Recommendations
- Develop a joint commissioning strategy which addresses the following across all our partnerships
- Improve how we use data across the system to map and model service delivery and demand so that planning is improved
- Improve communications between all levels of the system
- Ensure that all children have the opportunity to reach their full potential including developing the workforce
- Further develop the governance system to oversee the implementation of these recommendations
Develop a joint commissioning strategy which addresses the following across all our partnerships
Rationale for recommendation
The SEND system is a complexed one, which has numerous partners with different accountabilities. To ensure that service planning and provision comes together to effectively support children and the services which support them, a joint commissioning strategy should outline the key actions and responsibilities to ensure provision is joined up using the latest data, intelligence and feedback from service users and their families.
We have invested additional money into Autistic Spectrum Disorders (ASD) assessments, we still do not have enough assessments, and Attention Deficit and Hyperactivity Disorder (ADHD) has not had the same investment as ASD and so those waiting lists remain high. We need to understand the current demand, and commission a model of assessments that is flexible to meet the needs of children, young people and adults.
Actions
Consider increasing the provision of services to meet the increasing numbers of children, young people and adults requiring treatment
- Continue to implement the Speech and Language therapy service redesign
- Continue to implement the review and increase commissioning of Short Breaks in collaboration with Parents, families, and children with SEND to ensure that there is a wide range of opportunities for children with SEND that parents can access
- Consider the design of Physiotherapy/Occupational Therapy provision. We need to look in depth at who is providing what and ensure that the level of services is adequate for the current level of children requiring Special Educational Need support
- Ensure that a diagnosis does not become a barrier to accessing support for conditions which all children have a right to access at the same time ensure unmet need doesn’t lead to additional children requiring SEND support
- Consider whether children in special schools fully access the resources in mainstream schools, particularly around health education
- By bringing organisations together to commission services together, we have an opportunity to reduce duplication, improve multidisciplinary working, understand better any blocks across the whole system and work together more effectively to address these blacks.
- Consider redesigning the continence service for children with disabilities.
- Consider benchmarking service provision between our services and those of our statistical neighbours.
Improve how we use data across the system to map and model service delivery and demand so that planning is improved
Rationale for recommendation
Changes in demand can be impacted by many things, system leaders should use the latest data, information, and intelligence to ensure that the direction of SEND strategies and the services they oversee are performing in a way that maximises the intelligence we have. Developing a dashboard which brings that data, information and intelligence will give the SEND board an effective overview of programme of work ensuring problems can be identified early and changes to strategic direction can be implemented in a timely way.
Actions
- The Integrated Care Board (ICB) to lead work across the NHS and other partners to improve data sharing, ensuring that the SEND board gets the data it requires to make timely and effective decision making
- Collect ethnicity data for those taking up/not taking up funded 2-year-old early years entitlement placements. Consider what else can we do to encourage uptake of a funded place when this is not statutory
- Consider how we can capture repeated absences and children missing from early years setting, as this gives an indicator for how school ready children
- Explore the disparity in outcomes will be data between 2 year Health Visitor check and the preschool checks in more depth, ensuring quality checks across the system, integrate checks where appropriate, building on the current pilot
- Consider collecting the SEND status of a child when referrals are made to secondary/community services such as Child and Adolescent Mental Health Service (CAMHS), this could include making the link between all ill health acute admissions and SEND
- Understand whether the Mental Wellbeing Tier 2 service is supporting children with SEND effectively to prevent the need for tier 3 services
- Consider if there is a potential to link and then use the education number and NHS number so the records talk to each other
- Update the data supplement on a 2 yearly cycle.
- Consider how we might use data to explore the complexity of SEND children within Coventry
Improve communications between all levels of the system
Rationale for recommendation
Communication is key to ensuring that individual families get the support they require.communications is good, but as always communication can be improved, and occasionally better communication would improve outcomes for children with SEND and their carers. Communication between services, from service providers to commissioners could be enhanced to improve outcomes.
Actions
- Explore whether multidisciplinary team meetings could be used to ensure that services are joined up and focused on the child's need, develop a “Best interest” style meeting that is inclusive
- Improve communication between all partners, and especially those who work on the frontline ensuring that all professionals can deliver the right care at the right time.
- Consider how schools can support the uptake of the annual Learning Disabilities health check once children become 14 years old
- Explore how we could improve partnership working around the annual reviews.
- Ensure that interpreters understand the role they play in ensuring accurate data captured
Ensure that all children have the opportunity to reach their full potential including developing the workforce
Rationale for recommendation
Sometimes, children could have their learning needs identified earlier, thus ensuring that the support that a child receives works to ensure each child reaches their full potential. We believe that the earlier an issue is identified the more effective our services are, so we aim to identify all children who would benefit from SEND support as early as possible.
Actions
- Explore which children do not take up the free nursery offer for 2-year-old education offer, understand what influences parents to take up this offer
- Explore the impact of the increased universal entitlement to funded early years education on SEND children from April 2024
- Ensuring that parents from ethnic minority groups are helped to understand SEND so that they recognise the benefits of taking up the support offer, with work to support parents from black heritage backgrounds and Asian backgrounds.
- Look at how we support the link with portage and Nursery placements to improve uptake of nursery placements by children with SEND
- Understand further which parents take up private assessments and how we can support such assessments, making sure parents are clear about what the Coventry position is around such assessments
- Upskill the workforce to ensure that all staff, from any sector are supporting the child in the right way, so that care is consistently being delivered in all settings
- We need to increase the skillset of staff so that there is capacity to provide ongoing workforce development for early years settings. This work has started, but we need to go further
Further develop the governance system to oversee the implementation of these recommendations
Rationale for recommendation
Having a good system of governance around the SEND agenda will enhance communication between partners, ensure that issues and changes we need to make have a clear and agreed place to gain understanding and resolution. We want all our children, families, services and staff to be confident that there is a transparent and understandable way in ensuring our offer is joined up, understood and monitored effectively.
Actions
- Further develop an inclusion dashboard across all partners so that the data elements are readily available and review on a regular basis by SEND board.
- Formalise the links between the Children's Joint commissioning group and SEND Board through the Health and Wellbeing Board.
- Hold systems partners to account for performance.
- Ensure that all partners across the SEND board are sighted on issues which need addressing so that a collaborative approach to problem-solving is adopted.
- Develop a quality assurance framework so that standards and improvements can be noted.