Agenda item

The report sets out Medway's Local SEND Reform Plan, approved jointly by Medway Council, NHS Kent and Medway Integrated Care Board and the wider Local Area Partnership. The Plan sets out the next stages of whole-system reform creating a sustainable, inclusive, and outcomes-focused 0-25 SEND system.

The reform programme responds to significant growth in demand, increasing Education Health Care Plan (EHCP) requests, increasing reliance on specialist placements and persistent gaps in outcomes for children and young people with SEND.

SEND is not solely an education issue. Poor outcomes for children and young people with SEND are closely associated with health inequalities, poorer mental health, reduced school attendance, increased family stress, and poorer preparation for adulthood. The reform programme therefore seeks to improve educational, health and wellbeing outcomes through earlier intervention, stronger inclusion, integrated support, and improved access to services.

The Plan is closely aligned to Family Hubs, Best Start in Life and wider Children's Services reforms, creating a single preventative system where needs are identified earlier and support is delivered closer to home. Health partners are central to delivery, particularly through community therapies, mental health support, integrated commissioning, and the development of the Experts at Hand model. The programme adopts an invest-to-save approach, shifting resources towards prevention and mainstream inclusion to reduce reliance on expensive independent placements and improve long-term financial sustainability.

Discussion:

Budget – it was asked what financial benefits would be realised from streamlining provision as the reform changes continued to be developed. The  Committee was informed that in terms of the Family First programme, work was being undertaken on early intervention and statutory programmes on prevention to minimise escalation of issues. By putting in early resources, the aspiration was that there would be a reduction on the need for costly resources in the long term. It would however take time for the impact on the budget to be realised.

School outcomes -  it was highlighted that outcomes in some schools were better than that of others, whilst some schools performed very well in areas of SEN support, some did not. There were also some schools that were resistant to change and did not always recognise the bigger picture. It was asked if the larger schools in academy trusts would be partnered with smaller schools that  were not part of trusts to provide support. The Committee was informed that there was rise in referrals and request for assessments and work was being undertaken on how best to support and work with schools. The main challenge for schools was not always financial or with funding but more with maintaining a sufficiently trained workforce. There would be  work undertaken with schools in this area as well and some commissioning of support. This is part of the SEND reform plans and Experts at Hands to support capacity building within mainstream schools.

Inclusion - it was commented that careful consideration needed to be given to the expectation of schools to take on children with specialist needs and  understanding that main stream schooling was not right for every child. Additionally, to support children that were in specialist school to move into mainstream school, as often when children started in specialist provision from a young age they did not tend to transition to mainstream provision. The Committee was informed that children with very specialist needs would continue to be supported in specialist provision and decisions on where a child received education was made on an individual basis. Many of the children in mainstream school with additional needs were there as that was the right environment for them and there had not been a significant increase in the number of children with additional needs in mainstream schools. The increase noted in the report was as a result of children that were already in mainstream education that were waiting for their EHCP to be finalised as part of the backlog the local authority was addressing at the time.

Partnerships - in response to a question on ensuring that some responsibilities did not end up falling on a small number of organisations, and that the whole system would work to ensure that children received the right support when needed, the Committee was informed that the aspiration was to move away from the current system which was heavily diagnostic driven. The aim was for a needs based system, not one dependant on diagnosis. There were many practitioners already working with children and it was vital to ensure needs were being recognised and met right from the stage of early years and for adaptation to service provision to be implemented as needs  changed or emerged throughout various stages of a young person’s life.

Concern was raised regarding the complexity of the reforms and how the service would ensure that every element including social care and health be aligned to ensure that the aspiration of the reforms produce the intended outcomes for children and young people, in particular in a climate of resource gaps. The Committee was informed that the service had buy in from schools who were committed to the reform priorities. The main challenge for schools was related to training and specialist support, and work was being undertaken on provision of training and support through Experts at Hands. There was  extensive workforce planning taking place, in particular in areas of issues with recruitment, and on specialist and creative use of the workforce already in place.

Decision:

The Committee:

a)     Noted the Local SEND Reform Plan and associated delivery programme.

b)     Noted the partnership vision for a high-quality, inclusive and financially sustainable 0-25 SEND system.

c)     Supported delivery of the six strategic reform priorities.

d)     Agreed to champion collective responsibility across health, education and care partners for improving outcomes for children and young people with SEND.

e)     Noted the governance, performance and reporting arrangements that would monitor delivery of the reform programme.