Let`s Start a Dialogue- Are children getting the support they need?

VIEW conference 2014
Let's start a dialogue: are children
getting the support they need?
Sue Keil, RNIB
Sue Wright, Action
Working together to support blind and partially sighted people
Introduction and aims
• To start a dialogue with the VI sector
This is a challenge for us all:
• How, in the current climate can we continue to
support all CYP with VI appropriately and
• What does the evidence tell us about the
current situation?
• What are the experiences and concerns of
The current climate
• Children and Families Bill and new SEN Code of Practice
• Cuts to public sector funding
"…it is clear that local government is one of the foremost
casualties of austerity in the UK."
"…Local government has largely coped with the cuts thus far
by paring back costs and capacities. To cope with the cuts
to come, it is being forced to re-consider what services it
can provide and for whom." (Hastings et al, 2013, pp5 and 51)
VI services in 152 LAs in England 2011 to
• 27% of LAs had experienced changes to VI service
organisation and or funding
• Not all changes were negative
• 25% of LAs had lost staff posts
• 13% of LAs had lost or had frozen QTVI posts
• 17.3 QTVI posts lost, frozen or reduced hours
• 31% of LAs were anticipating changes to VI service
funding or organisation within the next 12 to 18
Reduction in provision to CYP 2011 to
• 17% of LAs had reduced or withdrawn support for
at least one group of CYP
• The 2 groups most affected:
• CYP with complex needs (12 LAs)
• CYP whose sight was below threshold for support
(12 LAs)
What eligibility criteria are VI services using?
• 89% of LAs use NatSIP criteria - or a modified
version - to determine eligibility for VI service
• Small number using clinical criteria (VA) and high
threshold (6/18)
NatSIP criteria AND professional judgement
• "…a modified version of the Natsip criteria 2013…fits
better with our way of working. The [LA] version is more
inclusive of children with cortical visual impairment and
early years children. Unlike Natsip the LA’s version also
takes into account fields of vision and near vision acuity,
not just distance..."
• "…a slightly amended version of the latest NatSIP support
allocation matrices which means that those scoring at the
lowest end of the scale are not removed from the
caseload but are kept on for monitoring".
Are some VI services using the criteria in a
prescriptive way to ration support?
• "Support is still available for pupils with a NatSip
score of below 50% but it has to be requested
and paid for by schools."
• "The adjustments [to thresholds for support]
reflect implementation of the Natsip criteria."
Criteria for support based on clinical definition of
VI - a slide back to a medical model of disability?
• "We have prioritised our work load to meet the needs of those
pupils with the most severe visual impairments, across the age
ranges. We no longer visit pupils below 6/18."
• "..The visiting criteria /threshold – CYP with vision of 6/18 or
worse or N14 or worse and an identified ophthalmic
• "CYPs without statements will no longer be supported other
than as an advisory case…If the children/young person’s vision
is below 6/18…they are seen on an advisory basis only…
VI voluntary sector functional definition of VI in
• The child or young person's vision impairment interferes
with optimal development, learning and achievements,
unless adaptations are made in the methods of presenting
learning experiences, the nature of the materials used
and/or the learning environment.
• (The term 'learning' includes not just academic learning but the
acquisition of mobility, life and social skills that in the case of a
child or young person with vision impairment would be provided
through habilitation education. This definition includes children
and young people with other disabilities/impairments in addition
to vision impairment, including those with profound and
complex needs.)
• Raising thresholds for support - they are the
same children
• Individual assessment and taking account
of other SEN
CYP without EHC plan
• Concerns for CYP with 'mild' VI and 'mild' other types of
• Much poorer wellbeing and educational outcomes for
CYP with VI and additional SEN compared to CYP with
VI only
• Who takes ownership?
• Schools don't know what they don't know
• Funding constraints - schools as gatekeepers?
• What concerns do parents have?
Parents concerns
• Through the RNIB helpline we receive approximately 150
educational enquiries from parents / carers each year
• NBCS receive approximately 200 education enquiries
from parents / carers each year
• The majority of calls are about the provision their child is
receiving at school (with or without a statement)
• In addition NBCS receive a high number of enquiries at
the point of diagnosis and early years
Sample enquiry
• Child age 8 with optic dystrophy and nystagmus
(indentified at 4 years old but only recent confirmed
• Registered partially sighted
• Parents concerned about level of support
• VI service wrote a report and gave advice to the school
but no further input
• SENCO does not feel the child needs an IEP as she is
‘bright’ and is saying there is no problem
Sample enquiry
Child age 3 with congenital bilateral cataracts
Visual acuity not confirmed but thought to be 6/36
Lack of support from nursery
Parent had received no education or home support from
specialist service
• VI service will only take a referral from the hospital and not
direct from parent
• Ophthalmologist saying doesn’t warrant extra support as
responding to treatment
• Parent not aware that she has the right under COP to
request an assessment
• This is the start of a dialogue
• What do you think are the challenges in ensuring
that all children and young people with VI get all
the support they need?
Conclusion and next steps
• Collated questionnaire responses on VIEW
• Discussion can continue online
• VIEW will take forward
• Hastings A, Bailey N, Besemer K, Bramley G, Gannon M and Watkins
D (2013) Coping with the cuts? Local government and poorer
communities. JRF Programme Paper: Austerity. University of
Glasgow for JRF
• Keil S (2014) Local authority vision impairment (VI) education
service provision for blind and partially sighted children and
young people. Report on findings from RNIB Freedom of
Information (FOI) requests 2013. London: RNIB