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Chapter 4: Planning and Provision
Children's Services Plans
Corporate Approach
1 The numbers of children with severe low incidence needs are small and effective provision may require the deployment of highly specialised personnel from across a local authority and various agencies. There is therefore the need for authorities to develop a sound framework to ensure that the contribution of the various necessary agencies is acknowledged. Section 19 of the Children (Scotland) Act 1995 lays a duty on local authorities to prepare and publish plans for "relevant services" for children within their area. While these plans need cover only services provided by authorities under the Act and the Social Work (Scotland) Act 1968 and related Acts, authorities are encouraged to look beyond those services when drawing up their plans. Local authorities are expected to produce a plan which is a corporate document, including the contributions and commitments from all collaborating agencies involved with children services.
2 The Committee considers that local authorities' use of Children's Services Plans must be the central element in ensuring that quality provision and appropriate agencies and resources are in place for children with severe low incidence disabilities. It welcomes the broad commitment that local authorities' plans represent to strengthening inter-agency working. It considers, however, that plans are variable in quality and approach with some authorities further ahead than others in translating intentions into actions. The Committee considers that plans should include a corporate commitment to ensure that professionals across different parts of the authority play a full part in delivering objectives for children with severe low incidence disabilities. It is also concerned that there may be a tendency on the part of some authorities to place responsibility for development and delivery of these objectives solely on the shoulders of an authority's SEN officers.
| Local authorities should ensure that Children's Services Plans clearly identify the responsibility of all those concerned in delivery of services for children with severe low incidence disabilities, including education, social work, housing and health and the voluntary sector. |
Joint Provision
3 The Committee received evidence of particular examples of joint planning between authorities, for example, from South and North Lanarkshire Councils which make joint provision for children with hearing and visual impairment; and South Ayrshire Council which has reciprocal arrangements with East and North Ayrshire Councils for provision of services to children with hearing impairment. The Ayrshire Councils also share integrated Visiting Support and Educational Audiological Services for hearing impaired children and young people from the time of diagnosis of a significant hearing loss until school leaving age. An inter-authority agreement allows staff to work as a team from one central resource base, with an educational audiologist working across all three authorities liasing with the Visiting Service on a daily basis. Complementary provision for children and young people for whom sign language is an appropriate mode of communication is provided in two separately staffed units within mainstream schools: one for primary age pupils situated in North Ayrshire; another for secondary stages within East Ayrshire. Both units are available to children in all three authorities.
4 In spite of these examples, evidence from authorities suggested that, in general, there was little in the way of formal planning of provision between authorities. This situation reflected the wish of authorities generally to develop their own special educational needs provision. Even in the case of the Ayrshire Councils, the Committee was informed that these arrangements may be open to change as councils move to develop their own provision. The absence of inter-authority planning may lead to difficulties for provider and purchaser authorities. For example, Glasgow Council's inherited extensive special provision, combined with a declining population, leaves it dependent on attracting children from neighbouring authorities, with an unpredictability in uptake of places. Development by some neighbouring authorities of their own provision may lead to a process of rationalisation of Glasgow-based provision. This process may then have consequences for other neighbouring authorities which either do not wish, or do not have the resources, to develop their own provision.
Effect of Local Government Reorganisation
5 The Committee received evidence to suggest that local government reorganisation in 1996 has led to authorities facing varying and sometimes contradictory challenges in planning provision for pupils with severe low incidence disabilities. These difficulties can be acute for the smaller unitary authorities formed from the disaggregation of large regional councils into smaller unitary authorities. New authorities which correspond to previous regional or island council areas have been faced with less of a challenge and the pattern of provision in areas such as Highland and Dumfries and Galloway have a continuity with what existed previously.
6 New authorities which came about as a result of disaggregation have differing experiences. Some have inherited significant educational resources in terms of special schools or specialist units which formerly served larger areas. Others may have access to a more limited range of provision. Smaller authorities have generally continued to maintain pupils at schools outwith their area, leading to the need for cross-boundary arrangements which in some instances have raised disagreement over charging policies.
