Joint SEND Commissioning Plan 2021-2024: Introduction
Contents
Introduction
Every child and young person in Devon has the right to the best start in life and the opportunity to thrive. This means that all children and young people should have access to the right support, at the right time, and in the right place. The Devon Children and Families Partnership (DCFP) is committed to achieving this. Our shared ambitions for how we aim to do this are set out in the Children and Young People’s Plan 2019-2023.
More information about the local and national strategic and legislative context can be found in the appendices.
Devon SEND Strategy 2021-24
In 2021, we published our strategic intentions to improve outcomes for children and young people with special educational needs and/or disabilities (SEND) in Devon. Co-produced with parent carers, young people with SEND and professionals in children’s services, education settings, healthcare providers, commissioners, voluntary and community sector organisations, the SEND Strategy 2021-2024 sets out our ambitions for all children and young people with SEND in Devon over the next four years. Along with the Children and Young People’s Plan, they guide our intentions for joint SEND commissioning in Devon. Joint commissioning is a process of shared planning, delivery, and reviewing of services together with children and young people, parent carers, and all partners.
Living with COVID-19 and what next?
Devon’s SEND Strategy and Joint SEND Commissioning Plan come at an important time for children and young people with SEND. Over the course of 2020-21, children, and young people with SEND and their families have experienced substantial disruption to their health, care, and education support, as well as their everyday lives, as a result of the COVID-19 pandemic. As part of our strategic partnership response to COVID-19[1], we heard directly from families, carers[2] and children young people, who told us about both the positive and the negative impacts of the pandemic and lock-downs. It is important to recognise the exacerbating impact on inequalities of COVID-19. Nationally, young adults with learning disabilities (aged 18-34 years old) have been 30 times more likely to die of COVID-19 than others their age[3]. In addition, families of children with SEND already being more likely to experience socio-economic disadvantage[4]. During the pandemic, we adapted the ways we worked to ensure we were reaching the most in need and being flexible in how we offered support. A continuation of face to face support was important for many children and families and, for most children with an EHCP, as was the continued access to attending school in person. The increased use of technology and the digital service offer has been very well-received and has enabled continued support to more children and young people.
Locally, many children reflected positively on having reduced class sizes and fewer movements and changes during the day. For some, they were happier during lockdown with quieter public spaces and more time to spend at home. However, for many others, the restrictions added pressures onto their emotional wellbeing and increased levels of anxiety[5]. Schools are considering how the learning from this can change the school day in the future.
[1] ‘Our Lives with COVID-19’ is the DCFP’s strategic response to the impacts of COVID-19 on children and families in Devon. It is based on extensive feedback, operational learning, local data and intelligence and national evidence following the first national lockdown
[2] In June 2020, the co-chairs of Parent Carer Forum Devon presented to the DCFP on their experiences during the first lockdown. Further information on the views of children and young people with SEND and parent carers can be found in appendix 6.0
Our Commitment to Listen, Hear and Understand
The Devon Children and Families Partnership are committed to listen, hear, and understand[6] the views, interests, and experiences of children and young people with SEND. Listen, Hear and Understand[7] are the principles developed by the Champions for Change – an engagement group in Devon for children and young people with SEND. They were adopted across the Devon Children and Families Partnership (DCFP) in 2019 and form the foundations of the Children and Young Peoples Plan and the SEND Strategy. We are committed to ensuring co-production and the voice of children and families is at the centre of all our commissioning and how we deliver services.
We will continue to make sure sufficient resources are available to support parent carers and family members of children and young people with SEND to be heard. NHS Devon Clinical Commissioning Group (CCG) and Devon County Council continue to commit, for 2021/22 and beyond, to fund the Parent Carer Forum (PCFD) in addition to the Department for Education Grant received by Forums. In 2021, the PCFD moved to be a Community Interest Company and formed a self-sustaining committee. The work of the PCFD has been phenomenal before and during the pandemic, with their membership now exceeding 400 parent carers. More details on our shared ambitions for participation and engagement can be found in appendix 5.0. The views of parents influencing the priorities of this plan can be seen in each section.
[3] “Deaths of people identified as having learning disabilities with COVID 19 in England in the spring of 2020” Public Health England, Nov 2020. https://www.gov.uk/government/news/people-with-learning-disabilities-had-higher-death-rate-from-COVID 19
[4] Sam Parsons & Lucinda Platt, “Disability among young children: prevalence, heterogeneity, and socio-economic disadvantage”, Institute of Education, University of London (November 2013)
[5] More information about what children and young people with SEND, and their families have been telling us about their experiences during COVID-19 can be found in appendix 6.0.
[6] Published online at: Get involved – Devon Childrens’ and Families Partnership (dcfp.org.uk)
[7] Find out more about what Listen, Hear, Understand means on the DCFP website: Get involved – Devon Childrens’ and Families Partnership (dcfp.org.uk)
Key Shifts in 2018-2021
Over the last three years, a number of key shifts have been taken to fundamentally change how we deliver SEND services in Devon. These all have important strategic implications for commissioning and part of our continued journey to improve and integrate delivery to achieve better outcomes for children. This plan should be read and considered in the context of these changes.
