Single Plan and Personalisation

Pathway

Version 11:December 2012

1.Introduction

2.Links to Local Plans

3.Pilot Outcomes

4.Underpinning Principles

5.The Single Plan Pathway

5.1Diagram of the Pathway

5.2Referrals

5.2.1Submitting the Referral

5.2.2Receiving the Referral

5.3The EHC Assessment

5.4EHC Panel (1)

5.5Resource Allocation

5.6Drawing up the Plan

5.7EHC Panel (2)

5.8Implementing the Plan

5.9Review

6.Working Practices

7.Brokerage

8.Money Management

9.Consultation

10.Selecting Families for the Pilot

11.Inclusions and Exclusions

12.Financial Management

13.Commissioning and Market Management

14.Appendices

Appendix 1Key Worker Functions throughout the Process

Appendix 2Referral form

Appendix 3EHC Summary Assessment

Appendix 4i.Terms of Reference

Appendix 4ii.Panel Decision Sheet

Appendix 5Resource Indication Questionnaire (RIQ)

Appendix 6EHC Plan

Appendix 7Money Management Options

Glossary of Terms

BrokerThe personResponsible forsupporting a family with their Personal Budget and drawing up a person centred Support Plan

CCGClinical Commissioning Group is the name for the new health commissioning organisation which will replace Primary Care Trusts from April 2013. CCG is responsible for the planning and buying of healthcare to meet the needs of the local population

EHC PlanEducation, Health and Care Plan is the single plan referred to inthe new reforms and is proposed to replace the existing Statement for Special Educational Needs

Key WorkerA named person to support the family through the process

LALocal Authority

PCTPrimary Care Trust is responsible for the planning and buying of healthcare to meet the needs of the local population. The PCT will be replaced by the CCG from April 2013

Personal This is an allocation of money that a local authority agrees is Budgets required to meet an individual’s outcomes as specified in their EHC Plan

PlanThe person responsible for drawingup the EHC Plan

Co-ordinator

RISResource Indication System. A system which is being developed to calculate an indicative personal budget

RIQResource Indication Questionnaire. A questionnaire to identify and child and family’s needs to enable an accurate level of indicative resource to be determined

SENDSpecial Educational Needs and Disability

SupportA plan drawn up with the Broker to describe what a person

Planwants tochange about their life and how they will use their personal budget to make these changes happen.

1.1Background

The SEN Green Paper and the Pathfinder Programme demands ambitious and fundamental changes to working practices with a greater focus on learning and life outcomes for children and young people with SEN and those who have a disability

The development of a new assessment process and single Education, Health and Care Plan is at the heart of thechanges proposed by the Government.It also recognises that parents should have more control,withLocal Authorities and PCTs being more transparent about services that are available and providing the option of a personal budget for all families where children have a statement of SEN or a single EHC plan.

It is recognised that the identification of children and youngpeoplewho have SEN or a disability will take place at different ages depending on the type of difficulties they are experiencing. Some children will be known to have a disability at, or even pre birth, and others may be at school before their needs or the impact of the difficulties are recognised

In many cases the needs of children and young people with SEN or who have a disability may be met through support of a single agency. For others whose needs are more complex a range of agencies may be involved with assessments and interventions taking place overtime.

It is envisaged that referral for a single EHC Plan will occur where the level of severity of the child or young person’s needsrequires access to services over and above those offered at a universal or targeted level.

1.2Introduction to Personal Budgets

The approach to personal budgets for children in Wigan will be delivered as two parallel pieces of work; the development of a Resource Indication System (RIS), and testing the allocation of personal budgets to families.

In consultation with In Control, and colleagues in People’s Services Finance, it has been agreed that the development of a RIS requires a significant number of families to have completed a resource indication questionnaire (RIQ) to determine their levels of need to enable an accurate level of indicative resource to be determined for the SEN:D cohort.

The next steps are as follows;

  • To consider a range of ways to build up the RIS over the course of the extended SEND Pathfinder to enable Wigan Local Authority and the Clinical Commissioning Group (LA / CCG) working in partnership to offer families in the borough the option of a personal budget fromSeptember 2014.
  • To offer families in the SEND Pathfinder pilot an opportunity to access a personal budget for the period of the pilot, to enable the partnership to evaluate the benefits that this brings to children, young people and their families.

This parallel approach allows the LA / CCG Partnership to pilot the delivery of the critical processes that make personal budgets function as a delivery mechanism, including person centred planning, brokerage support, money management, governance and decision making, audit and review.

Families that wish to access a personal budget will be able to draw down resources that the LA / CCG Partnership have been able to map, and covert this into a direct payment. This includes; a range of specialist services that are available via social care, learning support and home to school transport and children’s continuing care.

