Leaks in the press about reduction in send spending

[Perzival]

I haven't seen a thread on this so thought i'd start one.

Over Christmas some newspapers inc the Times and Telegraph have leaked reports that the Government intend to tackle the cost of SEND by only issuing EHCP's to those children with the most severe needs. School's (mainstream) will then be responsible for meeting the needs of those with "moderate" or "minor" (not my wording) needs. Appeals to sendist by parents will be restricted (i'm guessing to those who still have an EHCP) and schools will have to liase with the LA regarding the needs of the other children requiring support.

To avoid drip feeding, my ds has severe/complex needs and attends special school, he'll never be able to live alone....

I have really mixed feelings about this. The current system is causing some LA's to go bankrupt, schools are already massively underfunded, lack of special school places, time it takes for tribunal and don't have the specialisms required but i also see huge waste like the removal of LA owned transport in preference for taxi contracts, the cost of inde provision (not disputing need but wish there was a way for thatto be provided locally by LA's without the profit margin) and the cost to families for professional reports from inde speacialists for tribunal / section f- provision.

If this goes ahead what will happen to the kids who will be failed? What impact will it have on the kids without send in classes with more children with unmet send? If something doesn't change where will the money come from for send with some LA's already blamimg SEND for bankrupsy?

I'm not looking for a discussong rather than an argument. The SEND groups can be an echo chambre so looking for different views.

https://www.specialneedsjungle.com/leaks-denials-fake-conversations-not-inspire-parental-confidence-send/?fbclid=Iwb21leAPInu5jbGNrA8iej2V4dG4DYWVtAjExAHNydGMGYXBwX2lkDDM1MDY4NTUzMTcyOAABHrItacXo4jijUu3mrF_32165ExI-sVCsVWcUNjc49IsMqP3NOT7kEg3neK8j_aem_AOqVBm2C3Uk7R5u6D-3GIw

They are starting to, end of year 8 we got a letter from our local authority asking if we wanted we could move our child to technical college from year 9 onwards, we didn’t get it for our eldest who is two years older and we didn’t move house in between so I can only presume it’s a new school.

I though LAs could say something wasnt an efficient use of public resources. But I guess thats only when comparing options. If there is only one option that meets the need that option has a chance at overcharging, which i guess is how private equity has milked the tax payer.

I think the biggest issue focusing on 100k options these are outliers and it doesnt appear to be this issue that is being leaked as being tackled. The majority of people with an ehcp attend mainstream and 75% of new plans issued were for mainstream. It seems to be they are focusing on creating savings in that group.

So it might be the big figures that upset the general public and shock people into wanting action, but it looks like with talk of early help, inclusive classrooms, resources bases in each school and ehcps only for special schools, that they havent gone down tackling private equity, big costs, high transport costs etc.

But the leaks could be wrong.

That's really good to hear, thanks for that.

I think that in some LAs - especially those with high numbers of independent specialist schools - there are more children with EHCPs in specialist schools that mainstream. £50k+ transport packages are extremely common. Children just aren't coping in mainstream so end up in expensive provisions. I don't know how high needs funding works, whether the money tied up in expensive packages means that schools get less support or funding which leads to specialist provisions. It's a real issue though.

My post is not misleading.

Cost (incompatible with the efficient use of resources for placements that are not wholly independent and unreasonable public expenditure for those that are) is considered, but only if looking at more than one placement that can meet needs. If needs cannot be met at one/the other options, then cost isn’t relevant to the naming in the EHCP. A placement that cannot meet needs is pointless. That would be a waste of money. It will lead to further costs (financial and otherwise) in the longer term. So, yes, there is still provision DC with SEN don’t get and are not entitled to by law. No one is legally entitled to the best possible provision. It is not ‘almost unlimited’. To say otherwise shows a lack of knowledge of SEN law.

Besides, if you reduce the provision provided by education, social care and NHS costs would increase.

DS1 has a comprehensive EOTAS package. Yes, it is very, very expensive. He also receives children’s continuing care funding. Yes, also very expensive. The package of care the ICB funds would need to be significantly more if he didn’t have the EOTAS package he has. He has a smaller package than he otherwise would because he has a comprehensive EOTAS package. He would also cost the NHS more in other ways. For example, he receives therapies via his EOTAS package rather than the NHS. There would probably be an increase in the number of hospital admissions he has too.

