Meeting documents

SCC Somerset Health and Wellbeing Board & Integrated Care Partnership
Monday, 21st March, 2022 11.00 am

  • Meeting of Somerset Health and Wellbeing Board & Integrated Care Partnership, Monday 21st March 2022 11.00 am (Item 24.)

To receive and consider the report.


Dr Rob Hart, Assistant Director for Inclusion at SCC, made the presentation with his colleague Vikki Hearns.  He began by noting that 27% of the Somerset populations is under 25 and that one in six of those young people will have some kind of disability or special educational need.  When one is talking about SEND, it entails children and young people with mental health needs, physical and sensory difficulties, learning disabilities such as autism, speech/language/communication issues, and difficulties requiring additional support in school.  The health outcomes for those children and young people are worse than for those without such difficulties, and there can only be equal outcomes when they are able to live independently, access employment and community services, etc.  In 2014 the Children and Families Act set out the framework for new ways of working together across health care and education; this presentation provides an update on where we are currently.

In March of 2020, the Care Quality Commission undertook an inspection of SEND services across Somerset and found 10 weaknesses: 

·         Joint working between services underdeveloped

·         Autistic spectrum condition assessment pathway dysfunctional

·         Too much variability in implementation of reforms across front line services

·         Timeliness of assessment process for plans too slow

·         Rate of exclusion of children and young people with SEND too high

·         Limited capacity to bring about improvements needed

·         Little evidence to show betterment in experience for SEND children and families

·         SEND reforms implemented too late with widespread weaknesses in identification of needs

·         Joint commissioning limited and resources underutilised

·         Quality of assessing and then meeting needs inconsistent and often weak with EHC plans lacking input from health and care professionals


In response, Somerset SEND produced nine Written Statements of Action to address these deficiencies, along with a plan to implement them; each improvement priority (IP) has a named lead, IPs are grouped in themes with school leaders and parent carers involved, there is dedicated project management support from SCC and the CCG with external support available from DfE and NHS programmes, a fortnightly delivery group brings together IP leads to monitor delivery, a monthly strategic partnership board provides a forum for discussion and planning, another monthly improvement board receives progress reports, and there is a quarterly monitoring meeting with DfE and NHS England advisors.

Somerset SEND is also promoting a culture of inclusion and collaboration; 445 new families have joined the PCF since the inspection, and families will be involved in service design.  There is also improved communication within the SEND community through various means.  A Joint Commissioning Strategy has been developed, barriers to assessment have been removed, and joined up work involving therapies, specialist equipment, schools, local authorities and health services has improved.  A school-led Inclusion Enquiry has engaged with school leaders to strengthen inclusive practice; and processes for identification, assessment and planning have been strengthened.

DfE and NHS monitoring in January 2022 found that the local area has maintained good progress in implementing the Written Statements of Action, while those actions that are behind schedule have been identified and corrective measures put into place.  Significant improvement in collaborative activity has been observed.  Risks and challenges remain with respect to engagement, data use, commissioning restrictions, the effects of the pandemic, reorganisations of the ICS and Somerset Council, and budgets; while more needs to be done with respect to strengthening joint working and work with families, autism assessment, inclusion, improving access, Covid recovery, and the new SEND strategy from 2023 onwards.  Vikki Heard emphasised that a needs analysis was paramount in for this new strategy moving forward, and Dr Hart opined that a focused development session with HWBB would be very useful in this respect.

The Chair thanked the presenters, noting that it was very evident how much work had been put in to arrive at the current point, and she asked for questions and comments from the Board.  Cllr Keen enquired with respect to exclusion of children if the issue had existed even before the pandemic, if it had to do with the time required for assessments, and if the numbers were included with those who are home schooled; she said that it was a matter of concern and asked if there could be a more detailed discussion of this in future, with the Chair agreeing that there was a need for more information on alternative education.  It was responded that it was, in fact, a concern before the pandemic, with a drop-off in the numbers during the pandemic; it does not appear, however, that there is a link between the length of time required for assessment and exclusion, as the timeliness of assessments has improved significantly over the last 18 months and is now better than the national average.  At times excluded children have not been identified by the school as having any special educational needs, but afterwards these needs are identified, so there is a need to strengthen school identification and to give support to elective home education.  Families have a right to educate children in ways other than at school, and many get a very high-quality experience from elective home education.  They do track the numbers of children educated at home and have processes whereby they can check with other agencies as to whether there are any associated risks.  The government has announced plans for a type of mandatory registration for families to inform that they are home schooling.  With respect to a more in-depth discussion on the subject, a report was made to the Scrutiny Children’s committee in February, which could be of interest to this Board, although he is happy to share future updates as well.  The Chair agreed that the presentation mentioned would be helpful and sharing of the report would be followed up on, and she is 100% behind holding a joint development session.  She thanked the presenters for their work.


The Advisory Somerset Health and Wellbeing Board noted the recommendations on Page 22 of the Agenda pack and the suggestion for a development session.



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