normal speech and language development • Know whether a child has a difficulty or not • Use a range of activities that promote speech and language development. These areas of training need would fit in well to the aims of the Joint Professional Development Framework. This is a project funded by the DfEE, (now the DfES) to enable teachers and speech and language therapists to work effectively with children with speech and language and communication needs in an educational setting. This was to be achieved by creating an outline of professional development that could be undertaken jointly and collaboratively by both professional groups. Early Years The speech and language therapy department needs to develop flexibility in its work places and work closely, not only with EYDCP, but also with Health Visitors whose focus is usually those who are not yet in any form of pre-school provision. It needs to look at parent programmes such as Hanen and the Parent-based Intervention Programme (Gibbard 1998), as well as programmes designed to improve early identification and intervention. Screening A number of schools mentioned that this would be useful. The development of a screening assessment that is sensitive enough to pick up the children who need it, but yet quick enough to be viable would be a very interesting project. This development could be ongoing over the next few years, provided SLTs have caseloads small enough to make it feasible.
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Speaking and Listening Focus The development of a training and support programme for all staff working in Early Years settings that would boost the levels of language development on entry to school, perhaps at Year 1, would be another fascinating project to pursue. This would need to be developed and researched on a small scale first, as a pilot and so that its benefits could be closely monitored. The implications of this, should it be shown to be effective, would be long lasting and wide ranging. 2.2.6 Working with parents The development of more ‘parent friendly’ approaches include making sure that parents both understand fully and can support the therapy process with their child. It also involves producing resources that are of a high quality and in a form that parents can easily take away and use. Producing such resources on a regular basis could well be part of a Speech and Language Therapy Assistant’s role, working under the supervision of a SLT. It will also involve making sure that parents are as involved as possible with their child’s therapy once he or she is attending school on a full time basis. 2.2.7 Situation in 2004 Barking and Dagenham has a shared vision of inclusive education. It is about building the capacity of schools and the Early Years settings to manage a diverse range of educational needs, to work with parents and to promote collaborative work with other agencies. The Department for Education, Arts and Libraries (DEAL) is constantly seeking new and innovative solutions to improving practice and service provision. Multi-agency working is necessary in order to promote educational development, improve behaviour and promote better mental health. Early intervention at all Key Stages is the key to our improvements and we see Speech and Language therapy being central to our focus on high achievement for all. In the last two years DEAL has established a Communication Team that is located within the Community, Inspection and Advisory Service and includes four teachers and one speech and language therapist. The focus is on promoting whole school awareness and also on supporting individual pupils in order to promote the inclusion of those pupils with speech, language, communication and autism needs. Joint project work with Health and Deal’s Early Years and Social Inclusion teams has been part of the team’s brief. A detailed training programme has been provided for schools and Early Years settings. Specific work and training is currently being planned in order to provide parents with better support and advice. 2.2.8 Special Educational Needs, Review and Assessment Team They are a small team who have developed excellent multi-agency working practices. This involves joint training and work with the PCT and the LEA SEN Teams in order to provide assessment and support for pupils with a statement of SEN. They attend a number of annual reviews. Currently they have prioritised Year 6 and Year 9 pupils. DEAL provides financial support for
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pupils who have a statement of SEN. Currently it maintains 1114 pupils’ statements of Special Needs at a cost of just under £5 million. 167 of these children have speech and language as their main presenting need. The majority (80%) of the SEN statements, where speech and language is the main presenting need, are in mainstream schools. Each individual statement is allocated specific hours which vary from 5 to 30+ hours (each statement with 25 hours support costs DEAL about £11,000 per year. This does not include the cost of advisory teams who provide support for the individual teacher and training for all school staff. Support is also provided by the Education Psychology Service and [insert full name here] (SENART). The other 20% of pupils have more complex speech, language, feeding needs and are in specialised provision. Either in the special school, a mainstream addition resourced provision (such as Hunters Hall primary), or in out of borough special provision. DEAL currently spends over £3 million on the Special School and over £1 million on our Additional Resourced Provisions (ARP). Additional costs are incurred for any pupil in an out of borough special school. 2.2.9 Multi Agency Work Best Value Indicators are used to measure, for example, the percentage of statements prepared within 18 weeks including those involving other agencies. In 2001/2002 only 37% achieved this standard. This improved to 63% in 2002/2003 but this was still far short of what other LEAs had achieved. With the good relationships SENART have established with the health service, and with their support, DEAL has made significant improvements in this area. In April 2004 this indicator was achieved at the 100% level. 2.2.10 Joint professional training programme This project is led by DEAL and supported by the health service. Twenty-eight schools have committed resources and time to training their teachers and learning support assistants. Schools will be expected to appoint a lead speech and language professional. This training programme should eventually lead to specific qualifications for learning support assistants to become therapy assistants. The schools fund the staff. The multi-agency team provides ongoing support. DEAL’s speech and language therapist will initially provide support for the LSA but in future it is hoped this will be part of joint work with the health service. 2.2.11 Education staffing levels DEAL employs the following speech and language therapists/ specialist teachers: Early Years One Play and Language Therapist (qualified Speech and Language therapist). Foundation Stage DFES Funded Project One and a half Play and Language Coordinators (There is currently a vacancy for one Play and Language Coordinator. The post has been advertised three
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times and no applications have been received for this important post. It may be because this is a short term DFES funded project and prospective candidates are unwilling to leave permanent positions for temporary positions). Trinity School Two part time Speech and Language therapists. (One has recently resigned and has been replaced by a Speech and Language Therapy Assistant). Community Inspection and Advisory Service (CIAS) Speech and Language Needs Two teachers and one speech and language therapist focus on language difficulties and help schools to follow language programmes by providing specialist advice. They also support schools to implement specialist speech programmes provided by PCT speech therapists. The team have developed very close and effective working practices with health service colleagues. There has been joint training in school and inset sessions attended by large groups of teachers and other support staff. This team is part of a multi-agency speech and language working group. DEAL funds one primary ARP based at Hunters Hall. It is specialised resource for up to six pupils with speech and language needs. There is one teacher and one LSA employed in the provision. The PCT supports this provision by providing two sessions per week SLT and three sessions per week SLTA to provide direct therapy for the pupils. Complex Social and Communication Needs Team (autism and those on the spectrum) Two teachers provide support and advice to schools on autism and related needs but there is at present insufficient contact with health professionals from the PCT. There is one ARP at secondary level for up to six pupils and this has one teacher and two LSAs. Hearing Impaired Service There are three advisory teachers and one Head of Service who provide support and advice to schools and early year’s settings. They work closely with PCT and parents. There are two Additional Resourced Provisions, one at primary the other at Secondary. The Primary Additional Resourced Provision has places for 16 primary pupils and four nursery-aged pupils. The secondary unit caters for up to 12 pupils aged 11-18. The PCT provides a speech and language therapist for eight sessions per week to work in the Hearing Impaired Additional Resourced Provision. DEAL is spending over £500,000 per year on these three specialist advisory teams. This does not include the cost of the Additional Resourced Provisions. DEAL intends to continue moving towards developing co-located multi-agency teams. This is enshrined in the Every Child Matters agenda. It is important that DEAL, Health and Social Services promote and actively pursue joint
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working practices. A minimum number of Speech and Language Therapists need to be employed to work jointly with education and social services colleagues in order to provide an appropriate level of service for children and young people. 2.2.12 Future: There should be sufficient PCT funded speech and language therapists to support education area /cluster arrangements. There should then be a named speech and language therapist working with a cluster of schools and early year’s settings. This was envisaged two years ago. The focus shifted onto developing collaborative multi-agency teams. It was envisaged there would be five multi-disciplinary teams comprising advisory teachers, educational psychologists, health and social services personnel. These teams would work on joint projects. Two years ago the PCT speech and language therapists reorganised to achieve this. Schools were pleased with this arrangement, as they knew whom to contact if there were perceived difficulties. Parents were supportive as the therapists had a good understanding of the schools’ needs and were able to provide training for staff and parents. Five Multi-agency bases were also established. These portacabins are located in secondary schools and consist of a training room, working office, interview or parents room. In addition there is a need for a specialist speech and language therapist who can support DEAL’s Additional Resourced Provisions and Special School. 2.3 Complaints about the existing service At both stakeholder meetings and during the visits parents have complained about the service. Additionally parents have written to the scrutiny panel with specific accounts of their experience. The Panel has also received letters from the voluntary sector and from a Chair of Governors. Appendix 3 provides detailed information about these complaints. The following section summarises these responses. Many of the mothers wanted their child’s name to mentioned but the Panel decided to use the initial of their first name. 2.3.1 Parents’ views D is now nine and attends St. Margaret's Church of England School. He has been statemented since the reception class, almost 5 years ago. His statement includes speech and language therapy and he received speech and language therapy assistance for over three years. These were one-off appointments with a therapist some three to six months apart. Unfortunately he has not had any contact for the last 18 months, although a specialist has made a further referral. D has the support of the SENCO and Special Support Assistant at his school, but there is no programme in respect of his speech and language therapy. H was referred to the department by his school Manor Infants in his reception year. After an assessment he was put on a programme of sheets to use at home to help with sounds such as ‘F’ ‘S’ ‘T’. The school were also to be given a set of sheets to help him in school. However, the school never received copies, H’s mother had to do the copying herself. She was told that
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H would be seen each term at school by a Speech Therapist but that never happened. She chased the Speech Therapy Unit on several occasions but was told that the therapist covering H’s school had left and had not been replaced. Finally she was sent some more ‘sheets’ with blends to work on at home but again there was no follow up and this only occurred because she asked for them. Eventually this year she received a letter saying Barking and Dagenham were no longer running Speech Therapy for school-age children such as her son and that she was not going to get any more help. Therefore, in her view the service was inadequate – no follow up or support for child/parent or school and was most unsatisfactory. E, aged six has special educational needs. E's statement includes provision of Speech and Language Therapy. The LEA Educational Psychologist attended an assessment in March/April, after which E was to be referred to have speech and language therapy. E’s mother has not heard anything to date. Because she has not received any assistance, she is currently paying £65 per hour for the services of a private therapist. E sees the therapist either once a week or once a fortnight, depending on the programme being followed. Initially her mother also paid £200 for an assessment. She has been informed that there are 400 children on the waiting list for assessment and treatment. Apart from the cost, E’s mother was very concerned that E was not receiving the statemented time for Speech and Language therapy. M is 10 years old and has a medical statement for aphagia and attends St. Mary's R.C. School in Hornchurch. The London Borough of Barking & Dagenham pays for M's statemented needs. His original statement was when he was 2 ½ years old. The statement was for two hours per week. This was cut, with the parents' permission, from five hours per week. M did receive pre-school therapy, i.e. six weeks on, six weeks off for a short time. However M’s mother engaged a therapist privately. M’s mother stated that her son has not seen an educational psychologist in six years and has had one visit a year from the Speech and Language Therapist, although he has not seen a therapist for 18 months. He was assessed April 2001, August 2002 and November 2003. M’s mother pushed for her son to receive the service he was entitled to in 2001/2002, but got nowhere. She has since given up and assisted her son as much as possible. She said he can now hold a conversation, but has trouble with "f" and "s". She complained that the service for school age children was inadequate.
