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Overview

Demographics of Devon

Devon has a population under the age of 18 of approximately 150,000[35]. Children and young people represent around 18.3% of the county’s total population, a slightly lower proportion than the South West as a whole. We expect the total population of Devon to expand by around 3.6%[36].  between 2018 and 2023, with every district seeing a rise. Most of this is expected to come from domestic and international migration into the region, with average fertility rates dropping for the sixth year running to 1.65 from 1.7 in 2018[37]. Devon’s population is expected to get older over the next two decades, with a 94% increase in those aged 85+, compared with a growth rate of just 2% for those under 65 by 2040[38]. By ethnicity, Devon remains a predominantly white region, with only 2.5% of the total population reported as either Black, Asian, or ethnic minority[39]. There is a lot of variation in the size of the BAME population between localities, with just 1.3% in Torridge up to 7.5% in Exeter according to the 2011 census[40]. As a result of migration and birth rates within those populations, the overall proportion of BAME people in Devon is currently estimated to be between 3 and 5%[41].

Education and learning

There are a higher number of children and young people who have identified special educational needs in Devon schools than national and regional levels. This trend is also replicated in the numbers of pupils who receive SEN support in school or have an EHCP. The higher than average proportion of children with SEN is particularly the case for those relating to social, emotional, behavioural, and mental health needs.

While this section refers to children and young people who are in Education, a young person may have an EHCP up to the age of 25, while SEN Support refers to a specific cohort of pupils, of statutory school age, who receive targeted support in school. They therefore do not represent all children and young people with special educational needs and/or disabilities but provide a useful insight into levels of need and local support that is delivered.

Pupil characteristics: (42)

by characteristic % of Devon pupil population National South West
Recieving Free School Meals 13% 17% 15%
First Language other than English 4% 20% 8%
SEN EHCP(43) 4% 3% 3%
SEN Support 14% 12% 13%
any SEN 18% 15% 16%
BAME 8% 33% 15%
EHE 2%    

SEN support

At spring 2021, there are 13,624 children and young people receiving SEN support in Devon schools (this excludes independent schools and those receiving SEN support in FE colleges).  The proportion of pupils in Devon receiving SEN support has followed a similar downward trend when compared with the South West region, our statistical neighbours and the rest of England. Although since 2016, levels have remained relatively steady following a decline since 2011.

Proportion of children and young peopole receiving SEN Support breakdown by Devon district area (April 2021)

The image shows the top 5 primary needs for SEN support. Almost half of all pupils receiving SEN support have SLCN and/or SEMH as a primary need.

line chart showing % of all pupils with SEN support

As a large and rural county accessibility of services for all children and young people is important. It is recognised that the rurality of services impacts accessibility and how far families have to travel to access a service in Devon can affect their engagement. The chart (below) illustrates there are a number of children and young people across the Devon districts who have SEN needs and require support in school. The availability of services locally for this group of children and young people could have an impact on the need for statutory assessment, plans and further intensive support in the future.

The image is a green circular shape which shows the breakdown of SEN support by the child’s primary need

EHCPs

Since 2016, the number of children who have an EHCP has more than doubled, reaching 7,440 by the end of March 2021. This has resulted in increased pressures on local SEND services in Devon to meet this growing need. Despite this, since the end of 2018, the timeliness of EHCPs has improved dramatically. In this time, the proportion of plans issued on time has increased from just 3% to 54% at the end of 2020.

The number of pupils with an EHCP in Devon has more than doubled since 2015, but remained relatively steady over the last 12 months:


[35]  Mid-year 2019 0-17 yr population, published June 2020 by the Office for National Statistics (ONS)

[36]  Devon population projections, published by DCC

[37]  Births in England and Wales: 2019, published by ONS

[38] Devon’s joint Health and Wellbeing Strategy 2020-25, published October 2019 by the Devon Health and Wellbeing Board

[39] 2011 United Kingdom census data, published by ONS

[40] 2011 United Kingdom census data, published by ONS

[41]  Population characteristics research tables, published 2019 by ONS

[42]  Schools, pupils and their characteristics, published September 2020 by ONS

[43]  Education, Health and Care Plans, published May 2020 by ONS

Bar chart displaying the above average proportion of pupils receiving either SEN or EHCP support

The above average proportion of pupils receiving either SEN or EHCP support is, in part, due to a higher than average proportion of children and young people with SEN relating to social, emotional, and mental health (SEMH) needs and Speech, Language, and Communication Needs (SLCN)[44]. Autism, SEMH, and SLCN have accounted for the vast majority of the increase in EHCPs over the last four years. This indicates a growing demand for services to meet those needs of children and young people. While SLCN/SEMH also account for the largest proportion of primary needs of SEN support, this is not the case for autism. While only 6% of SEN support relates to autism, it is the primary need of around 27% of EHCPs in Devon. This suggests a shortcoming in the early support offered to children and young people with identified autism needs. To prevent escalation of needs.

Bar chart of total pf EHCPs maintained by Devon by Primary Need

Education settings

The chart (below) provides an overview of where children with an EHCP are educated in Devon as at April 2021. Almost half (44%) attend a mainstream school, while 22% are supported in a special school maintained by Devon County Council. We continue to review the sufficiency of school places to meet the growing demand of pupils with EHCPs. Significant funding for additional special school places was announced by Devon County Council earlier this year.


[44] Devon’s Joint Strategic Needs Assessment for Children and Young People with Special Educational needs and Disabilities (SEND), published in 2017 by Public Health Devon

[45] *ASD = Autism Spectrum Disorder, HI = Hearing Impairment, MLD = Mild Learning Disability, MSI = Multi-Sensory Impairment, PD = Physical Disability, PMLD = Profound and Multiple Learning Disabilities , SEMH = Social Emotional and Mental Health, SLCN = Speech Language and Communication needs, SLD = Severe Learning Disability, SpLD = Specific Learning Difference , VI – Visual Impairment.

Graph showing setting being attended by any child with SEND and an EHCP (%)

Children and young people in care with SEND

4% Devon’s children and young people with an EHCP are also children in care, and 64% of children in care have either an EHCP or SEN Support. Vulnerability is increased for children and young people experiencing a number of factors.

image displaying proportion of children in care 3-18 with an EHCP and also SEN

The vast majority (63%) of children in care who have an EHCPs have a primary need of SEMH. 13% of all children in care with an EHCP also had a secondary need and SLCN was identified most commonly. This demonstrates the close relationship between SEMH and SLCN, especially relating to histories of trauma and disrupted learning and development at an early age. For children and young people in care, as corporate parents[46], it is vital that we get the support right for them, ensuring it is trauma-informed and rooted in relationships with our children and young people which are built on restorative practice.