Community Health and Wellbeing Services
In early 2018, NHS Devon CCG and Devon County Council set an ambitious plan to re-design and transform the delivery of Community Health and Wellbeing Services for children and young people. The strategy which set out these ambitions was shaped by considerable feedback and engagement with parent carers and children. In April 2019, the 7-year contract to provide Community Health and Wellbeing Services was awarded to an alliance of partners ‘Children and Family Health Devon (CFHD)’. This was jointly funded through a Section 75[8] funding agreement. Its key priority is to improve and integrate services to better support for children and young people with emotional wellbeing and neurodevelopmental needs. This is being delivered through an integrated service model rooted in the THRIVE[9] framework of ‘getting advice, getting help, getting more help, and getting risk support’. At the same time the Early Years Complex Needs Service, Rehabilitation Officers for Visually Impaired Children’s (ROVIC’s), four short breaks childrens homes and the public health nursing service were transferring into direct delivery of the Council.
The delivery models of these services are based on the THRIVE framework. This aims to shift away from separated clinical interventions to a holistic and multi-disciplinary approach. An example would be to provide children who experience lower-level anxiety and low moods early advice and support.
Responding to children with neurodevelopmental needs is set out through collaborative working between CAMHS and Autism service teams as an expectation. Similarly, integrating therapeutic responses between Occupational Therapy, Speech and Language Therapy and Physiotherapy teams is also a specified development. The impact of this is will be the earlier identification of individual needs, especially where they co-exist, and earlier support being provided for children and young people with SEND to reduce the escalation of need. These changes to local services underpin the ambitions in this plan to support children with neurodevelopmental needs, support the emotional wellbeing and mental health of children and young people with SEND, and create inclusive education spaces from which pupils with SEND can learn and develop.
[8] Section 75 of the NHS Act 2006 allows NHS CCGs and local authorities to pool budgets to commission health and social care services jointly to meet common aims
[9] Wolpert et al. “The THRIVE Framework for system change”, The Anna Freud Centre, 2019
In 2020, Children and Family Health Devon (CFHD) restarted a transformation of Autism Services. This has inevitably been impacted by COVID-19 through 2020 and early 2021. The review has led to substantial changes to the Autism team which have been implemented during Spring 2021.
The delivery of the strategic priorities that shaped the re-commissioning of community health services continue today with our performance data showing a worsening position in some key services such as autism, speech and language therapy and occupational therapy. Parents are telling us about the negative impact on their children from the length of time waiting for support. This plan sets out the priorities to improve this.
Giving children the best start in life
In April 2019, Public Health Nursing (PHN) Services were in-sourced to Devon County Council from Virgin care. At this point, a programme began to integrate pathways and processes across PHN, Childrens Centres and Maternity services under the umbrella of Best Start in Life. Through an integrated offer, there is greater opportunity for reaching infants and young children with SEND and identifying needs at a much earlier point in their lives. At the same time, the Specialist Early Years’ service for children with complex support needs[10] was insourced.
SEND Transformation
In 2020, Devon County Council, Devon CCG, and their partner organisations launched the SEND Transformation Programme. The Programme aims to transform the way services are delivered for children and families and is fundamental to achieving the aims of the SEND Strategy 2021-24. Phase One and Two of the programme, underway throughout 2020 and Spring 2021, set out the work to co-design an integrated SEND service and a guiding Strategy for the next four years. Finalising the re-design of SEND services is scheduled for Summer 2021, with implementation from the Autumn and Winter of 21/22.
Education and Inclusion Services
Support for children and young people with SEND in education settings is commissioned by Devon County Council (Education and Learning) through the Education and Inclusion Services contract with Babcock LDP. This includes all support services to education settings and includes Educational Psychology services and a wide range of SEN support services, including Social Emotional and Mental Health (SEMH), sensory impairment, communication and interaction and physical difficulties. The outcomes for the service are to promote high quality inclusive SEN provision through the effective implementation of a graduated approach across the whole continuum of need, for all children and young people with SEND. This is done by providing advice, support, and challenge to all settings (early years, schools, and Colleges) in order to implement and comply with the SEND Code of Practice (CoP)[11] and SEN provision including use of SEN funding is appropriate, delivery of and quality monitoring of advice and reports and provide statutory advisory teacher provision equitably across Devon. The service also offers a traded element to schools for additional expertise to meet childrens needs.
[10] Devon Portage Service is an early years education service for children with significant or complex developmental delay ad is affiliated to the National Portage Association.
[11] The Code of Practice is statutory guidance which outlines the duties and responsibilities of organisations who work with children and young people with SEND.
As part of the wider SEND Transformation, and in response to public consultation Devon County Council’s Cabinet, on 10 March 2021 it was agreed that Education and Inclusion services would be brought into the direct delivery of the Council from 2022 when the current 10-year contract ends. The transfer of these services into the Council’s wider Education and Learning services will enable the full integration of SEND services and the delivery of key statutory duties, as outlined in the vision of the SEND Transformation.
