Webinar on joint working and integration around SEND – sharing the learning from CDC’s regional events 21 st February 2019
Agenda “Joint working for quality improvement and integration • around SEND: what we’ve learned” presented by the Council for Disabled Children “The Emotional Health Academy”, presented by Sally Murray • and Barry Stormont “Developing an Outcomes Framework for children and young • people in Bedford”, presented by Mrunal Sisodia
Joint working for quality improvement and integration around SEND: what we’ve learned
CDC Regional workshops – what we did 9 events, 1 in each of the DfE Regions • Focus on joint working and integration • Updates from key partners – NNPCF, NHS England, • Transforming Care, Regional Networks 1-2 examples of new ways of working • Discussion and action planning •
Why we need a focus on joint working Engaging with reality – children and young people with SEND and • their families have complex lives; their needs cross traditional service boundaries CYP with SEND are also more likely to belong to other groups that need • support The policy context – the Children and Families Act and duties • around joint working The financial context – may seem to make joint working harder, • but integration has the potential to reduce pressures on families and professionals
Engaging with reality A complex web of inter-relating and intersecting vulnerabilities Young Offenders** SEND SEND Learning 23-32% Troubled disability LAC 1,244,255 families Dyslexia 43-57% Mental Children SEN support 45% Communi 60-90% 57.3% health CiN 28% EHCPs cation needing needs 26% Young disorder LAC ADHD 12% offenders support sentenced 72,670 6% Excluded Poverty ASD 15% 52% 25,700 * Alternative Young provision offenders
Context and sources Current figures for LAC, children with SEND and children in custody The number of pupils with special educational needs (SEN) was 1,244,255 in January 2017 (DfE, Special • Educational Needs in England, 2017) At 31 March 2017 there were 72,670 looked after Children (DfE, Children Looked After in England, 2017 ) • In 2016/17 25,700 children and young people received a sentence in court (Youth Justice Board/MoJ, • Youth Justice Statistics 2016/17) Intersection between vulnerabilities 57.3% of LAC have a SEN identified by the end of KS2 (DfE, Children Looked After in England, 2017) • 52%* of young offenders asked for a 2014-15 study said they were or had been in care (Youth Justice • Board, Children in Custody 2014 – 15, 2015) 45% of young offenders sentenced in 2014 at the end of KS4 were recorded as having SEN without a • statement, and 28% as having SEN with a statement (DfE and MoJ, Understanding the educational background of young offenders, 2016) 26% of boys held in YOIs in 2014-15 who said they had been in local authority care also reported having a • disability (Youth Justice Board, Children in Custody 2014 – 15, 2015) *This is the percentage who said they were or had ever been in care. The official figures are much lower and only represent children currently looked after. **Prevalence rates of neurodevelopmental disorders among young people in custody (Howard League What is Justice? Working Papers 17/2015)
What’s working well? • Early intervention and the graduated approach • Low intensity support, e.g. West Berks Emotional Health Academy • Starting in the early years, e.g. Northants Specialist SEND Support Services • Sharing resources and expertise locally • Collaboration between specialist settings, e.g. Lincolnshire Special Schools, to deliver support closer to home • Building skills and knowledge in universal settings, e.g. Therapies in Schools, Whole School SEND
What’s working well? • Shared outcomes and strategy • Hertfordshire Outcome Bees • Bedford’s shared outcomes • Meaningful co-production and participation • Working with forums and families from the start e.g. St. Helens ND pathway, Rotherham Charter • Empowering young people’s groups e.g. Suffolk Young Person’s Network
Key challenges for 2019? Links with Inclusion (and youth justice exclusion) system Identifying and supporting children and young people with autism only
The national picture: what’s coming up • SEND Leadership Board • NHS Long Term Plan Key worker role • Expanded mental health services and support • Information and training on LD and autism • Integrated Care Provider Contract and ICS Accountability and • Performance Framework Changes to Ofsted framework and exclusions review • SEND inspections and revisits ongoing • Autism review and strategy to include children (Autumn 2019) •