One mother who was unable to attend the stakeholder meeting on July 29th wrote in to say that she had no confidence that anything would be done to address the poor service provided in this borough. Her son used to attend Trinity School but one of the problems was the constant arguing over speech therapy. The specialist autistic speech therapist only worked two days a week and her son was statemented for two 30 minute sessions per week. He never received these simply because she could not fit it in with the other 32 autistic pupils. The school could not afford to pay anyone else to help. She felt very strongly about the way children with speech difficulties were treated and the fact that many parents had to resort to the private sector. The specialist autistic speech therapist at Trinity will see parents privately which she fits it in
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on her days off. The mother commented that children born with disabilities were entitled to the best possible service. She wondered if anyone that has to make these decisions to stop or decrease services had a child with a disability or needing speech therapy. If so they would not put up with this appalling service.
J’s mother wrote to inform the Scrutiny Panel that she had been forced to take her son to a Private Speech and Language Therapist as he was due an annual review of his statement, which took place on Friday 9th July. The school was very supportive, even though they felt themselves unable to provide the specific help her son needed. It was recommended by the Therapist that perhaps a laptop would help her son achieve his academic potential and also help in his exams. The school said that they would look into these recommendations. If the mother had not taken him to this Therapist the school would have been ill informed of the progress of her son. They could not, therefore, appreciate the speech and language difficulties J was encountering. She feel let down by the local NHS SALT and also felt angered at the fact that she had to pay £45 to get the assessment that her son was entitled to.
T aged 13 has had no speech and language therapy for over two years and this was one of the reasons that his parents sent him to Trinity school in the first place. They felt that their son has been very badly let down. He has limited speech. At every review meeting they urged the school to provide a service but this did not happen. They have written to the school many times but with no success.
A five-year old girl was diagnosed at 18 months with bilateral severe sensorineural hearing loss. She was issued with digital hearing aids and now is a well-established, independent hearing aid user. She was statemented, with speech and language therapy on the statement. As part of the statementing process a SALT assessed her. Appointments were made after school hours and the very young child was too tired to respond to the SALT’s instructions. Assessment took place in a health centre and this was not a friendly atmosphere. The mother was not happy with the assessment findings and requested another assessment in the girl’s nursery during a school day. This produced different findings due to the less frightening environment for the child and time of assessment.
A parent reported that a child with Downs Syndrome was moving in September from Hearing Impaired Base, where he has been receiving speech and language therapy sessions, to the mainstream school. There is no provision to maintain therapy for him to meet his needs. The speech therapist from the Resource Base is not able to carry on with the intervention A, aged seven, was seen by SALT on a weekly basis in the nursery. When he transferred to the primary school his parents were told that SALT would continue at school. In fact he had no therapy for a year and no review. His parents were not confident in the SALT programme. They decided to pay for private SALT sessions costing £65 per hour. SALT sessions have helped. A
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is a success story although a big disappointment that SALT was not provided by the NHS or the school. H, now aged nine, has delayed speech and learning difficulties. He was statemented for speech and language therapy. After SALT assessment he received a six weeks block of group therapy at the Five Elms Clinic. He was initially seen monthly, then termly. A programme was sent to his parents and teachers but was not followed due to lack of training. He has had no SALT sessions this academic year E aged five had glue ear and delayed speech. She was on School Action + but could not access the SALT service. The mother tried all the standard approaches including writing to her MP. Eventually she undertook some training in Cued Speech and articulation. She has been able to work with E and there is definite improvement. The mother would be happy to get involved in more general training of other parents and to share the knowledge and expertise that she has acquired. S is eight years old and has had speech and language difficulties since nursery. He was referred to SALT by his GP. No speech therapy was provided. Assessment seemed to be a waste of time if this was not followed by treatment. His difficulties in speech affect his understanding of language, ability to read and write and at times he is frustrated due to lack of communication especially with his peers. L left the Resource Base in December 2003. He was statemented and a speech and language therapy programme was implemented by LSA. However the LSA was not fully confident to implement the programme. His mother is concerned at possible deterioration of her son’s speech and language and possible bullying due to speech difficulties. She complained that there was not enough information about courses for parents. She would welcome proper training for parents.
2.3.2 Staff views
A SENCO, who is also an Inclusion Manager, and a Chair of Governors wrote to the Scrutiny Panel along the following lines. The current situation in the Borough means that many children experiences at least two years of missed opportunities to fully access the educational provision on offer. These years of missed opportunity cannot be clawed back and it makes it criminal to know that our children’s future is being played with in such a way. A statement of special educational needs is a legal document and anything included in part three should be adhered to. This is clearly not the case for those children who have a statement, as the lack of speech therapists means that they are not seeing a speech therapist or receiving any programmes. In many of the cases in our school this has been the situation for at least two years. In our school the SSAs run the speech and language programmes in order to meet the needs of those children who have speech and language difficulties. More training of SSAs in the delivery of these programmes is needed, as they are not trained speech and language therapists or speech therapy assistants.
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However, this is only a second best option. The first option will always be to have speech therapists delivering speech and language programmes.
With the current remodelling of the work force, which involves the regrading of SSAs the unions may not agree to their members delivering these programmes on their current levels of pay. Speech and language needs time and funding, which should be reflected in the level of SEB funding received by schools. Speech and language therapy is a health issue as well as an educational issue and therefore should also be funded by the NHS. There should be also programmes that address the specific needs of those children who experience difficulty around their speech and articulation. As a school they have received intensive training on speech and language from the Speech and Language Needs Team. The school is committed to ensuring that all children are able to access the curriculum. No one should be expected to do work of another professional body with no formal training. If children are truly valued they need to have access to the very best speech and language service. Unfortunately this is not happening unless parents can afford to pay for such a service.
A letter was received from the Chair of Governors of St Joseph’s RC School Barking. In her letter she commented that pupils' statements were not met with regard to the provision of Speech & Language Therapy by a qualified therapist. The move towards therapists visiting schools to work with both the children and school staff in a known environment rather than taking children to clinics where they are not comfortable was advantageous to all. The recent initiative by the JPD for speech and language was to be applauded. Any initiative jointly funded by Education & Health gives recognition to the importance of speech and language within an education environment. However as a consequence of this initiative the importance of trained Speech & Language Therapists must not be lost. The writing of programmes and their delivery can only be managed by a trained therapist working closely with the pupils, staff and parents/carers. Their role in the delivery of all speech and language therapy is essential to its future success.
In her letter the Deputy Head and SENCO at Grafton Infants School made the following comments. There was no speech therapy available to most children although initial assessments did take place. There was a 20 week waiting list for assessment. Children entitled to therapy through a Statement were not receiving this. Some parents were paying for private therapy although for many this was not affordable. Children working with Communication Needs Team based at Trinity do get therapy. However, they are limited as to the number of children they can take on. Parents of nursery age children are being told that a therapist will work with their children in school. This does not happen. 2.3.3 Voluntary sector views A letter was received from the Chair of the Barking & Dagenham Deaf Children's Society (NDCS). There is a local organisation of parents, families and carers that exist to support parents in enabling their child to maximise their skills and abilities. The fundamental role is to advocate for parents and
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carers as and when appropriate, whilst at all times ensuring the child’s welfare is paramount. NDCS services include: providing clear, balanced information and advice on many issues relating to childhood deafness, advice on audiology, equipment, education, support with benefit claims, legal advice, family weekends and training for families of deaf children. There is a parents’ support group of around 12 family members of hearing impaired children across all age groups. It meets monthly. NDCS is part of the Audiology Working Group (AWG) and the Children’s Hearing Strategy Working Group (CHSWG). NDCS has voiced concerns about speech and language provision for mainstream hearing impaired children. In the opinion of NDCS SALT should take into consideration the time of day for an assessment especially with very young children as well as providing child friendly surroundings so that they could assess the child in their natural mainstream placements. NDCS also commented that there used be a therapist for Early Years but the person left and her post has never been replaced. NDCS have concerns about the quality of advice to mainstream schools. Although the Education Services are more accommodating to meet the hearing impaired child’s needs there is some uncertainty in the level of support from teachers of the deaf for the new academic year. Who is going to continue on a regular basis with the speech and language programme? The NDCS had a number of improvement ideas: The Speech and Language Service should be involved in an Information Day organised by the local NDCS group. Communication among services involved with hearing impaired children across age groups should be improved. Speech and language training for parents and professionals (proper longer courses to give parents and professionals confidence in carrying speech and language programmes) should be organised. There should be an increase in the number of therapists. Clinic facilities should be improved and should become more child and parent friendly. This is not just a funding issue but also one of attitude. Recently one of the clinics refused to receive a donation of toys for the clinic’s waiting room. Lengthy assessments should be split in two sessions thus causing less stress for parents and children. Speech and Language Services should be reorganised so that they can deliver therapy at the mainstream school during the school day. The SALT’s sessions for the late afternoons should be reserved for secondary age children, who probably will cope better at this time of day. During SALT sessions some time should be spend for liaison with mainstream teachers and LSAs for discussion of progress and advice with some SALT resources provided. UK Council on Deafness Access to the NHS The RNID and deaf organisations across the country have worked in collaboration to conduct a survey of deaf and hard of hearing people's experiences when visiting their GP surgeries and hospitals. The resulting Report (A Simple Cure - A UK report into deaf and hard of hearing people's experiences of the National Health Service) reveals that the service received falls well short of what is reasonable, including shocking statistics about the risk deaf and hard of hearing people face when accessing healthcare.
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2.4 Adult services
2.4.1 Local provision
An audit was carried out in August 2002 to determine the need for speech and language therapy services for adults with neurological problems. It covered the service at both Oldchurch and Harold Wood Hospital. The aim was to assess the patients within three days of admission using a standardised screening assessment (called the FIRST). This assessment aims at obtaining a brief appraisal of functions that include dysarthria, dysphagia, dyspraxia and aphasia.
The required intensity of therapy and an estimate of total hours of contact needed were worked out from the scores obtained from the questionnaire. These consisted of the following:
Intensity of therapy and level of input
Intensity of therapy Level of input Hours per patient episode
Very high Assess, advise, programme of care and therapy 3-4 times weekly up to 25 interventions
20
High Assess, advise, programme of care and therapy once or twice weekly up to 13 interventions
10
Medium Assess, advise, programme of care for patient and family with a review on a weekly basis
6
Low Assess and advise only 2
During the audit 51 patients were assessed and in 39 it was considered that they would benefit from speech and language therapy. The diagnoses included cerebro vascular accident (CVA)/ transient ischaemic attack (TIA); head injury; tumour; Parkinson’s disease; and other.
Need for SALT for different clinical conditions
Diagnosis Number assessed Number needing SALT CVA/TIA 34 27Head injury 5 3Tumour 5 4Other 4 2Parkinson’s disease 3 3Total 51 39
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Given that the audit covered a two-week period it was possible to estimate the total service requirements for the whole year.
