West Midlands Region SEND Conference – October 2012
In the past few weeks the Department For Education together with the Department of Health have
been working with regional parent carer forums and other delivery partners to host a series of
regional conferences about the SEND reforms. These conferences have been titled ‘Bringing it All
Together – Improving Outcomes for Disabled Children and Their Families’. Each conference has
included presentations from families, the Department for Education, the Department of Health and
local Pathfinder Authorities. Each local parent carer forum was invited to send two parent carer
representatives to the conference, to meet with representative from local authorities and health
organisations from their area. The aim of the conferences was to ensure the sharing of information
and to encourage the joint working that will be essential in achieving the positive change in the
delivery of SEND support that is desperately needed.
The West Midlands Region held their conference on the 19th October. It was chaired, as all the other
regional conferences have been, by parent carers and was a very positive day. The Department for
Education and Department for Health both confirmed their commitment to reforming the SEND
system so that families achieved better outcomes. Peter Gibbs (DfE) told the conference that:
“There is a mixed picture at the moment and we particularly want to work on that, so that children
in all areas have a positive experience of support.”
Peter stated that the Department For Education wanted to be clear about what the proposals will
and won’t do. He stated that;
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Parent carers will have the right to request an assessment for an EHC plan and in fact, this
right had been extended to any individual who works with the family, moving the focus of
the process away from Education alone.
The draft legislation will not create an individual duty on Health to deliver the services
identified in the plan. That legal requirement will still only be present with regard to
Education. This is because service provision in the NHS is based on clinical judgement and
no other group of individuals who use the NHS, have the protection of an individual right to
services.
The Legislation will require by law the joint commissioning of children’s services by the Local
Authorities and Health organisations. This will have to be based on identified local need and
will require the pooling of budgets. It is intended that this legal requirement will create a
greater accountability for the delivery of services across all areas, education, health and
social care.
The EHC plan will be required to focus on outcomes which will also increase accountability.
The draft legislation for the Children’s and Families Bill provides the basic framework for the
reforms. A lot of the detail will be in the regulations, which is secondary legislation and this
will provide the opportunity to reflect on the learning from the Pathfinder work.
No decision has been made about over what period the new proposals will be phased in.
Until that point the current 1995 legislation will still apply.
Finally Peter informed the conference that the review of the SEN Code of Practice will be the next
piece of work to be started and that a decision will be made on the extension of the Pathfinder work
by March of next year.
A brief question and answer session followed as outlined below.
Q: Who will parent carers address the request for an assessment to?
A: That role will remain with the Local Authority.
Q: You stated that children with more complex needs will be eligible for an EHC plan. How will this
group be defined?
A: The same legal definition that is currently used to identify children and young people who are
eligible for a Statement will be retained. That is where the resources that are normally available are
not sufficient to allow access to an education. This eligibility for support to access education will be
extended to the age of 25. Those children and young people who do not meet this legal definition
will be supported via the Local Offer.
Q: Can you clarify what will happen to children who are currently supported by School Action or
School Action Plus?
A: These categories will be replaced by a single school based SEN category in which it will be the
schools responsibility to provide the resources needed. The resources available to support the
children in this category will be defined in the Local Offer.
Christine Humphrey spoke next on behalf of the Department of Health. She focused on three main
areas; the national health reforms, the emphasis on outcomes and local changes.
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Health Reforms – the structure of the NHS is changing and will now be based around three
main groups; commissioning bodies, a range of provider organisation (it is Government
policy that the number of providers will continue to increase) and professional groups who
will advise. When working with health, relationships with all three of these groups will need
to be developed.
The reforms are radical and they will take time. There is a strong emphasis on providing an
integrated service to avoid the fragmentation of the past. There is a new duty on the NHS
Commissioning Board and Clinical Commissioning Groups to work in an integrated way and
to deliver quality services. The health service is placing greater emphasis on service user
engagement, ‘no decision about me without me’, and in terms of children’s health services
parents and families need to be at the centre of our thinking.
This is a bottom up not a top down approach. It is about localism and using the legal
framework to deliver what works locally.
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Children’s Health Outcomes Forum – this piece of work focused on all children in the health
services but included a specific group that considered the needs of children with long term
conditions and disabilities. The report and recommendations from the Forum went to the
Secretary of State for Health in July and a response to the report is expected soon. This is
likely to be in the form of the first national child health strategy. The forum identified
particular concerns around;
1. The time it takes to receive a diagnosis
2. The provision of integrated care
3. An effective and healthy transition between children’s health services and adult health
services.
Outcomes should drive the commissioning of services. The focus is moving from provision to
what is actually being achieved by the services provided.
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Local Changes – The local Health and Wellbeing Boards should be the mechanism that brings
services together. The Joint Strategic Needs Assessment should identify the needs of the
local population and identify gaps in services. These should be clearly reflected in the local
Health and Wellbeing Strategy, which will drive joint commissioning arrangements so that
they meet local need at an individual level. The intent is that this will deliver accountability
for the Local Offer and EHC plans.
