Weekly political news round up – 25th April 2014

April 25, 2014 in News by Whitehouse

Around the sector

Children and Young People Now has reported that early years experts, including Melian Mansfield, chair of the Early Childhood Forum and Neil Leitch, chief executive of the Pre-school Learning Alliance, have written to all three main political leaders arguing that the wellbeing of young children could be compromised if the government continues to advocate a “developmentally inappropriate practice” to early years education. The complaints follow an increasing emphasis by the Department for Education on formal academic learning in early years settings.

BBC News has reported that the National Union of Teachers have used their conference to increase the focus on formal learning and assessment within early years settings which they claim is putting “undue pressure” on young children. Christine Blower, general secretary of the National Union of Teachers (NUT) said the current focus on testing ignores young children’s social and emotional needs, setting them up to fail within education at an early age.

Baroness Morris of Yardley, who was Education Minister under Tony Blair, has written in the Guardian that the debate over how best to educate under-fives has become too polarised, with the Department for Education feeling that children should be better prepared for school, and early years experts and teaching unions believing that children should not be pushed into formal education too early. She argued that a middle ground should be sought that combines both views.

National Institute for Health and Care Excellence launches consultation on nocturnal enuresis quality standard

The National Institute for Health and Care Excellence (NICE) has published the draft quality standard for nocturnal enuresis in children and young people. NICE quality standards are designed to drive measurable quality improvements within a particular area of health or care where a need has been identified.

In identifying the need for this particular quality standard, NICE have recognised that nocturnal enuresis, or bedwetting, is a “widespread and distressing condition that can have a deep impact on a child or young person’s behaviour, emotional wellbeing and social life”. The definition of nocturnal enuresis in this quality standard mirrors that used in the NICE clinical guideline on nocturnal enuresis, which was published in 2010. In this definition, nocturnal enuresis is a term used to describe the symptom of involuntary wetting during sleep and without any inherent suggestion of frequency of bedwetting or pathophysiology.

NICE believes that this quality standard will contribute to improvements in the quality of life for children, young people and their families and carers, as well as the psychological wellbeing of children, young people and their families and carers.

There are three draft quality statements, which state that:

  • Children and young people (aged 5-18 years) who are bedwetting have an initial assessment that includes their bedwetting pattern, daytime symptoms, fluid intake, toileting pattern and any physical, social, emotional or developmental issues.
  • Children and young people (aged 5-18 years), and their parents and carers if appropriate, have a discussion about initial treatment with an alarm or desmopressin when bedwetting has not improved after changing their daily routine.
  • Children and young people (aged 5-18 years) whose bedwetting has not responded to treatment with an alarm or desmopressin or both are referred for a specialist paediatric continence review.

The consultation asks for views on two questions:

  1. Does this draft quality standard accurately reflect the key areas for quality improvement?
  2. If the systems and structures were available, do you think it would be possible to collect the data for the proposed quality measures?

Weekly political news round up – 18th April 2014

April 18, 2014 in News by Whitehouse

Around the sector

BBC News has reported that Schools Minister David Laws has called for a “significant period of stability” following the coalition government’s wide-ranging reforms. Laws added that “I hope that whatever the outcome of the May 2015 general election, parties will focus in these areas on implementation rather than further change. I certainly intend that my party should set out a commitment to much greater policy stability in our manifesto.”

The Guardian has reported that the Children’s Commissioner for England, Dr Maggie Atkinson, has warned that the effective age to begin compulsory education is danger of becoming two rather than four as parents try to gain an advantage in winning places in coveted schools by putting their infants in the school’s nursery provision. As part of the study on school admissions, researchers found that parents of children with special educational needs strongly felt that they were dissuaded from applying for certain schools, both actively and tacitly.

The National Children’s Bureau has published a report showing that parents and practitioners greatly value children’s centres and the service they provide to families, and that their continued funding should be secured. The report, based on a survey of over 200 practitioners and parents, found that over 80% wanted children’s centres to continue to work with all children under five. Respondents felt that the highest priorities for children’s centres should be: family and outreach support; early education and language development; and play opportunities.