Total service requirement for the whole year
Required intensity
Number of patients per year Total number of hours needed to see all patients
Very high 390 7800High 104 1040Medium 416 2496Low 130 260Total 1,040 12,636
To provide the total number of 12,636 hours would require 10.3 speech and language therapists for neurology. Stroke patients contribute about 80% to the overall workload. This means that approximately eight whole time equivalent speech and language therapists are needed for stroke patients alone.
Number of qualified therapists in post per 100,000 population
Category Number of qualified therapists in post per 100,000 population
ITU 0.03 Neuro/head injury 0.00 ENT 0.00 Progressive neurological diseases
0.89
Rehabilitation 0.15 Older people 0.28 Total 1.35
The numbers quoted are for whole time equivalent staff and they shown per 100,000 people in order to compare them with national norms. The national figures are based on the research-based recommendations in the paper by Enderby and Davies (1989). This document written in 2002 recommended that there needed to be the following numbers of qualified speech and language therapists for the following caseloads.
2.4.2 National recommendations
Category Number of qualified therapists per 100,000 populationStroke patients 4.6 Progressive illness 1.4 Head injuries 1.0 Dysphonia and laryngectomy 0.4 Care of the elderly 1.1 Total 8.5
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There is some difficulty in matching these standards against the current provision because the local services are categorised in a different way from that above. Nevertheless it is clear that the recommended levels are more than six times the current provision.
2.4.3 Contacts
Contacts for the year April 2002-March 2003 Barking and Dagenham residents
Hospital Inpatients or outpatients
Initial contact or total face to face
Number
BHR Inpatients Initial 133 Total face to face 633 Outpatients Initial 63 Total face to face 354Neurocare Initial 3 Total face to face 20St George’s Hospital Inpatients Initial 30 Total face to face 208 Outpatients Initial 6 Total face to face 71 Ryder Unit Initial 4 Total face to face 96Memory Clinic Initial 1 Face to face 2Collaborative Care Team
Outpatients Initial 11
Face to face 336Community Rehab Service
Outpatients Initial 22
Face to face 74
2.4.4 Adult caseload
A snapshot of the number of Barking & Dagenham residents over 65 years of age on the caseload was carried out in July 2003. This showed
Caseload for those over 65
Hospital Number Percentage over 65 Oldchurch 15 90% Victoria Centre outpatients/domiciliary
35 50%
St George’s Inpatients 18 99% St George’s Outpatients/day hospital/domiciliary
17 99%
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Information was not available for Harold Wood Hospital patients.
The total adult caseload in June 2004 was as follows:
Adult caseload in June 2004
Harold Wood Hospital Outpatients 193Harold Wood Hospital Inpatients 34St George’s Hospital Outpatients 77Ste George’s Hospital Inpatients 47Ryder Stroke Unit 10Ryder Stroke Unit Outpatients 15Victoria Centre 187Oldchurch Hospital 55High Wood Hospital Outpatients 34High Wood Hospital Inpatients 7High Wood Stroke Unit 9Total 668
2.4.5 Local provision of services for those with difficulty swallowing (dysphagia).
An audit of the frequency of review of dysphagic inpatients was carried out at Oldchurch Hospital and Harold Wood Hospital 2001 and again at Oldchurch Hospital in 2003. This audit provided a breakdown of the frequency of review of dysphagia for all new patients referred for a one-month period. The initial audit was carried out in November 2001 and there was a further audit at Oldchurch in October 2003. The picture in 2001 was as follows: 36 reviews were carried out on 30 patients at Oldchurch and 16 on 18 patients at Harold Wood (the combined total being 52 reviews on 48 patients). The 2003 figures for Oldchurch were 96 reviews on 49 patients this being a 63% increase in patients being referred and a 167% increase in reviews. The mean time between reviews was 6.79 days for the 2001 patients and 3.7 for the Oldchurch patients in 2003. This would suggest that despite the increase in referrals there was a substantial increase in the number of reviews. There was also a reduction in the interval between reviews suggesting an improvement in patient care for this particular patient group. It should be pointed out, however, that this improvement was the result of a short term, time-limited increase in funding by the Barking, Havering and Redbridge acute Trust targeted at reducing hospital waits to meet government targets.
2.4.6 Audit for adult inpatients and outpatients at St George’s Hospital December 2003 with dysphagia
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This was carried out by Sarah Colley. The audit covered St George’s Hospital inpatients, outpatients seen at the day hospital and outpatient domiciliary patients. The number of inpatients varied from 30-41. During the trial week approximately 30% of patients came from Havering and 70% from Barking and Dagenham. There were 21 new referrals during the trial week and all were considered appropriate. One third of new referrals were transfers and all of these patients were transfers from Oldchurch Hospital.
The number of Day Hospital Outpatient on the case load ranged from 48 to 50 per week. Of these 66% were Havering and 34% Barking and Dagenham residents.
The number of domiciliary outpatients on the caseload ranged from 34-35 per week. Of these patients 80% were from Havering and 20% from Barking and Dagenham. Waiting times ranged from 5 to 77 days for hew referrals.
2.4.7 Audit of tracheotomy patients - January 2004
During the period from March 2002 to August 2003 there were 65 tracheotomy referrals at Oldchurch Hospital. During the first six months there were 16 referrals, during the second six months 21 and during the final three months 28. The present funding is for five hours per week and this includes one hour for a multidisciplinary ward round and four hours per week contact time with patients. The speech and language service has to cover the Intensive Therapy Unit (ITU); the High Dependency Unit (HDU) ward B2 including Neuro ITU; E1 and E3 the designated tracheotomy wards. The actual patient time being spent at present is approximately 20 hours per week. The aspects of the role have developed significantly since it was first created. Particular attention now is given to weaning patients off their tracheotomies. The post-holder has been involved in the development of Trust protocols for this client group. Considerable time has been spent on training colleagues and ward staff. The result of inadequate patient contact time with tracheotomy patients is that they will spend more time in hospital. The longer the tracheotomy is in situ the longer the rehabilitation process.
2.4.8 An analysis of time spent by therapists on different activities
An audit was carried out for the whole speech and language therapy service for one week in November 2003 to establish what activities the therapists and assistants were engaged in. The following table summarises the results.
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Time spent by therapists on different activities
Activity % Activity % Face to face 29% Attending courses/ training 2%Report writing 11% Liaison with carers 2%Planning and analysing 8% Telephone contacts with
patients 1%
Routine clerical 7% Case conferences 1%Professional liaison 5% Adaptation of equipment 1%Policy planning note writing 5% Audit 1%Statistics 4% Teaching parents 1%Meetings support groups 4% Public/carers training 1%Travel 4% Clinical supervision 1%Liaison with other agencies 2% Other health professional
training 1%
Telephone contact general 2% Liaison with non carers 0%Goal setting 2% Own discipline training 0%Ward rounds 2% Student training 0%Other telephone contacts 2% Professional advice and
support 0%
These figures were compiled from the paper data sheets used by 20 therapists. It can be seen that no time is found for professional advice and support, own discipline training and student training. All these activities are important in terms of professional development and in the retention of staff. Training other health professionals, training the public and cares and teaching parents amounts to a total of only 3% of the therapists’ time. In addition data from the group of ten therapists using hand held computers (Psions) to collect information showed that 1% of their time was spent in professional advice and support and 6% on own discipline training.
2.4.9 The planning process
It is clear from a letter from the Acting Head of Profession to the Head of Older People’s Services in Havering PCT (See Appendix 1) dated 7th July 2003 that those with a responsibility for the delivery of the service were trying to find ways of increasing its visibility with a view to its being given a higher priority. The Acting Head of Profession expressed her concern about the potential risk to patients resulting from the low establishment level for speech and language therapy at St George’s; the changed nature of in-patient needs and its effect on the intensity of speech and language input required and the growth in the number of patients going home on modified diets and the need to carry out essential follow up. She also stated that there was an establishment of 0.8 wte speech and language therapists at St Georges to cover inpatients for all wards, outpatients, domiciliary outpatients, and day hospital outpatients.
Activity statistics for the year ending March 2003 were as follows. For inpatients there were 103 initial contacts and 645 total face-to-face contacts.
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For outpatients including domiciliary visits and day hospital patients there were 29 initial contacts and 225 face-to-face contacts. The notional caseload proposed by the Association of Speech and Language Therapy Managers in 1995 was one wte for 30 patients for domiciliary care of the elderly and one wte speech and language therapist for 35 care of the elderly inpatients.
In a follow up letter, copied to a wide group within the PCT, the Acting Head of Profession reiterated her concerns and enclosed the results of the audit for adult patients dated December 2003.
2.4.10 Complaints of the adult service
At the first stakeholder meeting the wife of a stroke patient described the problems she had encountered in trying to get speech and language therapy services for her husband. In 2000 her husband had a CVA leaving him with aphasia. He did receive some therapy whilst in Harold Wood undergoing rehabilitation and for a while after discharge. Then somebody made the decision to stop this, which she was not happy about. She was told that her husband had gone as far as he probably could go and therapy was stopped. At this stage he could not draw a shape on command; he could not draw any letter of the alphabet and could not write his name. He could only say yes and no. A friend of a friend told her about a unit called "Connect". Her husband had an interview with them and was taken as a client. “Connect” not only do speech and language therapy, they promote total communication, in so many ways. Her husband can now sign his name on documents, letters of alphabet but not spell very well. He can do easy sums, can handle money and can now speak about 200 words. While her husband has been in therapy, she, along with other patients’ relatives, formed a Family Support Group. People go to Connect (which is part of City University). They come from all parts of London, Kent, Essex, Surrey even Eastbourne. In this family group all manner of topics come up, finance, emotion, legal things, gardening, computing, almost anything we want. They did a project where they contacted all sorts of places to see if our local Boroughs could support in any way people with aphasia - i.e. libraries. There seemed to be no funding for people with aphasia but there were funds for the deaf. She was unable to get speech therapy from the local service. She recommended that the local Speech and Language Therapy Service get in touch with Connect in order to explore collaboration on training, support, and communication skills
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2.5. Learning disabilities
2.5.1 Children’s services
The service to special schools and portage per-school provision was the subject of an audit in September 1999, which mapped speech and language therapy provision against caseload size and complexity over a 4½ year period. This was reviewed the following year and this information was provided to the (then) Health Authority to assist them in the preparation of their development plans. The audit concluded that caseloads were increasing significantly in complexity and rising at a rate of 27.5% over the four-year period for Havering and 57% for Barking and Dagenham. There was no corresponding increase in speech and language therapy service provision.
The resulting action plan recommended that service delivery should be regularly monitored in order to identify changes that should be made in terms of staffing and skills mix. There was, originally, no service provided for adults with learning disability. Services to special schools, purchased by Paediatric Commissioners, provided for children up to the age of 16. The establishment of speech and Language Therapy input into community teams for adults with learning disability provided a service for young people of 18 years (19 years if they remained in full time education) and over. This was purchased by adult learning disability commissioners. Despite the need for provision to cover 16-19 years olds being raised with the Health Authority this has never been provided and there continues to be no service for young people attending further education centres in special schools, at local colleges or in employment. The information for this section was provided Lesley Nicholls – Speech and Language Therapist and Susanne Marsh – Specialist Speech and Language Therapist.