[46] Corporate parenting refers to our responsibilities as partners to be responsible parents to all children and young people with experience of living in care by promoting their interests and protecting them from harm as we would for our own children. These responsibilities are outlined in statutory guidance, available online here.

The image is a green circular shape which shows the breakdown of EHCPs for children and young people in care by the primary need

The chart (below) illustrates of the children in care with an EHCP at April 2021, a higher proportion of these children and young people were aged 13 to 16 years. At this life stage transition support, developing life skills, experience and independence to allow children and young people to move forward onto the next steps positively is crucial.

Children in care with an EHCP are, proportionally, much more likely to attend a special school than those with an EHCP who are not in care – almost half of children of statutory school age in Devon attend a special school. In addition, a far lower proportion are NEET.

Bar chart showing education setting being attended by CiC in Devon with SEND and an EHCP

Inequalities in outcomes for children and young people with SEND

The population of children and young people with SEND is a wide and diverse group, who have different experiences, challenges, and levels of resilience. However, those with special educational needs and/or disabilities are more likely to face unequal barriers to achieving good education, employment, and health and wellbeing outcomes. Children and young people with SEND, and their families, are also far more exposed to the damaging interplay between multiple vulnerabilities.

Analysis, undertaken by the Office of the Children’s Commissioner for England[47], finds that the existence of multiple vulnerabilities compounds poor educational outcomes. Vulnerabilities are measured by SEN support, Free School Meals eligibility and having a social worker. Nationally, for children with SEN support, only 32% pass their English and Maths GCSEs. However, children with SEN support and FSM, only 20% pass, and for those with SEN support, FSM and a social worker, this drops further to 17%. Supporting the education of children with SEND therefore takes a holistic, multi-disciplinary approach, focusing on breaking the links between deprivation, safeguarding risks, SEND and worsened educational outcomes.

In Devon, pupils with SEND are disproportionately likely to live in households with a low income and be eligible to receive FSM. During the year of the COVID-19 pandemic, the proportion of pupils with either an EHCP or receiving SEN Support has increased from 22% to 29.1% since the 2018/19 academic year. This compares to 13% of the total Devon pupil population who receive FSM and is just below national levels[48].

Proportion of pupils on FSM by SEND cohort

Academic year (49) EHCP SEN Support EHCP or SEN Support
2018/19 28.9% 20.4% 22.0%
2019/20 30.2% 23.3% 24.9%
2020/21 33.1% 27.8% 29.1%

Educational outcomes

It remains too early to truly assess the impact of the pandemic on education outcomes for pupils across the UK. However, attendance across the country has been variable as a result of local levels of infections, differing levels of restrictions, and the capacity of individual schools. The significant disruption to school attendance since March 2020 is likely to have had a negative impact on the learning of the vast majority of pupils. However, it is widely acknowledged and evidenced that far lower levels of direct face-to-face teaching will have been disproportionately felt by children and young people with vulnerabilities, including those with special educational needs and disabilities. In the absence of attainment data for 2020/21, attendance is used as a proxy measure of the anticipated impact on children and young people’s learning, development, and formal education since March 2020.

During the pandemic, overall school attendance in Devon has been consistently above national averages, including among pupils with SEND:

Bar showing school attendance rate of all groups of children and young people, who are classed as vulnerable during the pandemic

Before the pandemic, children, and young people with EHCPs were achieving better outcomes than nationally across all stages of education and learning. The graph below shows that for pupils with EHCPs, 18.3% were achieving target levels of Attainment 8, compared to 15.2% nationally. For pupils receiving SEN support, Devon’s average Attainment 8 score is level with England. While slightly more pupils with SEND support are achieving a pass grade in English and Maths GCSE in Devon compared to England, fewer are achieving a grade 5 or above in Devon.

2019/20 headline key stage 4 results
Bar chart showing proportion of Devon Young People ages 19 years qualified to level 2, including English and Maths

Electively home-educated children

The overall number of pupils who are electively home-educated (EHE) has increased by over 40% between October 2018 and January 2021. The increase has been disproportionate among pupils with EHCPs: an increase of 119%. There are 30% more pupils, who previously received SEN support, who are now EHE. However, the majority of this rise came at the start of the autumn term 2020/21, during the pandemic.

line graph showing the number of pupils with a special educational need who are registered as being electively home-educated between October 2018 and January 2021

Overall, following a spike in new notifications of EHE registrations in September 2020, the trend returned quickly to levels seen before the pandemic.

Line chart showing new notifications of children being electrively home educated

Alternative complementary education

All pupils in Alternative Complimentary Education settings (or Alternative provision) in Devon have either an EHCP or receive SEN support. Since 2018-19, there has been a considerable shift in the proportion who have an EHCP, from just over one in ten pupils to over a third.  Some of this increase can be attributed to the 78% rise more generally in the total number of EHCPs in Devon between 2018 and 2021. However, it demonstrates that over the last three academic years, children and young people attending alternative complementary education settings – the vast majority of whom have significant needs beyond educational – are increasingly receiving the right levels of support to meet their individual needs. It also follows a trend seen nationally, where the proportion of pupils in alternative complementary education settings with an EHCP saw a slight increase, between 2018-19 and 2019-20, from 13.8% to 16.8%. National data for the current academic year is not yet available.

Proportion of pupils in alternative provision by EHCP or SEN Support

Academic year [50] EHCP SEN Support
2018/19 12.8% 87.2%
2019/20 20.3% 79.7%
2020/21 34.8% 65.2%

Nationally

Academic year [50] EHCP SEN Support
2018/19 13.8% 69.3%
2019/20 16.8% 66.1%
2020/21 Not available Not available

[50] Data source:Spring School Census Returns (January)

Early years

There are 36,270 children under the age of 5 in Devon. 95.6% of all 3 and 4 year-olds in Devon accessed their Early Years Entitlement during the Autumn term 2020.

162 children between 1 and 5 years of age accessed the Early Years Complex Needs Service. The service offers both a home-based and community offer for young children with complex needs, and also includes support transitioning into an Early Years setting as well as completing an EHCP.