Children and Young People Now has reported that the quality of staff employed by Tribal Group, a provider commissioned by Ofsted to deliver inspection services in early years settings, has been criticised by former Ofsted Inspector Debbie Alcock, who is now managing director of Influential Child Care Training. She claimed that they lacked training and that she was “shocked by some of the things that are happening at the moment – unprofessionalism, the way people are working – just awful”.

Department for Education publishes revised SEN Code of Practice

The Department for Education has published a revised draft SEN Code of Practice asking for further comment from those organisations and professionals that “must have regard to the Code” by 6th May.

This revised document has been published to satisfy a pledge that the DfE made to schools that they will be given “two terms notice” to implement the reforms using the Code. The DfE also seems to be making a concerted effort to win the sector’s endorsement of the Code, for final comments and tweaks to be made before it is debated and approved in Parliament. The document has substantially improved on the previous draft and has taken on the sector’s comments in many areas.

The following aspects of the Code have changed since the October draft:

Format

The length of the code has increased considerably, from 172 to 242 pages. The reason for this change is primarily to do with additional detail added into every section, but paragraphs have also been split up to make key issues clearer and more diagrams and tables added to explain different issues such as the accountability of services. Other linked legislation, especially the Equality Act, has been referenced throughout to clarify the legal framework.

However, the format is still a weakness because the Code is still trying to address multiple audiences, parents, service users and service providers, in one document. As such, there is a risk that many parties will have difficulty referring to the document even though  the Code is supposed to become a universal reference tool.

Early years

The responsibilities of all education and health providers, from the early years to further education, to identify and support children and young people have been given far more detail. There is an entire chapter dedicated to early years providers and their responsibilities, including private and voluntary providers (PVI). PVI early years providers have been clearly requested to have regard to the Code and LAs have been required to do so. The references to the Early Years Foundation State (EYFS) seem to be have been made more robust and clearer and linked with the identification and support of need.

However, the Code now reflects the changes to primary school accountability, where the EYFS profile is no longer statutory and providers are not required to implement it but this draft still sets out its value clearly. More detail has been given on the value of the 2-year-old progress check and how it may be used to identify needs, but more information is still required on what it will entail. The Code also contains a requirement on health bodies to advise parents of the educational services and VCS guidance available to support their children – a responsibility made far clearer in this latest draft – while health professionals are also expected to understand the non-medical needs of children with SEN and offer advice.

Support in schools

The chapter on the responsibilities of schools is far more proactive than the October draft, offering far more advice on how schools can identify and support children with special educational needs. This has included a more detailed section on the graduated response. The Code also explains in greater detail how identification and support links in with pupil attainment and behaviour and why early intervention should be encouraged in schools – effectively better linking SEN support with the reforms to school accountability to make it clearer that progress for all pupils is in their interest.

Joint commissioning, the local offer and accountability

This section makes clearer where the responsibilities of different services lie and how the process of joint strategic needs assessments (JSNAs) and the local offer link. More emphasis has been placed on the involvement of children and young people and their parents in the design of services, in particular in relation to the local offer. The Code also proposes that a Designated Medical Officer is appointed by CCGs to be accountable for health services, although this role is non-statutory. Area SEN coordinators are another role encouraged by the Code to coordinated services, but again are not compulsory. The responsibilities of certain bodies have been defined more clearly, including the role of Health and Wellbeing Boards in overseeing JSNAs. The social care section has been expanded considerably, but the detail here is sparse compared to other parts of the Code as it is essentially a late addition.

However, what this draft Code does reveal even more clearly is that joint commissioning will be disjointed across the country because there is no set leadership for encouraging joint-working, stating that CCGs and LAs will have “considerable freedom” in how they work together meaning that those areas with good relationships between partners are much more likely to succeed in ensuring good service provision. The accountability of various bodies from schools and local authorities to health bodies has also been described more clearly (3.69) but there remains the problem that the accountability structure is haphazard and without an ultimate overseer.