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3. Costs 3.1 Current costs of the service 3.1.1 Current costs of children’s service Barking and Dagenham
Havering Brentwood
Community SM 1.0 NL 1.0 JF 0.6LN 0.1 LN 0.6 CM (locum) 1.0RY (locum) 1.0 SS (SLTA) 1.0 BB (locum) 1.0 SS (SLTA) 1.0 EL (locum) 1.0 SH (locum) 1.0 JR (locum) 0.6 Subtotal 3.1 Subtotal 6.2 Subtotal 1.6
Special needs LN 0.3 JR (tech
instructor) 0.5 RW 0.2
SM 0.2 MF (tech instructor
0.3
SM 0.4 Subtotal 0.5 Subtotal 1.2 Subtotal 0.2 Hunters Hall ARP Language base
Language Units Language Units
RW 0.2 RW 0.2 RW 0.2JR (Tech instructor))
0.3 KR 0.6 CG 0.5
ES 0.5 JR (Tech instrctor)
0.2
Subtotal 0.5 Subtotal 1.3 Subtotal 0.9
Hearing impairment AT 0.6 AT 0.4 NL 0.4 TW 0.5 MY (locum) 0.2 Subtotal 1.2 Subtotal 0.9 Total sessions 5.3 9.6 2.7
In addition to there are administrative and management sessions Administrative 1.56 1.56 0.88Management 0.5 0.4 0.2Grand total 7.16 11.76 3.78
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Estimated cost £309,700 £401,300 £145,000
The total estimated cost of the current paediatric services across the three PCTs is £856,600. 3.1.2 Current costs of adult service The adult service is provided by Barking and Dagenham PCT to its own population, to Havering PCT, to Brentwood, Billercay and Wickford PCT and to the Barking, Havering and Redbridge Hospitals Trust. In terms of whole time equivalent staff the service is as follows Numbers of whole time equivalent staff and costs for the adult service Barking and
Dagenham PCT
Havering PCT
Brentwood, Billercay & Wickford PCT
Barking, Havering & Redbridge Hospitals Trust.
Clinical establishment
0.3 2.950 0.8 6.525 10.575
Admin, Clerical and IT support
0.35 3.250 0.9 7.125 11.625
Pay costs £10,735 £77,711 £27,015 £187,650 £303,111On costs £2,684 £19,428 £6,754 £46,912 £75,778Courses and equipment
£500 £3,250 £1,000 £10,000 £14,750
Mileage £2,035 £5,000 £1,275 £4,200 £12,510Total £15,954 £105,389 £36,044 £248,762 £406,149
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3.1.3 Adults with learning disabilities Current numbers of staff and costs
Speech Language Adult Service Clinical Sessions June 2004
Barking & Dagenham pct
Havering pct
Brentwood, Billericay Wickford pct
Total
Speech and Language Therapists WT
Adults with Learning Disability
SD also supervises therapists across Havering & Brentwood 0.600 SM 0.400 Communication Access Worker 1.000 1.000 MRE Communication Access Worker 0.5 L.H student 1.000 Vacancy 0.500 Total WTE 2.100 2.500 0.400 5.000A&C + IT support *0.05 *0.05 0.050 0.150*Secretarial Support from ALD Team Offices Pay Costs £53,004 £58,819 £15,735 £127,558On Costs £13,251 £14,708 £3,934 £31,893Courses, Supervision. Equipment £2,500 £2,750 £500
£5,750
Mileage £2,500 £2,500 £1,000 £6,000Total £71,255 £78,777 £21,169 £171,201
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3.1.4 Summary of current costs and budget for all three services Paediatric Adult A.L.D. TOTAL Cost: £856,600 £406,149 £171,201 £1,433,950Budget: £689,820 £210,616 £57,705 £958,141 GAP £475,809 3.2 Future costs of the service 3.2.1 Future costs of children’s services The following table describes the requirements of the future service based on national averages to meet all demand. The management sessions remain the same. Administrative services increase proportionately. SLTs and SLTAs would need to be appointed at different grades to develop the specialisms required. Barking and Dagenham
Havering Brentwood
Community SLTs pre-school 4.0 SLTs pre-
school 4.0 SLTs pre-school 2.0
SLT schools 5.0 SLT schools 5.0 SLT schools 2.5
SLTA pre-school 4.0 SLTA pre-school
4.0 SLTA pre-school 2.0
SLTA schools 5.0 SLTA schools 5.0 SLTA schools 2.5Training (Pre-school
0.2 Training (Pre-school)
0.2 Training (Pre-school)
0.1
Training (schools)
0.4 Training (schools)
0.4 Training (schools 0.2
Subtotal 18.6
Subtotal 18.6 Subtotal 7.3
Special needs SLT pre-school and school
3.3 SLT pre-school and schools
2.4 SLT 0.5
SLTA 2.6 SLTA 0.6Subtotal 3.3 5 Subtotal 1.1Hunters Hall ARP Language base
Language Units
Language Units
SLT 0.2 SLT 1.3 SLT 0.8SLTA 0.3 SLTA 0.4 SLTA 0.4Subtotal 0.5 Subtotal 1.7 Subtotal 1.2
Hearing impairment SLT preschool 0.5 SLT preschool 0.5 SLT preschool 0.2SLT school 1.0 SLT school 1.0 Subtotal 1.5 Subtotal 1.5 Subtotal 0.2
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Total sessions Clinical SLT 14.
6 Clinical SLT 14.8 Clinical SLT 6.3
Clinical SLTA 9.3 Clinical SLTA
12.0 Clinical SLTA 5.5
In addition to there are administrative and management sessions
Administrative 1.6 Administration 3.7 Administration 1.6Management 0.2 Management 0.4 Management 0.2Grand total 25.
7 Grand total 30.9 Grand total 13.6
Estimated cost £918,411 £985,318 £384,897 3.2.2 Future costs of adult service Adult service staffing levels. Prediction for September 2004. Barking &
Dagenham PCT
Havering PCT
Brentwood, Billericay Wickford PCT
Barking, Havering & Redbridge Hospital Trust
Totals
WTE Speech and language therapists
0.300 2.950 0.800 6.525 10.575
Admin, clerical and IT support
0.350 3.250 0.900 7.125 11.625
Vacancies 0.2 0.75 0.2 0.725 It needs to be pointed out that the total cost would not all fall on Barking and Dagenham as the adult service covers the three boroughs and BHR Acute Trust. The table below shows the notional case load and suggested numbers and costs of WTE speech and language therapists. Notional Case Load based on the findings of the Association of Speech and Language Therapy Managers
Caseload category Number on Caseload
Suggested WTE Speech and Language Therapists
Mixed Hospital Adult Caseload 30 1.00 Mixed Adult Caseload Community 30 1.00 Stroke Unit 15 1.00
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Neurosurgical Unit 15 1.00 Domiciliary Adults - mixed caseload 25 1.00 Adults with swallowing problems 15 1.00 Care of the Elderly Inpatients 35 1.00 Care of the Elderly - Day Hospital 27 1.00 Care of the Elderly Domiciliary 30 1.00 Laryngectomy 20 1.00 Adults who stammer 30 1.00 Voice problems 12 1.00 Domiciliary Stroke - all ages 35 1.00 Care of the Elderly Acute/ Rehab 35 1.00 Head Injury 10 1.00 Oncology 10 1.00 Dysphagia Clinics 15 1.00 Voice clinics 15 1.00 Total 404 18 Average case load for one therapist 22.44 Our Service's Adult Caseload = 855 Suggested number of therapists for this caseload would be 38 WTE When fully staffed our establishment is 10.575 WTE Estimated cost of 38 WTE x £25,000 £950,000 25 % Oncosts £237,500 Courses supervison equipment £38, 000 Mileage £12,000 Total £1,237,500
The chart at the bottom of page 36 and continuing on page 37 represents the cost to the Adult service of the Proposed Reconfiguration of the Department to reflect career progression, recruitment and retention. This strategy had to be abandoned because of the financial deficit. 3.2.3 Future costs of adult learning disabilities service [Not yet available]. 3.2.4 Total cost to Barking and Dagenham of ideal future service Paediatrics £918,411 Adults £1,237,500 Adults with Learning Disabilities
(Not yet available)
Total (Not yet available)
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3.3 Expansion plan 3.3.1 Staged expansion plan for new posts for children Stage 1 Training Post SLT 0.4wte Community Pre-School
SLT 1.0wte SLTA 2.4wte
School Age Special Needs
SLT 1.6wte
Mainstream Schools
SLT 2.0wte SLTA 2.0wte
Hearing Impairment
SLT 0.5wte
Stage 2 Mainstream Schools
SLT 3.0wte SLTA 3.0wte
Stage 3 Special Needs Pre-School & School Age
SLT
1.4wte
Stage 4
Community Pre-School
SLT 1.0wte SLTA 1.0wte
Hearing Impairment
SLT 0.2wte
3.3.2 Expansion plan for new posts for adults
Therapist
WTE National salary scale 01.04.2004 including Outer London Allowance
1. Part-time clinical specialist 0.100
Clinical Specialist Acute/Rehabilitation £3,194.50
0.500 £17,864.50 2. Part-time clinical specialist 0.025
Clinical Specialist NICU Dysphagia £860.38
3. Part-time 0.140 Clinical Specialist £4,818.10
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clinical specialist
Tracheotomy /Voice
0.660 £22,713.90 4. Full-time therapist with 0.500
Clinical Specialist Laryngectomy/Dysphagia £13,772.00
Three part-time posts 0.200 £5,309.80 0.300 £9,583.50
5. Full-time with 0.400
Developing Specialist Acquired communication disorders) /traumatic brain injury £12,778.00
two part-time posts *0.6 £15,929.40 6. Part-time post 0.500 Stroke rehabilitation £13,274.50
7. Split adult 0.6WTE 0.600 Generalist £13,758.00/paed 0.4WTE 8. Full time with 0.400 Fast stream £9,172.00With two part-time posts * 0.6 £13,758.00Total £156,786.58 Re-structuring of present posts will cost an additional £18,150. Additional posts as proposed include a new clinical lead post at £40,220; an upgrade of the Joint Team Leader Post, £2,500 and the re-structuring of the Adult With Learning Disability Service will require s new clinical lead post. Havering PCT pay for the two part posts marked with * as the therapists are part of the Havering Community Rehab. Team. The service level agreements with Havering PCT, BHR, and BBW PCT should be adjusted to reflect restructuring. There are savings to be made with the reduction of costs of locums. 4. Comparison with other services In addition to the recommendations of the North Thames managers Group it has been possible to draw on the guidance and guidelines published by the Royal College of Speech and Language Therapists. In comparing the service in Barking and Dagenham with other boroughs, documents have been received from South London, now Lambeth PCT, Southwark PCT and Lewisham PCT and from Camden PCT. In the case of South London there is a single lead organisation that provides services to three London Boroughs.
