Reports from NHS professionals

[debs40]

Our OT report is helpful and it sets out lots of things that need doing.

However, of course, it does not specify the provision required for achieving the 4 pages of recommendations.

My OT (who is head of the dept) told me a while back that the LA had challenged her dept for putting 'needs 1:1' on reports, saying that is a matter for teaching strategy not health professionals.

So we have the very roundabout/vague 'some time allocation needs to be set aside to practice specific activities daily. Other recommednations are just adjustments to everyday choices or can be incorporated into daily life at school or home. Some of the recommendations require allowances and consideration of DS' needs'

Would you expect an NHS professional to be more specific? What is your experience

Debs was it an actual assessment or just a sensory profile OT did?

No debs I wouldn't. I did at first, until the Head of SALT told us that the LA had issued them with very detailed guidelines about how to make recommendations for statements, ie don't specify anything.

Can you put in a Freedom of Information request for all information supplied from the LA detailing how provision is to be explained. You can use that to hit them with later.

But ffs, if a child needs 1:1 OT there is no 'teaching strategy' that could accomplish that except 1:1

You could also challenge the OT and make her say something that can only mean 1:1. I.e. ds needs to be guided though these excercises for 7 hours a day!?.

Claw she has spent 6 months assessing him and she is the head of the team. She knows him really well.

BornintheCrap would that FOI request go to the LA Education Dept?

I'd send it to both tbh. These things are weeded so the more people involved the more mistakes they might make.

Tis I - the self-opinionated one!

That sounds like a comprehensive needs assessment then. She should be able to give her opinion of your ds needs and if that is 1:1 help then so be it. Whats the point of the report, if she isnt prepared to state what he actually needs.

Perhaps say to her she can recommend what the hell she likes, it is then up to school whether they follow her recommendations or not.

Bloody ridiculous isnt it, no one wants to commit themselves!

I know. I don't want to upset her as if she came to Tribunal she would be very direct and helpful. She clearly is not prepared to put 1:1 in writing though.

Do I just go through the general FOI procedure for the hospital? Rather than drag her in.

Debs, would she actually go to a tribunal though and if she did would she say he needs 1:1 or just more of the same of what she has written?

I have learnt to be very wary of OT's, its all about functional ability, so even if ds displayed this behaviour at home, if school said he didnt, it would quickly turn into, yes he has difficulties, but is obviously able to overcome them in school.

No professional i have ever meet, will get involved in school disputes ie as long as the school are backing you, they will. If not youre on your own!

That's a tough one for sure. You have few enough friends in this business without upsetting the ones that can be marginally helpful. If you ever DO fall out with her you'll have to write to her to confirm the contents of your conversation:

ie. you told me that whilst he needs 1:1 the LA have refused to allow you to make the recommendationsa your are professionally qualified to make..........

You also have to figure out whether or not your friends are really your friends if they aren't actually helping you iyswim.

I suppose the crux of it is, is she more helpful in the long run by being allowed to be this limp fish, or would it be more helpful to drop her in it? It is horrible, horrible, but a little boy's life is at stake!

School are backing you right?

Could you ask school to put their concerns in writing to OT and request recommendations?

I will speak to her head on when I see her aty the end of the month but I may make a general request to the whole hospital as other depts will be involved e.g. SALT who discharge to schools for EVERY case of SCD.

She has not been wishy-washy about his issues. She says he clearly has poor coordination, poor muscle tone, hypermobility, and sensory modulation disorder consistent with a Social Communciation Disorder

She does not distinguish between home/school for this as you could not.

She did actually come to school to support me (along with the Community Paed) when I had a meeting with school when they were doing nothing to outline DS's needs and made them minute it all.

She has also been ready to be a Tribunal witness for other people in the same position.

I think I will speak to her face to face first.

I see, a potentially good egg.

Perhaps then you could gain her permission to write to her outlining that she has told you that she can't recommend 1:1. Even if she said she'd rather you didn't she will understand that you are not going to drop this and may be helpful in other ways.

I really hope she a good un Debs.

If she is willing to report to a tribunal that he needs 1:1, why cant she write this in her report.

Whats the difference? Writing it in a report could prevent it from going to tribunal in the first place.

Claw, yoou're right I know. I don't know but I suppose there has probably been a policy agreed somewhere.

