Definition of SEND

• Definition of special educational needs and disability (SEND)

Role of NHS GM in relation to SEND

• What is the role of NHS Greater Manchester in relation to SEND?

• What are NHS Greater Manchester's SEND functions?

• What services are commissioned for children and young people with SEND?

Co-production

• How does NHS Greater Manchester work with children and young people with SEND and their families?

Quality Assurance and Improvement

• How is SEND quality improvement achieved in the NHS?

• ICB SEND Quality Assurance Framework

• SEND quality improvement tools

SEND Governance

• How are arrangements for SEND governed and managed in NHS Greater Manchester?

• NHS Greater Manchester SEND Governance

• Further information about committees and groups

Glossary of Terms

• Glossary

  
  

Further Information and Learning

• Further information and learning

• Has a significantly greater difficulty in learning than the majority of others of the same age, or

• Has a disability which prevents or hinders them from making use of facilities of a kind generally provided for others of the same age in mainstream education settings.

The Equality Act 2010 defines someone as being disabled if they have a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on their ability to do normal daily activities. ‘Substantial’ means something that is than minor or trivial, for example an impairment which impacts on daily tasks, and ‘long-term’ means lasting for 12 months or more.

Not all children with special educational needs are disabled and children and young people with a disability do not necessarily have a special educational need.

From a health perspective, children and young people with SEND may receive health provision from public health, primary care, community, acute and specialist services with a wide diversity of need as described in the diagram above, spanning both children and adults.

• Everyone has an opportunity to live a good life,

• Everyone experiences high quality care and support where and when they need it,

• Everyone has improved health and wellbeing, and

• Health and care services are integrated and sustainable.

As health service commissioners, it is NHS GM’s responsibility to understand the health needs of the Greater Manchester population, to identify children and young people with SEND, inform decision-making and provide appropriate health care provision to meet the needs of this population, and improve outcomes for children and young people as they prepare for adulthood.

NHS Greater Manchester will work in partnership with the ten Greater Manchester local authorities and the Greater Manchester Combined Authority (GMCA) to identify, implement and drive forward SEND priorities and improvements, underpinned by the Children and Families Act (2014). Partners across health, education and social care will work effectively together to reduce health inequalities and improve outcomes for children and young people with SEND aged 0-25 years.

The statutory duties which apply to Integrated Care Boards are explained in the SEND Code of Practice (2015) statutory guidance for organisations which work with and support children and young people who have SEND. NHS GM will also cooperate with local authority and other partners in relation to Area SEND Inspections that are jointly undertaken by the CQC and OFSTED, and use the outcomes from those inspections to inform our key SEND priorities and areas for future development

• Support the identification of children and young people who may require SEND provision.

• Improve data and information to measure impact, success & areas for development.

• Jointly and creatively commission to achieve equity of health.

• Develop a workforce that feels informed, confident and supported.

• Work with children, young people, families and communities as partners to actively design and deliver services.

• Develop a personalised integrated approach to health, care, and wellbeing.  

• Support young people in preparing for adulthood by improving navigation through services with clear and timely transition planning.

• Work with local authorities to contribute to the local offer of services available.

• Ensure commissioning arrangements are in place for health care provision as specified in Education, Health and Care Plans (EHC plans).

• Consider personal health budgets where these are provided for children & young people with EHC plans.

Coproduction is a way of working that involves people who use health and care services, carers and communities in equal partnership; and which engages groups of people at the earliest stages of service design, development and evaluation. It recognises that people with ‘lived experience’ are often best placed to advise on what support and services will make a positive difference to their lives.

NHS GM works closely with the ten Parent Carer Forums in Greater Manchester. Parent Carer Forums are organised groups of parents and carers of children and young people with SEND, who aim to make sure that services meet the needs of children in their area with SEND and their families. They do this by gathering the views of families and by working in partnership with local authorities, education settings, health providers and others to highlight where services, processes and commissioners are working well, or highlight and challenge when changes or improvements need to be made

• Community & hospital paediatric services.

• Specialist nursing, including epilepsy, diabetes, continence.

• Therapy services: speech and language therapy, physiotherapy, occupational therapy.

• Specialist dental & children's audiology.

• Mental health services.

• Health services for Looked After Children.

• Learning Disability and Autism Annual health checks, conducted by GP surgeries.

• Continuing Health Care assessments & packages.

• Equipment, for example wheelchairs and mobility aids.

Locality Individual Commissioning Teams are responsible for the assessment, commissioning and case management of individuals with complex health needs, including NHS Continuing Healthcare, NHS Funded Nursing Care, Mental Health Act and subsequent aftercare, hospital discharge and end of life care.