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In the case of Camden there is a service across two London Boroughs, the lead organisation being Islington PCT.
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5. NHS plans
The NHS planning system is relatively complex and it takes a long time to initiate change unless this fits in precisely with meeting Government targets. Speech and language therapy services are not currently targeted. The pressures on the PCT are such that despite significant increases in their overall budget little of the new money is available for non-targeted services. The planning system requires that local development plans should be negotiated, generally on a three year rolling programme with updates and amendments each year. There is one factor that might influence the prioritisation of speech and language therapy services of children and that is the new Government emphasis on the health and education of children. The appointment of directors of children services as senior executives within the local authority is a signal that priority will be given to children in the next few years. This should have some impact on speech and language therapy. Although there are no formal targets for adults there are national service frameworks (NSFs) for cardiovascular disease and stroke and for cancer and these do provide some indictors of good practice on which speech and language therapy can hang. There are some initiatives for those with learning disabilities but these are insufficient for PCTs to increase funding.
Some insight into the problems facing the PCT can be seen in the following transcript of a report from the PCT Chief Executive to the PCT Board on 24 June 2004. The new Chief Executive said that Board members should be aware that there is continuing concern from parents with school aged children not being able to access SALT. The Children and Families Directorate of the PCT took the decision in March to reduce the input into mainstream schools and concentrate on pre-school provision. This was due to a large number of vacancies and not being able to find locums, combined with a general lack of resources. The PCT has now successfully recruited three therapists. However, the issue is wider than this in that children’s services costs are significantly in excess of the budget due to overly ambitious Service Level Agreement (SLA) income projections set last year based on the actual 2003/4 agreements. It has further been established that SLA activity in 2004/5 is also not covered by the income contracted for and the interim Director of Children’s Services is negotiating either a reduction of service to the other PCT's/trusts or a commitment to additional income. MP's in both Barking and Dagenham and Havering (to whose residents we provide SALT) have also sent in letters questioning our position. On this basis the PCT will need to review its overall position on the provision of SALT shortly in conjunction with Havering PCT.
Returning to the issue of recruitment information from the Children and Families Directorate has clarified the numbers of new recruits over recent months. On June 24th one therapist was appointed. She had successfully trained with the PCT while being sponsored by them. Two other graduate posts were advertised and have been successfully filled.
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6. Key issues 6.1 Caseload and waiting lists At present demand outstrips supply. Comparisons over time and with other services lead to the inevitable conclusion that staffing establishments are inadequate. One of the most dramatic shortfalls is in secondary schools where there is essentially no service. Waiting times are excessive. Following detailed audits the limitations of the Speech and Language have been described by successive NHS bodies, initially the Barking and Havering Health Authority and subsequently the Barking and Dagenham Primary Care Trust. At a national level the effectiveness of speech and language therapy has been published. At a local level the need for an increased and enhanced service is clearly established. It is recommended that the Director of Public Health of Barking and Dagenham confirms the need for increased speech and language therapy services for children as a matter of urgency. 6.2 Communication and involvement of parents During the visits and at the stakeholder meetings it was possible to assess some of the problems facing children and their parents. The impression was given that not enough information was given to parents. For example, parents might not even know the name of the therapist. Parents appreciated that front line staff tried to their uppermost to deliver a high quality service but they were hampered by insufficient numbers of therapists. Many commented that they would be interested in more involvement in the management of their child’s speech and language problem and that they would be willing to attend training courses if these were available. Extra support for parents is needed and this could include training as well as setting up groups. Information is needed so that parents know what to expect at the visits. They need access to resource ‘library’. Parents need to be included in therapy sessions to ensure carryover and generalisation at home and other social situations outside of school. It is recommended that more resources should be targeted at parents. These should include training, support and the provision of materials. 6.3 SEN statementing issues This was a significant area of complaint. The statements themselves took a long time to complete but the real problem was that children who were statemented with speech and language as their principal problem and those where it was a secondary problem were not getting the service that the statement required. There were many cases where private funds had been used to provide assessment, treatment and care when the NHS and the local authority had failed. There is a question of legal liability for cost of treatment of statemented children in cases where it is written into Part 3 of the child's Statement of Special Educational Needs as an "educational provision", and whether parents have a case for reimbursement. Camden is one London Borough that has budgeted for reimbursement of private care if the local services have not been able to comply with the statement.
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It is recommended that the Council and the PCT formally acknowledge their responsibility for providing services to statemented children in cases where it is written into Part 3 of the child's Statement of Special Educational Needs as an "educational provision", and they make public how this is to be funded. In the absence of public provision the Council should make clear its policy on the reimbursement of parents whose children have been assessed and treated in the private sector. 6.4 Multi-agency working There are many examples of excellent multidisciplinary and multi-agency working. At a formal level there is the Local Strategic Partnership, a Children’s Services Strategy Group as well as a specific group between Education, NHS and the voluntary sector for speech and language services. There is substantial cooperation between the agencies on terms of those delivering the service. The major barrier to more successful working is the failure, of the NHS to allocate sufficient funds to speech and language therapy services. The Scrutiny Panel recognised the excellent multi-agency working that currently exists. Most of the difficulties arise from inadequate funding. It is recommended that adequate arrangements are made to ensure that proposals in the report are implemented and monitored through existing joint strategy groups ( for example, for children, the Children’s Services Strategy Group). 6.5 Service delivery to children with speech difficulties There is a specific problem of providing a service to mainstream schools. There has been a substantial investment in speech and language therapists by the Education Service. It is important to recognise the changing system of funding with over 90% of the Education budget devolved to schools and so they have an increasing role in setting priorities. One development has been the decision to bring groups of schools together in five clusters. This should help with the organisation and delivery of services. The SALT service has prepared a forward plan for the expansion of the service. This plan has been included in the main text. The Scrutiny Panel strongly recommends that the PCT include the implementation of Stage 1 of the expansion plan, prepared by its own operational staff, in the local delivery plan, in particular the training post, the two speech and language therapists and the two speech and language therapy assistants for maintained schools and that this plan is implemented at the beginning of the year 2005-2006. (See also section 7.13 below). 6.6 Service delivery to adults The current adult SALT team cannot meet the current demand. Their expansion plan is described in the main text.
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It is recommended that the Director of Public Health of Barking and Dagenham confirms the need for increased speech and language therapy services for adults as a matter of urgency.
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6.7 Service delivery to those with learning disabilities There is a continuing question of the adequacy of services to those who are in transition between childhood and adulthood. It is recommended that the Director of Public Health of Barking and Dagenham confirm the need for increased speech and language therapy services for those with learning disabilities as a matter of urgency. 6.8 Early identification and intervention There is consensus on the importance of early identification and intervention for children with speech and language difficulties. This will soon become even clearer with the introduction of neonatal hearing screening. Central funding for this initiative is for the screening programme itself and not for the consequential investigation and treatment. Some of this treatment will fall on the NHS and some on the Education Authority with an emphasis on the pre-school and pre-nursery age group. It is recommended that the Council and the PCT make increased provision in their 2005-6 budgets for the treatment and support of children with hearing problems, which will include those identified by the Neonatal Screening Programme. 6.9 Recruitment and retention The recruitment and retention of speech and language therapists is a national problem. A survey commissioned by the DFEE found that recruitment difficulties nationally are part due to a shortage of speech and language therapy courses and this is now being addressed. With regards to retention they suggested that there is a need to develop an educational specialism that is attractive to speech and language therapists, allowing them recognition and status as autonomous and adequately remunerated professionals. The latest proposal from the Government ‘Agenda for change’ has not been well received by speech therapists and at present it appears that more may be leaving the public services than are recruited. In fact in a recent telephone pole 90% of SALTs said they would leave the profession if Agenda for Change went ahead. SALTs may not agree to levels of pay. In Barking and Dagenham it was stated that some SALTs are currently in posts that command a higher grade than they are being paid. Even if financial resources became available it might still be difficult to recruit therapists and attract them to the area. One factor is that there are only limited numbers of therapists available. One possible way forward would be to increase the training of other grades and other staff so that they can extend their role within the overall service. Agenda for Change (AFC): how will this affect recruitment and retaining of therapists? It is recommended that the Council and the PCT review their existing policies for supporting key workers and formulate and implement an action plan to improve the recruitment and retention of speech and language professionals in Barking and Dagenham, looking at issues including pay, work/life balance, benefits and affordable housing. It is also recommended that both organisations acknowledge the
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exceptional contribution made by existing staff who have worked hard to provide a high standard service with inadequate resources.
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6.10 Service evaluation The speech and language therapy services have been extensively audited over the last few years. Audit is a continuous process that can provide useful information to improve clinical practice. It is also frequently used to aid planning and priority setting. It appears to the scrutiny panel that the time has come for action on the results of these previous audits and that there is no need for further audits to assist the planning process in the immediate future. 6.11 Complaints Over the last few years the level of complaints for both children and adults has been unacceptable. The vast majority of these complaints have been related to under-provision of the service. Many are voiced within the local setting; many others are made formally to the different organisation. Many parents that provided information to the Scrutiny Panel spoke of being ignored and of feeling that their child’s problem was not been taken seriously. It is recommended that both the Council and the PCT ensure that future complaints are fully recorded and monitored and that reports are discussed within both organisations and also at the joint working groups with responsibility for children, adults and those with learning disabilities. 6.12 Problems arising from lead PCT responsibilities across several PCTs There is a problem delivering a service to a wide population including specifically those living in Havering and Brentwood by a single service. Inevitably there are questions of fairness in the way in which services are supplied to the three populations. It is possible that each PCT will want to manage its own SALT service in the future. However, there remains the continuing problem of critical mass and the fact that in some subspecialties a single therapist will have a caseload across more than one PCT. At this stage an option appraisal has not been carried out and it should not be assumed that three small teams have advantages over a single service across three PCTs. It is recommended that the two PCTs that receive services from Barking and Dagenham PCT consider as a matter of urgency whether they wish the lead arrangement and shared arrangements to continue. The Scrutiny Panel recommends that these organisational arrangements be confirmed so that they can be operational by the onset of the year 2005-2006. 6.13 Budget issues The Panel has been given insight into the budgeting of the PCT since it came into existing in 2002. It does appear that prior to 2003-2004 there was no clarity about the budget for Speech and Language Services. Now that there is greater clarity it appears that there is 30% shortfall between current expenditure and allocated budget (or put another way there is a 30% overspend on the current budget). This remains a major problem for the PCT both for the current year and for future years. At the stakeholder presentation
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by the PCT the problem of prioritising Speech and Language was discussed. Given that the PCT is required to focus on current Government priorities that concentrate on hospital waiting times in Accident and Emergency Department and on waiting lists for elective surgery it is not surprising that Speech and Language Therapy Service remain under-financed. The Scrutiny Panel would like to see a substantial shift in budgetary allocation to the Speech and Language Service for children, adults and for those with learning disabilities. It would look to the PCT to describe the necessary changes in the forthcoming local development plan. In line with approaches in other London Boroughs the Scrutiny Panel would like to see further discussion about the further integration of services and about the possibility of moving ahead on shared or pooled budgets. It is recommended that Barking & Dagenham PCT fund the gap between current budget and spend where it relates to services for the Barking & Dagenham population, and that Havering and Billericay Brentwood and Wickford Primary Care Trusts and Barking Havering & Redbridge Hospital Trust are asked to fund the service at the current level provided. It is recommended that the PCT accepts the long-term plan to increase Speech and Language Therapy establishments across, children, adults and those with learning disabilities. The Scrutiny Panel strongly recommends that the PCT include the implementation of Stage 1 of the expansion plan, prepared by its own operational staff, in the local delivery plan, in particular the training post, the two speech and language therapists and the two speech and language therapy assistants for maintained schools and that this plan is implemented at the beginning of the year 2005-2006. The Scrutiny Panel recommends that the PCT re-profiles its future budgets so that appropriate resources are made available for children, adults and those with learning disabilities who have speech and language difficulties. 7. Action plan The Health Scrutiny Panel would like to formalise the steps that will need to be taken to improve the current unsatisfactory situation regarding the local speech and language therapy services. They will be writing to the Barking and Dagenham PCT and the Council asking for early responses to their recommendations and an action plan. The Panel recognises the difficulties experienced by the NHS in finding funds for new developments, particularly those that are not currently of high priority within the Department of Health. The Panel would like to see a collaborative approach between the PCT and the Strategic Health Authority in prioritising speech and language therapy services in North East London. It would be helpful if this service could be discussed during performance management meetings between the two
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organisations. The Panel would propose that local collaboration is further increased and that speech and language therapy services become a standing item on the Children’s Services Strategy Group. The Panel would also propose that this body takes responsibility for the implementation of an action plan. The Panel is particularly concerned about the failure to provide statemented children with the Speech and language therapy services service that they are entitled to. They would therefore ask the PCT and the Council’s Department of Education, Arts and Libraries to address this issue as a matter of urgency.