DS3 also has a comprehensive EOTIS package. Very expensive but not as much as DS1’s. He receives social care support. If you reduced the education provision, his social care provision would increase. He too would also cost the NHS more e.g. therapies.

Both have some of their EOTAS/EOTIS provision delivered at home. Something we cannot be compelled to accept. If the LA reduced their provision (including the provision outside of the home), this is a decision we would need to revisit. If the LA were forced to find and fund suitable premises to deliver the provision we currently allow to happen at home, it would increase costs.

As I said, I know all about QALYs due to having DC on medication for an LLI that the NHS initially refused to fund. It wasn’t possible to buy it privately in the UK. Most, including us, could not afford to buy it abroad. That type of situation is far more nuanced than your post suggests.

There are lots of differences between the NHS and education. For example, if someone is unhappy with their local hospital, they can choose to go elsewhere. At the moment, at least. Although some ICBs have paused some RTC referrals for some conditions, not the ones you are using as examples. With education, you can’t just opt to use another LA. Another difference is you don’t have the huge numbers of people having to take the NHS to court just for an assessment. Yes, there are a few cases, but nowhere near on the scale of education. The vast majority of people who need suspected cancer investigating don't need to go to court to force the LA's hand. Similarly, there are far more upheld LGO cases than PHSO cases.

They won’t get a life extending drug by going to a different hospital.

And I don’t understand this point about ‘costs in the long run’. Sadly the differences made by ploughing £££ are so minimal to society that we really do need to reevaluate. And frankly we need a cap on how much can be spent on 1 child; £100,000 plus a year unless for complex medical care round to clock is absolute madness, sorry. You can’t blame the public for being staggered by these amounts and frankly not really wanting to pay it.

I think your particular circumstances also highlight the issue in that SEN is now so common that it’s quite normal to have multiple children on expensive packages in 1 family. This used to be almost unheard of, or very rare. I know one family with 6 children all with EHCPs and expensive placements and provision. This is simply bankrupting county councils and council tax is now basically a SEN and elderly care tax.

I’m glad this looks to be properly addressed but they CANNOT U-turn on this, Labour need the guts to see it through. It cannot continue. It’ll end up like immigration if not addressed - a pressure cooker resulting in huge public grievance and a hostile climate.

They won’t get a life extending drug by going to a different hospital.

I didn’t say they would! As I said, I have firsthand experience of such drugs. My point was about choice of provider of care.

If you place a child in an unsuitable placement, you will increase the costs in the long run. For example, if DC can’t attend because of unmet needs, you not only have the money needed to fund the placement named in I even if the child isn’t attending but also s19 provision (note there hasn't been any leak about changing s19 provision). You also spend money on things like early reviews, updated advice and information, potentially needing a placement costing even more than the original one that was more expensive. NHS costs might increase because they might need increase NHS input from, e.g. a psychiatrist they may not have needed because of school trauma, a hospital admission or more ICB funding for continuing care funding. There may be increased social care costs.

I think that’s the point though, these legal obligations are going to be watered down.

None of the leaks suggest changes to s19 provision, social care support, NHS care or things like early reviews (which involve updated advice and information) will be made.

BTW, if you or anyone can find a placement(s) my DC can attend, they would be attending. EOTAS/EOTIS isn’t the easy or simple option some think it is. Before DS3’s SENDIST hearing, the LA consulted with 41 schools. None could meet needs because it is inappropriate for provision to be made in a school. Unless you know of a school without other pupils…

With the greatest of respect how will he ever work if he can’t be in a classroom with others, under any circumstances?

He probably won’t.

And it isn’t just about the classroom. There are some SS who can teach 1:1. If it was just the classroom, there may be a school he could attend.

Ok so this is sort of what we’re discussing. It’s brutal but you seem willing to engage with the conversation. If he’s unlikely to work ever, should he have a very very expensive placement (as you described it)? He definitely needs a placement because you deserve to work and not be forced into a 24/7 caring role. But there used to be ‘day care centres’ when I was younger which local people attended, and seemed to enjoy. Low pressure, fun activities, no goals or targets.

DS1&3 aren’t in a placement. They have EOTAS/EOTIS. That means section I is blank. There isn’t a placement or type of placement named.

Lots of areas still have day care centres, although they may be called something else, but they aren’t appropriate for all.

