Karen Levell, SEND & Inclusion Service Manager, Shropshire Council

Jen Griffin, Designated Clinical Officer for SEND, NHS STW

The Board received the joint report of the Assistant Director Education and Achievement, the SEND and Inclusion Service Manager, the Deputy Director of Partnerships, Shropshire Telford and Wrekin ICS and the Designated Clinical Officer for SEND – copy attached to the signed minutes – which updated the Board on the Ofsted/CQC Area SEND Inspection Revisit in November 2022 and set out the next steps following publication of the inspection report in February 2023.

The SEND and Inclusion Service Manager introduced and amplified the report and highlighted the key areas to note including the progress that had been made and that which was still required.  She drew attention to the Accelerated Progress Plan (APP) which had been published on their local offer website, progress against which would be monitored monthly.  Progress was also monitored by the Department for Education and NHS England both formally and informally.  Following a recent informal visit, no concerns were raised and the formal monitoring was due to take place at the beginning of November and six monthly thereafter.

The SEND and Inclusion Service Manager informed the Board that Shropshire was one of four local areas within the West Midlands to be selected to work on the SEND Change Programme to test and design aspects of that system.  The Change programme was officially being launched on 19 September and would run for two years.

The Designated Clinical Officer for SEND discussed their work around the diagnostic pathway for ADH and ADHD for which the average waiting time nationally was over 9 months with a further 7 months until treatment.  Locally this had been addressed by allowing access to services and support without the requirement of a diagnosis along with work undertaken to clarify and improve access and timeliness of diagnostic pathways.  Although increased funding had been provided to undertake additional diagnostic assessments, demand was still outstripping capacity.

She then highlighted the challenges around waiting times for speech and language therapy services which had very high referral rates and a very variable service offer and how it was commissioned across the Country.  Locally, support was being provided whilst waiting and access to the services in a timely way was being addressed.  Again, demand was still outstripping the capacity of that service and she went on to discuss the next steps.

Turning to EHCP, the SEND and Inclusion Service Manager explained that nationally there were gaps in external provision and training, a lack of coordination between services, weak co-production and a lack of accountability.  Locally, feedback had shown an inconsistency in the quality of the input from Education, Health and Care in relation to the advice and reports that are collected prior to issuing an EHCP, along with a lack of effective quality assurance processes and plans not being updated or issued in a timely manner.  She went on to inform the meeting about the work being undertaken by these workstreams. Timescales for issuing new EHCPs were now more or less in line with the national average.

The Portfolio Holder for Children & Education commented that the partnership working around this had been a real success and only by coming together could a way forward be found.  She queried whether the ICB were considering additional funding for mental health services for young people.  In response, the Deputy Director of Partnerships at Shropshire, Telford & Wrekin ICS agreed to share their profiling around mental health spending with Board Members which set out the latest information.  She explained that in terms of the amount of investment into services, this was continually reviewed by the ICB and as part of their investment process they had strengthened their commissioning arm which would help them to look at some of the data behind the commissioning intentions and work as a system to build those investment cases going forward. 

The Chair reported that he ICB did meet the mental health investment standard and although the funding was not where they wanted it to be, it had grown since previous years and was 20% higher than the national average and there was a focus on continued investment in this area.

The Executive Director for People congratulated the team for all their work both pre and post inspection and she was pleased to see that the inspectors were assured that significant progress had been made with three areas of concern and that the remaining three areas were both a national and local problem. However, huge progress had been made since the last inspection.  In terms of demand and capacity, she was interested to learn of the work being done and to really understand the demand moving forward to ensure the right support was available.

In response, the Deputy Director of Partnerships, Shropshire Telford and Wrekin ICS felt that they were in a much better position than back in November in terms of understanding the profile of the additional demand.  They were working with regional and national teams to look at this pattern of demand, whether it would continue to grow or whether there would come a point whereby demand would level out along with work to understand how to commission services differently in terms of triage around assessments.

The Executive Director of Health, Wellbeing and Prevention felt, in relation to the waiting times, that it would be helpful for ShIPP (Shropshire Integrated Place Partnership) to have oversight of the long-term trends and the impact all the good work was having and where further support was needed.

RESOLVED:  To note the recommendations contained in the report.