Agenda item

Sarah Callaghan, Director of Education and Skills, Lancashire County Council and Zoe Richards, Senior Programme Manager for SEND, Lancashire and South Cumbria provided an update on the Accelerated Progress Plan.

Following suggestions at the previous meeting, that members would find it useful to have some more detail on the data that is used to shape the response in the Accelerated Progress Plans, a presentation, Lancashire SEND Data Dashboard, had been circulated to members of the Sub-Committee prior to this meeting.  The presentation aims to give an understanding on how the data is used and also the process behind the data.

One of the areas that is subject to ongoing monitoring is that Leaders have an inaccurate view of the experience of children and young people with special educational needs in Lancashire, therefore the application of data is really critical for that better understanding. To facilitate a better understanding, Sarah presented some data on children and young people with SEND in Lancashire to the Sub-Committee.

Slide 2 – This indicated how many children and young people across Lancashire have special educational needs, as a percentage of those children who attend school.  There are 176,456 total pupils at all schools and of that number, there are 17,705 pupils who have SEND support and 8,085, that have Education, Health and Care Plans.  The reason for highlighting this is that typically in Lancashire the percentage of children with Education, Health and Care Plans hovers around 3.4%, which is in line with national figures, however, in contrast to national figures is that the number of children with SEND in special schools which is higher in Lancashire than the national figure.  The aspirations of the SEND Reforms that were introduced nationally in 2014, was to enable a higher number of children with special educational needs to stay in mainstream schools, as this is better for them in terms of their ability to develop life skills, and it prepares young people with the life skills to be more independent.  It is not always appropriate for all young people with SEND to be in mainstream schools but where it is possible that has to be our ambition as it supports better outcomes and it is often more cost effective. 

The Council's ambition is about supporting the best outcomes, so to enable those children with special educational needs to stay in mainstream provision where appropriate, is what the Council wants to do.  The data also included a breakdown of children with SEND who are also electively home educated, currently 62 children with special educational needs, are Electively Home Educated, this is where parents/carers have made the decision to education young people at home.  In total across the County there are approximately 1700 children and young people who are Electively Home Educated and 62 of those have Education, Health and Care Plans.  In comparing this data with national and Lancashire's statistical neighbours, anomalies can be identified, and discussions prompted where it appears that the Lancashire data is at odds with other areas.

Slide 3 - The Sub-Committee were presented with information and data on broad areas of need, comparing local and national information of mainstream primary and secondary schools.  The data is a starting point for discussion and the information is being considered against national and statistic comparators to show how Lancashire compares to similar areas.  This data helps health to demonstrate the understanding of prevalence of needs in non-mainstream, alternative and independent provision so that the right type of provision can be developed in response to growing need,

Slide 4 - The Lancashire SEND Partnership Data Flow graph detailed the different soft and hard data sources are collated and analysed and through this analysis officers are able identify which "deep dives" are required if any.  So, for instances, if a particular type of need is growing at a much faster rate in Lancashire than our statistically comparable neighbouring Local Authority areas, we can look at what might be driving this anomaly.  Understanding the patterns of need then shapes the commissioning of services that are co-produced and co-designed to support children and young people.  In this way, it is a continuous cycle of understanding and testing of data with some of the qualitative studies and soft intelligence from schools and parents and carers, which combined, help shape the commissioning of the right support to meet the different needs across different areas of the County.

Zoe Richards presented the following slides:

Slide 5 – This demonstrated the rounded narrative of which the data flows.  In relation to the Accelerated Progress Plan there were specific actions that were needed to be taken by December 2020, March, July and September 2021 and information on this slide gives the information of where the plan is currently at.

The blue scrolls indicate the five documents that are in place for the duration of the work that has been done to date, in the first six months of the Accelerated Progress Plan.  The documents are:

·  Accelerated Progress Plan

·  Revised Autism Spectrum Disorder (ASD) Pathway Definition – this is now being adopted.

·  Reviewed and revised Joint Commissioning Framework – now approved and is being used.

·  Developing Co-Produced SEND Plan 2021/25 – at the early stages of development and will inform how work carries on beyond the Accelerated Progress Plan.

·  Approved Integrated Care System (ICS) Bowel and Bladder Framework (continence) – as of the 9 March 2021.