EHC Plans

This section remains broadly the same, although more detail has been offered in certain stages and some of the more complicated explanations broken up, while it is still suggested the Plans quantify the support available. The role of personal budgets for children and young people with Plans has been explained in more detail but as they are up for local areas to design and introduce, it is expected that they will not be in widespread use because their implementation has proved too difficult in health and social care.

Scottish Government publishes guidance to support provisions in the Children and Young People (Scotland) Act 2014

The Scottish Government has published the proposed outline of the statutory guidance to support three parts of the Children and Young People (Scotland) Act. These three parts are: Part 4 (Provision of Named Persons), 5 (Child’s Plan) and 18 (General). These provisions aim to support the Getting It Right For Every Child (GIRFEC) approach, and its implementation across Scotland. GIRFEC is the national approach to reforming children’s services to improve outcomes for all children and young people.

By enshrining key elements of GIRFEC in the Act, the Scottish Government hopes to ensure there is a single planning approach for children who need additional support from services, create a single point of contact for every child and provide a holistic understanding of wellbeing. The guidance is intended to ensure all services are included in a common approach, with an emphasis on prevention and early intervention to provide effective support, and a key role for children and families in shaping service delivery.

The Provision of Named Persons (Part 4) states that when a child is born, their local Health Board will have a duty to provide them with a Named Person service. The Named Person is a single point of contact for every child so that no one is left without potential support. They will ensure that action by services will be co-ordinated, child-centred, efficient and responsive. Whereas a parent has the right and responsibility to bring up their child, the Named Person is a professional in the universal services of health and education, most often known to the child and parents/carers, and available to support children and families when there is a need, and to act as a point of contact for other practitioners who may have a concern about the child.

Although there will always be a single Named Person, this person will change over time. From birth to around 10 days the Named Person will be the midwife who delivered them. From 10 days onward, the role of the Named Person will be handed over to their assigned Health Visitor. When the child starts school, the Named Person will typically be the school head teacher. It is hoped that by introducing a Named Person, signs of potential concern amongst children will be identified sooner and support offered will be more effective.

The Child’s Plan (Part 5) seeks to address the current situation where parents find that there are several different plans that seek to address issues with the child’s health, learning needs or home circumstances. In this situation, agencies may be working in isolation to address specific needs, perhaps because they are unaware that other bodies are involved, or do not know that there are other concerns that may lie outside their main focus.  By offering a single plan for a child’s wellbeing, the Child’s Plan seeks to change this.

Where the child’s main needs lie within the Named Person’s agency (health for pre-school children or education after starting school) the Named Person is expected to initiate a single agency Child’s Plan and co-ordinate delivery of support where additional targeted help is needed (a ‘targeted intervention’), unless this requires a level of coordination out with the scope or capacity of the Named Person. For example, for a young child where concerns are highlighted at the 27-30 month review, the Health Visitor may seek support from other specialist health professionals and coordinate that support through a Child’s Plan. Where the child is of school age, the Head Teacher can call upon education services out with the school’s resources to meet aspects of the child’s wellbeing. The support and the desired outcomes will be outlined in the Child’s Plan.

The Named Person will work with the lead professional, who is the professional best placed to carry out the coordinating role and work with the family to improve outcomes for the child, and should always be involved in the decision to initiate the Child’s Plan even if they do not work for the agency leading on preparation of the plan. Although for many children there may be an incremental approach to planning and support, moving from a single agency plan to a more complex, multi-agency plan supported by a Lead Professional, for a minority a sudden event or crisis might require multi-agency planning and support as a first step.

As a key principle of GIRFEC, the child and the parents should be actively involved in the process of development and review of the plan and their views will be considered and recorded within the plan. Only in exceptional circumstances will professionals have to make the decision that it is not possible, or appropriate, to seek views and involve the parent and/or child in aspects of the assessment and planning process.

The Scottish Government stated that the full statutory guidance on the Children and Young People (Scotland) Act will be available and subject to consultation in due course.