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8. References Ball M. Relationship between school, family and the community. London: Joseph Rowntree Trust, 1998. Barking and Dagenham Council. Access to primary care. Report from the Health Scrutiny Panel. Barking: Barking and Dagenham Council, 2004. Beresford. The needs of parents of children with physical disabilities. London:The Social Policy Research Unit, 1995.
Campbell, T. Measurement of functional outcome in preschool children with neurogenic communication disorders. New York: Thieme, 1998.
Campbell, T. Functional treatment outcomes in young children with motor speech disorders. In: Caruso A, Strand E. (Eds.). Clinical management of motor speech disorders in children. New York: Thieme, 1999. (pp. 385-396).
Conradie G. Outcome measurement grids. Bulletin of the Royal College of Speech and Language Therapists 1997: 543; 10-12 Department of Health. Practice makes perfect: providing therapists’expertise in the new NHS; developing a strategic framework for good patient care. London: Department of Health, 2000. Department of Health. The vital connection: an equalities framework. London: Department of Health, 2000. Enderby P, Davies P. Communication disorders: planning a service to meet the needs. British Journal of Disorders of Communication 1989;24:301-330.
Enderby P, Emerson J. Does speech and language therapy work? A review of the literature. London: Whurr Publishers Limited, 1995. pp180.
Glogowska M, Roulstone S, Enderby P, Peters T J. Randomised controlled trial of community based speech and language therapy in preschool children British Medical Journal 2000:321;923-926. Greener J, Enderby P, Whurr R. Speech and language therapy for aphasia following stroke (Cochrane Review). In: The Cochrane Library. Chichester, UK: John Wiley & Sons, Ltd., 2004 Issue 3.
Hall, P., Jordan, L. & Robin, D. Developmental apraxia of speech: theory and clinical practice. Austin, Texas: Pro-Ed, 1993.
Jacoby, G., Lee, L., Kummer, A., Levin, L., Creaghead, N. The number of individual treatment units necessary to facilitate functional communication improvements in the speech and language of young children. American Journal of Speech-Language Pathology 2002:11;370-380.
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National Deaf Children’s Society (NDCS). Parental survey on newborn hearing screening. NDCS. 2000. Law J. Evaluating interventions for language impaired children: a review of the literature. European Journal of Disorders of Communication 2000: vol 3. Law J, Garret Z. Does speech and language intervention for children with speech and language delay/disorder work? Briefing paper for meeting at the Nuffield Foundation Thursday March 6th 2003.
Law J, Garrett Z, Nye C. Speech and language therapy interventions for children with primary speech and language delay or disorder (Cochrane Review). In: The Cochrane Library. Chichester, UK: John Wiley & Sons, Ltd., 2004. Issue 3.
North Thames Managers. Report on appropriate levels of staffing for a given caseload. 1998).
Nye C, Foster SH, Seaman D. Effectiveness of language intervention with the language learning disabled. Journal of Speech and Hearing Disorders 1987;52:348-357.
Pearson VA. Speech and language therapy: is it effective? Public Health 1995; 109: 143-153.
Royal College of Speech and Language Therapists. Communicating quality 2. Professional standards for speech and language therapists. London: Royal College of Speech and Language Therapists, 1996. Sebba, Sachdev. What works in inclusive education. London:Barnados 1997. Yoshinaga-Itano C. Factors predictive of successful outcomes of deaf and hard-of-hearing children of hearing parents. 1998
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9. Glossary Aphasia Absence of speech ARP Additional Resource Provision BHR Barking, Havering and Redbridge NHS Trust DEAL Department of Education, Arts and Libraries CDC Child Development Centre CIAS Community Inspection and Advisory Service CSSG Children’s Services Strategy Group CVA Cerebro Vacular Accident (for example, a stroke) DfEE Department for Education and [complete] DfES Department for Education and Science DoH Department of Health Dysarthria A speech disorder that is due to weakness or
incoordination of the speech muscles. Speech is slow, weak, imprecise or uncoordinated
Dysfluency A disorder of speech fluency that interrupts the forward flow of speech. All individuals are dysfluent at times but the kind and amount of dysfluency differs from normal.
Dysphagia Difficulty swallowing Dyspraxia An impairment or immaturity or the organisation of
movement. It is an immaturity in the way that the brain processes information, which results in messages not being properly or fully transmitted
EYDCP FIRST A standardised questionnaire HDU High Dependency Unit ITU Intensive Therapy Unit LDP Local Development Plan LEA Local Education Authority LBBD London Borough of Barking and Dagenham LSA Local Service Agreement LSP NDCS National deaf Children’s Society NHS National Service Framework PCT Primary Care Trust RNID Royal National Institute for the Deaf SALT Speech and Language Therapy SENART SENCO Special Educational Needs Coordinators Session The working week is dived in ten sessions that is five
mornings and five afternoons SLT Speech and Language Therapist SLTA Speech and Language Therapist Assistant SSA Specialist Support Assistant Tracheostomy A an operation to to insert a tube into the trachea to
assist breathing WTE Whole Time Equivalent. A WTE of 0.4 would imply that
four sessions were covered
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Appendix 1 List of written evidence
Item Date
Author Title
1 April 1998 North Thames Region Speech and Language Therapy Managers Group. Lisa Campbell, Jenny Green, Margi Kot, Maria Luscombe, Diana Moir
Position statement on service delivery to children in mainstream schools
2 1999 Royal College of Speech and Language Therapists
Communication: quality 2. Professional standards for Speech and Language Therapists.
3 November 2000
Community Health South London NHS Trust
Review of Paediatric Therapy Services
4 December 2001
S Mulcahy Business case for the development of community resources
5 August 2002
Melanie Whitehead, Speech and language therapist to the Ryder Stroke Unit, the collaborative Care Team and Harold Wood Hospital
SALT audit of patients with communication problems or swallowing difficulties in Barking, Havering and Redbridge Trust
6 August 2002
SALT Adult Team An audit of all newly admitted neurological inpatients to Harold Wood and Oldchurch Hospitals to determine the numbers of those who would benefit from Speech and Language Therapy -
7 February 2003
London Borough of Camden Report of the Speech and Language Therapy Services Scrutiny Panel
8 July 2003
SALT Adult Team Snapshot of Barking and Dagenham residents over the age of 65 on the Speech and Language Therapy Caseload
9 July 2003
Angela Thomas Acting Head of Profession
Letter to Head of Older Peoples Services Havering PCT
10 October 2003
Angela Thomas Summary of review priorities for inpatients, outpatients and domiciliary patients
11 October 2003
Angela Thomas Notional case load study for adult client groups
12 October 2003
SALT Adult Team Frequency of review of dysphagic patients
13 October 2003
SALT adult team An audit of the frequency of review of dysphagic inpatients; Oldchurch Hospital and Harold Wood Hospital 2001 and
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Item Date
Author Title
Oldchurch Hospital 2003 14 November
2003 SALT Team Acitivity analysis November 2003
15 December 2003
SALT Adult Team Audit of Speech and Language Input for follow-up for dysphagic patients at St. George's Hospital, Hornchurch -
16 December 2003
SALT Paediatric Team Caseload demands audit December 2003
17 December 2003
Sarah Colley SLT Audit for adult inpatients and outpatients
18 January 2004
Nisha Patel SLT (Tracheostomy) Audit of tracheotomy patients -
19 January 2004
SALT Team Adult Services Tracheotomy post based at Oldchurch Hospital
20 January 2004
Angela Thomas Acting Head of Profession
Letter to Head of Older Peoples Services Havering PCT
21 May 2004 SALT Adult Team Minutes of the Adult Team meeting held on 7th May 2004
22 June 2004
Ann Nash Deputy Head/SENCO Grafton Infants School
Letter
23 June 2004
Mrs Teresa Baumann, Chair of Governors St Joseph's RC School
Letter from Chair of Governors
24 June 2004
PCT Chief Executive Report to the PCT Board
25 June 2004
SALT Adult Team Review of caseload in the autumn 2001 and the school base priority treatment proposals
26 June 2004
Dr. Sharon Davis and Margaret Rose
The role of the communication access worker
27 June 2004
Speech and Language Working Group
Agenda for the meeting of the Speech and Language Working Group on 25th June 2004
28 June 2004
SALT Team Minutes of Staff Meeting of the SALT Service 19th June 2004
29 June 2004
SALT Adult team Adult service caseload June 2004
30 June 2004
Community Inspection and Advisory Service Speech and Language Needs Team
Supporting paper to stakeholder meeting on June 17th 2004
31 June 2004
Lesley Nicholls SLT Background paper on NARP therapist role for the visit on 23rd June 2004
32 June 2004
Scrutiny Office A model for accountability
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Item Date
Author Title
33 July 2004
Miss J Walters (SENCO and Inclusion Manager) and Mrs P Martin, Chair of Governors
Letter
34 July 2004
Liesel Batterham Issues in relation to statements of special educational need
35 July 2004 Anna Volkmer SLT and Melanie Whitehead SLT
Communication aids resources
36 July 2004 SALT team Draft supervision policy 37 July 2004 Lisa Ferrary SLT Continuing professional
development 38 July 2004 Lesley Nicholls SLT and
Susanne Marsh SLT Learning disabilities
39 July 2004 Ann Tingle SLT and Nicola Lewi SLT
Hearing Impairment
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Appendix 2 List of oral evidence The panel received oral evidence from the people listed below. Alison Palmer Co-ordinator SEN Curriculum Development - DEAL Debbie Reith Acting Team Leader, Paediatrics, Barking and
Dagenham PCT Angela Thomas Team Leader, Adults and Acting Head of Profession
Barking and Dagenham PCT Dr. Sharon Davis Head of Speech and Language Therapy for those with
Learning Disabilities Marie Kearns
(Acting Director, Child and Family Services, Barking and Dagenham PCT)
Robin Land (Deputy Finance Director of Barking and Dagenham PCT)
Liesel Batterham Head of SENART - DEAL Ann Jones Head of Education Inclusion Team DEAL
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Appendix 3 Information provided from the visits In addition to the presentations at the two stakeholder meetings visits were organised to health settings and schools. These included the Julia Engwell Health Centre, Valence Nursery, Vicarage Fields Health Centre and St Georges Hospital. At the Julia Engwell Health Centre the following issues were raised. The room space was inadequate if all the speech therapy posts were filled. The booking of rooms was also difficult. The centre was under resourced in terms of equipment as well as computers to record the results of assessments. Reports were therefore written up at St. George’s Hospital that inevitably meant there was some time delay. Suggestions to improve the current position included the establishment of a training post, the identification of additional space and space that was for the sole use of speech and language therapists and could be used to store equipment. It was clear that there needed to be an increase in SALT assistants and that more projects should be started and current projects should be continued and extended. At Valence Nursery it was stated that children slip through the net for different reasons, but in particular due to age changing their status from pre-school to school-aged. It was unclear who was the key person to contact. Statements indicated the number of hours the child should receive but there was no therapist in place to provide the service. When children move on there is no therapist to carry on with monitoring and advice. There was a 20 weeks waiting list. Suggestions included recruiting more SALTs or providing a private service. Extra training should be provided to teachers and parents. One useful programme would be ‘Way 2 Say’. Parents need to be taught that communication can be developed significantly through play language and one specific programme that might be useful would be the Hanan-programme. There needed to be a waiting list initiative to tackle the unacceptable delays. There needed also to be a training initiative. Funding should be made available for training. At the Vicarage Fields Health Centre the following issues were discussed. Worksheets can become boring very quickly and then parents have to wait for the next appointment before they receive new sheets. There was a high ‘DNA’ (did not attend) rate. Some speech and language difficulties are well supported until school age but then there is no one to continue the level of support in pre-school or school. It was suggested that more information should be available to parents. This would include information on the web. The development of a library resource centre should be encouraged. Team meetings should discuss how to support parents more and their training needs. Leaflets should be further developed that inform parents what to expect from the session, what resources are available, and what toys/books are appropriate for their child. Therapist felt that the main thing they all wanted was to develop a working relationship with parents. The criteria for the two-year check should be reassessed. Support at both pre-school and
