Agenda item

(To receive a report from Sara Gregory, Commissioning Manager - Children's Strategic Commissioning, which invites the Committee to consider and comment on a report whichrecommends the re-commissioning of the Autism and Learning Difficulties (ALD) Service from 1 September 2022, prior to a decision being taken by the Executive on 1 February 2022)

The Committee considered a report which set out the business case for the recommissioning of the Autism and Learning Difficulties (ALD) Service from 1 September 2022, prior to a decision being taken by the Executive on 8 February 2022. The Chairman invited the Head of Service - Children's Strategic Commissioning to present the report. Members were advised that the ALD service was a term time only service commissioned on behalf of Lincolnshire schools and academies to provide support for autistic Children and Young People (CYP). Support included training, workshops and targeted outreach support to empower and up-skill school staff with the knowledge, tools, and confidence to create inclusive autism-friendly environments and encourage mainstream education. The Service commenced 1 September 2015 and was currently valued at £617,500 annually. While the Council had no explicit duty to provide an ALD Service, it supported a number of the Council’s statutory duties. Despite the rising number of CYP with SEND, Lincolnshire saw a decrease in suspensions and exclusions. The ALD Service was rated Good in terms of performance and had received positive feedback from service users who have accessed it. Future modelling would comprise of a greater emphasis on the training and workshop offer, with core, and non-core, training and workshops being available to both carers and professionals to improve understand and support capability. Funding recommendations for future ALD services would not see a reduction in ALD outreach workers despite partners’ staffing model discretion.

Members of the Committee were given the opportunity to ask questions to the officers present, their responses are included below:

• The continuation of the service was supported as it had shown benefits in helping to lower exclusion rates and enabling children with autism and learning difficulties to remain in mainstream education. Early intervention was important to give children the best chance to progress in school.
• There were regular and robust meetings with the schools providing the service to monitor and challenge the performance information and data to ensure that the requests for support were matched with the provision offered and that the services were having an impact.
• The service was first commissioned in 2015 and there have been lessons learned throughout the agreement term. There had been periods of underspends which had been either reinvested to develop the service or brought back within the authority to be utilised in a different way. As the budget had not been fully utilised previously, officers were confident that the same budget would be sufficient going forward. If there was a huge increase in demand in future, then officers would seek a further variation or additional funding. It was suggested that it might be useful to keep the Committee informed of the performance and the levels of demand for the service.
• Consideration had been given to how to refine the service moving forward which had shown a trend for quite a large reliance on the outreach element which provided direct work with children and young people. However, a greater focus on training would be needed going forward as this provided greater sustainability and benefitted all children by ensuring the workforce was equipped to really support children in mainstream education.
• Lincolnshire used to be the second highest excluding authority in the country but had now moved to the bottom quartile for exclusions. The percentage difference was small but represented a significant number of children. Lincolnshire was now at the forefront with managing exclusions through a partnership arrangement with schools. There was a whole suite of services around this need which were currently being reviewed. It was requested that a report be brought back to the Committee regarding this review and setting out how these services complement each other, and that some headteachers be invited to attend to talk about their experiences with accessing these services.
• In relation to benchmarking against other local authorities on spend per child and the delivery of the services, this was difficult to undertake as other local authorities provided different services to Lincolnshire, which was demonstrated by the examples set out in the Commissioning Plan. Lincolnshire had a range of services covering different needs with pathways to support children to move between them where possible. The Executive Director of Children’s Services agreed to look into whether any financial benchmarking for this specific area of spend was available.
• The pathway around the diagnosis of autism was not working well and led to families experiencing long waiting times. In addition, when benchmarked against other areas, the rate of assessment and the number of diagnoses of autism in children were higher than expected. Some children may have received an autism diagnosis due to presenting in a similar way to those who have experienced trauma and potentially had other emotional wellbeing concerns and not necessarily autism. There was now a joint pathway whereby community paediatrics and clinical psychologists would triage the referrals to make sure families were not on waiting lists for an autism diagnosis when it was more appropriate to be referred to another service. This was a pilot being funded by Lincolnshire CCG and over the last year the waiting times had reduced significantly, and the pathway was NICE compliant. The Council was working closely with the CCG to have this joint pathway embedded within practice. The data on the pilot could be shared with members of the Committee.
• The service was funded through the Dedicated Schools Grant and the Council worked with the Lincolnshire Schools’ Forum to identify what services schools wanted funding through the high needs block. Commissioning the service for all Lincolnshire schools provided much better value for money and resulted in a more joined up system.
• The graduated approach provided a fluid increase in support when a child’s needs increased and then a de-escalation when appropriate, so that children were helped within universal services wherever possible. The ALD service targeted really specific cohorts of children but would not necessarily meet all of that cohorts needs, so there were additional services that provided support such as Healthy Minds Lincolnshire and the Behaviour Outreach Support Service. There was a range of services being delivered in relation to early intervention which had seen an incremental climb in demand.

RESOLVED

1. That the Children and Young People Scrutiny Committee unanimously agreed to support the recommendations to the Executive.

2. That the comments listed above be passed on to the Executive in relation to this item.