Access to information about the support available for children and young people with SEND and their families can be found on the Local Offer website of the local authority in which they are resident:

• Bolton

• Bury

• Manchester

• Oldham

• Rochdale

• Salford

• Stockport

• Tameside

• Trafford

• Wigan

The NHS must function within the parameters of national policy, professional standards and guidance. The NHS 10 Year Health Plan for England aims to reinvent the NHS, creating a new model of care which is fit for the future, achieved through 3 radical shifts:

• hospital to community

• analogue to digital

• sickness to prevention

National Standards

The NHS must follow guidance, advice and quality standards from the National Institute for Health and Care Excellence (NICE). Health professionals must comply with quality standards set by their respective professional body with which they are registered, for example the Royal Colleges or Nursing and Midwifery Council.

Integrated Care Systems

Integrated systems are partnerships of organisations that plan and deliver health services through integrated care boards and partnerships which are the statutory organisations through which this is executed. NHS England » What are integrated care systems?

Integrated Care Boards

Following the Health and Care Act 2022, Integrated Care Boards (ICBs) became statutory NHS organisations on 1 July 2022, replacing Clinical Commissioning Groups (CCGs). ICBs are responsible for developing a plan for meeting the health needs of the population, managing NHS budgets and arranging the provision of health services in a geographical area. NHS England » Integrated care systems: guidance

Integrated Care Partnerships

Within each ICB are place based partnerships that are required to lead the detailed design and delivery of integrated services across localities and neighbourhoods. They include NHS, council, voluntary and community services, local people, service users and other key community partners who have a role in supporting the health and well-being of the local population. SEND partnerships are usually place based.

Area SEND Inspection

The place based local authority and corresponding ICB have joint responsibility for ensuring the needs of children, young people and their families are met, and this is inspected by Ofsted and the Care Quality Commission (CQC) through Area SEND inspections

Quality Improvement Focus and Oversight

Quality improvement is supported through a national structure of communication and collaboration between the tiers of Government, NHS England, ICBs/ICPs and NHS providers. Each tier supports, challenges and drives improvement at each level through integrated strategic boards and formal monitoring reviews to ensure oversight and continuity of care.

• Local area SEND boards in place with appropriate ICB representation

• Localities attend SEND Oversight Group and SEND Collaboration Group

• Assurance provided and risks highlighted to ICB Executive Lead for SEND through regular highlight reporting

• SEND data dashboard in place in Local Areas and at ICB level

Quality Improvement

• Robust workforce development framework in place at local area and ICB level to ensure staff at all levels understand their roles and statutory responsibilities

• Learning from SEND inspections, thematic visits, LGA SEND Peer Reviews

• Learning from tribunals, mediation and complaints is coordinated across the ICB

• Quality improvement projects focus on the lived experience of children, young people and their families

Partnerships

• Local Area Inclusion Partnership in place with regular attendance of all stakeholders

• Each Local Area has a Joint Self Evaluation position statement

Children, Young People & Family Voice and Impact

• Coproduction Framework/Strategy in place in Local Areas 

• Feedback on health services is routinely sought from parents, carers and children and young people

• The Local Offer includes current, accessible information on health and care

• The Local offer is coproduced and reviewed with families, children and young people

• ICB colleagues at both Place and ICB level have regular meetings with Parent Carer Forum

Joint Commissioning

• JSNAs in place that describes health need at a Local Area level informed by both local and national datasets

• Joint Commissioning Strategy in place at Local Area level

• SEND strategic priorities are informed by the JSNA at Local Area level and by the Joint Forward Plan at ICB level

Each locality (place) has an Executive Place Based Lead, who is also an executive member of the ICB. The Place Based Lead is accountable on behalf of the ICB for health and care at place, including delegation of SEND responsibilities.

In addition to the Executive Lead for SEND and Place Based Lead:

• Each of the 10 localities within NHS Greater Manchester has a Local Area SEND Partnership Board which reports to both the Locality Board and the NHS GM Integrated Care Board.

• Designated Clinical Officers (DCOs) work closely with the local authority and assists the ICB in meeting its responsibilities around SEND. They are a point of contact for local authorities, schools and colleges who need advice or support about health for children and young people who have SEND.

The posts below describe the ICB governance arrangements for SEND.

CQC – Care Quality Commission. The independent regulator of health and social care in England.

CYP – children and young people.

DCO / Designated Clinical Officer – a role that works closely with a local authority and assists the Integrated Care Board in meeting its responsibilities around SEND. They are a point of contact for local authorities, schools and colleges who need advice or support about health for children and young people who have SEND.

Education Health and Care Plan / EHC plan – a legal document, issued following an Education, Health and Care needs assessment, which describes the special educational needs of a child or young person aged up to 25, including the support they need and the outcomes they would like to achieve. The provision described in an EHC plan must be provided by the child or young person’s local authority.

GM – Greater Manchester.