During 2019-20:

  • 212 children under 5, who have an EHCP, accessed their universal Early Years entitlement through an Ofsted-registered provider
  • 479 children accessed additional funding to support their attendance at an Early Years setting
  • 174 children accessed Disability Access funding for children aged 3 or 4 who receive Disability Living Allowance from the Government
  • 256 children were supported by the Nursery Plus service, which supports Early Years settings to meet the needs of children with identified SEND
  • 266 children under the age of 5 accessed a targeted Early Help service through a Children’s Centre

Note that some children will access support from more than one source, so it is highly likely that there is crossover between these figures.

Further education, employment and training

Between April 2020 and January 2021, the average rate of young people (Year 12-14 cohort) in Devon who are not in education, employment, or training (NEET) is 4.68%[51]. This compares to 3.9% across the same period in 2019/20. Of young people who have an EHCP, the NEET rate increases to an average of 10.6% for 2020/21. As of January 2021, 6.5% of young adults aged 18-24 were claiming Universal Credit in Devon, a drop from a peak of 7.5% during July and August 2020. Only 7% of adults with a learning disability are employed in Devon.

The graph below shows fewer numbers of children and young people receiving SEN support and EHCP  in recent years have gone on in education, employment or training. While the rate has also decreased among those with no SEND, the downward trend since 2017 (for SEN Support) and 2018 (for EHCPs) has been much steeper for KS4 pupils with SEND.

Line chart showing Proportion of KS4 pupils in Devon going to, or remaining in education and employment/training overall

[51] Data produced by CSW group in February 2021 for Devon County Council

Children and young people with SEND supported by social care

Children in Need

Children in need (CIN) are defined as children under the age of 18, who require local authority social care support under Section 17 of the Children Act 1989. This includes children and young people who have a disability.

There are almost 3000 CIN in Devon as at March 2021. 14% of whom have a disability – amounting to 372 children in total. 6% had ‘child illness or disability’ recorded as their primary need. This compares to a total of 2372 CIN in March 2020 – over 20% below the current size of our CIN population. In 2020, a slightly larger proportion of CIN had a disability (16%), and a considerably bigger proportion had ‘child illness or disability’ recorded as their primary need (10%) than currently.

The proportion of CIN who have a disability has dropped considerably from a peak of over a third in the year 2018/19 and an average of 23 in the four years prior. However, the current rate remains above the figures for England, the South West, and for Devon’s statistical neighbours.

Child Protection Plans

A Child Protection Plan is a higher level of statutory safeguarding intervention that local authority children’s services can use to protect children from harm and abuse under Section 47 of the Children Act 1989.

As of March 2021, there are 552 children in Devon who have a child protection plan. This is a rate of 38 per 10,000 0-17 population, up from 34 during 2019-20. Of the 552 children, 7% have a disability. Since March 2020, there has been a rise in the total number of children with child protection plans from 462 – almost a 20% rise. The proportion of those children who had a disability has remained steady at 7%.

Children in care

At March 2021, there are 817 children in care, 139 of whom (17%) are recorded as having a disability.

This is a rise of 51 from a total of 766 children in care at March 2020, of whom 123 children had a disability (16%).

Children in care are disproportionately likely to have a special educational need and/or disability than the wider 0-17 population. In Devon, 22% of all children and young people in care receive SEN support at school and almost a third (33%) have an EHCP. In total, over half (55%) either receive SEN support or have an EHCP.

Disabled Children’s Service

As at the end of March 2021, there are currently 262 children receiving support from social work teams in the Disabled Children’s Service (DCS). Of these, 64 are children in care, 31 are on a Child Protection Plan, and 167 are Children in Need.

Pie chart highlighting the children receiving support from disabled childrens social work teams

Edge of Care Service ‘Bridges’

‘Bridges’ is our Edge of Care service in Devon. The service supports children and young people who have higher levels and complexity of need. Supporting children and young people to be able to remain safely with their families and within their community, so that they either don’t need to come into our care or that they are able to safely return home from being in our care. The service officially started their work in autumn 2020, and they will play a pivotal role, during the years to come, in providing support to children, young people, and their families as early as possible and mitigating care entry. 81% of families open to the service have a Prevention Plan and the remainder are focused on a return home from care.

Since their creation, and to the end of March 2021, the Edge of Care Service have received 115 referrals. 38% (44 young people) of those have SEND (either an EHCP or SEN support. A slightly higher proportion (86% vs 78%) of young people with SEND, referred to Edge of Care, are for a rapid response as opposed to planned.

Transitions to adult social care

The numbers of young people, who transition to adult social care (ASC) services, is variable in any given year. The yearly average is 156 – ranging between 133 and 189 each year.

Of young people transitioning to Adult Social Care who have an ECHP, the proportion with a primary need of autism has remained consistent over the last three years.  However, the proportion with any learning disability has steadily dropped from 20% in 2018-19 to 15% in 2020-21. SLCN, SEMH and sensory impairments needs have remained relatively consistent over the last three years, while the proportion of young people with physical disabilities requiring ASC support has dropped to 2018-19 levels following a spike in 2019-20.

The graph below shows young people who started to receive support from adult services – split by the primary need of their EHCP (as a proportion of whole cohort). The proportion who have autism has remained steady over the last three years, within the context of increasing numbers of young people transitioning without an EHCP.

Bar chart showing young people who started to receive adult funded services by EHCP primary need

Youth offending

There is widespread evidence that many of children known to youth offending services have a special educational need, especially relating to speech and language. Nationally, approximately 80% of young offenders have speech and language needs. In Devon currently, of children and young people known to YOS, almost three-quarters have an identified specialeducational need.

A pilot Speech and Language Therapy project in 2010 which screened all the young people coming into the Youth Offending Service (YOS), over a 13 month period, found that 91% had significant communication difficulties. However, only 3 out of a total of 32 young people (9%) who were then referred for assessment, had been previously known to the Speech and Language Therapy Service. Presently, only a very small proportion (under 3%) of those assessed by the Highly Specialist Speech and Language Therapist within the youth offending service have had their severe speech, language and communication difficulties previously identified.

Pie chart showing young people known to YOT

National legislation and policy

SEND reforms

The Children and Families Act 2014 brought about a significant shift in how local public services are expected to work together to improve the lives and outcomes of children and young people with special educational needs and/or disabilities (SEND).