7 In addition, some authorities are concerned that they may no longer be able to secure provision in neighbouring authorities which have inherited specialist provision following disaggregation. This may lead to pupils, perhaps with needs more severe than those in the neighbouring authority's specialist provision, being placed further from their home area than may have been the case prior to local government re-organisation. Not only does this arrangement impose an additional transport burden on some children, it could lead to less satisfactory provision for individual children. On the face of it, this outcome seems undesirable, although the Committee recognises that under legislation, an education authority inheriting specialist provision has a duty, like all authorities, to ensure provision for its own pupils. Even where access to neighbouring authorities' provision is secure for children already in such placements, purchasing authorities may still feel powerless in terms of issues of staffing and quality assurance.
8 The Committee considers that these issues should be addressed through joint planning and provision between authorities. While responsibility for education rests with home authorities, there seems no bar to local authorities developing or managing facilities on a consortium basis to ensure the needs of children with severe low incidence disabilities across authority boundaries are met. One approach, given the importance of health services to many children with severe low incidence disabilities, may be to consider establishing consortium arrangements relating to health board boundaries.
9 The Committee has concluded that effective systems for inter-authority planning are not in place, leading to frustration on the part of both the purchasing and the providing authorities and major anxieties for parents and their children. At the same time, it recognises that the issue of inter-authority planning of provision is one which does not affect all authorities equally. The Committee takes the view that, where necessary, authorities should include reference to inter-authority planning issues when drawing up their Children's Services Plans. Where authorities purchase education provision from neighbouring authorities, arrangements should be agreed between authorities to clarify purchaser-provider issues.
| Local authorities, when planning to meet the needs of children with severe low incidence disabilities, should identify the scope for inter-authority provision with their neighbouring authorities (and health boards). Where appropriate, they should establish consortium/consultative arrangements with these authorities to consider issues such as placing policy, quality, staffing and charging within a structure for payment of inter-authority fees. |
Background
10 The Committee was asked to consider the issue of inter-authority payments for cross-boundary provision of educational services. Its discussions on this issue were aided by developments which took place during the course of its work.
11 Cross-boundary provision requires authorities to agree a system of determining payment for services provided by one authority on behalf of another. In the year after local government reorganisation in 1996, education authorities through the Convention of Scottish Local Authorities (COSLA) agreed a banded rate for special needs pupils sent to schools in other areas. That rate bore little or no relation to actual costs _ the difference was met either by the provider or the purchaser. In the event of disagreement reference would be made to the Secretary of State under Section 23 of the Education (Scotland) Act 1980.
12 Since the Committee was set up, COSLA has recommended that payment for cross-boundary provision should in future be calculated on an actual costs basis. This recommendation takes account of the decision made by the Secretary of State in June 1998 in respect of a dispute which arose between Falkirk and Clackmannanshire Councils about the level of charges proposed by Falkirk Council over the cross-boundary provision of education services for pupils with special educational needs from Clackmannanshire Council.
13 Under Section 23(2) of the Education (Scotland) Act 1980, in the event of a lack of agreement between authorities, the Secretary of State may determine the level of contribution to be made. In doing so, the Secretary of State has to have regard to the estimated costs of provision. Irrespective of the merits of a banding system, the terms of the Act do not allow the Secretary of State to adopt a "broad brush" approach that a banding system applies.
14 Against this background, the Committee takes the view that payment for cross-boundary provision for special educational needs should be made on an actual cost basis. It notes, however, that education authorities are concerned that the calculation of charges on an actual costs basis is likely to lead to substantial increases in fees for some pupils requiring high levels of support. These increases will have implications for authorities with a large number of pupils receiving educational provision outwith their home authority area. There is, therefore, a need for transparency over how charges are calculated.
