Strategy for the learning provision for children and young people with complex additional support needs 2017-2026: full consultation analysis

Content

Section 1. Our Vision, Aim and Objectives

Question 3: Do you think the aim of the Strategy and the four objectives are the right ones to achieve the Scottish Government's purpose of improving outcomes for children and young people with complex additional support needs through strategic commissioning of services?

Answer	Total	% of all respondents
Yes	42	69
No	6	10
Don't know	1	1
Not Answered	12	20

The majority of respondents agreed the aim of the strategy and the four objectives were the right ones to improve outcomes for children and young people with complex additional support needs through strategic commissioning. Positive comments included – 'The aim is in line with Scottish Learning Disability Strategy, The keys to life (2013) and The Christie Commission (2011) which highlight the need for strategic commissioning based on quality of life and outcomes for individuals in Scotland and supported the objectives and views them as 'fitting well within the recommendations of The Doran Review (2012).' Another response stated 'The aims and objectives are in line with wider national objectives and will ensure that this document is relevant and helpful to all local authority services'.

A number of the positive responses called for the 'improved outcomes for children' to be set within the context of the Getting it Right for Every Child (GIRFEC) wellbeing indicators. Some of the comments included 'Overall we agree with the vision, aims and objectives. Although it is mentioned within other areas of the document, it may also be useful to consider the delivery of improved outcomes for children within the context of the GIRFEC wellbeing indicators – we note that these are referenced later, but only in relation to service self-assessment' and 'Yes with qualification. It would be useful to consider the delivery of improved outcomes for children within the context of the GIRFEC wellbeing indicators'.

A number of respondents felt that it was reasonable to link improved outcomes for children and young people with complex additional support needs to the National Improvement Framework's (NIF) six key drivers for improvement: school leadership; teacher professionalism; parental engagement; assessment of children's progress; school improvement and performance information. However, a small minority of respondents did so with a caveat that attainment of children and young people with complex additional support needs has to be broader than a 'literacy and numeracy' measure. One respondent stated 'the value of these objectives will very much depend on how well the NIF articulates a broad understanding of 'attainment. A narrow focus on literacy and numeracy measured in part through standardised assessments will miss the richness and diversity of achievement and attainment for many children with ASN, and particularly those with very complex ASN.'

There were a couple of suggestions to add an additional objective. These related to engagement and views of children and young people with complex additional support needs. One respondent, for example, stated 'we feel there should be an additional objective about making sure that children and young people with complex additional support needs are listened to and actively engaged in decision-making about their education. We believe that this should be at the centre of any policy that hopes to drive improvement in outcomes'.

Finally a number of respondents commented that while they felt the aim and objectives of the strategy were 'welcomed', 'ambitious' and 'to be commended', these comments were tempered with concern over perceived falls in resourcing and funding of additional support needs and complex additional support needs in the last 5 years.

Section 2. Why we need Strategic Commissioning for Learners with Complex Additional Support Needs?

Question 4: Within the context of The Doran Review recommendations – do you agree with the explanation of why we need Strategic Commissioning for national provision/services for learners with complex additional support needs?

Answer	Total	% of all respondents
Yes	44	72
No	4	7
Don't know	3	5
Not Answered	10	16

The majority of respondents agreed with the explanation in the strategy of why we need strategic commissioning for national provision/services for learners with complex additional support needs. Some comments related to the equity of the current national funding for example – 'The explanation is clear and targets the key issues of equity. Over the last number of years it has felt that finance has been directed to services which mainly meet the needs of children and young people within the central belt. It is hoped that the rationale for strategic commissioning as this moves forward will redress this balance' and 'Increased parity of experience across the country is required in order to ensure that all children with complex ASN receive appropriate services and support regardless of geographical location.' A similar comment from another respondent said – 'In remote and rural areas, where specialist services are not so readily available, a national commissioning approach would be of benefit to ensure achievement of the objectives within the Strategy. The explanation provided supports this approach'.

Another respondent commented 'We welcome the commitment to increased strategic commissioning of services. Its use is necessary to make the best use of available resources, based on the needs of children and young people with complex additional support needs, and informed understanding of what services work most effectively in meeting these needs.'