The SEND Code of Practice outlines, in statutory guidance, the duties of local authorities, health commissioners and providers, schools, and colleges to ensure there are joint commissioning arrangements to consider and agree the education, health and care provision required by children and young people with SEND from 0-25 years of age., and how it is planned, funded and delivered. Partners are expected to engage with children and young people with SEND, and their parent carers to inform their commissioning decisions. These legislative changes are the principle national policy driver of Devon’s SEND Strategy, Joint SEND Commissioning Plan and transformation  of local SEND services.

Joint commissioning arrangements must cover services for children and young people with SEND up to the age of 25 – including those who have a EHCP and those who do not. They should include the advice, information and support that is provided to children and young people with SEND, and their families, as well as targeted and specialist support. The SEND Code of Practice expects effective co-operation between local authorities, health and education providers, and other providers of services, in the best interests of children and young people. Children and young people, and their families must also be engaged and involved directly in the commissioning of services and be able to share their views, experiences, and expectations freely and with purpose.

Working together 2018

Working Together 2018 is the statutory guidance on inter-agency working to safeguard and promote the welfare of children. The role and responsibilities of the Devon Children and Families Partnership is how we enact our statutory duties to work together in Devon. While it is local authorities, under the Children Acts of 1989 and 2004, who hold the principal duty to safeguard children and young people, the Children and Social Work Act 2017 places new responsibilities on partner agencies (the Office of the Police and Crime Commissioner and Clinical Commissioning Groups) to work together, alongside the local authority, to safeguard and promote the welfare of children and young people in their area.

NHS long term plan

The NHS Long Term Plan, launched at the beginning of 2019, is the strategic roadmap for the NHS to respond, over the next 10 years, to important challenges including funding, staffing and increasing inequalities and pressures from a growing and ageing population.

There are six key areas of the Long Term Plan:

  • Implementing integrated care systems (ICS) across the country to provide improved and more joined-up health and care support for local populations
  • Preventing and tackling health inequalities
  • Setting priorities for improving care quality and health outcomes
  • Tackling workforce pressures and developing the future growth, support, and sustainability of NHS staff
  • Upgrading technology and promoting digitally enabled care empowering people and support health and care professionals, clinical care and clinical efficiency and safety
  • Securing the long-term financial stability of the NHS and health and care system

Included in the Long Term Plan is an explicit awareness of the need to support children and young people with SEND, and their families, to access a fragmented system of health and care support[52]. This included the important commitment to rolling out the Keyworker pilot for children and young people with a learning disability and/or autism across the country. Increased funding for mental health and community health and wellbeing services, as well as a commitment to reducing wait times for autism diagnoses will also play a key role in improving outcomes for children and young people with SEND over the next 10 years. Finally, the Plan also acknowledges the importance of transitions to adulthood and adult services for young people with SEND.


[52] What does the NHS Long Term Plan mean for children and young people with SEND? Council for Disabled Children, 2019, online at: What does the NHS Long Term Plan mean for children and young people with SEND? | Council For Disabled Children

Local strategic context

SEND Strategy 2021-2024

Devon’s SEND Strategy 2021-24 has been produced by colleagues from across the Partnership, working in collaboration with representatives of parent carers of children and young people with SEND. The development of our vision and priorities included extensive engagement with children and young people with SEND, as well as hundreds of families and professionals. The Strategy sets out our strategic vision for children and young people with SEND, as well as four key areas of focus that will guide our planning, delivery, and evaluation of services over the next four years.

Our vision is for all children and young people with special educational needs and disabilities to dream, believe and achieve, and fulfil their potential.


[52] What does the NHS Long Term Plan mean for children and young people with SEND? Council for Disabled Children, 2019, online at: What does the NHS Long Term Plan mean for children and young people with SEND? | Council For Disabled Children

Priorities

Over the next four years, for children and young people with send, and their families, we will:

  1. Build trust by:
    • listening, hearing, and understanding
    • doing what we said we would do, and keeping families informed
  2. Provide opportunities to co-produce by:
    • working together to shape services; and
    • supporting children and young people with SEND and their families to make informed choices about the care and support they receive
  3. Provide access to help and support which is:
    • early, easy to access, and provided through a system which is easy to navigate; and
    • met in the right way, at the right time, by an integrated service
  4. Support the life chances of children and young people with SEND:
    • by having high aspirations for children and young people with SEND to achieve; and
    • preparing them for life, by gaining the skills to become independent and thrive

DCFP Children and Young people’s Plan 2019-2023

The Children and Young People’s Plan 2019-23 is the strategic plan of the Devon Children and Families Partnership. It sets out our shared vision for all children, young people, and their families across the county. Our vision is founded upon four key pillars of the lives of children and young people; each of which are needed for them to truly thrive. Under each pillar are a set of specific priorities and actions which provide the framework for the delivery of our aims.

The Plan also includes a set of agreed principles through which the Partnership operates. These act as a map and guide for all the work that we do with children, young people and families, ensuring our support is effective, timely, and sustainable.

Vision

We believe that every child in Devon should have the best possible start in life and the opportunity to thrive. We want to ensure children and families receive the right support, at the right time, and in the right place.

The four key pillars

  • Life Chances

Children and young people achieve their potential and have opportunities to thrive.

  • Be Healthy and well

Children and young people have the best start in life, stay healthy and well and can thrive.

  • Feel safe

Children and young people are safe, within their communities, from abuse and exploitation.

  • Be protected from harm

Children and young people are protected from harm within their homes from abuse, violence and neglect.

Our principles

  • Children are best brought up in families
  • We will support families to find their own solutions
  • We will listen to each other and work together with services shaped by all
  • Children and families will always know where they stand with us

DCFP Our Lives with COVID-19 and what next

Our Lives with COVID-19 and What Next sets out the DCFP’s priorities in responding to the immediate risks and impacts of the COVID-19 pandemic on children and young people. It also sets the foundations for the partnership’s strategic recovery out of the pandemic with the ambition to build back better for all of our children and young people.

The effects of the pandemic will last long into the months and years. It is also clear that we are not “all in the same boat”. Some in our communities, including many children and young people with SEND have faced disproportionate disruptions to their health, wellbeing, education, and life chances. The significance of ensuring an equitable and transformative response and recovery should not be overstated. In this context, our strategic intentions for joint commissioning will play an important role in ensuring that no child or young person is left behind as we move forward.

Responding now:

  • Preventing hidden harm and exploitation

We will protect children from the changing nature of criminal exploitation of young people and will continue our focus on domestic abuse, substance misuse and adult mental health. We will have a particular focus on the significant vulnerabilities of infants to harms within the household.

