The reforms: Opportunities for
getting it right for children whose
behaviour challenges
Christine Lenehan
Director
Policy in a political framework
• Edward Timpson MP appointed Parliamentary
Undersecretary of State (Children and Families)
• Dr Dan Poulter now Parliamentary Under
Secretary of State Health
• Children and Families Bill Published 4th February
2013
• Care and Support Bill due in parliament later this
year
• NHS changes implemented 1st April
• Ongoing changes in Welfare Reform
• SEN School Funding Changes
Understanding the
opportunities
• Children and Families Bill
• Care and Support Bill
• Children’s Health Outcomes
Strategy
Draft legislation - key highlights
• New requirement for local authorities, health and care services to
commission services jointly, to ensure that the needs of disabled
children and young people and those with SEN are met.
• LAs to publish a clear, transparent ‘local offer’ of services, so parents
and young people can understand what is available.
• More streamlined assessment process, which integrates education,
health and care services, and involves children and young people and
their families.
• New 0-25 Education, Health and Care Plan, replacing the current
system of Statements and Learning Difficulty Assessments, which
reflects the child or young person’s aspirations for the future, as well as
their current needs.
• Option of a personal budget for families and young people with a Plan,
extending choice and control over their support.
• New statutory protections for young people aged 16-25 in FE and a
stronger focus on preparing for adulthood.
• Academies, Free Schools, Further Education and Sixth Form colleges to
have the same SEN duties as maintained schools.
Joint commissioning
• Outline of the clause: requires local authorities and their
partner clinical commissioning groups to work together to
agree arrangements for the education, health and care
services for children and young people with special
educational needs.
•
Purpose:
• Parents often find that LAs and health bodies fail to work
together to make sure they provide services
• So the clause requires them to agree what services need to
be secured and by whom; and this must take account of
education, health and care needs assessments, the content
of Education, Health and Care plans and personal budgets
• Effective joint commissioning already takes place in some
areas – but this clause will require it everywhere
Promoting integration
• Outline of the clause: to promote integration between
special educational provision, health provision and social
care provision, to improve the health and well-being of
children and young people.
• Purpose:
• Parents tell us that their experience is often poorly
coordinated across service areas
• So the clause requires LAs to integrate special
educational provision with health and social care
provision – and apply this across all aspects of the draft
Bill
• Health bodies have a parallel duty to ensure that all
partners are acting with a view to integrate health and
social care with health-related services
Local offer
• Information on the education, health and
care services a local authority expects to
be available
• Includes services available outside the
local area
• Regulations:
– what the local offer should include
– who should be consulted
– Complaints mechanism
Education, health and care
assessment & plans
• EHC plans replace statements
– Threshold for assessment the same
– Threshold for plan the same
• EHC plans extend to FE and training
– 139A assessment replaced
– Could continue in an apprenticeship or if ‘NEET’
• Regulations may set out:
– how assessment conducted
– how it might be combined with other
assessments
• Duty to secure the educational provision
set out in EHCP
• Health and social care needs to be
recorded in EHCP
• Rights of appeal the same, but include FE
Personal budgets
• LAs to prepare a personal budget:
– in relation to an EHC plan
– where a request has been made by parent or
young person
– may include a direct payment
• Details in regulations
Key drivers of the health system
• Outcomes Framework
• Healthwatch
• Government’s Mandate to the NHS Commissioning Board
• CCG statutory duties:
• to meet the reasonable health needs of all patients;
• to act consistently with the Mandate;
• to act with a view to integrate health, and health related, and
social care services;
• to work with local authorities and their partners in identifying
local needs, in a Joint Strategic Needs Assessment (JSNA),
and agree a Joint Health and Wellbeing Strategy (JHWBS);
• to draw on these in developing their commissioning plans.
The Mandate : A mandate from the Government to the
NHS Commissioning Board: April 2013 to March 2015
• Sets priorities for the NHS for the coming two years.
• The NHS Commissioning Board is legally required to pursue the
objectives in the Mandate. CCGs have a statutory duty to act
consistently with the Mandate.
• The Mandate states:
“…there is a particular need for improvement, working in
partnership across different services… in supporting children
and young people with special educational needs or
disabilities. The Board’s objective is to ensure that they have
access to the services identified in their agreed care plan, and
that parents of children who could benefit have the option of a
personal budget based on a single assessment across health,
social care and education.”
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Govt response to the outcomes
forum
• DH and DfE will work with the Forum to consider
how to:
• Effectively measure the outcomes of integrated
commissioning for children with SEN or disability
who have an Education Health and Care Plan
• Prioritise improved outcomes for children and
young people with challenging behaviour and
• Best support young people with complex needs in
making the transition to adulthood
In summary
• There are significant opportunities but ……
• The challenge is ensuring they deliver for this
group of children
• That the sector both lobbies on delivery and
supports its implementation
• That change in Westminster translates to practice
on the ground