Joint Commissioning Strategy for Children and Young People 0 - 25 years old with Special Educational Needs and Disabilities (SEND) and their Families within South Tyneside

In 2021, a review of the previous JSNAA^[1] was completed, this highlighted the present strengths and opportunities within South Tyneside at this time. Following the publication of the JSNAA, the following commissioning strategy aims to highlight the present commissioning priorities. The priorities are directly informed by the JSNAA finding and additional guidance from the residents in South Tyneside.

We want to ensure that it is clear what families can receive, what the next steps are and how outcomes will be achieved for children and young people with SEND needs. We will work in coproduction with families to ensure their voice is heard when considering new service delivery and how we will achieve this.

We believe that by taking a joined-up, strategic approach to our commissioning we will work better together to develop and sustain effective, whole system approaches to local support for children and young people with Special Education Needs and/or Disabilities (SEND).

By taking this approach we will bring about positive improvements in information, advice and services, and most importantly we will improve outcomes for children and young people with SEND and their families.

Through this strategy, our ambition is to ensure that services can respond when people need it most. We are committed to working together to commission services that will allow us to deliver a system that is joined up, consistent and both efficient and effective. It should not matter which part of the system you enter, you should get to the right support, understand clearly what the next steps are, and have a clear shared view on the outcomes that will be achieved.

The Children and Families Act 2014[2] provides statutory guidance on duties, policies and procedures to local commissioners who are required to work together in the interests of children and young people with special education needs and disabilities. The SEND Code of Practice lays out the statutory duties which must be considered by bodies such as local authorities, clinical commissioning groups, governing bodies of schools (including non-maintained schools) the management committees of pupil referral units, independent schools and independent specialist providers.

We are ambitious for children and young people with special educational needs and/or disability and uphold the national vision, as set out in the SEND Code of Practice, which aspires that all children and young people will progress well in their early years, at school and at college, and lead happy and fulfilled lives. We want them to have choice and control over decisions about their health, education, employment and relationships.

Our vision for our children and young people with special educational needs and disabilities (SEND) is “for all young people aged 0-25 to have high aspirations and that they achieve well at school and college and lead fulfilling, happy lives".

To achieve these aims, we have aligned the facts, priorities and areas for further development in the JSNAA.

Whilst the significant financial investment for SEND and alternative provision, is clear evidence of our commitment to this ambition, the outcome of the SEND inspection by Ofsted/Care Quality Commission has highlighted that we need to do much more to ensure all families and young people feel that we are listening. This means our joint commissioning, as well as our wider work on special educational needs and alternative provision must be co-ordinated and responsive to the needs of South Tyneside families, based on their feedback about what needs to change, with clear evidence about what has worked well and where we have clearly made improvements.

South Tyneside has a wealth and breadth of resources and assets in the community that can be better optimised to support improved outcomes for all children and young people with SEND. For some areas of support, we need to work better with providers to be able to deliver improved outcomes for children and families in a financially sustainable way that meets the assessed need. We are committed to commissioning together using the total resource in the system in the most effective way possible.

The purpose of this strategy is to:

• Deliver improved outcomes for children and young people with SEND across the local area.
• Provide a framework for effective joint planning, understanding and review of SEND services in South Tyneside.
• Identify a set of key commitments and priorities that will underpin all joint planning and commissioning decisions, informed by the SEND Joint Needs Assessment and in line with the requirements of the SEND Code of Practice: 0 to 25 years and feedback from our communities inclusive of children, young people, parents and carers.
• Provide a framework for effective joint planning, understanding and review of SEND services in the borough, which should inform all elements of the SEND Improvement Plan and working practices (including Emotional Health and Wellbeing Services, and therapy services).
• Ensure that we jointly commission services with a clear assessment of local needs, delivering personalised integrated support that delivers outcomes and brings support together across the system.
• The Strategy will inform the development of robust priorities and effective joint working which will inform commissioning intensions and meet local needs more effectively.

The Children and Families Act 2014 extended the provision of services for children and young people with special educational needs and disabilities (SEND) from birth to 25 years of age and introduced new processes to promote the provision of integrated education, health, and social care services.

A child or young person is defined as having special educational needs “if he or she has a learning difficulty or disability which calls for special educational provision to be made for him or her.” Learning difficulty typically refers to conditions affecting specific areas of learning while learning disability refers to reduced intellectual ability and difficulty with both learning and everyday activities.

The term SEND also encompasses disabilities, which are defined as “a physical or mental impairment which has a long-term and substantial adverse effect on the ability to carry out normal day-to-day activities”. These classifications are conceptually distinct but may also overlap, with some children and young people having both a disability and special educational needs (SEN).