  • Supporting children and young people’s emotional health and wellbeing

We will offer extended services to support emotional wellbeing, mental health and recovery for children and young people.

  • Supporting the return to learning

We will support the return to learning for all children, with extra additional support for vulnerable children and those with Special Educational Needs and Disabilities.

  • Focusing on communities

We will work alongside communities to offer targeted family support and early help, identifying where changes to jobs can affect communities and increase pressure in families.

Building back better:

  • Extending the offer for young people into work and training opportunities

We will work with our partners to ensure as many young people as possible are accessing education, employment and training opportunities, including apprenticeships, traineeships and kickstart placements. We have a particular focus on under-represented groups, including care leavers and young people with SEND.

  • Combatting inequalities

We will combat the inequalities that have been exacerbated by COVID-19 in all that we do. We will strengthen our communities to be diverse, inclusive, and empowering places, where people are able to express themselves as individuals.

  • Tackling the climate emergency

We will support our young people to put their voice at the heart of the response to the climate emergency in Devon.

Community Health and Wellbeing services for children and young people – Service strategy

Community health and wellbeing services in Devon are a commissioned service, delivered by Children and Family Health Devon. This service strategy sets out how we want these services to be delivered for the next 7-10 years, from March 2019, in order to achieve our shared ambitions for all children and young people in Devon to have the best start in life, grow up in loving and supportive families, and are happy, healthy and safe.

Our plans for community health and wellbeing services are built firmly upon what children, young people and families have told us. Extensive engagement activity was undertaken throughout 2011 to 2016 covering what the current state of health and care services for children and families were in Devon. Then, in 2017, further engagement was conducted with families to assess what services needed to look like over the following 10 years. Feedback was clear in saying that services needed to be easier to access, timelier in their delivery, and communicate more effectively between professionals and with families themselves. Specifically, CAMHS and support for children with autism were two service areas where improvement was needed most.

The strategy articulates the ambition to integrate multi-disciplinary services and base our support on the system-wide THRIVE framework. THRIVE emphasises the importance of prevention and early intervention in service design and delivery. Community health and wellbeing services will be offered at a population level and targeted at specific groups where we know improving outcomes is particularly important. The promotion of good physical and mental health and wellbeing will be a goal across multiple service areas on a community-wide basis. Self-help and signposting services build on this, with the aim of empowering and equipping all children , young people, and families to be able to take care of their own health and wellbeing at an early stage. Where more help and support is needed, interventions from community health and wellbeing services will be evidence-based and focused on improving outcomes in lasting, meaningful and sustainable ways. As a result, children, young people, and families will be clear about the impact of the support they are receiving. It will allow professionals to understand better the individual’s needs and ensure they are getting the right support, at the right time, and in the right place.

Healthy Lives, Vibrant communities, housing choices: a joint strategic approach to supporting people to live independently in Devon 2020-2025

Healthy Lives, Vibrant Communities, Housing Choices outlines our shared vision for empowering people to choose where they live. By working in partnership, it sets out how young people approaching adulthood, who may receive health and care support, will be supported to become independent adults through a diverse range of accommodation and support options that suit their individual needs. Find out more about the joint strategic approach here.

Devon NEET reduction strategy 2020-23

Devon’s Not in Education, Employment or Training (NEET) Reduction Strategy 2020-23 sets out the commitment of Devon County Council, alongside its partners, to ensure every child and young person has the best possible start in life and has the opportunities to realise their individual potential and thrive. Fundamental to this is providing high-quality, ambitious education and access to employment, training and apprenticeship opportunities as young people become adults.

The NEET Reduction Strategy is the framework by which we will deliver on the aims of the DCFP’s Children and Young People’s Plan to expand the life chances of children and young people in Devon.

Living well with a learning disability strategy 2018-22

Living Well with a Learning Disability is a joint strategy between Devon County Council, Plymouth City Council, Torbay Council and NHS Devon CCG. The document guides how we support people with a learning disability, including young people approaching adulthood, through a focus on promoting the independence of people with learning disabilities and helping people achieve the things that matter most to them. Our vision for Devon is as a place where people with learning disabilities are confident, resilient, and connected. We are doing this by:

  • ensuring there is appropriate housing that meets individual needs,
  • creating good employment opportunities,
  • improving access to healthcare, expanding community support for people with, learning disabilities to live as independently as possible,
  • making sure our communities are safe for people with learning disabilities, and
  • listening, hearing, and understanding what people and their families/carers are saying matters to them.

The Integrated Care System for Devon (ICSD) is a partnership of health and social care organisations across Devon working together with local communities across Devon, Plymouth, and Torbay to improve people’s health, wellbeing, and care. The ICSD, launched on 1 April 2021, marks an important milestone in the implementation of the NHS Long Term Plan to transform services and provide better outcomes for the population of Devon.

The vision of the ICSD is to see equal chances for everyone in Devon to lead long, happy and health lives. This involves an ambition to ensure that all children and young people in Devon have the best start in life, grow up in loving and supportive families, and are happy, healthy, and safe. The key strategic focus is on improving prevention and early intervention services, ensuring children and young people receive the right support, at the right time and in the right place.

The priorities for the ICSD will be published, in due course, within the Long Term Plan for Devon.

Healthy and happy communities: Devon’s Joint Health and Wellbeing Strategy 2020-25

Healthy and Happy Communities’, Devon’s Joint Health and Wellbeing Strategy for 2020 to 2025, was published by the Devon Health and Wellbeing Board in October 2019.  This strategy sets the priorities and overall direction for the Devon Health and Wellbeing Board and local health, care, and wellbeing organisations. It is the key driver for our priorities in improving public health across the county.

Our vision

Health Outcomes and health equality in Devon will be amongst the best in the world and will be achieved by Devon’s communities, businesses and organisations working in partnership.

Our principles

  • Prioritise prevention and early intervention across the health, care, and wellbeing system
  • Recognise and support the growing contribution and needs of voluntary, community and social enterprise organisations to improving health and wellbeing, and the role of the public in the continuing development of services
  • Recognise the diversity that exists across Devon, and respond to inequalities: those differences in health which are avoidable
  • Seek to ensure that Devon’s citizens have access to the information and support they need to stay well, and receive health and care services tailored to their needs when required
  • Adapt for the future by developing relationships and supporting partnerships across the community to support individuals and families with more complex needs
  • Develop the wider health and wellbeing workforce and embrace digital solutions.