15 The Committee considers that it should be clear to purchasing authorities at the point of negotiation what provision is covered by the "basic" charge and whether additional charges would be levied for items such as visiting teachers, therapy services, transport and administration costs. It welcomes, therefore, the guidance on charging policy drawn up by COSLA for use by authorities from April 1999.
| COSLA should review its guidance on inter-authority fees for special educational needs provision in the light of the first year's experience of applying the new charging system. |
16 Successful provision for children with severe low incidence disabilities depends on a range of factors, not least of which is the importance of effective interaction and a shared commitment between agencies. According to evidence to the Committee, inter-agency working is a key issue for all authorities and presents them with challenges given current funding arrangements at local authority and health board level. The importance of good joint working practices between education, health, social services and voluntary sectors was highlighted in representations from COSLA and local authorities.
17 Oral and written submissions were received from COSLA. In its view there was generally good inter-disciplinary and inter-agency working on the ground. It expected education and social work departments in councils to work together as a matter of course to develop strategic planning and agree operational responsibility for special needs pupils. It also considered that the development of Children's Services Plans strengthened inter-agency planning and that in many councils the monitoring groups for these plans had got off to a good start. It believed that the involvement of health professionals was also vital. It hoped that the community planning agenda would give more impetus to inter-agency working and strongly endorsed any moves to ensure that health authorities worked with councils in this way.
18 Local authority submissions highlighted the inter-agency co-operation which took place at all stages of schooling for children with severe low incidence disabilities. In particular they generally reported that there was strong inter-agency working at the pre-school stage. Many referred to Pre-School Community Assessment Teams which involved personnel from education, social work, health and, in some instances, voluntary agencies. The degree of involvement of the various professionals working with individual children varied according to the child's needs and the stage of education they had reached. For example, the involvement of social work services during the 5-14 stage of schooling may be less than at the pre-school stage and at the Future Needs Assessment post-14 stage for recorded children.
19 Children with severe low incidence disabilities often have therapy needs which require support across agencies. The Committee received reports that the best intentions of inter-agency planning for therapy services can be undermined by disputes over funding. It noted that, in the case of speech and language therapy, education authorities were in a stronger position to secure services because of their direct access to funding for speech and language therapy provision for recorded pupils. This provision of direct funding allows local authorities to contract with different health boards, if necessary, or employ their own therapists directly. The Committee is aware, however, that these funding arrangements are not considered satisfactory by many education authorities in that the money is not reserved for speech and language therapy and may therefore be used for other local authority purposes.
20 Notwithstanding these flexible funding arrangements, several authorities reported difficulties in securing provision due to shortages of therapists. There was particular concern over occupational and physiotherapy services.
21 The Committee considers that the overriding requirement for children with severe low incidence disabilities is to ensure that there are clear arrangements in place to ensure that the needs of these children can be met within a reasonable time scale. The difficulties faced by authorities in securing these services, whether because of a shortage of trained NHS staff or problems over funding arrangements, can contrast unfavourably with the overall care packages on offer in some independent and grant-aided schools. Evidence received by the Committee suggests that pressure on therapy services is leading to long waiting lists and unacceptable delays.
22 The Committee heard from the National SEN Training Co-ordination Project that there was growing interest in joint training for health and education staff in speech and language therapy. Unlike education authorities, however, health boards have no access to a specific grant for in-service training. This deficiency acts as a barrier to the development of joint training opportunities and inhibits the possibility of establishing a multi-agency approach when addressing the needs of children with severe low incidence disabilities.
| The Scottish Executive Health and Education Departments should examine the effectiveness of current funding mechanisms, provision and management of therapy services with a view to ensuring that the needs of children with severe low incidence disabilities are met effectively. In this examination they should consider means of facilitating more widespread joint training initiatives between authorities and health boards. |
23 Several authorities indicated that, wherever possible, they tried to combine education and respite care reviews which covered the educational, care and health needs of children with severe low incidence disabilities. The Committee is of the view that the joint review approach is particularly appropriate when considering the needs of these children; it allows the needs of the whole child and their family to be discussed and planned in an integrated way. Such an approach can strengthen the commitment of differing agencies to agree mechanisms for ensuring that the necessary resources are identified and shared. The Committee also considers that agreement between professionals on what is required to meet the needs of such children should be matched by appropriate funding arrangements.