GMCA / Greater Manchester Combined Authority – an organisation made up of the ten Greater Manchester councils and Mayor, who work with local services, businesses, communities and other partners to improve the city-region. It is run jointly by the leaders of the ten councils and the Mayor of Greater Manchester.

ICB / Integrated Care Board – a statutory NHS organisation responsible for developing a plan for meeting the health needs of the population, managing NHS budgets and arranging the provision of health services in a geographical area.

Joint Strategic Needs Assessment / JSNA – a document which considers the needs of the population of an area including specific analysis of the needs of children and young people and other vulnerable groups. The JSNA informs the joint commissioning decisions made for children and young people with SEND and is the basis on which local areas agree strategy and a set of holistic outcomes that they want to achieve for children, young people and their families.

LDA – Learning disability and autism.

LGA – Local Government Organisation. A National membership body for local authorities.

Local Offer – local authorities have a legal responsibility to publish a Local Offer with clear, up to date information about the provision they expect to be available across education, health and social care for children and young people in their area who have special educational needs or disabilities.

NHSE – NHS England. Leads the National Health Service (NHS) in England.

NHS GM / NHS Greater Manchester - the Integrated Care Board for Greater Manchester, which is responsible for making decisions about health services across Greater Manchester and in the ten boroughs and cities.

NW – the North West region of England.

Ofsted – the Office for Standards in Education, Children’s Services and Skills. Ofsted inspect and regulate organisations and individuals providing education, training and care. This includes childminders, nurseries, schools, colleges, training providers and local authorities.

Personal health budget – an amount of NHS money that is allocated to support an eligible individual with their health and wellbeing needs.

Primary care – primary care services provide the first point of contact in the healthcare system, acting as the ‘front door’ of the NHS. Primary care includes general practice, community pharmacy, dental, and optometry (eye health) services.

Public health – organised measures to prevent disease, promote health, and prolong life among the population as a whole.

VCSE – Voluntary, Community, and Social Enterprise. An umbrella term for the sector which encompasses a range of organisations including voluntary and community groups, social enterprises, charities, and not-for-profit organisations, which are driven by a shared commitment to creating positive social impact.

The Council for Disabled Children (CDC) has developed a suite of online training designed to improve knowledge, understanding and practical skills and support in range of key areas that impact children and young people, particularly those who are disabled or with special educational needs:

Council for Disabled Children learning platform

SEND Guide for Health Professionals

Department for Education and Department of Health and Social Care, 2016

SEND: guide for health professionals - GOV.UK (www.gov.uk)

SEND code of practice: 0 to 25 years

2014 statutory guidance on the special educational needs and disability (SEND) system for children and young people aged 0 to 25

SEND code of practice: 0 to 25 years - GOV.UK (www.gov.uk)

Membership includes local healthcare professionals, lay representatives, local councillors, voluntary sector representatives and the NHS Greater Manchester executive team.

The board meets monthly and meetings are open to the public.

It is attended by elected member representatives from each local authority and senior NHS Greater Manchester colleagues, with wider membership to reflect the partnership approach to addressing the health and care needs of the population including determinants of health and wellbeing such as employment, environment, and housing.

Meetings are open to the public.

The website contains examples of effective practice, reports, literature reviews and established evidence of what works at a system-level in SEND.

'What Works in SEND' is part of a programme of work led by the RISE (Research and Improvement for SEND Excellence) Partnership. The RISE Partnership is led by the Council for Disabled Children in partnership with ISOS Partnership, the National Development Team for inclusion (NDTi) and the University of Warwick.

It seeks assurance that commissioning strategy is supported by intelligence, and delivers quality, performance, population health, and oversight functions in a way that secures continuous improvement, whilst ensuring that the ICB operates as a strategic commissioner.

The Committee will have a strong focus on improvement, prevention, population health and the left-shift as set out in the 10-Year Health Plan.

Membership includes Non-executive Directors, NHS GM Chief Officers and NHS GM Partner Members.

The committee meets monthly and meetings are open to the public.

Purpose

The GM SEND Strategic Partnership provides an opportunity for SEND collaboration across GM, allowing strategic SEND leaders to take a coordinated approach to SEND system priorities and challenges.

This includes:

• System leadership, strategic oversight and direction in relation to responding to national and regional reforms, and addressing outcomes of local area SEND inspections.

• Identifying and developing opportunities for joint working and collaboration that reflect shared priorities within locality improvement and development plans.

• Ensuring co-production values and the lived experience of children, young people and their families is at the core of the partnership’s working.

• Overseeing an agreed programme of work that addresses identified priorities for the SEND population of GM.

  
  

Membership includes local authority SEND leads, ICB colleagues and school leaders. The voices of parents, carers and children and young people with SEND are also represented. The partnership is chaired by a GM Director for Children's Services and the NHS GM Executive Lead for SEND.

Meetings are bi-monthly.