There were other comments on the current model of national funding. One respondent commented that while in principle they agreed with the need for strategic commissioning, they also highlighted concerns that future changes under strategic commissioning 'could make matters worse for pupils and provider organisations.' Another respondent suggested that the current grant allocation did need to be reviewed to ensure that 'those children currently with the most complex additional support needs receive the specialist interventions they need.'

A theme from a number of responses was that while supportive of strategic commissioning in principle; concerns were raised around the 'lack of detailed and comprehensive available data' currently available. They requested additional statistics/data on children and young people with complex additional support needs and that strategic commissioning decisions must be based on the analysis of that data.

Question 5: The 'Scope of Services to be commissioned' on page 8 relate to education, care and health, research and training and is informed by the Doran Review recommendations and the National Needs Analysis, which was completed in 2015. Can you please comment on any services within those headings, which would particularly wish to see featured here? Please tell us if you think it should exclude any aspects or include any others?

Overall, there were 61 responses with answers to one or more parts of Question 5.

Service	Total number of responses
Education	41
Care	30
Health	32
Research	37
Training	39

The National Parent Forum of Scotland stated – 'We are encouraged by the 'Scope of Services to be commissioned, which is a comprehensive list.'

Education

The main themes covered in the 41 responses to education were:

• Teacher / staff training, learning & development;
• Types of provision;
• Capacity building and local delivery;
• Early years.

Teacher / staff training, learning & development

Respondents highlighted the importance of training, learning and development for all staff working with children and young people with complex additional support needs. A number of responses emphasised the importance for teachers to have the appropriate training to support pupils with additional support needs. This will optimize pupils learning opportunities and attainment potential, and ensures pupils with additional support needs are taught and supported in a truly inclusive environment 'Training builds pedagogical skill and ensures more effective and consistent delivery. It enhances inclusion and this needs to be the aim.'

A few respondents raised concerns in relation to investment in teacher/staff training – 'The learning and training of staff is something that needs substantial investment.' There were also other concerns over workforce planning and initial teacher education (ITE). A few respondents mentioned perceived shortages in experienced and qualified teachers of pupils with a visual impairment (QTVI) – 'Students with visual impairment rely on QTVI to support their unique needs to give them access to an education equal in standard to that of their peers. The number of active QTVIs across Scotland should be monitored to anticipate any downward trends in the number of QTVIs and any shortages.'

Some responses expressed the view that the time spent and the content of training additional support needs during Initial Teacher Education, was not sufficient to adequately equip new/probationary teachers with the knowledge and skills required to best support pupils with additional support needs. One respondent stated 'Provision for supporting learners with complex additional support needs should not be just postgraduate as an add on or afterthought. Should be front and centre of all ITE training.. .'.

Some responses recognised the knowledge and skills of professionals working within the independent school and residential sector. There were calls to share learning and expertise between professionals in those sectors and the public sector.

A message from most of the respondents was that Leadership, as well as the wider professional learning opportunities needed to be a key focus of the strategy – 'The focus on effective leadership is also very much welcomed, with access to professional learning opportunities for a range of staff.'

Type(s) of provision

The types of provision identified as needing to be commissioned within Education were:

• Social, Emotional and Behavioural Needs (SEBN);
• Autism;
• Mental Health;
• Assistive / specialist Equipment including augmentative & alternative communication;
• Transitions.

Some local authorities identified that there were gaps in good transition services and many respondents had concerns that there was not enough expertise to support young people with complex additional support needs to move on to successful and meaningful outcomes post 16+.

Many respondents felt that more needed to be done to support this group of young people – 'We firmly believe that training, career and work opportunities should be included prior to the current transitional transition year planning. Career planning should indeed start at the earliest opportunity but no later than at age 14.' Another respondent stated – 'We welcome the commissioning of services which look toward positive employment outcomes for children and young people with complex additional support needs.'

Transitions featured prominently and this theme was repeated in responses to other areas of the consultation and are reflected in other parts of this report.

Capacity Building / Local Delivery

Over half of the 41 responses raised the theme of Capacity Building and Local Delivery. The majority of these suggesting that National Funding for learning provision for children and young people with complex additional support needs should be more focused towards supporting local authorities build capacity and wherever possible deliver services at a local level – 'The emphasis should be on capacity building to ensure children and young people have their needs met as locally as possible' and 'Close liaison with local authorities in relation to the range of provision available will be vital.'