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mainstream levels needs to be focussed on the staff on a continuous basis and not necessarily on specific individuals. Group therapy may need to be extended. Clusters of schools need to be established. The local service should bid for new projects, for example, ‘On-track’ that is working well in Southwark. The visit to St. George’s Hospital looked at the role of the speech therapist that specialises in children’s eating and drinking problems. The post was currently filled by a full-time locum. Much of her work was with young children and she spent a lot of time in clinics, doing home visits and visiting hospitals. In fact travelling takes up a lot of her time. There appeared to be some confusion on the exact nature of the role and possibly some duplication. Some of the children she saw were already on the caseload of another speech and language therapist. Files on these children were not always readily available. Therapists had limited access to a computer to type up reports. Computers were often shared between three other professionals. The IT log out system caused problems if a person forgot to log out. Personal safety was an issue when carrying out home visits. There were several administrative issues. In some complex cases a six-page document needed to be filled in and put into the file. It appeared that the therapist was expected to complete two sets of statistics, one for the Speech and Language Team and one for the Child Development Centre (CDC). IT support was poor. If there were access to email some of the paper-based problems would be reduced. Communication between teams was poor. The therapist at St. George’s was isolated from the rest of the team. In addition to the health settings, visits were arranged to several schools. Five Elms Primary School is a mainstream school with a resource base for hearing impaired pupils and a nursery intake. There are about 400 children on the roll: 11 pupils are statemented and most of these statements include speech and language therapy. 20 pupils are on School Action + and a further 30-35 pupils on School Action. There was an open referral system for Speech and Language Assessment. However speech therapy was not available for statemented children at school or clinic. Only a small percentage of parents choose private therapy as generally parents were not able to meet the costs. There was no allocated SALT for the school. All the statemented children had had an assessment but there was no programme to follow. The SENCO was not in charge of School Action+ or statement budget. So far the Headteacher had not looked at the possibility of buying in a service. The Specialist Support Assistants (SSA) had not had any specialist S&L training to be able to carry on with Speech & Language Therapy targets. The mainstream school was not able to access any SALT service even for the nursery. For statemented children the school tried to meet their needs through allocating an SSA and using good classroom strategies (e.g. modelling speech). Some concerns were voiced about the partnership between the mainstream school and the Resource Base. There was good communication between SENCO/school and SALT (letters and assessment reports sent to school), but no action to follow up. It was stated that there was a shortage of SALTs in other mainstream schools across the borough. An emergency speech and language programme was put in place for one of the pupils who recently
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joined the mainstream school. However, the SSA or classroom teacher was not able to deliver this programme due to lack of specialist training or guidelines from SALT. Proposals that were put forward during the visit to improve the situation included increasing the number of SALT posts and training for SSAs. This could be difficult at present due to pay modification and there is quite a lot of resentment within the SSA staff as additional pay is only given for English and Maths. The school provided background information on the partnership between the mainstream school and the Resource Base. Two years ago, as a temporary measure due to staff shortage the SALT Service in one of the Resource Base for Hearing Impaired Pupils in Havering started to act as an umbrella service for the mainstream school. The SALT does the S&L Assessment and Programme of Support, which are carried on by a trained Learning Support assistant from the mainstream school. The same arrangement was put to Five Elms but was not agreed. The Resource Base is staffed by two full-time and one part-time (0.5wte) Teachers of the Deaf and one part-time (0.8wte) Communication Support worker. All are employed by LEA/Hearing Support Services. From September 2004 there will be a decrease of one full-time Teacher of the Deaf post. In addition there are three therapists employed by the NHS with for twelve sessions per week, with four sessions per week being paid by education. The centre was originally resourced for 12 children. At present there are 21 children. The team adopts a Child Centred Approach (using BSL, SSE, oral speech and symbols. All children are statemented or undergoing statementing procedures at the Nursery. The degree of hearing loss is mostly severe/profound. 50% of children have additional difficulties e.g. medical, syndromes, learning difficulties. The teacher in charge of the Resource Base feels that there should be more joint work between the teachers in the centre and the school. Each child receives therapy on a regular basis, depending on his/her needs. This could be 1:1 therapy, group therapy. The teachers of the Deaf work closely together with both formal and informal discussions. The SALT service does home visits during holidays. A number of improvement ideas were proposed. Education could purchase SALT Assessment Packs. The SALT service could be involved in policy writing for the mainstream school. There were concerns about children who were more difficult to manage because of complex needs. There was good joint working between SALT and Teachers of the Deaf but more involvement was needed from the staff in the mainstream school. The second school visit was to the Eastbury Secondary Comprehensive School (Rosslyn site). There were 1650 students on the roll and 300 on the Special Educational; Needs (SEN) register. The staff felt that a further 100 to 150 students should be on the SEN register. 52 students were statemented, of whom 12 were statemented or on School Action+ with speech and language difficulties. Amongst the findings were; no Speech and Language therapy was provided even if the pupil was statemented; there was no buying in of the SALT service; occasional SALT visits took place for assessment; secondary schools were not a priority; the Communication Team from LEA
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came to train LSAs which was positive but not enough; the LSA was not confident in delivering a SALT programme because of lack of training. It was concluded that there needs to be a Language and Communication Resource Base for secondary age students (as occurs in Newham). At present the only Language and Communication Team are based in Trinity School. Overall there are eight secondary schools in the borough, all of them without regular SALT provision Improvement ideas included organising placements for trainees with accommodation; introducing NVQ level 2 and 3 qualifications for LSAs; giving housing assistance for the NQ SALTs; sponsoring SALT courses; providing additional SALT training for LSAs; monitoring how SEN statements funds are spent. General information was provided about the Hearing Resource Base. It was part of the Hearing Support Service and for this academic year it is in a transition phase prior to becoming a school responsibility and being funded by them. The Head of the Resource Base is a member of the Senior Management Team. At present there are 12 students in KS3 and two students in KS4. All students are statemented or placed for assessment purposes. They use ‘Total Communication’ as their mode of communication. The staffing is two whole time equivalent teachers of the deaf and two whole time equivalent communicators. Comments that were made about the service included. There was good access to SALT, a specialist SALT being available one day a week. There was continuity as the same therapist provided the SALT service. The range and type of therapy depended on individual needs. Assessments took place every year and programmes were monitored. Close work with ToD ensured joint targets, regular discussions and reviews. All staff involved are working towards achieving the same targets. The final visit was to Hunters Hall Primary School and its Language Resource Base. This is a mainstream school, one of the largest primary schools in the borough, with 750 pupils on the roll. There are 11 SEN statemented children and 38 on School Action +. Nine children had SALT assessment but have not been seen for two years. There have been continuing changes in SEN school budgets that have made planning difficult. At present there is a buy back system for Advisory Social Communication and a separate budget for Statements and School Action+. There appeared to be a lack of support for children coming out of the Resource Base. This led to a tendency to keep children for longer. The school was happy to extend numbers to eight in the Resource Base, but this would put a strain on the SALT service. After leaving the Base children usually stayed in the mainstream school. There was a tendency to increase numbers in early years due to better diagnostic tools. There was an increase in the number of children with communication problems (difficulties in expressive and receptive language). Teachers and LSAs were reluctant to implement SALT programmes due to limited time and lack of training. Ideas for improvement included: involving health visitors in early identification of S& L problems; speeding up the process of referral and assessment and the
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introduction of the intervention programme; providing SALT training for teachers, LSAs and parents; and ensuring that the SALT service would provide detailed instructions on how to implement programmes and regular monitoring. There was further discussion about the Language Resource Base. The only provision within the borough for S&L difficulties was at Trinity School. They were resourced for six children over 12 years ago and plans were drawn up to extend this to eight but this was not implemented. The responsibility for funding this service has been transferred to individual schools. All children are statemented. The aim is to provide intensive therapy and then to transfer children to mainstream schools at some point during primary education. The SALT service is involved in admission. Staffing includes one day per week SALT, 1.5 days per week SALT Assistant, a whole time equivalent teacher and whole time equivalent LSA. There is an Outreach Team (eight people including 2-3 SALTs based in the Westbury Centre). Pupils spend most of the time in mainstream classes supported by the base teacher. Comments included the need to extend the Resource Base. At present it is too small for existing needs within the borough to be met. There was good communication with the Outreach Team. Some parents had difficulty in using resources provided for home. There was good use of school/home book. Regular termly and annual reviews took place. Advice and resources were provided for parents, mainstream teachers and LSAs. Coffee mornings were organised for parents. This provided an opportunity for advice, support and the exchanging of experiences among parents. There was no secondary S& L Base provision. Parents were advised to look at three different secondary learning bases (for learning difficulties e.g. Warren School), residential or special schools in neighbouring boroughs. Improvement ideas included extending the Resource Base by using the Outreach Team; and the setting up a secondary school Resource Base. A further idea was that there should be more independence in who is given a place in the Resource Base. At present the decision is made by the SEN with some input from the Resource Base. References to the Language and Communication Team, based at Trinity School, the Advisory Social Communication Team and the Outreach Team (eight people including 2-3 SALTs based in the Westbury Centre) all refer to the same team, the two parts of the Community Inspection and Advisory Service (CIAS).