24 The Committee heard evidence about the development by Lothian University Hospitals NHS Trust of packages for provision for children with complex disabilities jointly funded between it and social work departments which promoted a unified assessment process and shared agreements.
The key element to these agreements is to make the needs of the child paramount and to ensure the various funding agencies take a broad and not overly bureaucratic view of their required financial contributions. The Trust recognises that where local authorities and health board/trust areas are not co-terminous, it might be necessary to identify a lead agency to manage shared funds on behalf of constituent authorities and agencies.
25 The Committee also heard from Borders Council about integrated planning arrangements for children with severe low incidence disabilities. Borders is developing an inclusive policy in which it aims to provide services as close to local communities as possible. Its approach recognises that complex needs require a sophisticated web of services. It is developing a multi-agency approach, which includes planners, practitioners and financial interests, to ensure that resources are built into the planning process from the outset. This approach has lead to a new special centre in which the authority will be able to offer specialist services for children with challenging behaviour closer to home than hitherto.
26 The Committee is encouraged by these, and other similar approaches, and considers that they provide a sound basis for further development by other authorities and agencies working together.
| Local authorities should include in their Children's Services Plans a specific statement of what they are doing, in the case of provision for children with severe low incidence disabilities and their families, to develop joint funding arrangements, both within a local authority and between the local authority and other agencies. |
27 The Committee is aware of the Government initiative to develop New Community Schools, which seeks to develop an integrated approach to the educational needs of the child, family support and learning, and health needs. It considers that this approach is of vital importance to local authorities in meeting the needs of children with severe low incidence disabilities and their families.
| The Scottish Executive should consider, as part of the New Community Schools Initiative, proposals which foster inter-agency co-operation and cross-sectoral provision to meet the needs of children with severe low incidence disabilities and their families. |
Voluntary and Non-Statutory Agencies
28 Voluntary agencies and non-statutory agencies contribute in several ways to supporting educational provision for children with severe low incidence disabilities. They offer the direct provision of education; specialist advice and support for parents and staff working with children with severe low incidence disabilities; services in the pre_school stage; support for children in, after and out of school; and support for staff in the school setting, for example, in the assessment of communication requirements for pupils with severe impairments and developing their access to communications technology.
29 When developing their Children's Services Plans, authorities are required to consult with voluntary agencies which they see as (a) representing the interests of people who use or are likely to use the "relevant" services and (b) providing services in the area that could be relevant services. The Committee heard representations that the development of Children's Services Plans brought issues of partnership between local authorities and voluntary agencies into sharper focus. Authorities generally welcome the role of voluntary agencies in supporting the education of children for whom specialist help may be required; they were seen as having complementary roles to the statutory sector. Within this generally positive relationship, however there appear to be tensions between authorities and voluntary agencies when the latter act as advisers to or advocates for parents in discussions on children's rights.
30 The Committee considers that genuine consultation
with, and involvement of, voluntary and non-statutory agencies in developing
Children's Services Plans helps to emphasise their strategic role in supporting
local authorities.
It suggests that it is also important that authorities and non-statutory and
voluntary agencies develop good local working practices. In some instances,
arrangements may take the form of local service agreements. For example, the
CALL Centre, based in Edinburgh University, has operated service level agreements
with some authorities to provide assessment services to schools for children
with severe communications difficulties and to support staff in utilising specialist
technology.