Some respondents suggested that under Education Reform, Regional Improvement Collaboratives could be a potential vehicle to aid the Scottish Government and the Doran National Commissioning Group identify where there are gaps and/or improvements needed in local services and how national funding could support capacity building.

A few respondents expressed a different point of view. This included the view that capacity building did not need to translate as local delivery, but that grant-aided special schools have that role already to capacity build where mainstream provision is not sufficient – 'The existing GASS provide high quality education and address (increasing) gaps in mainstream provision. This provision of national services should continue. Further provision of, and support for, training for educational and support staff in mainstream settings is required' and 'The principle of 'provision being locally provided wherever possible and inclusive in nature' does not reflect the entirety of services offered by some organisations which are specialist, and provided on a periodic basis and due to their specialist nature, are not widely available within the child and young person's local environment.'

A few of the local authority respondents recognised the value of provision from grant-aided special schools, however the geographical location of the schools remains a factor – 'While it is important that direct services in relation to care, health and education are retained for those children and young people with the most complex additional support needs it is very encouraging to see that the commissioning will extend to research, training and the delivery and support of services within and across local authorities. To date, to access support from grant-aided special schools, children and young people from more remote authorities were required to live outwith their home and local community. Building services to increase the capacity of staff across services within local authorities will have significant impact on the successful inclusion of children and young people within their family, school and community.'

In summary, there is recognition of the value added by grant-aided special schools but also a wish to see services delivered in such a way as to ensure that children and young people can remain in their communities.

Early Years

Some respondents highlighted a lack of any detail in the 10 year strategy pertaining to early years provision; even though there are references to this in the Doran Review – 'We think that education services commissioned should include early years and early intervention services that can support early years and education practitioners to better meet the needs of children with complex additional support needs in early years settings. This is particularly important in the context of the extension of early learning and childcare and could be linked to the proposed early years inclusion fund.'

Finance/Resources

There were a few references to finance and resources around teacher pay, national control of ASN budgets and/or ring fencing ASN funding and provision. As stated earlier finance and resources are not within scope of the ten-year strategy consultation.

Care

There was not as many common responses on the topic of Care. An eclectic range of comments were provided, however the main themes are as follows:

• Types of provision;
• Integrated Planning;
• Staff training & learning;
• Family engagement/advocacy and children's rights;
• Self-Directed Support.

Types of provision

In relation to types of provision that should be commissioned under Care, there were some themes that were also raised under Education. These were:

• Transitions;
• Social, Emotional and Behavioural Needs (SEBN); and
• Mental Health.

Other types of provision identified under Care were:

• Respite; and
• Out of school care.

Some respondents felt that wider Respite provision was required to support and strengthen the principles of Mainstreaming and Inclusion. Lack of respite support can put strain on families and the child or young person with complex additional support needs – 'Respite care should be considered more fully for children with complex needs who are perhaps supported in home and community more than they have been in the past' and 'Respite opportunities need to be recognised as a core element for children and young people with severe and complex learning needs, and they should be given the opportunity to participate in social experiences (clubs, activities) to promote wider achievement.'

Integrated Planning

A few respondents emphasised the importance of joined up working and integrated planning. Most felt that while this principle was widely acknowledged as 'best practice' the reality was that good joined up working and integrated planning was used inconsistently. Some comments were:

• More creative pathways should be considered;
• Care and support planning must take account of future education/work/training opportunities and be fully included in these plans. Planning should be streamlined between health, education and social work services to ensure a seamless and person centred service for the individual;
• Social work input should be an integral part of future planning meetings. Transition from child and family to adult services requires a co-ordinated approach;
• We agree with the overall scope of services included but would note that the need for a partnership approach should be given greater emphasis. This more joined up approach and inclusion of the overarching child's plan should be considered as part of the scope of services to be commissioned.

A few commented on the reasons behind 'drivers' in local authority decisions to place a child or young person into a special school. One highlighted that in many cases the decision to place a child or young person in a special school was driven by social care rather than educational needs. Another respondent highlighted that a lack of local specialist provision or difficulties accessing suitable local provision; was often the driver to placing children and young people out with their local community and into special school provision. Respondents felt this issue should be directly addressed in the strategy. Comments included - 'As in many cases the key driver for placement independent special school is not principally educational but social care this needs to be addressed directly in the strategy. Although the roots of the funding lay in education this needs to be extended to full address the world of getting it right for children and young people' and 'Finding from our joint inspections have been that some children and young people had difficulty accessing specialist resources/placements within their local communities or local authority area. The Strategy should address the intention (and potential challenges) of ensuring there is local provision to meet identified need, wherever the child lives in the county.'