96% of Leaders scored 100% in the SEND Board quiz which was above the target set for December 2020, and another quiz has been carried out in March and analysis on this is being carried out currently.  Early results are showing again, the March figures will be above target for Leaders.

The red shapes on the diagram relate to the Local Offer and the £20k NHSE (NHS England) funding that was received to improve health input through co-production and work has started immediately in terms of working with families around health input.  A survey has been shared with families as part of the Local Offer Social Media Awareness Campaign has had a high response rate, with over 90 responses in five days and the quality of the feedback has been really high.  59% of people are using the Local Offer and by being on the website they do find information they are looking for and find it useful to their needs.  There is still a need to improve the navigational aid in user interfaces on the webpage (breadcrumbs) and this is the next piece of work to be undertaken.

The orange shapes are about the Workforce Development and there is one Draft Strategy which is crucial in ensuring that Leaders have a good strong understanding of the local area.  As part of this, Zoe has attended various virtual Team meetings, where 244 people had attended the "SEND is Everyone's Business" briefings which has had a positive effect and requests to deliver more sessions have been requested.  It was also noted that three staff are on the SEND Leadership Programme and feedback has been that there is a lot of learning from it and being implemented within Lancashire.

The teal green shapes relate to transitions in health care and 20% of young people have had a good or very good experience of transitions, which is disappointing, however, as this is the baseline, it is indicative of that fact that local area is known and work that is being done with the providers have indicated that this is not an accurate picture and verbal feedback that has been received from those who have transitioned are saying it has been a very good experience.  Therefore, from the 1 April 2021, there is a new survey approach and it will identify which provider, who will be encouraged to pass the survey on when somebody has had a transition appointment.  Another piece of work that has been identified through the £20k NHSE funding is to create a 90 second video for practitioners on the Local Offer, so families can watch it and will empower them to go to appointments and be a part of it.  All providers have agreed to the transition model and transition pathways and 30% of 14 year olds have indicated that they have a transition plan.

The grey circle indicates that 100% of all schools know the name of their Public Health School Nurse and is now on the Portal and a presentation has been sent to the them and Karen Gosling, Senior Public Health Practitioner, Lancashire County Council, will attend a Headteachers meeting to present it to them.

The green shapes all relate to the Autism Spectrum Disorder (ASD) and is a good example of the approach used for data flow which is proving to be incredibly powerful.  An improvement has been made to the waiting list, however it will be difficult to have every area at zero, due to continuing increasing numbers of children and young people who are referred onto the waiting lists, however there are three funded ASD Waiting List initiatives across the area.  50% of those who have gone through the process and had ASD support throughout the pathway, were happy with that support, however there is more work to do on this and ensuring that work that is done from within health, is matching what parents want.  80% of people are saying they are happy with the ASD assessment and with the outcome and 100% have had a first contact appointment offered, however, not all have taken this up.  100% of people have had their first clinic appointment within four weeks, however, Fylde Coast piloted the Neuro-Developmental Pathway across the whole of the Integrated Care System (ICS) and is an example of the need to address a move back to this pathway due to demonstrating that having this a whole approach, with all the areas of the pathway, including speech and language, Attention Deficit Hyperactivity Disorder (ADHD), has been a much more positive approach and receive the range of assessments that are relevant to them, and there is nobody waiting for an ASD triage on the Fylde Coast and only five who are awaiting their first clinic appointment and who have only come on to the waiting list in the last month.  There is currently a review on the Fylde Coast taking place on Speech Therapies.  The whole system is proving to be very powerful across the support offer, and a piece of work is being done with Lancashire County Council to deliver some training to the new Special Educational Needs Co-ordinators (SENCOs) Network that has 500 schools currently subscribed to it and is increasing.  Training is being provided on ASD referrals to help people understand the support mechanisms that can be adopted, prior to referring somebody onto a health model approach and support starts at the first point of need.

Finally, the purple box shows the percentage of people who were satisfied with the level of support they got from Special Educational Needs Information, Advice and Support Services (SENDIASS) from a 25% return rate of which 79% of those people were satisfied.