Published in 2015, the SEND Code of Practice provides statutory guidance for local authorities, schools, and other organisations responsible for implementing the Children and Families Act 2014. It describes a graduated approach involving an ongoing cycle of assessment and review to ensure that each individual receives the level and type of support necessary to meet their unique needs. It also outlines two broad levels of support available to children and young people with SEND:

SEN Support

Refers to additional assistance provided by educational settings and is often organised by teachers and SEN Coordinators. SEN support replaces the previous categories of School Action and School Action Plus.

Education, health, and care plan (EHCP)

Refers to a legal document compiled for children and young people who require a more intensive level of assistance than is provided through SEN support. EHCPs replace statements of SEN and Learning Difficulty Assessments.

In February 2021 the government published Integration and Innovation: working together to improve health and social care for all (White Paper). Within this, it describes partnerships between commissioners and local providers of health services with local authorities and other partners to plan and design health and care services in England for their local population. These will be known as an Integrated Care Systems (ICS).

The White Paper outlines the duty for NHS and Local Authorities to collaborate. Statutory duties of CCG’s will transfer to the ICS NHS Body.

It describes the core service of an ICS to:

• Improve outcomes in population health and healthcare
• Tackle inequalities in outcomes, experiences and access
• Enhance productivity and value for money
• Help the NHS to support broader social and economic development

There is information available about South Tyneside on the Council website[3] that is refreshed on a regular basis. In South Tyneside we take a partnership approach and the joint commissioning unit has overall responsibility for commissioning arrangements across the CCG and the Council. South Tyneside has a population of 150,265 people, and approximately 43,253 aged 0-25.

South Tyneside maintained EHCPs for a total of 1,412 individuals in 2020. Data from SEN2 indicates that the percentage of the population ages 0 to 25 years with an EHCP more than doubled in South Tyneside between 2015 (1.6%) and 2020 (3.3%), showing a steeper increase than that seen in the North East, England, and among statistical neighbours. South Tyneside also has the second highest percentage with an EHCP among the 12 local authorities in the region

SEN2

The Special Educational Needs Survey (SEN2) is an annual data collection exercise undertaken by local authorities in England which provides information on individuals ages 0 to 25 years with EHCPs. The SEN2 captures all individuals for whom each local authority is responsible (including children receiving support out of area) and is thus the most complete data source for this population.

The percentage of pupils receiving SEN support is higher in South Tyneside (16.6%) when compared with statistical neighbours (14.2%), the North East (12.8%), and England (12.1%) and has been relatively stable since 2014/15. South Tyneside also has a comparatively higher percentage of pupils with EHCPs (4.1%), which has been increasing in recent years.

The age profile of this population has been shifting over time, with the number of individuals ages 16 to 25 years with a statement/EHCP increasing more than eightfold over the past five years The 16 to 25-year-old age group now accounts for nearly a third of the local population with EHCPs whereas it comprised less than 10% of the total in 2015. The shift toward older age groups has been driven by the SEND reforms introduced in 2014 and highlights the increasing importance of services focused on transition planning and preparation for adulthood.

A refresh of the Joint Strategic Needs and Assets Assessment (JSNAA) was conducted in 2021 to consider the needs of South Tyneside’s population and interactive sessions were advertised to facilitate conversations with families across the borough.

In 2020/21 we undertook a thorough review into the needs of population of children and young people aged 0 to 25 years who have SEND. These themes have informed the commissioning priorities listed in this strategy and will continue to inform service review and planning objectives in the future.

Key themes

• Around one in five pupils (20.7%) in South Tyneside has SEND. The prevalence of SEND in schools is higher in South Tyneside than in geographical and statistical neighbours and has been rising in recent years.
• The most common primary need is Autistic Spectrum Disorder (ASD) among those with EHCPs and speech, language, and communication among those receiving SEN support.
• The number of pupils with ASD in South Tyneside has increased by 80% over the last five years while social, emotional, and mental health needs increased by 42%.
• The number of young adults with EHCPs has risen rapidly since the introduction of the SEND reforms. In 2020, nearly a third (32.2%) of individuals with an EHCP maintained by South Tyneside were between the ages of 16 to 25 years compared to less than 10% in 2015.
• Preparation for adulthood is a key area for improvement. The percentage of 16 and 17-year-olds with EHCPs who are not in education, employment, or training (NEET) or whose status is unknown increased from 11.7% in 2019 to 18.7% in 2020 and is higher in South Tyneside than in geographic and statistical neighbours.
• Individuals with EHCPs placed out of borough are more likely to be children looked after and have social, emotional, and mental health as a primary need. Close tracking of out of borough placements over time will be important for identifying and addressing gaps in local provision.
• The findings from a recent SEND inspection and feedback from the SEND Information, Advice, and Support Service (SENDIASS) indicate that wait times for mental health services are a concern. Significant efforts have been made to reduce the wait list for the local Lifecycle Mental Health Service and it is important that these efforts continue as COVID-19 restrictions are eased.
• Awareness of the Local Offer remains low and some content is out of date. Work is currently underway to update this in collaboration with the South Tyneside Parent Carer Forum.

