Agenda item

This paper provides the Medway Children’s Overview and Scrutiny Committee with a summary of the commissioning and provision of health and support services for Medway children and families, detailing the strategic shift towards early intervention.

Discussion:

The Committee received a report and presentation which detailed the commissioning and provision of health and support services for Medway children and families, detailing the strategic shift towards early intervention.

Members raised several comments and questions which included:

Education Health Care Plans (EHCP) – it was asked what provision was in place to support children as EHCPs went beyond legal school age. The Committee was informed that  Medway Community Healthcare  worked closely with the Local Authority to maintain health care plans  beyond the age of 18. There was a register held for young people in transition and monthly meetings took place to ensure maintenance of continuity of care, which was crucial during the transition period, to ensure that young people did not fall through the gap.

Signposting  - in response to a question on signposting to services, the Committee learned that there had been extensive investment  through the Start for Life funding and in the family hubs so that people were aware of how and where to access services. Partner organisations such as schools, voluntary sector and health disseminated information via their websites. Additionally,  Medway Parent and Carer Forum provided support with distribution of information. There were continuous efforts undertaken to ensure that families remained informed about the services and support  available to them.

It was further commented that families may not be aware of some of the services identified in the report and some services did not always signpost where relevant. Medway Community Healthcare (MCH) acknowledged that there had been delays in updating their communications and including all signposting within letters to parents, but this had now been addressed. 

Referrals – it was commented that there had been a rise in referrals received by services, and it was asked what was being done to manage increased need and the impact on services. The Committee learned that there were several factors for the increase in referrals, some of which were post pandemic, but some trajectory was occurring prior which was further exacerbated by lockdown. The focus and priority now was to identify needs and determine if there was capacity and capability to meet needs without necessarily referring for specialist support. The Start for Life programme had helped to promote a needs first approach. The Children’s Wellbeing and Schools Bill reforms would also drive forward change as it sought to instil an early intervention approach and departments were currently working in preparation for the reforms.

It was further asked how it was determined that a referral met the criteria for intervention, and the Committee was informed that all referrals were reviewed extensively. A recent validation of waiting lists had been completed for specialist children’s services which highlighted that a large proportion of  referrals received met the criteria for a service.

Needs based approach – the needs based approach was commended and it was asked what mitigations were in place to ensure that as a child progressed in life, their emerging needs would be linked and addressed at each stage presented. Officers in attendance acknowledged the need to be mindful when taking this approach and the need to continue to ensure that a holistic approach was taken once a referral received. MCH clarified that assessments were holistic and looked at all needs not just a single diagnosis.

Speech and language - in response to a question on how the effectiveness of the service was measured given the number of sessions allocated, the Officer from Medway Community Healthcare acknowledged that there were challenges with the number of available  therapists, however, there were also technical assistants in place who also provided ongoing contact and support for families. The effectiveness of therapy was not measurable by the number of sessions a child accessed, but on measurable outcomes. It was crucial that all involved in the child’s life (family and schools) were delivering speech and language support for the child guided by the strategies developed by the specialist to maximise the opportunity for the child’s development.

Tiny Talkers - it was asked how parents were engaged with and what was being done to mitigate in instances where English was not the first language. The Officer from HomeStart in attendance confirmed that interpreters could be commissioned to support where necessary, but they had not received many referrals where a family did not speak or understand English to a level that impacted their ability to engage. When a referral was received for the service, the family was invited for an in depth conversation about their needs. Families were extremely engaged with the service; they attended all sessions and welcomed the support provided. A risk assessment was taken at the beginning and end of the programme, and a follow up exercise took place to track progress.

Decision:

a)     The Committee noted the report.

b)     An update report from Children’s Services on the Children’s Wellbeing and Schools Bill reforms be presented to a future meeting of this Committee.