Agenda item

To inform the Board of the work of the Children’s Delivery Group, including activity undertaken since the Hot Focus Session and learning from the LSCB Exclusions Audit.

The Board considered a report (Agenda Item 9) which summarised the Terms of Reference, the strategic priorities and workplan for the Children’s Delivery Group.

Andrea King introduced the item by informing the Board that she was the Chair of the Children’s Delivery Group which oversaw the strategic priorities around safeguarding children but did not replicate the statutory role of the West Berkshire Local Children’s Safeguarding Board.

The Board was asked to note that following the establishment of the inter-agency Emotional Health Triage functions and the Emotional Health Academy (EHA), the number of children and young people waiting for Tier 2 Emotional Health support had reduced from 120 children in August 2015 to 0 children in April 16.

The Children’s Delivery Group was also responsible for the co-design of one shared partnership vision for Targeted Prevention services (ie. to provide strategic coherence in a time of staffing and resource reductions across early help and targeted prevention services).

The report highlighted the recent learning from West Berkshire Local Safeguarding Children Board (LSCB) analysis of local children and young people excluded from school; and the significant number of children and young people within this cohort who were waiting for Autism Spectrum Disorder (ASD) or Attention Deficit Hyperactivity Disorder (ADHD) diagnosis. It was found that schools had a perverse incentive to exclude children in order to access additional help and this caused increased safeguarding risk for children and young people; this was a  strategic challenge for the H&WBB.

Sally Murray explained that an audit of exclusions between September and December 2015 had shown that the majority of children who were excluded had challenging behaviour which built up over time. Emotional health and wellbeing of these children needed to be a priority for all partners.

A number of improvements had been made since September 2015, including increased capacity within tier 3 of the Child and Adolescent Mental Health Service (CAMHS).

Staff on the Berkshire Healthcare Foundation Trust (BHTF) Autism Spectrum Disorder (ASD) pathway had worked with Autism Berkshire and Parenting Special Children to develop workshops for families waiting for an ASD assessment. These workshops were piloted in 2015 and had been offered to all families waiting for an ASD assessment. These workshops continued through 16/17, funded by Future In Mind investment and delivered at venues across Berkshire West. Autism Berkshire had been commissioned to provide additional support for families whose teenage children had ASD as this could be a particularly challenging period of time. Autism Berkshire was commissioned to provide telephone helpline. BHFT were to launch additional telephone and online support for families who were awaiting ASD diagnosis.

Councillor Lynne Doherty commended the work of the Children’s Delivery Group. Referring to the terms of reference, she expressed the view that more consideration to schools representation be given. She also noted that there had been a reduction in the waiting list on the ASD pathway but asked for the figures to gain a better understanding of the facts.

Councillor Doherty further suggested that it would be helpful to see quarter one data when it was available and asked if there were any key themes emerging from the workshop held on 23 June 2016  ASD Appreciative Inquiry Event.

Dr Lise Llewellyn commended the overall approach and priorities but commented that health visiting was a universal service and could not be solely focussed on vulnerable groups. The preventative approach was welcomed. Dr Llewellyn noted that often families were desperate to receive an ASD/ ADHD label but enquired what resources were released by that label, also noting that a child had needs whether they had a diagnosis or not.

Andrea King responded that it was not always clear that a diagnosis released additional resources, it was clear that a child’s vulnerability increased while waiting for that diagnosis. The focus was on supporting children and their families with managing these behaviours. Special and Independent schools were offering workshops to maintained schools to support them to manage the behaviours that when unchecked, often led to exclusions. Andrea King advised that she would find out what services a diagnosis released to a child.

Dr Llewellyn expressed the view that challenging behaviours were being medicalised and labelled rather than being supported.

Councillor Mollie Lock agreed that ADHD should not be siloed without looking deeper into the behaviours. She enquired whether the EHA was getting into academies, noting the good work of the restorative practice pilot work in schools and the impact on reducing exclusions. Andrea King advised that all staff were receiving restorative practice training which was achieving positive outcomes.

Shairoz Claridge thanked the officers for a comprehensive report and asked a further question about restorative practice. Andrea King explained that 13 out of 86 schools were receiving restorative practice guidance and were seeing a significant improvement in attendance and attainment, in addition to reducing exclusions.

Shairoz Claridge requested that the terms of reference be amended to reflect the Delivery Group’s role in providing assurance to the Board about its work. She also noted that the work of the EHA was very positive and noted that some schools did not contribute to it so asked whether they still received support. Andrea King reported that school buy-in was increasing week on week and that it was the schools decision whether to buy the service or not. Councillor Lock noted that small schools often found these services prohibitively expensive but that she knew of schools joining together to share the cost.

Councillor Hilary Cole stated that the EHA had proven its worth and achieved good outcomes. She observed that the terms of reference did not identify a specific relationship with Independent schools, explaining that in West Berkshire a large number of children attended independent schools and this should be reflected in the membership of the group to allow information to be disseminated.

Andrew Sharp questioned whether the BHFT target to reduce the ASD waitlist to zero by October 2017 was ambitious enough. Sally Murray responded that the original target had been to achieve that reduction by the end of the 2015/16 financial year however this had not been achieved due to the numbers involved. Nationally the wait was around 42 months so West Berkshire was still performing better than elsewhere.

Sally Murray continued that a system-wide discussion was needed regarding diagnosis; a diagnosis should not be about access to services. A child’s needs were the same before and at the point of diagnosis. Challenge was needed of parents’ view that a diagnosis was a ‘golden ticket’.

Andrew Sharp advised that one case had been brought to Healthwatch regarding a sensory workshop which was only available in Reading and at a time which prohibited most West Berkshire families from being able to access the service. There was no value in Berkshire West solutions that West Berkshire residents could not access.

Councillor Lock asked how children who were home tutored or from traveller backgrounds might access the EHA. Andrea King advised that regarding home tutored children, there was a national problem in knowing who they were because councils relied on parents informing them. Statutorily, councils had to undertake one visit to known home-tutored children per year. Children and young people were now self-referring so there were gaps but this self-referral was vital.

Dr Bal Bahia concluded the discussion by commending the work that had been undertaken by the Children’s Delivery Group and requesting that the Future in Mind data was reported to the Board meeting in September 2016 and a further report was presented to the Board in November 2016.

RESOLVED that the report be noted.