Principles of joint commissioning

Commissioning refers to the process by which services are planned, purchased, and monitored[1]. Joint commissioning is where this is conducted in partnership, with the aim of improving overall outcomes and value for money. The SEND Code of Practice makes clear the responsibilities that health, care, and education services have to ensure that joint commissioning arrangements cover services for all children and young people with SEND aged 0-25 years old. Partner agencies are expected to work effectively together, integrating provision for children and young people with SEND, wherever it is deemed to best promote their wellbeing.

The growing scale and complexity of demand on public services, as well as continuing funding pressures, reinforces the imperative for commissioners to seek innovative and transformative commissioning partnerships that work to common purposes for the communities they serve.

We believe that services are best delivered and most effective when commissioning is rooted in the following principles. When we plan, commission, and deliver services in Devon, we will hold these at the core of all that we do:

  • Joint SEND commissioning acknowledges that supporting children and young people with SEND is everyone’s responsibility, beyond that of statutory services.
  • Joint commissioning has a focus on prevention and early intervention, with the ultimate goal of removing or reducing the need for that service itself.
  • Joint commissioning involves participation, engagement and co-production with children and young people with SEND, and their families and other key stakeholders.
  • That services are targeted to meet need, equitable and sustainable in their delivery and the outcomes they achieve.
  • Joint commissioning is rooted in both local and national evidence and focuses on the strengths, needs and interests of the populations it serves
  • Joint-commissioning is outcomes-focused, and its key objective is to improve the lived experiences, resilience and strengths of individuals, families, and communities
  • Joint commissioning aims to provide care and support that is as close to home as possible, where this is in the best interest of the individual and their family.

The Commissioning Cycle [54]

The joint commissioning cycle shows the three stages of; strategic planning, procuring services and monitoring and evaluation, which form the commissioning process. The complete cycle ensures services are efficient and effective in meeting the needs of local populations. As a result, commissioning activity secures services that offer good value for money and are of a high standard and quality. Cyclical commissioning processes also allow services to be flexible to meeting changing needs and demands, sustainable in the long-term, and equitable in providing care and support fairly to those who need it most.

The image shows the joint commissioning cycle as published by NHS

[53] What is commissioning and how is it changing? Published in 2019 by the King’s Fund

[54] Commissioning cycle, NHS England, available online at: NHS England » Commissioning cycle

Engagement

Every child and young person has a right to express themselves freely, and have their opinions heard and taken seriously[55] .The Devon Children and Families Partnership sets out in our Children and Young People’s Plan 2019-23 how services will listen, hear, and understand the voice and lived experience of children and families across Devon. In order to achieve the best outcomes, we aim to get under the surface of the root causes of issues and work in ways that build on the strengths of children and families.

On top of this, for children and young people with SEND, it is particularly important that they are directly involved and engaged in decisions that are made affecting their lives – both at an individual and a strategic level. Under the Children and Families Act 2014, there are clear expectations for us to “ensure that children, their parents and young people are involved in discussions and decisions about their individual support and about local provision”[56].

This section summarises what we have heard from children and young people with SEND and their families about their lives, experiences during COVID-19 and their thoughts on how local services can best support them.

Our vision for participation and engagement in Devon

Our shared vision is to provide children and young people with SEND, and their parents and carers, opportunities to participate in, engage with, and co-produce services, making sure their voice is at the heart of decision-making.

In Devon, we hold firm the belief that all children and young people should be able to express themselves as unique individuals, regardless of their background. Children and young people, particularly those from under-represented groups, disadvantaged backgrounds or those who may have an additional need which may prevent them from having their voice heard, have a fundamental right to be actively supported by services to participate in and engage with the services designed to support them.

Furthermore, we believe in the principle that when children and young people influence the planning, design, and delivery of services, the support we offer is made more effective as a result. That is why our SEND Strategy 2021-24 makes clear the importance of both building trust in SEND services across Devon, and ensuring they are co-produced with children and young people with SEND, and their families. We will:

  • Build trust by:
    • listening, hearing and understanding
    • doing what we said we would do, and keeping them informed
  • Provide opportunities to co-produce by:
    • working together to shape services
    • supporting them to make informed choices about the care and support they receive

Participation, engagement, and co-production lead to more trusted services that are more sustainable, equitable and effective in achieving better outcomes for children and young people as a result.

Strategic outcome

We want to see all children and young people with SEND in Devon empowered to have their voices heard and their individual needs and interests put at the heart of the decisions affecting their lives.

This will be measured by:

  • The number of children, young people, and parent carers involved in the co-production of services and strategic plans.  The number of children, young people, and parent carers we regularly engage with including groups of children with additional vulnerabilities and needs are heard.
  • Our ability to say, “you said, we did” and show the direct impact of the voice of children, young people, and their families in the ways in which services are designed and delivered
  • Children, young people, and their families report they have more trust and confidence in our services to deliver the improved outcomes for children and young people with SEND

[55] UN Convention on the Rights of the Child Article 12

[56] SEND Code of Practice 2014 Section 1.3, page 20

Developing our SEND Strategy 2021-24

To develop our shared vision and priorities for children and young people with SEND over the next four years, we engaged with children and young people with SEND, their families, carers, and professionals to make sure their voices were right at the heart of our strategic-planning.

This began with a workshop, held in July 2020, which was attended by parent carers, advocates for young people with SEND, and professionals from all service areas. The event identified the key things that we wanted to see happen both now and in the future for children and young people with SEND. As a result, a strategic vision was agreed, and emerging themes were put out to further consultation of young people, parent carers, and professionals in order to arrive at four proposed priorities. Two phases of consultation gathered over 500 individual responses, 30 of which were directly from children and young people with SEND, although many responses from professionals and parent carers were conducted alongside children and young people. Throughout the process, the two co-chairs of Parent Carer Forum Devon – representing hundreds of parent carers across the County – have been equal partners, alongside senior service managers, to co-produce the vision and priorities.

