EVIDENCE TO THE EDUCATION SELECT COMMITTEE INQUIRY INTO SPECIAL EDUCATIONAL NEEDS AND DISABILITY FROM THE DISABLED CHILDREN’S PARTNERSHIP
Introduction
1. The Disabled Children’s Partnership is a coalition of more than 60 charities campaigning for improved health and social care for disabled children and their families. We believe that disabled children, young people and their families should have access to the services they are entitled to, when they need them.
2. Given our focus on health and social care, this response only covers those elements of the SEND reforms. A number of our member organisations will have put in their own responses, and/or contributed to the response from the Special Educational Consortium, covering the whole range of the reforms.
Aims of the SEND reform programme
3. The stated aim of the reform programme was to ensure a more holistic approach to meeting the needs of children with special education needs and disability. Important amendments were made to the legislation during its passage through Parliament so that key parts of it apply to all disabled children, not just those who also have special educational needs. We consider, therefore, that it is important that the Committee’s enquiry examines fully the impact of the reforms and the wider environment on health and social care services for disabled children and their families.
Joint working between education, health and social care
4. Paragraph 1.22 of the Special Educational Needs and Disability Code of Practice says:
If children and young people with SEN or disabilities are to achieve their ambitions and the best possible educational and other outcomes, including getting a job and living as independently as possible, local education, health and social care services should work together to ensure they get the right support.
5. We agree with this statement. However, in reality, this is not happening and the vision of the reform programme for integrated support is not being delivered. This is apparent at both strategic level – where joint commissioning arrangements are often in their infancy and not effective – and individual level, where too many Education Health and Care Plans do not sufficiently cover health and social care needs and provision.
6. Funding pressures on all parts of the system, including the high needs budget, social care and health services, mean that we are increasingly seeing commissioning decisions being driven by cost-cutting rather than a strategic assessment of the needs of the population. We have not seen evidence of the local offer acting as a driver for improved services.
7. We have increasing evidence of cuts to services for disabled children and their families. A 2015 report[1], found that a majority (58%) of local authorities cut spending on short breaks between 2011-12 and 2015-16. This trend is continuing, and in particular we are seeing ‘cost-shifting’ between the health services and social care, with children and families falling between the cracks. Ofsted/CQC joint inspections have also identified reductions in services such as short breaks. For example Lancashire’s report says “They struggle to identify any areas that have improved as a result of the implementation of the reforms. In fact, many described a reduction in services that were a strength in the past, such as access to short breaks” . This same report identifies weak arrangements for joint commissioning.
8. The overall legal framework for health and social care for disabled children is complex. It stems from more than ten different Acts of Parliament, regulations and guidance which have developed over the past 50 years. Whilst the 2014 Children and Families Act made important changes to the law which we welcome, it did not remove this complexity. The joint commissioning duties were intended to address this, by ensuring that arrangements are in place to resolve disputes between agencies. Instead, we are increasingly seeing parents forced to take legal action to protect services and clarify legal responsibilities – for example the recent judicial review of the decision to close Nascot Lawn Respite Centre in Hertfordshire.
9. Poor joint working is impacting on the quality of individual Education, Health and Care Plans. Too often, plans do not include a proper assessment of health and social care needs, and therefore risk leaving children and young people with unidentified needs and/or without the provision to meet those needs. We are also concerned that local authorities are not meeting their statutory duty to assess the needs of parent carers (section 97 of the Children and Families Act).
Recommendations
10. We have published a Five Step Plan[2] calling on the Government to take action to address the growing crisis in health and social care for disabled children and their families. We asking Government to
Step 1: Make disabled children a priority
Provide ministerial leadership to ensure a cross-departmental approach to improving outcomes for disabled children and their families.
Step 2: Review current funding
Review funding of short breaks provision for disabled children and families.
Step 3: Clarify existing rights
Clarify current rights and entitlements by co-producing with families guidance for local authorities and clinical commissioning groups (CCGs) on their existing statutory obligations.
Step 4: Create a Fund
Improve health and social care services for disabled children by providing an early intervention and family resilience fund.
Step 5: Change the system
Commission a review of health and social care law, to strengthen and clarify rights and entitlements for disabled children and their families.
11. Finally, we are concerned that any accountability with regard to local joint working will be severely diminished if the Ofsted/CQC joint area inspections do not continue into the future. We believe that it is essential that this inspection programme is maintained.
[1] Short breaks in 2015: An uncertain future Every Disabled Child Matters, 2015
[2] Secret Life of Us: Five steps to address the growing crisis in health and social care for disabled children Disabled Children’s Partnership, 2017