News story

Strong leadership essential to integrate services for disabled children and young people

As the summer holidays commence, so too does the battle facing most SEND parents trying to get everything in place for the next school year.

EHCP’s, access to school transport, endless form filling, and dealing with outsourcing means that parents face a fragmented SEND system.

A report launched today by the Council for Disabled Children and supported by the True Colours Trust, highlights the importance of strong leadership in streamlining and integrating the different systems of support that disabled children rely upon.

It takes leaders to break down siloes is based on interviews with over seventy staff from education, health and social care teams, as well as parents and carers, in three geographically and demographically diverse areas of England.

Fragmented, confusing and stressful

Researchers found that despite successive government initiatives over the past decade designed to improve how care for children with SEND is coordinated, the system remains fragmented and, in reality, confusing and stressful for parents trying to navigate it. Strategic leadership emerged as the single most important factor in enabling or hindering joint working and integration at a local level. It was found that strong local leaders had the power to set strategy, influence organisational culture and support initiatives that enable integration.

Other barriers to joined up care

The report also highlights other significant barriers to better joint-working:

  • A sustained pressure on resources was a consistent theme raised by respondents, presenting a particular challenge in the face of rising demand and the growing numbers of children and young people with complex needs or life-limiting conditions.
  • Government policy was found to act as both a lever and a barrier to better integration. Where Government initiatives aligned with local priorities and provided clear directives and accountability – such as the roll-out of Education, Health and Care Plans – it could enhance co-operation at a local level. However, interagency working could be hampered by a lack of join-up between government departments and NHS England in developing and implementing change programmes.
  • Good quality data and effective information sharing processes should aid integration at both a strategic level and for individual care. However, areas reported being held back both by practical challenges and poor population level data.

Overcoming the difficulties

Despite these challenges, there are ways in which local areas are overcoming difficulties and enabling some degree of integration. Joint-commissioning was becoming a reality in some cases – especially around commissioning roles which support joint working such as the Designated Clinical Officer for SEND.

Similarly, participants in the study felt that joint-working arrangements like co-location, helped teams to understand each other’s perspectives and develop their work in a more integrated way.

Involving children and families

Local areas also reported how involving children and families in decision-making could improve integration. At an individual level, building dedicated time into support planning processes for a conversation with the child or young person and their family, and ensuring this conversation informs the resulting support package, was found to support better integration by uniting agencies around the needs, outcomes and aspirations of their service users.

Dame Christine Lenehan, Director of the Council for Disabled Children, said,
‘Integrating services is especially important for children and young people with SEND, who not only often rely on support that spans health care, education and social work, but may be vulnerable in others ways. While the urgent need for better integration has long been recognised, in reality families are often faced with a wall of paperwork to get their child’s needs met.

‘The cruel irony is that initiatives designed to improve joined-up working have themselves failed to align with other programmes with the same aims from different parts of the system. Of course some areas, often those with strong leadership structures in place, are finding ways to improve local co-operation, but many others are not. This report is a wake-up a call of the urgent need to break down siloed working.’

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