Weekly political news round up – 11th April 2014

April 11, 2014 in News by Whitehouse

Around the sector

Children and Young People Now has reported that officials from the early years sector have criticised Sir Michael Wilshaw, the head of Ofsted, for claiming that childcare providers are failing to meet the needs of disadvantaged children. Anne Longfield, Chief Executive of 4Children, responded that it was “simplistic and misguided to suggest that all children will be better served by the provision of formal education in schools from two”, adding that children need “nurturing environment where [they] are able to play and learn”.

Mencap and Every Disabled Child Matters (EDCM) have issued a public statement expressing concerns that the final SEN Code of Practice will have few changes from the draft guidance, despite previously stating that the guidance “is not fit for purpose”. The warning follows the publication of a letter from Children’s Minister Edward Timpson instructing schools to use the draft guidance to prepare for the changes to the SEN system.

Answer to written question on continence care

Labour MP Jim Dobbin has received an answer to his written question asking the Health Secretary what steps he is taking to ensure that continence care products are provided on the basis of clinical need.

Care and Support Minister Norman Lamb responded that clinical commissioning groups (CCGs) are responsible for commissioning continence services for their local populations and performance managing their providers in the delivery of high quality services.

He added that NHS England is responsible for the commissioning of specialised continence services and has produced a number of service specifications on various types of incontinence, defining what is expected to be in place for providers to offer evidenced-based, safe and effective services. The service specifications published by NHS England include: “Colorectal services: faecal Incontinence (adults)” (which has a focus on surgical solutions), and “Complex Gynaecology: Recurrent prolapse and urinary incontinence”.

He concluded that the Department expected providers of continence care products to take into account any relevant National Institute for Health and Care Excellence (NICE) guidance on the management of incontinence.

Department for Education and Department of Health publish guidance on the implementation of SEND reforms

The Department for Education and the Department of Health have jointly published guidance for local authorities and health partners on the implementation of special educational needs and disability (SEND) reforms introduced by the Children and Families Act 2014. It sets out a timeline for implementation, summarises information on local readiness, and provides answers to some frequently asked questions.

Key dates are laid out in the guidance. In terms of legislation and the broader context, the following dates are relevant:

  • Late spring 2014: the SEN Code of Practice will be published for Parliamentary approval.
  • Spring 2014: New burdens allocations for local authorities announced.
  • April 2014 – March 2015: SEND Reform Grant provides additional money to local authorities in 2014-15 (within Early Intervention Grant).
  • April 2014 – March 2015: support available to local authorities from SEND advisors, pathfinder champions, and CDC strategic partner and specialist delivery partners.

In terms of local implementation, the following dates are relevant:

  • April 2014 – September 2015: local authorities involve partners and parents in planning for implementation and delivery of the reformed system
  • From September 2014: local offers published following consultation; joint commissioning duty commences; new assessment and planning starts (for new entrants); personal budgets offered as part of Education, Health and Care (EHC) plans; mediation arrangements in place; local authorities should publish plans for EHC plan transfers.
  • September 2014 – September 2016: young people with Learning Difficulty Assessments (LDAs) transfer to the new system.
  • September 2014 – April 2018: children and young people with statements of SEN transfer to the new system.

The guidance provide a useful simple overview of the reforms – especially how 18-25s will be supported, how they work in tandem with the Care Bill over the transition to adult support and how young offenders will be supported under the provisions.

Most significantly, the guidance for local authorities and health partners issues an unprecedented directive saying that health bodies are obliged to advise parents of children with complex needs of the educational support available to them in early years settings. Paragraph 28 states:

“Where complex developmental and/or sensory needs are identified at birth or in the very early years through regular health checks, which mean a young child under compulsory school age has or will have SEND, the health body must inform the parent, discuss it with them, and let them know about any voluntary organisations that are likely to be able to provide advice or assistance. This includes the educational advice, guidance and intervention to be put in place early and before the child starts school. The health body must also draw that child to the attention of the appropriate local authority, who must then consider whether the issue is sufficiently complex and long term that an EHC plan assessment is appropriate.”