Importantly families who wish to access personal budgets will need to remember the following guidelines;

  • Personal Budgets must support the outcomes identified through the revised EHC processes for SEND.
  • Personal Budgets must be supported by a Support Plan that is person centred.
  • Families accessing a Personal Budget cannot also access the service that the resourceallocation has been determined from.
  • Personal Budgets that are created within the Pilot are valid until 31st March 2014, and will be subject to review within that period to determine if they continue to meet the outcomes that have identified with the family.
  • Personal Budgets must be approved with the EHC Plan and the Support Plan at the EHC Panel where clinical governance and safeguarding will be underwritten.
  • Personal Budgets are being tested and families will need to remember that flexibility and patience will be required to establish a robust system for future.
  • Existing guidance applying to direct payments in Social Care will still apply, including the conversion of overnight provision at Ladies Lane.

2.Links to Local Plans

The Single Plan and Personalisation Pathway for children and young people with a SEN&D is integral to Wigan’s Corporate Strategy(2011 – 2016)and aligned to the following long term outcomes

  • The people of Wigan are confident that they have and can make the right choices and decisions for themselves and their family;
  • they are taking control of their lives and are less dependent on public services;
  • and they feel a sense of purpose and a quality of life;
  • they are confident that they can live safely and independently in their own homes and community;
  • they know they can access the care and support they need close to where they live;
  • they say they are treated with dignity and respect

The Pathway also meets the following priorities as outlined in the Children and Young People’s Plan (2011 – 2014);to improve the prospects for children and young people at risk of being disadvantaged, narrow the gap in educational achievement and improve children and young people’s health inequalities.

3.Pilot Outcomes

3.1Children, young people and their families report increased satisfaction with the services they receive.

3.2Children, young people and their families report that they have greater choice and control about services they receive.

3.3Health and well-being is improved.

3.4Families report increased access to social opportunities, and short breaks.

3.5Bureaucracy is reduced.

3.6A wider range of services are available through the encouragement of innovation in provision.

3.7 Value for money in personalisation is tested.

These outcomes will be measured locally and at national level by SQW.

4 Underpinning Principles

4.1There will be a shift in organisational culture to focus on the empowerment of children, young people and their families

4.2As far as possible, we will build on the existing systems, processes and resources that are available where it is clear they will deliver improved outcomes.

4.3Expenditure will be allocated fairly and consistently taking into account individual circumstances and needs.

4.4Documentation, systems and processes will be transparent and consistent across client groups, whilst taking into account individual circumstances and needs where appropriate

4.5We will foster a person centred, and user led approach, in developing personalisation.

4.6We will work with children, young people, their families and the workforceto create a new culture that embraces personalisation.

4.7We will foster a culture of innovation whilst minimising risk.

5.The Single Plan Pathway

The following diagram highlights the stages of the journey for child or young person and their family through referral for consideration of an EHC Plan to the offer of a personal budget and / or adelivered service.

5.1

5.2Referrals

5.2.1Submitting the referral

In the present system, all referrals for statutory assessments are sent to the SEND Team. For the pilot, it is proposed that a temporary team is established to support families through the process from referral to the drawing up of a plan. The temporary team will be known as the EHC team and will comprise of a Plan Co-ordinator from the SEND team and a Key Worker. The Plan Co-ordinator will draw up the EHC Plan with the family and work with other professionals and the Brokerage service to ensure that needs are being met across Education, Health and Care. The key workers role will be to ensure that the family is at the centre, guiding them through the process and acting as a single point of contact (see appendix 1 for Key Worker functions throughout the process).

In the pilot, referrals will be submitted to the EHC team. In order that a referral can be made for consideration of an EHC Plan the following will apply:

  • Both severity and process criteria will need to be met which will include evidence of interventions from appropriate agencies ( existing SEN severity criteria will be used in the short term)
  • Reports and assessment will be outcome focussed. Teams and Services will be consulted to develop and an outcomes framework
  • The views of the child and family will be included in the referral information

Referrals can be submitted by families, schools and other professionals to theEHC teamusing a concise referral sheet with relevant assessment and other reports attached (see appendix 2 for a copy of the referral form).

As part of the referral, Schools will be required to complete the Education section of the RIQ to give an indication of the level of need and the Key Worker will be required to complete the Health section of the RIQ with the most appropriate Health professional.

Where there are significant and substantial needs from a very early age, a EHC plan would be instigated as soon as possible.

For the pilot, an Educational Psychology report will be required for each child. However, in the future, this will depend on legislation and the need for one.

In the future there will be a requirement for a multi-agency team comprising of staff from SEND, health and social care to support the pathway. For the purposes of this paper, it is assumed that this will be rolled out as services are re-designed and shaped to respond to the new ways of working which the Pathfinder is trialling.

5.2.2Receiving the referral

The Plan Co-ordinator willlog receipt of the referral. TheKey Worker will be allocated to families at the point that they are recruited to the Pilot and support the family through the process, and liaise with other professionals as appropriate.