If DS3 can’t cope in an educational placement, what gives you the impression he would cope in a day care centre? He wouldn’t. He would need more individual support, which would be every bit as costly as his EOTAS/EOTIS package - which is my point, if you reduce education provision, you would increase social care (and NHS) costs for him.

Good luck with finding a daycare centre that will accept DS1. He has a complex mix of physical, medical, psychological and developmental needs. We can’t even find an AP setting that could be part of his EOTAS package who is willing to let him attend for even 30 mins even with his own 2:1 staffing on top of their staff. If you reduced his EOTAS package, his children’s continuing care package would increase, which would cost just as much.

What about the EOTIS are so expensive?

@2x4greenbrick have you given any thought to what you'll do/ your children will do post education? My ds is yr11 equiv and we're waiting for his updated plan/ section i. I hope he'll stay in his current setting until he's 19. While i know he can stay in education at the moment until 25 i doubt that he will. Following that i'm not sure. We've had a serious safeguarding incident with PA's so we're reluctant to have them again. Local day services are hit n miss. I think until he has to move because we can no longer care for him, he'll be with us.

This is very true if a child has very high needs across the board. And yes it's the cheaper option in this case.

For a cohort of children (different situation) it's often much cheaper to spend £100k than £300k in a residential placement which can sadly lead to an even much more ATU placement which can cost even more. That said this could be avoided in some cases if early intervention was available and children are properly supported from an early age.

I think that having all the money tied up in expensive specialist provision creates a snowball effect as all the resources get tied up in EHCPs, when children do get EHCPs LAs give minimal support as there's no money. This leads to appeals and expensive placements as children just can't manage in mainstream with useless EHCPs. And this in turn leads to even less money available. This is what I see anyway. It also leads to a lot of unnecessary trauma for families as the situation becomes extremely adversarial, gaslighting is rife and parents advocating for their children are seen as the enemy. Parents often develop mental health and/or psychical health issues from the trauma.

I was under the impression that the use of ATU's was being phased out? I know successive governments have missed their targets in this regard especially for those with Autism/ LD. Their continued use in this way is a scandal and deserves more highlighting in the press.

My understanding is that ATU's are cheaper than community care with the funding comomg from the NHS rather than the LA which it would if it was community based.

and this is exactly what I'm afraid is going to happen with my son.

Right now, he is thriving in mainstream but only because of his EHCP. Take that away because he isn't in special school and mainstream won't be suitable for him which is going to cost more money in the long run.

EOTAS/EOTIS packages aren’t all the same. They are different depending on the individual child’s needs and the provision they require.

There are lots of reasons EOTAS/EOTIS can be every bit as expensive as SS or even more.

LAs often try to fob parents off with a few hours of tuition. Maybe with a bit of SALT or OT thrown in. But that isn’t a proper EOTAS/EOTIS package. Done properly, it can be incredibly expensive. Think about all the professionals a child in a specialist setting has involved in their education. Not just directly, but indirectly. A child with EOTAS/EOTIS still needs this.

There are also tasks in schools that are provided by the school without it specifically being funded or only partially funded by the EHCP. For example, in schools you have a SENCO. While good EHCPs for DC in schools will include time allocated for e.g. ARs, many pupils in schools don’t have such good EHCPs but the school still allocate some time (maybe not as much as if it was in the EHCP) for the SENCO to undertake the tasks associated with ARs. Similar for e.g. those schools with SALT, OT, EP, CP and/or physio in-house or where school buy in such support. For those with EOTAS/EOTIS, this time specifically needs allocating, which costs money. If it isn’t in F, it won’t be provided.

Another example, in schools some DC get 1:1 even if it isn’t detailed, specified and quantified in F. That means it isn’t enforceable but is still provided by the school. With EOTAS/EOTIS, that wouldn’t happen. Staffing needs to be explicit.

Along the same lines, some have hydrotherapy in SS even if it isn’t in their EHCP. That wouldn’t be included in an EOTAS/EOTIS package if it wasn’t in F and it can be more expensive to deliver outside of school. There is other provision that is similar to this.

Also, DC in schools get things like online apps/subscriptions, resources, internet, technology, trips, exams and EAAs for those able to sit exams, the cost of other qualifications for those able to do them, extra-curricular clubs (not all SS offer these but some do even if it is at lunchtime rather than after/before school), revision classes or revision material (yes, not all schools. I am talking about in general)… A parent may have it contribute to some, but it isn’t always the whole cost they have to contribute. Even where it is the whole cost, economies of scale mean it is cheaper than for just one person. Whereas, the provision DC with EOTAS/EOTIS get is everything. They don’t get the extras schools provide that aren't part of the EHCP funding. It all needs to be accounted for.

