Joint Commissioning Strategy SEND

Vision

Our vision for children with special educational needs and disabilities is the same as for all children and young people – that Stockton on Tees is a great place to grow up, where children and young people are protected from harm and supported to be the best they can be in life.

Most importantly we want the views of children and young people and their parents/carers to be actively sought and their voices heard.We want services to be joined up with reduced waiting times and good information sharing in place so that families can tell their story once. We wantoutcomes for children and young people to be co-produced and identified and that outcomes are assessed and measured across education, health and social care to ensure outcomes for children and young people improve.

Partners have worked to develop this shared strategy with representatives across Education, Children’s Services, Adult Social Care, Public Health, Schools and Hartlepool & Stockton on Tees Clinical Commissioning Group. Parents, carers, children and young people have been integral to developing our priorities for action.This strategy provides insight into the immediate and longer term challenges that we currently face around joint commissioning for SEND and the practical steps that we are taking to address them.

What does special educational needs and disabilities mean?

A child or young person has special educational needs if they have a learning difficulty or disability which requires special educational provision to be made for him or her. A young person in this context is a person over compulsory school age and under 25. The SEND Code of Practice identifies that a child of compulsory school age or a young person has a learning difficulty or disability if he or she:

Has a significantly greater difficulty in learning than the majority of others of the same age, or

Has a disability which prevents or hinders him or her from making use of facilities of a kind generally provided for others of the same age in mainstream schools or mainstream post-16 institutions.

A child under compulsory school age has special educational needs if he or she is likely to fall within this definition when they reach compulsory school age or would do so if special educational provision was not made for them.

A learning difficulty or disability can affect a child or young person in many ways. Children and young people’s physical ability may be affected and they may find it difficult to concentrate, understand, read, write, socialise and make friends.

Children with special education needs and disabilities are eligible to receive additional support in school, like speech therapy, and children and young people age up to 25 who have more complex needs will receive an education, health and care (EHC) plan.

What is joint commissioning?

Commissioning is the process of identifying the needs of a community and planning services to meet those needs. Joint Commissioning is where the assessment of need and planning of services is undertaken by two or more agencies working together, often in health and local government, and sometimes from a pooled or aligned budget. The purpose of joint commissioning for special educational needs and disabilities is to ensure the best possible response to a child’s or young person’s needs, aligning and integrating strategic needs assessment, planning and delivery of services to achieve more. (B&Op34)

Schools, including early years providers, and post-16 settings can also be commissioners in their own right as well as partners in joint commissioning. Schools have a notional SEN budget and many schools will commission services (such as speech and language therapy, pastoral care and counselling services) to support pupils. Schools must work with the local authority in developing the Local Offer, which could include school-commissioned services. (p55)

(Include something about an asset based approach)

We aim to establish commissioning arrangements that enable a joint approach to:

What is the legal framework for joint commissioning for SEND

The SEND Code of Practice confirms that Section 25 of the Children and Families Act 2014 places a duty on local authorities to ensure integration between educational, training, health and social care provision if this would promote wellbeing and improve the quality of provision for disabled young people and those with SEN. The Care Act 2014requires local authorities to ensure co-operation between children’s and adult’s services to promote the integration of care and support with health services so that young adults are not left without care and support as they make the transition from children’s to adult social care. (p38) Local authorities and health bodies must have arrangements in place to plan and commission education, health and social care services jointly for children and young people with SEN or disabilities (Section 26 of the Children and Families Act 2014) (p24)

Under section 75 of the National Health Service Act 2006, local authorities and CCGs can pool resources and delegate certain NHS and local authority health-related functions to the other partner(s) if it would lead to an improvement in the way those functions are exercised. (p39)

The NHS Mandate, which CCGs must follow, contains a specific objective on supporting children and young people with SEN or disabilities, including through the offer of Personal Budgets (p39)

The Code of Practice identifies the scope of joint commissioning ascovering ‘the services for 0-25 year old children and young people with SEN or disabilities, both with and without EHC plans. Services will include specialist support and therapies, such as clinical treatments and delivery of medications, speech and language therapy, assistive technology, personal care (or access to it), child and adolescent mental health services support, occupational therapy, habilitation training, physiotherapy, a range of nursing support, specialist equipment, wheelchairs and continence supplies and also emergency provision. They could include highly specialist services needed by only a small number of children, for instance children with severe learning disabilities or who require services which are commissioned centrally by NHS England’. (p40)

Joint commissioning must include arrangements for:

Securing EHC needs assessments

Securing the education, health and care provision specified in EHC plans, and

Agreeing Personal Budgets

Children’s social care

Where a child or young person has been assessed as having social care needs in relation to their SEN or disabilities social care teams must secure social care provision under the Chronically Sick and Disabled Persons Act 1970 which has been assessed as being necessary to support a child or young person’s SEN and which is specified in their EHC plan. (p51)

Adult social care

The Care Act 2014 makes it clear that local authorities must continue to provide children’s services until adult provision has started or a decision is made that the young person’s needs do not meet the eligibility criteria for adult and support following an assessment. Children’s services must not be discontinued simply because a young person has reached their 18th birthday (p52)