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THE ASSEMBLY
5 JANUARY 2005
REPORT OF THE DIRECTOR OF CORPORATE STRATEGY
POLICY COMMISSIONS 2004/6 FOR DECISION The Assembly is required to appoint Policy Commissions under Article 6 of the Council’s Constitution. Summary This report sets out:
• the outline scopes; and • the Members that have indicated their preference to sit on the Policy
Commissions for 2004 – 06. Recommendations That the Assembly: a. Notes the outline scopes, lead officers and portfolio holders assigned to
commence work on the following Policy Commissions: • Use of Parks • Improving Employment Prospects • Partnership Working
b. Agrees:
• To identify up to 8 Members for each Commission from those indicating an interest
• either to elect a lead member for each of the Commissions or agree that the lead member should be elected at the first meeting of each of the Commissions.
• whether and which of the Commissions should be encouraged to invite external representation.
Contact: Sally Penessa
Corporate Policy and Information Manager
020 8227 2219 (telephone number) 020 8557 2806 (fax number) 020 8227 2685 (minicom number) [email protected]
1. Background to Policy Commissions 1.1 Assembly at its meeting in November agreed the following Policy
Commissions for 2004/6:
AGENDA ITEM 5
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• Use of Parks • Improving Employment Prospects • Partnership Working Policy Commissions are an essential feature of this Council’s political structures. They complement the overview and scrutiny function by assisting in the development of policy. In particular, they investigate policy issues relating to the social, economic and environmental well being of the area. They report their recommendations to the Assembly.
1.2 Policy Commissions are consultative and deliberative bodies.
Consequently provisions of the Local Government (Access to Information) Act 1985 do not apply because they are not formal committees, nor do the political balance requirements of Section 15 of the Local Government and Housing Act 1989 apply.
1.3 The constitution encourages Commissions to include external
representatives during their developmental work. Such co-optees cannot have voting rights.
2. Member Representation 2.1 The following Members have indicated their interest in sitting on the Policy
Commissions:
Policy Commission
Member Availability
Use of Parks
Councillors: Mrs Bradley, Bruce, H. Collins, Davis, Gibbs, Hemmett, Jamu, Jones, Justice, Miles, Mrs Osborn, Wade (Portfolio Holder), Wainwright, L. Waker and West
Improving Employment Prospects
Councillors: A Cooper, Denyer, Fani, Hemmett, Justice, Kallar (Portfolio Holder), Miles, Rush, Wainwright and L. Waker
Partnership Working
Councillors: Davis, Fani, Geddes (Portfolio Holder), Hemmett, Hunt, Miles, Mrs Osborn, Parkin, Rush, Wainwright, L. Waker and P Waker
2.2 The Commissions will run for approximately 6-9 months and meet on
average every 4-6 weeks. At the first meeting a Chair will be elected, expert witnesses and potential visits to best practice examples will be identified.
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3. Outline Scopes
USE OF PARKS POLICY COMMISSION Members 5-8 Members to be confirmed by Assembly Lead Officer Allan Aubrey, Head of Leisure and Community Services Officer Support
Corporate Policy and Information
Background Information - to be provided for the first meeting Current Strategic Position including: • Statistical Analysis of Local Geographic Factors • Statistical Analysis of Local Demographic Factors • Results of recent consultation on parks – including MORI Parks survey,
and pitch audit • Details of facilities currently available Key Documents e.g. • Parks and Green Spaces Strategy • Local Cultural Strategy • Community Strategy and Performance Management Frameworks Suggested Scope The Policy Commission will concentrate on: • What are the key attributes of a successful/unsuccessful park? • How can we improve parks so that the public makes better use of them? • Does the Council make full use of the parks as a tool to help create community cohesion? How can this be improved?
IMPROVING EMPLOYMENT PROSPECTS POLICY COMMISSION Members 5-8 Members to be confirmed by Assembly Lead Officer Jeremy Grint, Head of Regeneration Officer Support
Democratic Services, Policy and Information, Regeneration Implementation, and Lifelong Learning
Background Information - to be provided for the first meeting • Statistical Analysis of Local Geographic Factors • Statistical Analysis of Local Demographic Factors • Local and Regional Economic Review • Employment Trends • Framework for supporting Employment in Barking and Dagenham Key documents e.g. • Economic Development Strategy • Workforce Development Strategy • Community Strategy and PMFs Suggested Scope • The Skills Base in Barking and Dagenham • Barriers to Employment • Development of the Local and Regional Economy • Development of the Local existing and future workforce • The Leadership Role of LB of Barking and Dagenham on Employment
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PARTNERSHIP WORKING POLICY COMMISSION Members 5-8 Members to be confirmed by Assembly Lead Officer
Naomi Goldberg, Head of Policy and Performance
Officer Support
Democratic Services, Policy and Information
Background Information - to be provided for the first meeting • Audit of main partnerships – using PWC document • Themed approach to partnerships • Research of partnership best practice The Policy Commission will not review existing Partnerships. This has been covered in several different formats and is included as part of the background information. Suggested Scope • The Policy Commission will focus on identifying how Councillors can
get the best out of being a member of a Partnership. • What role should Councillors play in partnerships? • What resources should be put into partnerships? • What makes an effective Partner and Partnership? • How can Partners influence Partnership policies and
challenge/influence other Partners? • How can we build trust amongst Partners?
Background papers used in preparation of this report The Council’s Constitution Report to the Assembly 3 November 2004 Letter to all Councillors
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THE ASSEMBLY
5 JANUARY 2005
REPORT OF THE EXECUTIVE THE EXECUTIVE - RECENT BUSINESS
FOR DECISION
This report is submitted under Article 2, Paragraph 9.2 of the Constitution and presents to the Assembly recommendations from the Executive. Summary This report sets out recommendations made by the Executive at its meeting on 21 December 2004. The Assembly is asked to note that, in order to meet public inspection deadlines and due to public holidays and the closure of the Council’s offices over the Christmas and New year period, the recommendations below may be subject to amendment and / or call-in (the call-in period for the Executive meeting on 21 December expires at midday on Tuesday 4 January 2005). The details of any amendments or call-in will be reported verbally at the meeting. 1. Licensing Act 2003 – Licensing Policy
The Executive received a report presenting the final draft of the Council’s Licensing Policy, which is required under the Licensing Act 2003 to be formally adopted by 7 January 2005.
2. Council Tax Base 2005/06
The Executive received a report on the calculation of the Council Tax Base for 2005/06, which included information on powers available to the Council to reduce discounts for second homes and long term empty property, and to award locally determined discounts.
Recommendation / Reason 1. The Assembly is recommended to:
a). Approve the Council’s Licensing Policy;
b). Note that the Licensing Policy will be sent to the Plain English Campaign for Crystal marking; and
c). Authorise the Director of Housing and Health to publish the ‘Plain English’ version of the Licensing Policy for general distribution, subject to the Solicitor of the Council being satisfied that the terminology in the ‘Plain English’ version does not compromise the Council’s position.
2. The Assembly is recommended to:
a). In accordance with the Local Authorities (Calculation of Tax Base) Regulations
AGENDA ITEM 9
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1992, agree that the amount calculated by the London Borough of Barking & Dagenham as its Tax Base for the year 2005/06 shall be 50,838.9 Band ‘D’ properties.
b). Agree that the discounts for second homes or long term empty properties are not
reduced for 2005/06.
c). Agree that locally determined discounts should not be awarded for 2005/06. Contact: Alan Dawson
Democratic Services Officer
Tel: 020 8227 2348 Fax: 020 8227 2171 Minicom: 020 8227 2685 E-mail: [email protected]
Background papers used in the preparation of this report: Minutes, agenda and public reports for the Executive meeting held on 21 December 2004.
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THE ASSEMBLY
5 JANUARY 2005
REPORT OF THE DIRECTOR OF EDUCATION, ARTS AND LIBRARIES
GOVERNING BODY APPOINTMENTS
FOR DECISION
To request that the Assembly make appointments to fill vacancies for Representative Members to serve on governing bodies. Summary This report: (i) contains a list of the current vacancies for persons to serve as school
governors (ii) includes a list of candidates wishing to serve as school governors. Recommendation The Assembly is asked: (i) to appoint Councillor L Smith to the vacancy for a Representative Member to
serve on the Governing Body for Marsh Green Primary School (ii) to re-appoint Mr J Torrie, Headteacher, Dagenham Park Community
School, to serve as a Representative Member on the Governing Body of Beam Primary School.
Contact: Sandra Thomson
Administrative Services Manager
Tel:020 8227 3022 Fax:020 8227 3471 Minicom:020 227 3181 E-mail:[email protected]
1. Background 1.1 The criteria used for making such appointments is as follows:
• Serving Council Members • Former Councillors • Party Members • Present serving governing body members who hold an office/post
of responsibility (i.e. Chair, Vice Chair, Training and Liaison Governor)
AGENDA ITEM 10
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• Other present serving governing body members • Nominations from governing bodies • Nominations from Education Business Partnership/Chamber of
Commerce • Members of the general public
2. Current Vacancy Position Detailed below is a list of current vacancies: School Governing Bodies Number of Vacancies Cambell Junior 1 Eastbury Infants 1 Five Elms Primary 1 Grafton Junior 1 Manor Infants 1 Monteagle Primary 1 Ripple Infants 1 Ripple Junior 2 Southwood Primary 2 St Margaret's C of E Primary 1 St Vincent’s Catholic Primary 1 Thames View Junior 2 Valence Infants 2 William Bellamy Junior 2 TOTAL 19 3. Appointments The Assembly is asked to appoint persons to serve as Representative Members
on governing bodies as follows:
Name of Candidate
Address Proposer Governing Body
Councillor L Smith
Broad Street DAGENHAM
Marsh Green Primary School
Mr J Torrie Dagenham Park Community School
Term of Office ends 19 January 2005, would like to serve for a further 4 years.
Beam Primary School
Background Papers Return letter from Mr J Torrie.
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