Agenda item

The Assistant Director, SEND and Vulnerable Learners, updated the Panel on the review of the delivery model for medical education provision ahead of the findings and proposals being discussed at Cabinet in February 2021.

The Panel received a presentation and the following main points were made:

·       The Service was now at a point where the findings of the review could be assessed and plans could be made for implementation of a new delivery model.

·       The cohort of children using the medical education service had changed over time and the service now saw more children with mental health difficulties.  Approximately 80% of children referred to the service had low mood or anxiety.

·       In June 2020 Cabinet had approved an extended timetable for the review as COVID-19 had made it difficult to engage with stakeholders especially families and health colleagues.  This engagement work had been completed in July 2020.  Task and finish groups were held in October to develop a series of proposals which were circulated to stakeholders and made public via a webinar.

·       The proposals would be considered by Cabinet in February 2021 by which time there would be a clear implementation plan.  There was further work to be done on financial modelling, legal implications and HR issues.

·       It had been important to include all stakeholders in the co-production process to ensure an authentic voice and early buy-in for the proposals.

·       Feedback from children and young people highlighted many positives about the current service.  Parents and carers appreciated the small nurturing environment and the flexibility in learning provision.  Parents also welcomed the support for how to meet their child’s needs.

·       Schools wanted to see a wider curriculum with both short and long-term provision which maintained continuity with the GCSE curriculum for older pupils.

·       Feedback from Medical Education staff included pragmatic questions, such as where the service would be located, continuity of staffing and the implication of Ofsted registration. 

·       Health colleagues recognised the changes in the cohort of children attending medical education provision and the need for a jointly commissioned approach to meet children’s welfare needs as well as their educational needs.  With reference to children with an autism diagnosis, it was recognised that there was a growing cohort who had high anxiety but were academically able, and the service would work with mainstream schools to develop mainstream autism bases to meet the needs of this cohort.

·       The proposed pathway was based on a preventative approach and recognised the input needed from the whole system.  It aimed to intervene early to prevent issues escalating allowing children to remain in mainstream provision.  It recognised that, for some children, there may be a need for a short period of recovery and rehabilitation in a safe environment with a focus on recovery and reintegration.

·       Interim interventions would see the creation of a Multi-Agency Assessment Panel to offer advice and guidance to schools.  At this stage it was accepted that some children may need a short period out of school at a registered base.  There may also be an increase in outreach to schools and hospitals at this stage to provide direct advice and guidance to meet a child’s needs.

·       An emergency referral process would also be included for children who needed to come out of school immediately.

·       It was hoped that provision would be registered by September 2021 to allow quality assurance through Ofsted.  It may be that provision could be linked with an existing setting to access the benefits of the wider curriculum and social opportunities.

·       Medical education provision should prepare pupils for the next stage in their learning, building skills and recognising it was part of a pupil’s progression and not a destination.

·       Details of the proposals had been shared with stakeholders and further analysis was being undertaken from a HR, legal and finance perspective.

Members had the opportunity to ask questions and the following main points were made:

·       A Member of the Panel welcomed the move to register with Ofsted and recognised the need for external quality assurance.  She went on to suggest that the final proposals should look to physically separate medical education provision from the primary pupil referral unit in Kidderminster.

·       Concern was expressed that, although the medical education provision provided a secure and safe environment for very traumatised children, the team did not currently take steps to obtain EHCPs for those children who may need it for protection and support when they returned to a mainstream setting.

·       The Assistant Director agreed that the current Kidderminster site was not an appropriate physical environment and she recognised the vulnerability for some young people of co-location with the PRU.

·       It was confirmed that there were currently 48 children accessing the service, 15 of whom were in Worcester, 13 in Redditch and 15 in Kidderminster.  There were also 4 children being supported at home, 1 in hospital-based provision and 10 children awaiting placement.  Towards the end of the year this could rise to approximately 70 children and young people.

·       The Panel was informed that work had been done to reduce the average amount of time spent within the service as, for some young people, the provision could become a barrier to returning to mainstream provision.  The aim was to achieve an average of 2 terms’ attendance.

·       A question was asked about whether preventative work in schools in relation to children’s mental health was leading to an improvement in the situation.  Members were informed that over time there had been increasing levels of anxiety.  However, some of the adjustments schools had put in place as a result of COVID had reduced levels of anxiety, for example teachers moving from room to room rather than pupils having to move.

It was agreed that the Panel would receive a further update at its meeting on 29 January 2021 ahead of the Cabinet discussion in February.