High level priorities

• Strengthen outreach and engagement efforts to improve the awareness, accessibility, and use of Local Offer[4]
• Refresh the Local Offer and develop a clear process to ensure that the content is reviewed and updated on a regular basis going forward.
• Establish clear governance arrangements with the South Tyneside Parent Carer Forum to ensure that there are shared expectations for co-production and that their voice is formally represented in key decision-making groups (e.g. SEND Leadership Board).
• Proactively solicit feedback from children and young people with SEND and their families to monitor quality and inform service delivery
• Establish a process to regularly track the outcomes achieved by 16 to 25-year-olds with SEND across a range of domains (e.g. health, education, employment, etc.).
• Strengthen transition arrangements from children’s to adult services through reviewing current processes, better defining roles and responsibilities, and ensuring that there are shared visions, values, and expectations about what we want to achieve for our young people.
• Revise the SEND Commissioning Strategy to ensure that appropriate services are commissioned across the full 0 to 25 age range.
• Improve understanding of the health needs of the SEND population through linking local SEND data with relevant primary and secondary care datasets.
• Provide robust oversight of new quality assurance processes through the SEND Leadership Board to ensure continued monitoring and improvement of EHCP quality and completeness.
• Review and streamline quality assurance processes as necessary to promote uptake and sustainability.
• Explore higher than expected rates of special school attendance among pupils with certain primary needs (e.g. moderate learning difficulty, physical disability) to determine whether more pupils could be supported in mainstream settings.
• Ensure that appropriate mechanisms are in place to assess and support pupils with SEND whose needs may have increased since the introduction of the COVID-19 restrictions.

Commissioning is the process of identifying the needs of a community and planning services and activities to meet those needs within the resources that are available.

Joint Commissioning is where the assessment of need and planning of services and activities is undertaken by two or more partners working together, striving for continuous improvement. The SEND Code of practice requires us to have a Joint Commissioning Strategy across education, health and Social Care and ensure services are commissioned in response to identified need.

We have a proven track record in partnership working but we recognise that we need to further improve our partnership working and co-production activity in respect of SEND. Our approach to joint commissioning for SEND is designed to ensure the best possible response to a child or young person’s needs, aligning and integrated needs assessment, planning and delivery of services/activities to achieve the best possible outcomes within the resources available. This includes jointly identifying current and future needs, any gaps in provision and maximising resources and sharing intelligence across all services to both improve outcomes for children as well as help inform commissioning and planning decisions across all aspects of SEND support.

We will ensure we work with the local Safeguarding board and use its annual reports as part of our evidence-based Commissioning. We will continue to provide universal services that are accessible to everyone in the borough, through our localities and our 3 Primary Care Networks. We adopt the Commissioning Cycle identified in the SEND Code of Practice as outlined in the diagram above.

The SEND Leadership Board has representation from a number of partners, including:

• Director of Children’s Social Care;
• Director of Adult Social Care;
• Director of Operations from the CCG;
• School representation;
• Designated Clinical Officer (DCO) for SEND;
• SEND Services;
• Head of Education;
• Strategic Commissioning Lead for Health and Social Care Integration;
• Health Service representation;
• Parent/Carer Forum

The diagram below shows the governance structure for ensuring that SEND has strategic oversight in South Tyneside.

The Leadership Team meet on a monthly basis and report directly to the Health and Wellbeing Board.

This will enable us to collectively:

• Understand local SEN and Disability needs
• Plan and commission education, health and social care services to meet SEN and Disability needs
• Measure the outcomes and impact of services to deliver the improvements described in the SEND Strategy.

South Tyneside’s commitment to outcome-based commissioning:

Deciding how to use the total resource available to achieve desired outcomes in the most efficient, effective and sustainable way.

We will do this is through identification of needs of our population and focus on matching all our resources to deliver better outcomes across the borough. Then being clear on full Resource to deliver this including (Finance, Capital, Workforce, Markets, Citizens, Communities and Assets).

There is a clear relationship between population needs, what is commissioned for children and young people with SEN and disabilities, and individual EHCPs. We will consider the needs of our population as identified in our JSNAA and the thorough review into the needs of population of children and young people aged 0 to 25 years who have SEND. In line with the Local Area’s drive for early intervention and prevention we will take a preventative approach to manage rising demand from the earliest point in a child’s life, encouraging independence where appropriate and building on the strengths of families and their inclusive networks.

Our joint commissioning in South Tyneside will be outcome based, designed around the needs of the people that live here, joined up, inclusive, measured to ensure the impact is the right one and continually reviewed and improved to ensure we are delivering the best possible outcomes. We will continually measure quality to ensure provision is targeted to local needs and inequalities. We will routinely review national best practice and expertise to understand we can improve our services and the Local Offer.