The following points are the key themes of the views gathered, which have directly led to the vision and priorities of the SEND Strategy and Joint SEND Commissioning Plan:

  • Building trust in SEND services is important in achieving the best outcomes for children and young people with SEND. Trust relies on keeping promises on what we say we will do and providing clear and consistent communication about the decisions being made.
  • Help and support must be given as early as possible; it should be easy to access and able meet the needs of the individual. The barriers to accessing services should be removed, especially for those who find it less easy to engage with services.
  • Children and young people with SEND should have their voice placed at the heart of all decisions that affect their lives. This should include strategic-planning and the decisions-made about individual support packages.
  • Improving life chances starts early with a good education that meets individual support packages.
  • Young people with SEND need better access to employment and training opportunities that support their individual needs, interests, and ambitions. This is especially important as we recover from the socio-economic impacts of the COVID-19 pandemic.
  • Communities should play a bigger role in supporting children and young people with SEND to become thriving, independent adults.
  • Different organisations and service areas should work together effectively, communicating clearly with each other and with children, young people, and families. This will lead to support being more consistent and reliable, where families do not need to tell their story more than once.
  • Sufficient capacity and resources are needed in all parts of the SEND system to address the needs that have been identified, particularly following the impacts of the pandemic.
  • It should be a lot quicker and easier to get an Autism Spectrum Disorder diagnosis assessment.
Women speaking through a loud speaker

The impact of COVID-19 on children and young people with SEND and their families

During the June and July 2020, senior leaders across the Partnership heard directly from parent carers of children with SEND, as well as advocates of children and young people from two special schools in Devon, about their experiences of living through the first national lockdown[57]. Their feedback is structured under the following four headings:

Return – things we can’t wait to go back to doing
The advocates of children with SEND told us they missed having as much contact with friends and wider family. They couldn’t wait to get back into their usual routines and being able to do all kinds of extra-curricular activities such as playing sports, doing arts and crafts, and developing different skills.

Parent carers said that they really missed having face-to-face contact with others, including some of their more informal support networks. This meant that they were not able to make new connections and friendships with others ad they may have otherwise done. They told us they looked forward to children with SEND being able to access the full school curriculum again, with EHCPs and SEN support being delivered.

Retain – things we want to keep on doing now that we have started

Having smaller groups in school with a higher staffing ratio, as a result of lockdown restrictions, was working really well for those children who were in school. This helped create quieter, calmer environments, with more wellbeing activities able to happen in school. For children attending school in person and for those at home, it generally meant more quality time was being spent with families and carers. While many children reported looking forward to having normal routines back, many also spoke positively of the opportunities for more flexible routines at home and at school. This increased opportunities for more independence over the activities to do and access to social media.

While parent carers said that they missed having face-to-face contact, they did say that having virtual meetings with other parent carers and communicating with them much more regularly online was working well and they wanted to keep that up in some form in future. This includes having more opportunities to being able to co-produce services. Parent carers made clear that they liked having more control over direct payments and wanted that to continue beyond COVID.

Resist – things we don’t want to go back to doing

Following what children and young people said that they really missed and wanted to go back to doing, they told us that they didn’t want to go back to having large classes and being away from their friends. They didn’t want to return to environments where there was sensory overload, including busy public transport and crowded public spaces. It was also expressed that the balance of schoolwork needed to be made better than it usually was before COVID; less work being done at home.

When restrictions are eased and ‘normal’ life begins to return after COVID, parent carers said they wanted to maximise the blend of virtual and face to face meetings – they didn’t want to go straight back to having all meetings conducted in person. They also made clear that they wanted to continue to have flexible guidelines and criteria for services that are far more family-centred. After COVID, services cannot return to struggling with a lack of capacity.

Radical – the things that we could do differently now and in the future

Children and young people said they generally wanted to have more flexibility and freedom throughout their lives. This includes the school routine having opportunities for more breaks, holidays, and time for exploring the outdoors. They also reiterated that having access to quiet spaces would be a really good thing to have after the pandemic.

Parent carers called for an increased use of family-centred approaches where support builds on what is already working well and seeks to find solutions to the things children and families are struggling with. They said that a re-design of SEND services around the family at the centre would be a radical solution to many of the problems felt today.


[57] COVID-19 and what next: the right to be heard

Ongoing participation and engagement arrangements

Parent Carer Forum Devon (PCFD) is an organised group of parents and carers of children and young people with Special Educational Needs and Disabilities (SEND). The group’s aim is to ensure the voice of parent carers is heard and that services meet the range of diverse, varied, and individual needs of children and young people with SEND.

Logo of Parent Carer Forum Devon with the caption: Connect, Empower, Influence

The two co-Chairs and Steering Group of PCFD engage with the Forum’s 300+ members online through their website, social media, and regular newsletter, as well as meeting together regularly and hosting events such as Q&A sessions. PCFD allows parent carers to work collaboratively with Commissioners and Operational Managers across Health, Care and Education to ensure services have the lived experience of children and families at their heart. To date, the co-Chairs of PCFD have supported the design of the SEND Transformation programme, the DCFP’s COVID response and recovery strategic plan, services for children with autism, the 0-25 service’s EHCP charter, Children and Families Health Devon transformation programme, and the Disabled Children’s Service Short Breaks offer.

PCFD currently receive an annual grant jointly from Devon County Council Children’s Services and CCG to support their core functions. They also receive funding from a national allocation for Parent Carer Forums, which is administered directly from the DfE.

PCFD and Devon Information Advice and Support (DIAS) currently run an Ambassador Volunteer project which recruits and trains a network of parent carers within communities across Devon. Ambassadors work in their local communities to direct families to the right advice and support through local DIAS services when they need it. Ambassadors also play a key role in expanding the network of PCFD, enabling more parents, carers, and families to share their views about services in Devon and be directly involved in decision-making through the Forum. While the current DfE funding for the project is due to come to an end on 31 March 2021, additional resource has been secured from Devon County Council to maintain current levels for a further two years.

Devon Information Advice and Support (DIAS)

DIAS provide information, advice and support for children and young people with SEND up to the age of 25, and their families and carers. The service provides help and guidance throughout a child’s life, including through further and higher education, employment, and adulthood. Advice and support is offered through signposting, online information, by email, telephone and through face-to-face sessions.

DIAS is a statutory service jointly commissioned by Devon County Council (Social Care and Education) and Health (CCG), providing independent and impartial advice to children and young people and Families. Its reference group, made up of parents, carers, and professionals, supports the growth and development of the service throughout the year.

In the last 12 months, DIAS supported over 1500 young people and their families. Their offer was adapted during the pandemic to meet the changing needs of families in the context of lockdown restrictions and the impact on service delivery. These changes were well-received by families.