Staff training & learning

A few respondents raised staff training and learning as an area requiring support. One respondent felt that 'substantial investment' was required for staff working with children and young people with complex additional support needs, highlighting a lack of good staff training and basic awareness in autism.

Self-directed Support

A few of respondents raised Self-directed Support as another area needing to be addressed within the strategy. One stated – 'The importance of Self-directed Support in maximising the way in which people / families can maximise taking control of their lives also needs to be central to any consideration of national needs assessment. People increasingly wish personalised solutions, adopting unique approaches to address their need for support, and this needs to be considered prior to any population wide needs analysis' and another respondent said – 'Need to take account of fact that strategic commissioning of services has changed due to SDS.'

Health

The responses were similar to those received in relation to Care. There was not much consistency in terms of themes and the range of views expressed, however the main themes covered in the 32 responses, are as follow:

• Types of provision;
• Integrated Planning;
• Staff training & learning;
• Finance/Resources;
• Building capacity/Local Provision.

Types of Provision

In relation to types of provision that should be commissioned, once again the reoccurring themes of Mental Health, SEBN and Transitions were raised.

A few respondents raised mental health. They felt that more mental health provision was required for children and young people. One respondent highlighted the need for targeted mental health resources for children and young people with SEBN – 'These specialist interventions are not always readily available for children with SEBN and more targeted mental health resources are required in order to ensure the availability of such services and allow children the help they need.'

Though not directly mentioning Regional Improvement Collaboratives specifically, one respondent did make the that link, that improving mental health provision for children and young people would take regional collaboration – 'Mental Health and Wellbeing needs, particularly among adolescents, is an area which requires regional collaboration and commissioning.'

Integrated Planning

The theme of integrated planning and joined up working was also a focus in relation to Health. A few respondents raised the issue (similar to the Care responses) that continued improvement was needed in integrated planning and joined up working between Education, Care and Health. Some of the comments were:

• 'Healthcare provision for children and young people with complex additional support needs should be as integrated as possible with their educational and care provision.';
• 'Co-locating health and social care children and young people services alongside education will enhance support for children and young people with complex additional support needs. We would also wish to see an emphasis on the health team supporting the children and young people with complex additional support needs to engage in education.';
• 'Vastly improved links with all areas of health in particular complex medical needs, mental health etc.';
• 'Collaborative health services that identifies, prioritise and focus on these children and young people with complex additional support needs.'

Finally, another respondent suggested that, when making decisions on commissioning services, collaborative working between health and education services must be taken into account. An example of a 'Baseline Pathway'^[1] model developed by The Visual Impairment Network for Children and Young People (VINCYP) was put forward as a good example.

Staff training & learning

A few respondents raised staff training and learning in relation to health. One respondent called for more investment in staff training and learning and another respondent felt that improved links within branches of the NHS for training and resources was one way to deliver improvement.

Finance and Resources

There were a couple of references made to finance and resources. One respondent raised concern about the availability of Allied Healthcare Professionals and perceived local shortages which impact heavily on ability of 'the whole team around the child' being able to meet the needs of a child or young person with complex additional support needs.

Another respondent felt, that while there was a commitment to the continuation of direct education, care and health services as part of the strategy for strategic commissioning, they would support it only if this was not to the detriment of the current provision.

Local Provision

A few respondents referred to access to provision being delivered locally and within the community of the child or young person with complex additional support needs – 'Health is a universal service – how might it be engaged in the commissioning service? How can therapies be localised and on site in local communities to prevent the need for the child to be removed from his/her community.'

Scottish Government Consultation on Guidance on Healthcare in Schools

In 2017, the Scottish Government conducted a public consultation on updated guidance on 'Supporting Children and Young People with Healthcare Needs in Schools' – following this consultation new guidance was published on 20 December 2017^[2]. This guidance document is for NHS Boards, education authorities and schools to support children and young people with healthcare needs in schools. Social Work Scotland in their response under Health have suggested that reference to this guidance and links to it should be included in the strategy.