This directive means that education and voluntary and community service providers now may legitimately approach their local NHS and insist that they let parents know about the services they provide for young children with complex needs. This will mean that parents can ensure that their children receive crucial support that they may not otherwise be aware of.

The guidance also states that from September 2014, two-year-olds with EHC plans, statements of SEN or that are eligible for Disability Living Allowance will be entitled to 570 hours per year of funded early education. The Department for Education is currently consulting on the guidance for delivering this entitlement.

Little detail is provided in the guidance on how personal budgets will work in practice. It is stated that as part of their local offer, local authorities will be responsible for setting out a local policy for personal budgets, including how that funding will be made available, as well as the eligibility criteria and the decision making processes than underpin them. It is unlikely that personal budgets will be rolled out on any significant level as the Government has been unable to find a process that enables them to work in practice, which is consistent with attempts to introduce personal budgets through the health and welfare reforms.

Weekly political news round up – 4th April 2014

April 4, 2014 in News by Whitehouse

Around the sector

The National Children’s Bureau has published a report showcasing how innovations by primary and first access health care teams around England have improved children’s access to and experience of healthcare services. Though none of the projects were continence based, they show good evidence of how pioneering projects by local health care teams can make life easier for children with health needs.

The Scottish Government has announced that Sir Harry Burns has stepped down as Scotland’s Chief Medical Officer, being replaced temporarily by Dr Aileen Keel until a successor is found. Scotland’s new Chief Medical Officer will be tasked with helping shape the direction of Scotland’s future health priorities. Sir Harry had previously focused his work on the issue of health inequalities.

Children and Young People Now has reported that Shadow Education Secretary Tristram Hunt has confirmed at a speech to the NSPCC conference that Labour will be developing an overarching strategy for children with a “sharp focus on educational attainment and cognitive outcomes”.  He stated that Labour would be unlikely to invest additional money into children’s services, adding that “we have to think smarter about what we do with precious resources”.

Ofsted publishes first annual report into early years education

Ofsted has launched its first report on early years education provision. The report reiterates the importance of better baseline assessment for pupils in reception to use as a method to assess pupil progress and compare attainment among peers at a young age, recommending that this data should include information about the early years provider for Ofsted to use that data to make an assessment of their performance. The report also criticises the Early Years Foundation Stage Profile (p.13) by saying it does not produce enough of this data for inspectors to use, although it still recognises the profile as a key check that is used to monitor child development (p.14).

The annual report shows the continuing gap between outcomes for children from disadvantaged backgrounds and those from more affluent backgrounds, even before the age of five. The report found that only a third of children from low income backgrounds reach what is considered a good level of development at the early-years stage. Interestingly, the report relies on evidence from the Early Years Foundation Stage Profile – which the Government is making non-statutory – to show that children from low income backgrounds have fewer skills in areas such as learning, particularly in language and communication, than their more affluent peers.

The report also concluded that inspection reports very often highlight shared delivery of services and relationships with front-line health staff such as midwives, health visitors and speech and language therapists as significant strengths. The report also provides insight into the complexity of the sector (p.18), showing the number of providers in different forms from children’s centres to nurseries, 0-4 school provision to childminders.

The report makes a series of recommendations including:

  • There should be an agreement nationally on a small number of words for different types of early years provision that would be consistently used
  • The Government should introduce a nationally comparable and standardised baseline assessment at the start of Reception, with external marking for both the baseline and Key Stage 1 assessments
  • Schools should be given greater flexibility to support children in their early years and be incentivised to do so – including by removing the requirement for separate registration, regulation and inspection for this younger age group and more recognition of school leaders who voluntarily make themselves accountable for raising attainment on entry through engagement with the local early years sector
  • The new pupil premium for three and four-year-olds should be extended to two-year-olds at the earliest opportunity
  • Local councils that do not have enough high quality provision should consider incentives for schools to expand their provision either on-site or in linked provision

In response to the study, a Department for Education spokesman said high-quality school nurseries enabled children who are behind to catch up with their peers before starting school. The spokesman added: “we have been clear that we want to ensure more flexible, affordable and high quality provision is available for parents. We have already made great strides in early year’s provision with the introduction of the new early year’s pupil premium, strengthened early-years qualifications and encouraging schools to open from 8am to 6pm.”