For the purpose of the pilot:

the Plan Co-ordinator will:

  • Identify the range of needs across education, health and carebased on the information submitted
  • assess if further advice is required for the referral*
  • discuss the referral with the key worker who will liaise with the family and establish if there is any missing information
  • draw up the EHC summary assessment
  • Notify the Broker if a personal budget is requested

* If this is needed contact will be made directly with the appropriate agency

the Key Worker will:

  • ensure that the views of parents and those of the child are accurate
  • Complete the RIQ
  • Share the Summary Assessment with the family to determine if the EHC Summary Assessment is an accurate account of their child’s needs. If requested, families can meet with the Plan Co-ordinator to discuss the summary assessment
  • Share any new reports with the family if requested
  • discuss the potential option of a personal budget

In the future, the Key Worker functions may come from a number of existing roles.

5.3The EHC Summary Assessment

It is acknowledged that there are likely to be a number of assessments already in place / required for this cohort of children and young people, and that in order to consider whether an EHC Plan is required, a single document that summarises all relevant information from those assessments will be needed (see appendix 3 for a copy of the EHC Summary document). The EHC Summary Assessment will be drawn up by the Plan Co-ordinator and based on the evidence provided.

To achieve some commonality and adopt a more outcome focused approach, it is recommended that all professionals undertaking assessments, clearly identify the needs and outcomes for the child / young person.

In conclusion the EHC assessment will be a summary of:

  • those assessments undertaken prior to the referral and any additional assessments undertaken as a result of the referral;
  • the child /young person’s needs across education, health and care
  • the specific outcomes to be achieved;
  • the views of the child / young person and their family on how they would like services to be delivered;

5.4EHC Panel (1)

The EHC Panel will consist of a range of senior professionals. This will include:

  • Community Consultant Paediatrician
  • Health Care Provider Manager
  • Social Care Manager
  • SEND Manager
  • Primary, Secondary and SpecialSchool Managers
  • Early Years Manager
  • Post 16 Commissioner
  • SEND Commissioner
  • Health Commissioner
  • Educational Psychologist
  • Brokerage Service
  • Parent Partnership
  • Adult Social Care Manager
  • Targeted Educational Support Service Manager (EIP)

(see appendix 4i for Terms of reference)

The function of the panel at this stage in the process will be to:

  • determine if the criteria for a EHC plan has been met
  • approve the summary of assessed needsand outcomes (EHC assessment)
  • determine if a personal budget is an option takinginto consideration safeguarding and clinical governance
  • Agree an indicative resource based on information gathered from the RIQ and the EHC Summary Assessment. The Panels recommendation is the principle recommendation and the recommendation on which the allocation is based
  • if a personal budget is deemed appropriate, agree inclusions and exclusions and those by negotiation
  • give guidance on levels of support / resources required to meet need
  • record the summary of decisions

Decisions from Panel will be conveyed to the family by theKey Worker (see appendix 4ii for Panel Decision Sheet). The Plan Co-ordinator will notify the referrer and formally notify the family in writing. Parents will be advised of their rights of appeal and routes for mediation if they are unhappy with the decision.

All eligible children and young people will have an EHC Plan. At this stage it is envisaged that this will be those children and young people who currently have a statement of SEN or would have one in the future. The way in which provision is made for individual children and young people via an EHC Plan will be determined by:

  • their needs,identified through outcome based assessments,
  • the families preference for a personalised budget or a delivered service or a combination of both
  • the inclusions and exclusions described in the personalisation processdetailed at point 10, page 13-14.

5.5Resource Indication Questionnaire (RIQ)

An example of a RIQcovering Education, Health and Social Care can be seen in appendix 5. It should be noted that in addition to a RIQ a formula will be required to translate levels of identified need in the RIQ into an allocation of resource.

5.6Drawing up the Plan

The EHC Plan will be a personalised plan and will be drawn up using a person centred planning approach (see appendix 6 for EHC Plan).

The Plan Co-ordinator will arrange a meeting with the family and the appropriate professionals, including the Key Worker to draw up the EHC Plan. The Plan Co-ordinator will present a range of choices available to families based on the recommendations made by the EHC Panel.

One of the options under a personalised approach is a personal budget. If families opt for a personal budget, a broker will be commissioned to offer a degree of independence. The broker would require a knowledge of what is appropriate, safe and within budget for a family to ensure sign off by the EHC Panel. Money management options would also be discussed.

It is recognised that the EHC Plan may contain a combination of delivered services and those commissioned through a personal budget. For the education element of the plan, it is more likely to be a delivered service as school places and curriculum entitlement are not at present included within the personalisation agenda.

The responsibility for ensuring that all elements of the plan across education, health and care, whether delivered through a service or a personal budget, are addressed, will lie with the Plan Co-ordinator. Individual teams / services will be accountable for their contribution to the plan.