Champions for Change

Champions for Change is a network of children and young people with SEND across Devon who work with us to make their voice heard and improve services as a result. The group meets regularly throughout the year to discuss the different aspects of their lives, as well as participating in engagement events, projects, and activities. The Devon County Council Participation Team directly supports the work of Champions for Change through a dedicated FTE Participation Officer post, which is built into the existing structure of the team. There is no additional funding that the Champions for Change currently receives.

During 2021/22, we will support Champions for Change to develop a network to connect with other groups of children with SEND and to meet in multiple locations across Devon. Champions for Change are also due to meet with Youth Parliament and develop joint ideas for campaigning on Climate Change.  As we learn to live with COVID and make use of some of the opportunities it has brought us, we will build on some of the positive experiences of the virtual delivery of some meetings and events. While we understand the importance of face-to-face interactions for children and young people with SEND, the virtual delivery of participation and engagement activities will enable us to expand our reach to some children and young people who ordinarily would not be able to attendmeetings in person.

We will continue to work with schools and bring more mainstream schools into the Champions for Change network. We will also collaborate with DIAS to guide young people, who approach their services, to Champions for Change when it is felt the individual is keen to engage and have their voice heard.

The image shows three young people, who are members of our Champions for Change group, sat down and holding their arms up with their flat palms facing forwards.  The image is accompanied by the word ‘Listen’ in capital red text.

Stand up Speak Up

Stand up speak up logo

Stand Up Speak Up is Devon’s service to ensure our children in care and care leavers have space to express themselves, have their voice heard, and make a difference. Devon County Council’s Participation team run regular groups, sessions and meetings with children in care and care leavers in all four localities in Devon. This includes engaging with children in care and care leavers who also have special educational needs and disabilities.

Space Youth Services for children and young people with SEND

Devon’s youth service is commissioned by Devon County Council and delivered by Space. They offer a universal youth service for all young people and provide a number of regular sessions dedicated to young people with mild to severe disabilities from two of their youth centres in Devon. Space aim to increase this to being all of their centres by 2025. Space currently have an online offer for young people with SEND, aged 11-19 years of age, called ‘no blocks’. As of Spring 2021, these run twice weekly, and aim to create safe spaces for young people to have fun and meet new people. They are also improving the skills, knowledge, and competency of all their staff in supporting young people with SEND, including neurodevelopmental needs.

While the majority of the work of Space is not directly aimed at supporting children and young people to exercise their right to having their voice heard, they offer inclusive and engaging spaces for children and young people with SEND to meet together, have fun, and be able to express themselves. In addition to their regular activity, Space may be requested to conduct one-off pieces of specific engagement on certain issues with the young people that use their service.

Adult Health and Care Involvement team

The Adult Health and Care Involvement team routinely listens to what matters to young people, and their families and carers. Their voice guides the development and reviews of our strategic plans and the delivery of services and support. We challenge ourselves continually to ensure we are always opening up opportunities to listen to what matters to an expanding and diversified range of young people, families, and carers.

Throughout the COVID-19 pandemic, we have adapted our approach to engagement through the Learning Disability Partnership Board, Autism Involvement Group, Carer Engagement Forum and NHS Participation groups. We have embraced dynamic and flexible approaches to reach out to more people with SEND and listen to what matters to them. As we begin to move out of our immediate pandemic response phase, we will be putting into practice what we have learned over the last 12 months.

To support the delivery of the SEND Strategy 2021-24 and the SEND Transformation programme, we will provide opportunities to co-produce through:

  • Working in together with the children’s services Participation Team to increase opportunities to engage with young people and young adults with SEND under the age of 25 through all of our engagement groups.
  • Building on the range of approaches to participation and engagement, that were developed during the pandemic, to increase the number of young people and young adults with SEND we are in touch with.
The image shows a cartoon of lots of different people. The people are different genders, some have physical disabilities, they are from different ethnicities and are different ages.

Engagement with Health Services

NHS Devon Clinical Commissioning Group provides a grant to the three Parent Carer Forum organisations in Devon, these are Parent Carer Forum Devon, Plymouth Parent Carer Voices and Torbay Parent Carer Forum.

Within the Children’s Community Health and Wellbeing Services contract, commissioned by the CCG, engagement with children, young people, and their families is required and evidenced.

The Children and Women’s Team from NHS Devon Clinical Commissioning Group in response to the COVID pandemic met regularly with the three Parent Carer Forum organisations in Devon. Initially, this was aimed at creating and reviewing frequently asked questions about health services during COVID, but the group reflected on the benefits of this model and, as a result, a monthly open agenda meeting has been set up between the Parent Carer forums and the CCG.

Parent Carer Forums are also represented at the following groups:

  • Health Reference Group

A meeting for all health providers across Devon, Torbay and Plymouth focused on SEND.

  • Autism Spectrum Disorder Stakeholder Group

A meeting set up following the Devon SEND inspection in 2018 to improve the delivery of services for children and young people with autism.

  • Child Health Collective

A meeting for all Torbay and South Devon Foundation Trust facing services, including commissioners, providers, public health, and Primary Care. Both parent carer forums for Devon and Torbay are invited to attend and be involved in emerging pieces of work.

As well as membership on recurring groups, specific projects also engage with children, young people, and their parent carers. For example, Parent Care Forums have been directly involved with the development of the Key Worker Project, autism waiting-lists and annual health reviews. Participation Workers, who work with Children and Young people, are also involved with a range of engagement activities. For example, talking to children and Young People through CFHD’s Young Leaders group, which is run alongside Young Devon.

What we will do

  1. Develop a quarterly your said we did publication to go on to the Local Offer and partnership webpages
  2. Increase involvement of the Parent Carers Forum within the groups lead by NHS Devon Clinical Commissioning Group Women and Children’s Team.
  3. Hold monthly open agenda meetings with the Parent Carer Forums.
  4. Engage with parent/carers and children/young people regarding improvements to Children and Family Health Devon Autistic Spectrum Disorder waiting list.
  5. Co-produce the refresh of the Devon STP Autism Strategy with children and families
  6. Co-produce and design the implementation of the Devon-wide Housing Strategy
  7. Co-produce the re-design of the autism pathway
  8. Engage with parent/carers and children/young people in the development and evaluation of the Devon Key Worker Project.
  9. Engage with parent/ carers and children and young people in the review of the equipment and adaptations offer
  10. Co-design the future short breaks offer and Direct Payments and Personal Budgets Policy
  11. Engage with parent/carers and children/young people regarding Annual Health Reviews
  12. Co-produce the SEND health frequently asked questions.

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