Somerset CCG and County council were found to have 'widespread weaknesses' in their Special Educational Needs and Disabilities (SEND) services which were causing distress to many children, their parents, and their families.
The challenge
In March 2020 Ofsted and the Care Quality Commission carried out an inspection of Special Educational Needs and Disabilities (SEND) services in Somerset. Inspectors found 'widespread weaknesses' with staff working in isolation, which led to a lack of coordination between services. This was identified as 'causing distress to many children, their parents, and their families.' One of the key areas identified for improvement was Somerset’s pathway for Autistic Spectrum Conditions (ASD) and Attention Deficit Hyperactivity Disorder (ADHD).
Somerset CCG and County Council were given the opportunity to respond and compile a coordinated action plan to address the failings identified. We have long-standing relationships within the region, and Somerset CCG Deputy Director of Women’s and Children’s Health contacted the SCW Mental Health (MH) team for support with writing and co-ordinating the formal Written Statement Of Action (WSoA) back to the Inspectors, as well as specifically supporting the redevelopment of the ASD/ADHD diagnosis pathways in Somerset (including pre-and post-diagnosis).
Our solution
SCW expertly facilitated the development and tracking of the huge programme of improvements across the region, capturing progress and milestones for each area identified in the WSoA workplan. The team brought an independent voice to the region, breaking down organisational barriers, facilitating complex and difficult conversations, and ensuring real progress in the coordination of care for children and young people (CYP) in Somerset.
- Putting children with SEND and their parents and carers at the centre of the services and their redesign
- Establishing mechanisms to demonstrate that Somerset is improving its ASD/ADHD offer
- Reviewing and proposing improved ASD and ADHD diagnostic pathways to best practice standards
- Leading on promoting partnership working with parents and carers, schools, education, social care and service providers
- Facilitating a 'tell it once' culture across all CYP services within Somerset
Impact
Established datasets are still evolving but data compiled from April 2021 to February 2022 indicates the significant improvements made to the Autism and ADHD baseline data (April 2020) assessment pathway, as highlighted below:
- The source of referrals from GPs has dropped from 100% to 72% and continues to go down in line with multiple sources now being able to refer.
- The average number of referrals that result in assessment has increased from 11.2% to 65%, indicating that more CYP and their needs are being met through accessing the pre-assessment pathway.
- Average referral to treatment waiting times has decreased significantly from over 26 weeks to 16 weeks (which is now in line with the national average RTT). This is continuing to be monitored until it aligns with NICE guidelines of 12 weeks.
Next steps
After an initial three months of working with Somerset, our support was extended until March 2021 continuing the development of pre-diagnostic, diagnostic, and post-diagnostic ASD and ADHD Pathways within Somerset.
Added value
- An external view of the SEND improvement programme allowed SCW to take an objective and impartial approach to support
- Subject matter expertise was key in breaking down perceptions and barriers to gathering and analysing key material and processes
SCW supported managing a particularly complex piece of work focussed on co-producing neuro-developmental pathways with and for children and young people. SCW not only provided a wide range of experience, expertise, skills, and knowledge…their professional approach ensured that we could stay on track and evidence our journey…they were responsive, effective, and efficient…delivered what they promised.
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