Multiagency working

Getting good quality information to inform EHC plans

Issue: Ensuring high quality information is provided by education, health and care professionals.

What are LAs doing?

Several areas have developed templates for health, education and care professionals to improve the consistency and quality of information provided.

In these areas it was recognised early on in the reformed EHC process that work was needed to ensure that advice received from a range of professionals was more effectively fed into EHC plan development.

“We can’t write a good plan without good advice.”

The difficulty was that practice initially varied in terms of the type of information being provided, its suitability for being included in EHC plans, and how outcomes for young people were being articulated: for example, suggesting a particular placement as an outcome, as opposed to specifying education, health or social outcomes.

How are they doing it?

SEND Teams worked in partnership with health colleagues to develop and refine the processes for receiving health advice and set up agreed templates for information provision.

See the templates and guidance Waltham Forest have developed for medical consultants, Social Care staff, SLT, OT, physiotherapy and the Educational Psychologist.

Further examples of guidance and templates for gathering Health information from: Norfolk, Salford, Bolton

What is the impact?

Information provided is more consistent, of higher quality and is more easily fed into the development of EHC plans.

Engaging health providers in the EHC process

Issue: Engaging health practitioners in the EHC process

What are LAs doing?

The Norfolk Designated Clinical Officer (DCO) mapped health providers across the county to identify who is involved in the EHC process in the area.

 “This sounds like a simple task until you realise that they all have different boundaries; and many providers are based just in particular towns within the Districts, such as mental health support”.

How are they doing it?

The DCO drew up a training package which introduced this wide range of health practitioners – from midwives to CAMHS – to the new approach and their role within it. ‘Target’ groups were then identified to receive this specialist internal training.

The training details what the process is, including the legal obligations and motivations behind it. It breaks down the policy and process to identify the roles and responsibilities of Health practitioners. See an example here

Templates were developed, in collaboration with colleagues, to make provision of information and participation in the process simple and efficient. The key request from practitioners was that their involvement was ‘as streamlined as possible’.

Networks and events were identified at which he could deliver this training: area meetings of paediatricians, local GP planning meetings, quarterly CAMHS team events; and setting up e-learning modules.

What is the impact?

Health practitioners across the whole LA are more informed about the EHC process, their role and how to advise families.

This process identified an important problem – there was no single way of sharing information on the EHC process locally with Health professionals. To meet this need, an in-house clinical network has been established on the local health web resource to raise awareness and provide support to Health professionals. The e-learning training modules are held on this.


Joint commissioning

Issue: Services need to work together in partnership to co-commission services

What are LAs doing?

Norfolk has assessed how existing services were funded and ways of jointly commissioning these in the spirit of providing a more holistic system.

How are they doing it?

The Local Education Authority has funded a post in the Clinical Commissioning Group, to lead as the Designated Clinical Officer with responsibility for SEND. This reflects their desire to work in a joined up way County-wide across the two services.

Speech and Language Therapy (SLT) services have been jointly commissioned between Health and Education teams for the County.

Various Health and Education services across the area had contracts with SLT providers. Many of these varied but covered similar elements. The specification details were set out differently and were funded from separate pots. To streamline the process, and potentially reduce overall funding, they drew up a shared ‘spec’ for SLT service provision, agreed by Health and Education Directors across the county.

This meant there was one model of SLT delivery, with an agreed specification and a centralised funding system for the whole County. The Education authority and each of the CCGs made an agreed financial contribution to this funding. Once Directors had agreed funding levels and the specification, it was put out to tender and a provider agreed upon.

A similar process occurred for Mediation and Dispute services. Both sets of providers were spending money on buying in these services so a joint specification was agreed, along with levels of contribution each would make. The specification for this included other features of support, including continuing care and health services in adulthood.

What is the impact?

Having jointly commissioned services has led to sharing of responsibility, a more consistent approach and a reduction in disagreements about who should fund services.

Supporting workforce change

Issue: The SEND reforms require new ways of working, which some practitioners may need support to develop

What are LAs doing?

The SEND Team at Salford Council realised the newly reformed approach to supporting families of children and young people with SEND required a different approach to the way practitioners work. Many systems and processes needed to change and different skills were needed by the -often new in post- workforce.