31 Overall, the Committee is of the view that voluntary and non-statutory agencies can play a key role in meeting the needs of children with severe low incidence disabilities and their families and offering valuable support to local authority staff. Their contributions should be fully recognised and they should be fully involved as part of the corporate approach to developing and implementing the provisions of local Children's Services Plans.
| Local authorities should involve fully the voluntary and non-statutory sectors in drawing up and implementing Children's Services Plans. |
32 While opportunities for play and socialising are key aspects of learning and are important for all children, they are particularly crucial for children with disabilities who may have difficulties in accessing play and recreational opportunities. Voluntary agencies can play a key role in offering such opportunities. The Committee received a presentation from Play Plus which is working with Stirling Council to support children with disabilities and their families. Play Plus has a service level agreement with the education department to promote independent play opportunities for children with disabilities and to help develop their social skills. It also provides support for schools, for example, through training school staff, advising on playground issues and helping schools develop inclusive ways of involving children with disabilities in the whole life of the school. As well as building relationships with school staff, Play Plus projects also help to ensure continuity for children and their families between school and holiday time.
33 The Committee believes that the teaching of social skills for children with severe low incidence disabilities should be linked to their application outwith the school environment. Voluntary organisations have an important role to play in this area. The work of voluntary organisations is often funded by social work services and can be viewed as respite rather than in educational terms such as personal development or play. Stirling Council locates its children's recreational services within the education department rather than social services. Even where that is not the case, the Committee considers that, with appropriate inter-agency co-operation, attention should be given to the development of integrated play and other out-of-school opportunities.
| Local authorities, together with voluntary organisations within their area, should examine opportunities for developing integrated play and learning services for children with severe low incidence disabilities. |
Administration of Medicine and Medical Treatment
34 The administration of medicine and medical treatment in schools are issues where clear working arrangements between agencies are particularly important in meeting the needs of pupils with severe low incidence disabilities, who may have specific medical problems. There is no statutory obligation on local authorities to provide for the medical treatment of pupils, including the administration of medicines. Nevertheless, an education authority is, in terms of Section 13 of The NHS (Scotland) Act 1978, required to co-operate with a health board in the exercise of their respective functions. On that basis authorities should, in providing school education pursuant to the Education (Scotland ) Act 1980, co-operate with health boards in the matter of providing for the medical treatment of pupils. The review of health services in schools undertaken by The Scottish Office Home and Health Department in 1996 also made clear that it was the duty of health boards to provide for the medical treatment of all pupils in schools including the administration of medicines in schools. The review suggested, however, that in practice, the "day-to-day management of pupils requiring medication will normally be undertaken by education staff on a voluntary basis". This proposal raises important issues of training for staff, since it is very often SEN auxiliaries who are asked to take on the job of administering medicines. In practice, it has raised concerns amongst education staff over legal liability and indemnity and professional responsibility.
35 The Committee is aware that new national guidance on administration of medicines is being prepared for health and schools staff. It understands that this guidance is likely to clarify the current position on legal indemnity; where school staff voluntarily agree to administer medicines to pupils, with parental and education authority consent, they will be undertaking this task in the course of their employment. They will be acting, therefore, on behalf of education authorities which have responsibility for the actions of school staff in the administration of medicines. In that respect, education authorities must satisfy themselves as to the legality and safety of any arrangements that they undertake to make with health boards for the administration of medicines. These arrangements include an education authority requirement to satisfy themselves as to the appropriate indemnification of staff who undertake such voluntary duties.
36 While clarification of the law is welcome, the Committee's view is that it is unlikely to resolve the issue unless local authorities and health agencies agree on arrangements appropriate to local circumstances. In the case of children with severe low incidence disabilities who have particular medical needs, the Committee recommends that all such children should have an education and care plan, which includes provision for the administration of medicine and medical treatment procedures.
| Local authorities, as part of education and health care plans, should agree with health boards arrangements for the administration of medicines and medical treatment in schools and the training and indemnification of appropriate staff for this task |
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