Our approach to this will be focused upon:

• Co-production, consultation, engagement and participation;
• Outcome reviews;
• Developing a Framework to help us decide how best deploy resource, utilising the best possible procurement routes to market and contract models to ensure the highest possible quality and value for money within our financial envelope;
• Seeking to learn from good practice in other areas and make use of available research.

In developing our plans, we will take account of the Local Government Association paper "Developing and Sustaining an effective SEND System"[5] states the key ingredients to developing an effective approach to joint commissioning include:

• Aligning key sources of data and intelligence in the form of a joint dataset on children and young people with SEND (which may underpin the local area’s Joint Strategic Needs Assessment), so that partners can take decisions about joint commissioning based on a broad and shared understanding of current and future needs;
• Having an agreed set of outcomes that partners are seeking to achieve together through the services that they commission;
• Being clear on the resources required to meet current needs and achieve agreed outcomes, and what each agency will contribute;
• Bringing together frontline practice as much as possible, integrating services where possible but also doing simple things like organising joint training for staff across different agencies and ensuring that there is a common language and a consistent approach to support young people with SEND and their families across all agencies; and
• Pulling all this together in the form of a genuinely joint strategy, developed by agencies together.

The SEND Code of practice recommends that local areas should be involving parents and children and young people at each stage of the commissioning cycle.

We are committed to improving co-production, to ensure that the views of parents and carers, children and young people, providers and workforce are reflected in the planning process and delivery of this strategy, We will continue to use these forums and approaches to continue to offer real opportunities for coproduction and codesign as we deliver the priorities in our action plan.

The National Preparing for Adulthood Program sets out 4 main areas that young people with SEND say are important to them:

• Employment, Education and Training
• Independent Living
• Community Inclusion
• Health

An EHCP review at Year 9 should detail personalised support in the following areas:

• Identifying suitable post-16 pathways that lead to employment options or higher education;
• Training options such as supported internships, apprenticeships and traineeships;
• Support to find a job and learn how to do a job (for example, through work experience opportunities or the use of job coaches);
• Support to help the young person develop a lifestyle that is based on their hobbies, leisure activities, access to community facilities, meeting friends and having fun;
• Help in understanding any welfare benefits that might be available when in work;
• Preparation for independent living, including where the child or young person wants to live in the future, who they want to live with and what support they may need;
• Information about personal budgets and direct payments;
• Local housing options, including housing benefits and social care support;
• Support to help the young person participate in society, including activities, having friends, maintaining relationships and being a part of, and contributing to, the local community and voluntary opportunities;
• Information about lifestyle choices based on the young person’s interests and personal requests;
• Travel advice to enable young people to travel independently;
• Advice about continuing health care services so that young people understand which professionals may be supporting them in adulthood. This should include the production of a Health Action Plan and prompts for annual health checks for young people with learning disabilities.

As part of our Joint Commissioning Strategy we will review our transition pathways to ensure that they are meeting the needs of our young people.

Young people have identified several ways in which they were supported at times of transition and they would like further support in:

• Travel training;
• Help with life skills, and;
• Longer taster sessions in college.

Young people have identified several barriers for them gaining employment including:

• Academic achievement;
• Health needs, and;
• The ability to travel independently.

This information has informed our priorities

South Tyneside works hard to foster the ethos of inclusion in all our services.

Disagreement resolution arrangements cover all children and young people with SEN, not just those who are being assessed for or have an EHC plan.

They are available to parents and young people to resolve disagreements about any aspect of SEN provision, and health and social care disagreements during the processes related to EHC needs assessment and EHC Plans. Used early in the process of EHC needs assessment and EHCP development they can prevent the need for mediation, once decisions have been taken in that process and appeals to the Tribunal.

Children, young people, families and carers will be informed of the complaints process when they receive their EHC plan.

Where there are complaints regarding EHC plans, these will be reported to the South Tyneside Local Authority who will direct the complaint to the relevant agency. Each agency will follow their own complaints process and, where appropriate, a joint response will be prepared for response.

Within South Tyneside there is also an active SENDIASS service which is there to provide support to families throughout the process.

Effective dispute resolution is key to the success of the new procedures. The Local Authority and Health are fully committed to pursuing practical solutions with parents and young people at every stage and to ensure continuous review and reflection to further improve outcomes.

The Designated Clinical Officer (DCO) role is a key element in supporting health services in the implementation of the Children and Families Act and the scope of the role is very broad.

The key responsibilities of the DCO are as follows:

• Oversight – across all health professionals delivering healthcare to individual disabled children, young people and those with special educational needs;
• Coordination – in relation to the Local Offer, process for arrangements regarding the health elements of the EHC plan and EHC assessments with other key assessments;
• Strategic – contribution to the development of a joint commissioning strategy and participation and engagement strategy.