The local Educational Psychology Service (EPS) interviewed members of the SEN team (caseworkers, transfer officers and senior officers) to understand how able they felt to implement the spirit of the new approach. This covered not just what to do, but how to do it. See what Salford found. The exercise showed that staff needed more support with carrying out their work, and that they could benefit from many of the skills and knowledge within the EPS.

How are they doing it?

Funding from the Transformation Fund was allocated from the LA to the EPS. This is short-term funding but has covered an EP assistant who has had capacity to carry out this developmental work. The EPS have taken the lead in supporting colleagues in the SEND Team to develop appropriate skills for: working in partnership with parents, mediating, writing outcome-focussed reports and active listening.

Each member of the SEND Team is given a ‘Buddy’ in the EPS. Buddies are matched based on staff working with the same families. It is made clear that this system is just for skill support (the two services are clear about maintaining their professional difference, and that they are not always working to the same agenda). Joint planning meetings have also been held, where cases can be discussed between the two teams and approaches agreed.

What is the impact?

SEND Team Caseworkers feel more confident with the new ways of working. They also feel empowered by understanding, and having access to, more skills which help them work in partnership with families and other colleagues. The insight and support the EPS has given them has increased how able they feel to carry out their roles, and deliver the best service for families of children and young people with SEND.

Training and upskilling other providers

Issue: Services need a consistent approach across the 0-25 age range of children and young people with SEND

What are LAs doing?

The SEND Team in Gloucestershire want to provide a holistic support service to all families of children and young people with SEND. They understand the value in identifying and intervening with families as early as possible, to provide support and prevent future escalation of needs. They have a strong Early Years SEND Team and decided to use these skills to upskill Early Years providers. This will manage the county’s EHCP caseload more effectively and make the most of the Early Years SENS Team’s skills.

How are they doing it?

Gloucestershire have set out a clear pathway for SEN support in the Early Years. Over 1000 Early Years providers were trained up by the Early Years SEND team. The training covered signs to look out for that a child might have SEND, how families can be supported and the process for collaborative working locally. Early Years providers are tasked with observing the children they work with, and notifying the SEND Team if they have concerns about a child’s development.

A special team has been set up to carry out full assessments of the needs of young children and their families. Systems have also been set up, working with and understanding the processes of Social Care, to allow referral into local Early Help Assessments.

Stockport LA have put additional resource into upskilling the local Early Years workforce so they are better equipped to support children with SEND in their settings and make appropriate and informed referrals into the EHC process when required. They have formalised all of their processes and made sure that all practitioners are familiar with what the SEND Team offers and how to access their services. Funding is available from the SEND Team to local nurseries (through high needs top-up) for providing intervention for their children with SEND, attempting to prevent any issues worsening, and potentially reducing the need for an EHC plan at a later stage.

The model uses a strong ‘Team Around the Child’ approach and all of the Early Years practitioners are trained in Early Support. Team members from a wide range of disciplines (OT, SLT, portage, paediatricians, nursery providers, etc) regularly meet to discuss support for families on their caseload. The team has carried out joint training (on legal issues, developing appropriate outcomes, and working in partnership in the early years) and worked together on planning and developing processes.

The local information collection templates have been made suitable for use with an Early Years population. They system is set up so that a member of the Portage team helps families to complete the paperwork

What is the impact?

By building close links with Early Years providers and providing them with the skills to identify children with additional needs the service has a clear idea of all the children in its area who are likely to need which support, so they are able to plan what support is likely to be needed in future. For example, if a group of children with potential autistic spectrum conditions are identified in a certain area, the service would plan ahead so that there is sufficient supported provision in that area, or consider if they need a new resource there.

Families of children with SEND are engaged in the system earlier and the team can consider the future potential educational impact of their child’s needs and to build up links with relevant teams. This ensures that families are provided with the support they need as early as possible. Children with SEND are now entering primary school with an appropriate plan in place, rather than being referred at a later stage when difficulties become more challenging to address.

The local team are now looking to extend the training and information sharing up the age range, so that they are intervening as early as possible with children of all ages.