I’m sorry you had such an experience. It is hideous when we put our trust in these people and they put our vulnerable DC at risk. So much trauma caused.

DS1 & DS3 are teens at the moment. They will keep their EHCPs as long as possible. At the moment, that means until their 26th birthday. If the LA tries to cease to maintain before they age out, I will appeal.

DS1 has a team of carers (I say carers, but they aren’t your run of the mill NMW carers.) already funded via the ICB. It has taken a long time to get to the point where we found suitable people we trust. It hasn’t been without setbacks. Like the carer who quit very quickly because she didn’t like how much personal care was involved. She knew. We make a point of stressing it on application, during interview and during the trial shifts. Or the woman who raised her voice in anger at DS1 head-butting the floor in distress. We couldn’t manage his care without outside help, so we don’t really have much option. Our plan is to increase the care hours once out of education. They have gradually increased over time, anyway. Some of DS’s EOTAS provision looks the same as what carers do with him now.

With DS3, he already has a social care PA. That would increase if he wasn’t in education. Just like DS1, some of his EOTIS provision looks like what the PA does with him. But beyond that, what he will do, I don’t know. Maybe supported living. He would need an individual placement.

I think until he has to move because we can no longer care for him, he'll be with us.

The one thing I will say about this is it is often easier to make the transition while you are still here and able to help with the transition. That way, you have a say in the support and sort any issues. It doesn’t have to be straight away when DS is an adult, but it can help to do it at some point before you die or are otherwise unable to care.

Policy, at least publicly, was to reduce ATU usage. They are still used more than they should be. The easy (not for the patient or family) option.

@2x4greenbrick so many pa's/carers/ ta's shouldn't be in their roles. Thank you for replying, you clearly know your stuff and it's interesting to see what other people with complex children have planned.

Yes, we do plan to transition him before we can't be there to oversee. It would be too much for him to lose everything all at once. We're currently looking at deputyship too.

One of my fears in regards to the incoming changes is the jump from disabled childrens funding to disabled adults and the possible increase and acceptance of hospitals/ ATU's instead of community living. If they remove the right to education (which i hope isn't on the cards rather a reduction in funding) of a child what rights would they be willing to remove of adults.

I do think there are clear ways to save money in the special needs system but the removal of rights is a slippery slope.

ATUs are very expensive but yes funded by the NHS, it's more how costs snowballs overall. And of course there's then less incentive for LAs to then provide community care.

It's just a really difficult situation as obviously no early intervention and early support in nursery/school leads to no suitable provision for years and as we know has a massive knock on effects on social care, CAMHS, adult MH etc. There are very high numbers of people in prison with language disorders etc who had little support for SEND in school - this is historic. Resources are taken up by expensive placements. It's just not an equitable system at all as it does favour parents who are able to fight for support and that leads to a lot of resentment as it's seen as unfair. Which it often is. In turn the process traumatises families who can fight tooth and nail and have every right to advocate for their children.

It can't stay as it is, they realistically aren't going to throw even more money at the situation. LAs as a whole aren't the best at coming up with innovative solutions to save money and there's far too much bureaucracy and waste. SaLTs and OTs have left the NHS in droves to work privately. Nightmare!

@Perzival we have applied for Deputyship for DS1. Personal welfare. Shouldn’t need property and financial affairs because appointeeship should suffice for us. It hasn’t been granted yet with the long waiting time. DS3 should have capacity to make an LPA at 18.

If it applies to you, have you also looked at Deprivation of Liberty? Not all need it but some do. Deprivation of Liberty Safeguards (DoLS) only applies to 18+ in certain settings, but the Court of Protection can grant a Deprivation of Liberty Order before then and for people in other types of settings including for people living at home. We have also applied for this for DS1. It should come through quicker than Deputyship.

I think there are far fewer people with LD in ATUs but an increase in people with ASD without LD. It's something I really worry about too as we were on that trajectory for a bit and randomly throwing resources at the problem was making everything worse.

No we haven't looked at DOL's. I thought it was for agencies/nhs etc when they want to section? How would it be applied for family/ home use please? If you can point me in the direction of any info, i'd appreciate it please?