Joint commissioning intentions
Our intentions for joint commissioning and the outcomes for children and young people are rooted in what children, young people and families have told us matters most to them in life, and where there remains a lack of progress in the quality and effectiveness of support. The six key areas below have focused on our priorities for change, while comprehensive, do not intend to provide a full overview of all commissioned services. This can be found in the SEND Local Offer – How Children and young people can get involved.
The Devon Children and Families Partnership have a Joint Commissioning Group (JCG) who oversee the joint commissioning arrangements and ensure the priorities of the Children and Young People Plan are delivered. This includes representation from Children’s Services, Adult Services, Economy and Skills, Public Health, NHS Clinical Commissioning Group (CCG), Office of the Police Crime Commissioner (OPCC), Communities team and District Councils. As part of the joint commissioning arrangements, there is a Section 75[12] funding agreement in place for the joint commissioning of Community Health Services and Short Breaks and a Section 10 agreement in place with NHS England for the joint commissioning of health within the Secure Children’s Home in Devon, Atkinson House[13]. The Devon Independent Living Service is jointly commissioned between Adult’s and Children’s Services in Devon County Council and the CCG through the pooled budget of the Better Care Fund (BCF). In addition to these arrangements, we have joint funding arrangements and decision making as set out later in this document.
We have longstanding sub-regional collaborative arrangements in place for the joint commissioning of placements for children in care and these assist us in developing the market and quality assuring provision. We also work collaboratively with Plymouth and Torbay Councils, through our Sustainability and Transformation Planning (STP) arrangements, to review and plan services for children with learning disabilities, autism, emotional wellbeing and mental health needs and speech language and communication needs. These arrangements are transitioning into the new NHS Integrated Care System (ICS)[14] arrangements and the delivery and programme model of the NHS Long Term Plan (LTP)[15]. Through this, we will deliver our continued commitment to the priorities and outcomes set out here and in our SEND Strategy.
[12] Section 75 of the NHS Act 2006 allows NHS CCGs and local authorities to pool budgets to commission health and social care services jointly to meet common aims
[13] Atkinson Secure Children’s Home – Atkinson Secure Children’s Home (atkinsondevon.org)
[14] NHS England » What are integrated care systems?
[15] NHS Long Term Plan
Summary of our joint commissioning priorities for 2021-24
The following priorities will ensure we achieve the aims of our SEND Strategy. An action plan will be developed against the priorities in the following sections and progress will be reported annually through the Devon SEND web-pages:
- Children and Young People are fully engaged in their education and local community
Our priority for improvement is the further development of short breaks in line with feedback from parents, carers and children young people. In addition, further development of the response from universal services and expanding inclusive community activities for children with SEND. - Early access to services means children and young people are thriving and resilient. Services for needs such as autism, speech language and communication or social, emotional, and mental health needs are delivered at the right time.
- Autism: Address waiting times for diagnosis and develop a multidisciplinary continuum of support to include specialist family support, community intervention and assertive outreach offer.
- Speech language and communication: Address waiting times and sustainability of the capacity of SALT’s to respond to the needs of the population. Further develop training and skills in early help and education workforce and look beyond social and emotional needs to better identify unmet SLC needs.
- Annual Health Checks: deliver these in line with the ambitions of the NHS Long term Plan by increasing the uptake of AHCs to 67% by 2020/21 and to achieve 75% by 2023/24 among people with learning disabilities, from age of 14 to 18.
- Social Emotional Mental Health: develop the Community Mental Health framework to ensure an offer for 18-25 for young adults with SEND and Care Leavers (including those with SEND needs). Evaluate the emotional wellbeing in schools offer to better meet need early.
- Children receive early and effective support to prevent a crisis. If Crisis Care is needed this is provided as close to home as possible: Develop crisis provision for young people with learning disability and or autism. In addition, better use community intervention and assertive outreach to prevent escalation to crisis
- Children and young people are fulfilling their potential and achieving their goals. Planning for adulthood begins early and is based on young people’s individual needs, interests, and circumstances:
- Develop wider offer of accommodation options particularly specialist provision for young adults with Learning disabilities and or autism, resolve access to community therapies for young people 18-25 where pathways are not determined or there are gaps in provision.
- Children and young people are fulfilling their potential and achieving their goals. Children and young people access local, work and training opportunities:
- Through access to government funded programmes addressing youth unemployment, ensure priority is given to young people with SEND to address the increasing risk of not being in education employment or training as a result of widening inequalities due to the pandemic.
- Children and young people are fulfilling their potential and achieving their goals. Children and young people access local inclusive education:
- Through the insourcing of the education and inclusion services deliver on the integration opportunities in line with SEND Transformation. Deliver on the additional emotional wellbeing support to children in school to support return to learning. Develop more robust frameworks or the delivery of alternative complimentary education, resource basis and tailored support to promote inclusion and return to school. Expand and make sustainable access to community therapies to support inclusive education.
- Funding and Decision Making:
- We will review, streamline and integrate decision making panels and further develop pooled budget arrangements.