Consultation

To inform this Strategy consultation has taken place with children and young people who have Special Educational Needs and/or Disabilities, parents and carers and wider stakeholders. Children and young people were asked about what matters most to them. They said : Parents and carers were consulted on the priorities identified in this strategy and the vision we have for our children with SEND. Parents/carers particularly said: Wider stakeholders, which includes representatives from parent/carer groups as well as professionals involved in the provision of care for children with SEND, have been consulted on the

Joint Strategic Needs Assessment

BACKGROUND

  1. Children with SEND face greater challenges with learning than their peers, often have higher mental health needs, co-existing autistic spectrum disorders, challenging behaviours and physical health conditions. Furthermore, there is a marked correlation between SEND prevalence and poverty.[i]

THE NATIONAL PICTURE

  1. The number of pupils with special educational needs (SEN) has increased from 1,228,785 in January 2016 to 1,244,255 in January 2017.[ii] 14.4% of the pupil population had SEN 2016-2017, representing a decrease of 1% - predominantly due to a decline in the number of pupils with SEN without a statement or EHC plan. The proportion of pupils on SEN support has fallen from 18.3% in 2010 to 11.6% in 2017. At 2.8% of the pupil population in 2017, the proportion of CYP with a statement or EHC plan has remained constant since 2007.
  1. Moderate Learning Difficulty remains the most common primary type of need for pupils receiving SEN support, with ASD being the most prevalent for those with a statement or EHC plan.

SEND IN STOCKTON-ON-TEES

  1. The Borough has a population of 194,100, comprising 59,783 CYP aged between 0-24 years.[iii] Over the next 10 years, the 0-24 age group is predicted to increase by 2.9% (n=1,710).[iv] Projections show that numbers from 10-14 and 15-19 age groups will increase by 15% and 9.5% respectively, with a decrease in the 20-24 age group during this same period.
  1. Children from poorer households or who are living in more deprived neighbourhoods are more likely to be identified as having SEN associated with learning disabilities.[v] Whilst the percentage of children who were eligible for and claiming free school meals fell by 1% between 2000-2015, this rate rose amongst CYP with SEN associated with learning difficulties with a statement or EHC plan.[vi] There is a stark rise in the proportion of pupils claiming free school meals between mainstream primary/secondary and those in special school provision.
  1. Measuring the number of CYP with SEND is difficult as there is no one comprehensive and accurate data source. A challenge in terms of SEND health information is that whilst data relating to CYP disabilities may be recorded on local systems, these systems do not systematically record (and report) whether a child has SEN. Reliable prevalence estimates are not readily available which can be applied at a local level. Estimates relating to such prevalence vary widely from 3-7% depending on the definition of disability and the extent of the survey undertaken.
  1. In January 2017, 32,966 pupils were attending SBC schools of which 15% (n=4,946) were reported as having SEND. 2.6% (n=855) had a statement or EHC plan with 12.4% receiving SEN support.[vii]
  1. The proportion of pupils with a statement or EHC plan 2008-2016 has remained largely static both regionally and nationally. SBC figures show a gradual decline in numbers between 2008 and 2012 followed by a rise in 2013. The number has remained around 2.5-2.6% thereon. In terms of SEN support, data patterns are largely consistent between SBC, regional and national averages.
  1. At 31%, the majority of support is provided for pupils with MLD, with 20% and 17% receiving support for Speech, Language and Communication Needs (SLCN) and Social, Emotional and Mental Health Needs (SEMH) respectively.[viii]
  1. SBC disability register for CYP had 423 children registered in July 2017 with a total of 1005 diagnoses. Whilst the duty to maintain a register is statutory, registration is voluntary. The number registered represents a smaller proportion of those CYP in the Borough who have a learning difficulty, mental health issue, medical condition or physical disability which substantially limits or prevents them from living and developing as other children of a similar age. Learning difficulties account for the highest proportion of registered conditions, followed by ASD and SLCN.
  1. Data from July 2017 shows that 192 children from SBC were in out of area placements, with 60% (n=116) placed for cognition and learning/communication and interaction needs and 28% (n=53) placed for Social, Emotional and Mental Health needs (SEMH). 30% of these CYP have ASD diagnosis, 19% a SEMH need and 18% MLD. 16% (n=30) are looked after by SBC.
  1. Time-series data (July 2016 – March 2017) shows that 1,455 infants out of a possible 1,760 across SBC received their 2 – 2 ½ year review by health visitors (average across 9 months 83%, range 73.4 – 90.3%). During these reviews, health visitors may observe signs or behaviours that indicate that a child may have SEN. Referral can then be made if appropriate.
  1. An issue inherent within the data relating to the use of these SEND-related health services is that datasets do not identify those service-users with a diagnosed SEN or disability. It is, therefore, not possible at this stage to state which proportions of those engaging in these health services are SEND children and young people.
  1. In SBC, the number of children in need with a recorded disability in 2015/16 was 186 (8.5%), falling below regional and national averages of 12.7%[ix]. A child’s disability was the third most common primary need at assessment for children in need behind abuse or neglect and family dysfunction.
  1. In terms of educational outcomes (achieving expected standard), SBC performance falls consistently below the regional average:

