The reforms: Opportunities for getting it right for children whose behaviour challenges Christine Lenehan Director

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 4 th February 2013 Care and Support Bill due in parliament later this year NHS changes implemented 1 st April Ongoing changes in Welfare Reform SEN School Funding Changes Policy in a political framework

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 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.” 12

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