Slide 6 – The chart detailed the current position in terms of the actions that would be delivered on within the Accelerate Progress Plan.  The delays relate to the transitions in Healthcare and the Local Offer (Actions 4 and 5).  The Monitoring Visit with the Department for Education and NHS England will take place this week.  Plans are in place at Action 5 for significant work on the final actions, following the recruitment to a post on 4 January 2021 and by having somebody in place, has made a huge difference.  Prior to the recruitment, in January 2021, the post was filled on an interim basis, however due to the postholder being on long term sick, it impacted on delivery as a result.

In terms of the transitions, the red relates to the engagement of Adult Services and the data, which has been impacted by COVID-19 and there is a remit from the Collaborative Commissioning Board, having done an update to them on 9 March 2021 and Zoe will visit each of the Cells that are in place, In-Hospital Cell, Out of Hospital Cell and the Mental Health Cell to talk them through transitions and the importance of the Adult Services being responsible for receiving young people into their services as opposed to the other way round, and this will then be escalated to the Collaborative Commissioning Board on a regular basis, if the Adult Services continue not to engage.  Otherwise on Action 5, it is being delivered to target.

At the halfway point, it was reported that progress was more than halfway on with the actions and nearly a quarter of the way to completing other actions and plans are in place to ensure achievement of those that are delivering behind target or delivering with delays.

Following the presentation, the Sub-Committee commented that it was extremely useful to see the data presented as it had in this meeting.  It was confirmed that the deliverables (as detailed on the last slide) related to the original document that had been submitted to the Department for Education in September 2020, and under each action, it had a number of tasks that would be delivered on and for the purpose of Slide 6, Zoe has counted up each of those tasks and the core number of those deliverables and ensure they are reflected on where they are up to, however it does not demonstrate the broader range of actions and tasks that have been delivered on to make sure improvement continues.

Concern was raised with regards the lack of response to people on initial contact in relation to Autism Spectrum Disorder (ASD) and unfortunately if no response then nothing happens.  There has been a tendency, which is in the process of being changed, that in the past, people have talked in terms of the length of wait for an ASD diagnosis, from initial referral through to the point of diagnosis, which is usually referral to the initial point of referral, through to the point of diagnosis, so it is usually referral  to the first clinical appointment.  For those who do not respond, this does not mean that there is not a need there that needs to be addressed and therefore the work that is being done with the Special Educational Needs Co-ordinators (SENCOs) through the SENCO Network and linking in with work that is being done on the whole pathway for ASD is to help ensure that there are support offers in place from when a need is first identified.

The presentation and upcoming event with the Department for Education and NHS England on what is going to happen and when the outcome will be known and what is hoped from the outcome.

The six monthly review is on 24 March 2021 with the Department for Education and NHS England in attendance.  There will be a 20 minute presentation made to them of what the current position is including what the Sub-Committee have received today and the highlight report, with questions back from the DFE and NHS England in each of the categories.  There will be another review at the end of the year period to ensure that all that is expected to have been achieved has been.  Six weekly updates have been taking place with the DfE and NHS England, however, it is thought that these will not continue after the six monthly review, albeit this is for discussion.  As part of the meeting, it is hoped that there will be an indication as to how they think progress is being made and targets achieved.  There has been a lot of information submitted by Sarah Callaghan and Zoe Richards over the last few weeks, which will hopefully allow them to inform the direction of travel that the work is going and then a formal communication will be received over the next few weeks.  An updated agenda had been received today for the Review meeting, and the key is that the focus is very much on the five areas of the Accelerated Progress Plan that had not sufficiently progressed and they have also asked for any innovative practice that has been developed in response to COVID-19, which will give an opportunity to share some of the good practice, especially with regards to partnership working that has really strengthened throughout the pandemic.  There will also be a demonstration to them, that there is more work to do and there will be some delivery, monitoring and improvements and are working on developing a Special Educational Needs (SEND) Plan 2021-2025 which will show work that will need to continue to be delivered.

The Sub-Committee requested that when the outcome from the Review meeting was known, that they be informed and the outcomes shared.

Resolved:  That the Health and Wellbeing Board – SEND Sub Committee:

  i)  Noted the progress of the Accelerated Progress Plan (APP) on the five areas of concern, including the areas highlighted in 'red' or 'amber; and

  ii)  Challenged and questioned progress on the work being carried out to deliver the Accelerated Progress Plan (APP), including highlighting any particular areas of concern that the SEND Partnership is to provide further assurance on.