· Proposed Decision: To commission a dedicated service that offers robust and consistent support to parents whose child has either received a diagnosis, awaiting diagnosis, or considering a referral to the Neurodevelopmental (ND) Pathway. The scope of the new service aims to address the issues raised by parents by offering a range of options that can be delivered in addition to services currently on offer across the County. The Key Decision is to allow Commissioners to commence formal procurement activity to tender for a service, award a contract and develop internal provision for ownership and oversight of the activity.
· This proposal is to develop a new dedicated service that offers robust and consistent support to parents who are concerned their child may require some additional support, linked to Autistic Spectrum Condition (ASC).
· The Service will be facilitated jointly by parents, utilising lived experience, building resilience and developing self-help strategies amongst fellow parents. The overarching aim of the service is to reduce the emphasis on needing to wait for diagnosis before being able to access support, in turn it is hoped that this will have a positive impact on the diagnosis backlog and waiting lists.
· In January 2021 a working group was set up with multi-agency partners and parent representatives to co-produce key components required of the new Model. This group captured good practice, issues, and current gaps in the provision.
· In addition to the development of the ‘Supporting Parents Service’, this work will be used to further support future SEND inspections.
· Partners included, but not limited to, Kent PACT, Kent and Medway Clinical Commissioning Group (CCG), Information Advice and Support Kent, Specialist Teaching and Learning Service, Voluntary and Community Sector, Public Health, Disabled Children and Young People Services, SEN Early Years, Early Help, Adolescent and Open Access.
· The scope of the proposed new service aims to address the issues raised by parents and carers by offering a range of options that can be delivered in addition to services currently on offer across the County.
· The SEND inspection of 2019 highlighted issues regarding the following:
o The widely held concern of parents that the local area is not able, or in some cases not willing, to meet their children’s need.
o The limited role parents and carers have in reviewing and designing services for children and young people with SEND.
· Key to delivery will be facilitators with lived experience. Parents as service users have robustly reported that it is lived experience that is key to the success of their engagement with the programmes. In addition, having parents at the heart of delivery will ensure continuous improvement of the Offer.
· Following discussions with Kent & Medway CCG, they support the proposed Model and have agreed to add £100,000 to the funding pot for each year of the contract/Service Level Agreement, to support a Countywide multi-disciplinary ND resource.
· Year One of this provision will focus on children and young people currently in receipt of an Integrated Children’s Service intervention. The new service will increase the total Countywide Offer to parents by 42%.
· Whilst it is not anticipated to reduce demand, the overarching aim is to reduce levels of anxiety and reduce those parents reaching crisis point whilst on the waiting list. This work will also join up with the Parent and Place Workshops that will bring together a range of professionals that parents can access as part of their ND journey. The Model will include provision for a KCC Countywide Co-Ordinator post, whose primary objective will be to develop, join up and expand the parenting offer.
1. Do Nothing:
Support and advice to parents relating to the ND Pathway will continue to be fragmented, inconsistent across the County and difficult to find, resulting in a postcode lottery and additional stress for parents and families.
2. Create the new service In-House:
This option may impact on the capacity within teams, with the risk of staff being pulled back to their ‘day job.’ Also, parents have told us they are nervous/not likely to approach KCC regarding initial worries and support delivered with lived experience is more meaningful.
3. Externally commission the new service via Voluntary and Community Sector (VCS):
VCS are already set up to deliver the whole range of support to parents/families and benefit from long-standing relationships with parents as well as being very experienced in managing volunteers. Robust contract management will be in place.
4. Hybrid Model - Externally commission the new service via VCS – with additional oversight via KCC Co-ordinator post:
As above in Option 3, with additional dedicated KCC Service Co-ordinator post for robust oversight of whole County Offer. Service provision will be in addition to current in-house delivery.
· The main risk is to do nothing. The numbers awaiting diagnosis have doubled during COVID with a wait time between two and a half and three years. The overarching aim of the new service is to support parents to build resilience and robust strategies that help to reduce levels of anxiety and reduce those parents reaching crisis point whilst on the waiting list.
Decision type: Key
Reason Key: Expenditure or savings of more than £1m;
Decision status: For Determination
Division affected: (All Division);
Notice of proposed decision first published: 19/07/2021
Decision due: Not before 17th Aug 2021 by Cabinet Member for Integrated Children's Services
Reason: in order that the proposed decision can be published for a minimum of 28 days, in accordance with statutory requirements
Lead member: Cabinet Member for Integrated Children's Services
Contact: Sarah Challiss, Commissioning Officer Phone number:03000 415356 Email: email@example.com.
Financial implications: On 15 November 2019 CYPE Cabinet Committee approved for funding originally badged against the Early Help pathway within the Children and Young People Mental Health (CYPMH) contract to be repurposed, with the aim of reducing the burden on the ASC pathway. Total funding available is £500,000: £400,000 (From the Early Help Pathway in CYPMH contract) with the addition of £100,000 funding from Kent and Medway CCG per year for the length of the contract/Service Level Agreement.
Legal implications: This work is taking place, in part, due to the Ofsted and Care Quality Commission (CQC) joint review of SEND provision for Kent CYP and the resulting Written Statement of Action (WSoA) KCC implemented to address the concerns of the review. The proposed new Offer is a result of several areas found lacking in the review which are addressed through the WSoA alongside direct feedback from the Working Group.
Equalities implications: An Equality Impact Assessment (EqIA) screening has been completed and has concluded that the proposed decision does not present any adverse equality impact.