Statement or EHC (%) / SEN Support (%)
SBC / Regional / National / SBC / Regional / National
EYFS / 3 / not given / 4 / 21 / 29 / 26
KS2 / 5 / 7 / 7 / 17 / 19 / 16
KS4 / 4.8 / 7.9 / 8.8 / 20.2 / 21.6 / 23.5

Post-16 education and training, performance of SEN young people at both level 2 and 3 falls below both regional and national averages (save SEN with statement or EHC at level 3 which is above regional average). Regarding education, training or employment (ETE), in 2015 83.6% of SBC young people were gainfully occupied compared to regional and national averages or 88% and 87.3% respectively. NB – ETE of those aged 19+ (with and without SEN) cannot be ascertained as this data is not currently gathered or analysed.

SEND TRENDS IN STOCKTON-ON-TEES

  1. There has been a steady decline in numbers of children and young people with SEN (without statement) in Stockton-on-Tees. Following a four-year gradual increase in the numbers of children with a statement or EHC plan, the number in Stockton-on-Tees reduced between 2015/16 before increasing between 2016/17. It should be noted that the special educational needs provisions of the Children and Families Act 2014 were enacted in September 2014 and some reduction in number of children with SEN needs is likely to have been due to changes in categorisation (as is evident in national trends). Prior to the Act, statements of SEN and support under School Action+ were counted. Post-Act, SEN support replaced the support provided under School Action and School Action+, hence the significant rise in numbers of SEN pupils 2013-2015. It is highly likely that most of those new SEN cases which account for this rise were not necessarily diagnosed 2013-2015; they were not collected under the yearly census prior to the 2014 Act.
  1. Regarding primary need of SEN children in SBC, there has been a decrease of 3.7% (n=139) in the number of pupils with ASD between 2015-2017 and, whilst data relating to SEN support with no specialist assessment by type of need could not be collected before 2015, there has been a four-fold rise in pupils within this category 2015-2017. The same period saw a 30.5% increase (n=208) in pupils whose primary needs are speech, language and communication, with a four-fold rise in pupils with multi-sensory impairment.

PROJECTIONS

  1. Prevalence of learning disabilities in children and young people has been measured through the lens of special educational needs. Projecting future need for SEN services is complex as SEN is an umbrella term which covers a range of conditions and diagnoses. Reliable quantitative projection of both incidence and prevalence rates is complex due to the number of conditions which can be categorised as SEN.
  1. Projections of SEN are often based on past trends and there is no peer reviewed research available which could be applied to estimate future need. In the field of special educational needs these trends can be influenced by impacts made through improvements in treatment of those conditions which fall within the broad interval of special needs as well as changes in thresholds and categorisation (as exemplified by recent changes introduced through the Children and Families Act 2014). Furthermore, estimates for younger age groups may be unreliable due to the delay in identification of SEN (especially moderate learning difficulties).
  1. Forecasts of pupil numbers have been obtained from the admissions, placements and commissioning department of Stockton-on-Tees Borough Council and analysis of past time-series data has been applied to model the effect of either increases or decreases in pupils with SEN. In effect, projections will estimate future SEN numbers as per past trends.
  1. The rate of primary pupils with a statement or EHC plan in Stockton-on-Tees has fluctuated between 0.8% and 0.7% (mean 0.7% over the past three years). The rate for secondary pupils over the past three years has decreased from 1.3% in 2015 to 1.1% in 2017 (mean 1.2). Future estimates of pupils (excluding early years and special schools) with EHC plans, assuming the mean rates are as follows:

Estimates of primary and secondary pupils with EHC plan

Primary / Secondary
2018/2019 / 125 / 144
2019/2020 / 124 / 152
2020/2021 / 128 / 157
2021/2022 / Not provided / 163
2022/2023 / Not provided / 167
  1. Primary pupil SEN support rates have declined 2015-2017 (14%, 13.3%, and 13.2%). In secondary schools, the rate over the same period has increased (10.6%, 11.1%, and 11.4%). Table 12 shows the number of primary and secondary pupils with SEN support assuming rates of 13.1% in primary and 11.7% in secondary.

Estimates of primary and secondary pupils with SEN support

Primary / Secondary
2018/2019 / 2,346 / 1,402
2019/2020 / 2,328 / 1,473
2020/2021 / 2,397 / 1,528
2021/2022 / Not provided / 1,586
2022/2023 / Not provided / 1,624
  1. In terms of primary need for primary pupils with and without statement or EHC, estimates show gradual increases in all types of primary need between 2018 and 2021. Prevalence of need remains highest in speech, language and communication; social, emotional and mental health, moderate learning difficulties, specific learning difficulties, physical disabilities and autism spectrum disorder.
  1. Estimates for primary need in terms of secondary school SEN pupils indicate increases in all areas of primary need between 2018 and 2021 with highest increases being in MLD, Specific Learning Difficulties and SEMH (n=51, 28 and 22 respectively).

PARENT/CARER CONSULTATION