Ofsted has also published the results of a survey on how the most successful early years providers ensure disadvantaged and vulnerable children are better prepared to start school. This report can be seen as a document that further makes this case as an annex of evidence for the Annual Report to draw many of its conclusions from, especially to make the argument to introduce baseline testing.

Department of Health publishes guidance to local commissioners and providers on maximising contribution of school nurses

The Department of Health has published guidance for local commissioners and providers on maximising the contribution of school nursing teams to the public health of school-aged children (5 to 19). The guidance sets innovative ways that school nursing services can be commissioned and developed to meet local need to ensure effective, seamless delivery of public health for school-aged children and young people. The theme of the guidance is that although school nurses are a strong asset, they alone cannot be left to ensure public health needs are met.

The guidance states that commissioners will need a systemic, reliable and robust process to access population health needs that provides a basis for designing and reviewing services, together with workforce plans to ensure an appropriately skilled workforce can deliver public health locally. It also stated that services should be developed to meet an individual need and tailored to ensure individuals are supported.

Although the guidance highlights that school nursing teams lead and contribute to improving outcomes using their autonomy, clinical skills and professional judgement, it stresses that they cannot be held solely responsible and cannot deliver the 5-19 Healthy Child Programme agenda in isolation. It adds that school nursing teams will need to work with a number of partners, including health and social care teams, teachers and youth workers to delivery evidence based public health interventions.

With regards to continence, the guidance states that school nursing services must contribute to a reduction in the number of children with continence problems by:

  • identifying need on school entry
  • Sign posting and referral to appropriate providers commissioned by CCGs

Department for Education publishes evaluation on SEN Pathfinder programme

The Department for Education has published the latest evaluation of the SEN and Disability Pathfinder programme. This evaluation explores the readiness for reform and effectiveness of the Pathfinder Champions, who have been appointed to help non-pathfinder areas prepare for the SEN reforms. Generally the evaluation found that the pathfinders have continued to make progress between March and September 2014. Pathfinders had advanced in addressing issues around organisational engagement and cultural change, but were less advanced around setting up the infrastructure.

The study found that pathfinder areas were more advanced in their developments relative to non-pathfinder areas, and had made progress across the majority of the elements of the reforms between February and October 2013. For example, half the non-pathfinder areas that responded to a series of surveys at the end of 2013 had implemented between none and three of the nine main elements of the reforms. By comparison, the research showed 80% of the 20 pathfinder areas had developed, or were developing, between seven and nine of the reform elements.

It was also noted that progress against most of the reform elements was further advanced within SEN than in social care and particularly health. It was considered that this progress deficit was partly due to a lack of capacity to engage or clarity on how to contribute on the part of practitioners. It was found that good progress had been made engaging and involving families. The majority of areas had fully implemented or already established awareness-raising of the pathfinder with families (28 of 31 areas) and recruited families to participate in the pathfinder (26 of 31 areas). Implementation of peer support was more mixed. Sixteen areas had fully implemented peer support for parent carers, or already had existing structures in place. Peer support for children and young people was less prevalent still, and had been fully implemented by three of the 31 areas.

It was concluded that a good level of progress had been made in developing certain aspects of the reforms, including the Education, Health and Care (EHC) coordinated assessment and planning pathway, EHC plan templates, the local offer, and governance of the coordinated assessment and EHC plans. However, the following areas were marked as remaining at an earlier developmental stage: eligibility criteria for the EHC plan; joint commissioning arrangements between the local authority and partner Clinical Commissioning Groups (CCGs); joint resourcing arrangements; personal budgets – particularly in relation to SEN and health; and workforce development. Concern has been expressed at the slow progress in non-pathfinder sites and it was recommended that they should be closely monitored over the next few months and additional support offered for areas that need it.