She has listed 3-4 pages of recommendations and I've just spoken to ACE and they say that the fact that she has put that he requires this input daily moves him in to that SA bracket so it doesn't matter that she doesn't put 1:1

Star that is a good idea

We've had similar experiences in doing dd's statement for starting school in Sept..

SALT and OT were both so wishy washy. I met SALT doing an assessment at dd's nursery and she let slip that they are not allowed to recommend 1-1. She said she couldn't commit the SALT at SN school.. ( because she would be committing resources they may not have..) but after a long tough conversation she did change what she wrote. She originally said dd 'MAY need direct intervention in the future' but then changed it to dd ' currently requires a block of 1-1 SALT delivered by a SALT on a weekly basis for 4-6 weeks. At some point during first 2 terms at school will be offered dd will be offered one block of 1-1 sessions delivered by a SALT on a weekly basis for 4-6 sessions...'

We thought this was as good as was going to get.. She also agreed to take out that dd is ' an effective communicator'- which was ludicrous as dd now 4yrs 3 months uses single words and a handful of signs mostly to label things and people but has 1 word understanding and never tells us if she's hungry, too hot or cold or whatever.. and often cannot make her most basic needs known.. On a bad day she hardly says anything at all.. That's not very effective communication in my book..

OT did put that 'she would benefit from a programme devised and monitored by OT and would benefit from small groups and 1-1 work.' We're still wrangling with them to specify it but again they seem reluctant to commit to anything more that that..

DD's nursery and Portage were very clear that dd needs 1-1 supervision so that was good but LEA still revising statement after we had a meeting with them on tuesday.. we await their amendments which we hope will say 1-1 supervision at all times. If not fighting begins again.

The whole statementing system is a joke.. except it's really not funny..

Sorry for long post.. very grumpy about it all today..

Don't blame you for being grumpy! It is ridiculous isn't it. It's bloody exhausting isn't it and I've only just got started!

Grrrrr.

Going through my docs. In 6 months I asked no less than 26 times (15 in writing) how many hours 1:1 ds was getting and never once got a response.

They said 'he is getting as many as are specified in his statement, which has been written in a very specific way' and then all the responses after that said we have responded to your question already, see above!

His statement says 'some' 1:1!

I didn't realise how bad it had been until now when pulling all together the evidence!

Oh and the other non-responses to specific enquiries about what exactly IS he getting has been a broken record 'he is getting what is in his statement which has been carefully written to ensure that his needs are met'

Luckily though I have one silly response that says 'what your ds is getting is the same level provision as someone with his needs who does not have a statement because funds are now delegated'

er, - wtf!

J's psych said this at one point (pre-Tribunal application, I asked her to do a report to try to stave it off iyswim) and she said that she'd get in trouble if she actually wrote he needs full time 1:1.

However, she did write something like "J needs help with x, y and z during all classroom times and so would need individual support with this. He also needs support at break times and lunch times with x, y and z. He also needs support with x in assembly. In PE lessons, he will need help with x and y. etc. etc.". It covered it

I understand from the friend that this OT was going to go to Tribunal for that the OT will be more specific at a Stat Assess where she does specify the provision.

Thing is, before tribunal they are answerable to the LA and they have to do as they are told by them.

At tribunal it is different and they have to do what the LAW tells them. THAT is why they change their tune, not because they are nice really (although to be fair they may well be nice just caught between a rock and a hard place).

AHA as Alan Partridge would say...now she's sees it!

Will have chat with her at next apptmnt to see what she would suggest.

Yes. The shocking thing about all this is that they only seem accountable in LAW when it is brought before tribunal and not before.

Why can't they just be put in a police cell for not specifying their recommendations in the first place, given a caution and 3 more 'offences' have their license to practise removed?

yep im waiting on nhs report , but she wont specify how much he needs and how often , this is a child going into year 1 unable to write infact is still scribbing only holding a pen in his fist, cant use normal scissors , cant use a knife etc

The 'good' news if there every is any to be found, is that if you go to tribunal with independent reports that DO specify they are the stronger ones!

Both our Ot and Physio reports specify exactly the amount of input necessary from each professional (OT and Phsyio) and state that a TA will need to attend each session with DS so that the exercises are carried over into the classroom environment. In this way they do support the need for a TA, they also say that DS will need help with eating, dressing, toileting etc.