Local Health and Wellbeing Boards membership must include the Director of Children
Services and a representative from the local Healthwatch. The voice of children, young
people and their families must be reflected in the work of Healthwatch.
In summary Christine highlighted that the key changes outlined above are being delivered by three
pieces of legislation;
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The Health and Social care Act 2012
The Care and Support Bill
The SEND provisions in the Children and Families Bill
A brief question and answer session followed;
Q: There are a lot of concerns amongst parents about the need for improved accountability in health
services, how will this be delivered?
A: The introduction of Clinical Commissioning Groups (CCG’s) is a major change, they are different in
that they are clinically led and should respond to the needs of the local population in the way that
the previous system didn’t. Accountability will be through the local Health and Wellbeing Strategy
and the local Healthwatch organisation. The level of accountability will be dependent on the
strength of the local arrangements. This new system is still in development, for example the
Secretary of State’s mandate to the NHS Commissioning Board is currently out for consultation and
this will identify the priorities for health services. Clearly identified health outcomes will also
improve local accountability.
Q: Is any consideration being given to introducing a flagging system on a national basis for the
identification of young people with learning difficulties when they access hospital or GP’s surgeries
etc?
A: Nothing at that level of detail is being considered at the moment. The NHS is actually moving
away from being operationally focused and decisions about such systems are likely to be made
locally.
The question session was followed by a brief discussion about how the two main vehicles for
influence identified by Christine, i.e. Health and Wellbeing Boards and Local Healthwatch are the
two organisation that local parent carer forums are finding difficult to access. The regional feedback
was that these two organisations were very adult focused and it was proving very difficult to ensure
that the voice of children, young people and families were heard.
The initial presentations were concluded with a short presentation from the Council for Disabled
Children. Helen Wheatley from CDC started by reminding everyone that the SEND reforms are a
response to the difficulties within the existing system that lots of people have been highlighting for
many years. She pointed out that we are seeing an unprecedented level of joint working between
the Department for Education and the Department of Health. Both Departments have shown
themselves to be open to questions and have delivered a high level of transparency in their work.
All this has taken place in a period of great change but it still feels possible to achieve positive
outcomes for children with special educational needs and disabilities. Helen reiterated that the
legislative provisions that have been published for consultation are draft and that there is still scope
to make changes. She urged everyone to remember why we are all investing in this piece of work
and not to lose sight of what we are hoping to achieve and why. Helen reminded the audience that
recognition of the need to work together is not new, but it is not always easy to do. We all need to
be open and receptive to the views of others and be creative in our thinking.
Reflecting on previous discussion Helen stressed the importance of ensuring that the voices of
parent carers is heard by Health and Wellbeing Boards and encourage local Forums to take action to
address this. She commented that there is such a high level of change for SEND at the moment that
local champions are needed.
With regard to the reforms themselves Helen made the following comments;
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The Local Offer is vital in improving accountability and transparency in the system and there
will need to be a confidence that the Local Offer structure can deliver this. It is important to
know where the money is in the system. Pathfinder will provide some examples of Local
Offers in December and it will be crucial to examine these thoroughly to check that they
deliver the intended outcomes.
The voice of children and young people need to be developed further both locally and
nationally
The changes will stand or fall on one basic principle. That is whether or not the voice of
children and young people and their families are at the centre of the planning of services.
The remainder of the conference focused on the work that was being done in the west Midlands
Region to support the reforms. This included a presentation from Solihull, the only West Midlands
Pathfinder area and a variety of workshop co-presented by parents and professional from other
areas.
The conference was closed with final remarks from both the Department for Education and the
Department of Health. Christine Humphrey from the Department of Health commented that one of
the key issues she would be taking back to the department was the challenges local parent carer
forums were facing in engaging with Health and Wellbeing boards and local Heathwatch
organisations. She informed the conference that it had just been announced that Christine Lenehan
from CDC, who had jointly chaired the Children’s Health Outcomes Forum, had been appointed to
the Healthwatch England board. She hoped that this would be a positive step in ensuring that the
voice of disabled children, young people and their families would have a place in local Heathwatch.
Christine also commented that it was clear that transparency around funding was essential and that
the Department were aware of the concerns about the lack of data about children with disabilities
and were committed to improving this. She ended her summary with the following statement:
‘There is a danger that those who are not Pathfinders might just expect to take a readymade
solution off the shelf, but it needs to be understood that it is the journey to a new place itself that
makes the difference. We need to remember that so much of what we are trying to do is about
basic humanity and understanding.’
Peter Gibb from the Department for Education congratulated the West Midlands Region on a
successful conference. He had heard some inspiring stories and would be taking back lots of
possible case studies to illustrate the good work that was already being done to improve outcomes
for disabled children and their families. He had also heard a strong message about the need for local
flexibility supported by a strong national framework that identified minimum standards and
provided consistency and protection for families. He recognised that the work of pathfinders
needed to be shared more widely and that communication with families needed to be improved to
lessen anxiety about the changes.
Sarah Thomas
West Midlands NNPCF Representive