Opportunities for support Support to local areas through the DBOT partnership Audit tool • Regional events • Local support • DMO/DCO forum • Children’s Commissioners Forum • Can you help us? Survey on joint commissioning arrangements: • https://www.surveymonkey.co.uk/r/27NWPXC Survey on autism pathways: • https://www.surveymonkey.co.uk/r/XW9HZMW
Contact details Visit our website: www.councilfordisabledchildren.org.uk Subscribe to our blog: councilfordisabledchildren.wordpress.com Find us on Facebook: www.facebook.com/councilfordisabledchildren Follow us on Twitter: @CDC_tweets
The Emotional Health Academy Sally Murray (DCO & Head of Children’s Commissioning, Berkshire West CCG Barry Stormont (Manager, Emotional Health Academy)
Berkshire West West Berkshire
Catalysts, challenges and enablers • 2014 independent whole system stakeholder engagement on CYP emotional and MH across Berkshire • Wake up call! Relationships. Co- production. • 2015 Future In Mind published • Mandate to transform. • More co-production. • £ helped. • THRIVE approach- Anna Freud Centre • Outcomes, outcomes, outcomes. • More co-production
Enablers Co- production
Who we are • A network of professionals • Early intervention • Child and family centred • Part of a wider partnership
How we are funded • Mixed funding model • Local Authority • Berkshire West CCG • Public Health • Children and Family Services • Virtual School for Looked after Children • Trading with schools, families and organisations
What do we do • Provide advice and signposting • Coordinate support for families • Emotional health support for children and young people • Targeted support for emerging mental health problems • Training for schools
Our Core Offers Emotional Health Primary Mental Triage Health Support Emotional Health Outreach
Emotional Health Triage • Triage is the place to refer children and young people too who have mild or emerging difficulties. • Triage sits operationally with the EHA but it is a partnership model. • It has strong links with the Contact Advice and Assessment Service and BHFT CYPF Health Hub • A panel of key professionals meets every week to discuss cases
Emotional Health Triage • Anyone can refer in to Triage to make a referral to get help, or to seek advice. • Our Triage Coordinator makes contact with the family. • If the family cannot be immediately signposted the case is discussed at panel • The family, referrer, and GP are notified of recommendations • A review is carried out at 10 weeks.
Emotional Health Triage EHA ANDY SAFE! Research Project Clinic Triage Panel School CAMHS Nurses Time 2 CAAS Talk
Emotional Health Triage • We receive on average 132 referrals to triage each quarter. • Most of our referrals come from GPs, Parents and Schools. • Anxiety is a reason for referral in 55% of cases. Likewise for mood. • 10% of referrals had a diagnosis of Autism. • A further 10% were waiting for an Autism assessment.
Emotional Health Outreach • We have four Emotional Health Workers • Their time is bought back by schools, and more recently by parents. • Deliver low intensity emotional health interventions. • They offer classroom based interventions • Run PPEPCare Training and Restorative Practice Interventions
Primary Mental Health Support • We have four Primary Mental Health Workers (PMHWs). • Provide targeted interventions for emerging mental health problems. • They receive regular supervision from a CAMHS Practitioner. • They line manage and supervise our Emotional Health Workers.
Primary Mental Health Support • Two PMHW provide support for common difficulties such as anxiety, low mood, and self-harm • Our PRU Mental Health Worker provides systemic support to our pupil referral units, as well as individual and group interventions. • Our LAC Mental Health Worker provides assessment and treatment to children in care, and consultation to our LAC Service
Our Impact • By enabling earlier access to briefer interventions we are able to see more children and young people. We close 85 direct interventions per quarter. • We use Routine Outcome Measures to track improvements. 85% of children receiving our support report improvement in their wellbeing. • 1 in 10 children who access our support are stepped up into additional CAMHS support. • We see a further 250 on average per quarter in large group or classroom activities
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