Select Committee on Northern Ireland Affairs Minutes of Evidence


Supplementary Memorandum from Eastern Health and Social Services Board

  I attach further comments concerning the seven supplementary questions, which you raised following your memorandum of the 18 December 1998.



  The letter dated 18 December 1998 from the Clerk of the Northern Ireland Affairs Committee outlines seven supplementary questions regarding special educational needs which the Northern Ireland Affairs Committee requested in addition to the Board's memorandum and oral evidence.

  The following document outlines the Board's response to each of the seven questions in tabular form with explanatory narrative.

Q1. How many children have been referred to the Board for assessment for the purposes of SEN statements in each of the last five years in total and by type of professional assessment

  Staff respond to requests for advice in respect of statutory assessment of special educational needs from Belfast Education and Library Board and South Eastern Education and Library Board. The number of requests for initial advice, as well as updated reports for statutory assessments, over the five years period from 1994-99 is as outlined in the table below.
Area19941995 199619971998
North and West Belfast Trust (BELB)218 363425362 225
South and East Belfast (BELB and SEELB) 223225280 202195
Down Lisburn Trust (SEELB)350 298312286 209
Ulster Community and Hospitals Trust (SEELB) 187161129 134126
Total9781,047 1,146984755

  The geographical areas covered by the Trusts are as follows:

TrustGeographical area
North and West Belfast TrustNorth Belfast and West Belfast within the Belfast District Council area
South and East BelfastSouth Belfast and East Belfast within the Belfast District Council area plus the Castlereagh District Council area
Down Lisburn TrustDown Lisburn District Council areas
Ulster Community and Hospitals TrustNorth Down and Ards District Council areas

Q2. What has been the average time lapse between referral and actual assessment in each of the last five years, overall, and by type of assessment

  In general, formal medical advice for the purposes of the statementing process has been largely provided to the Education and Library Boards by Trusts within the six weeks period and up to three months for other professional reports.

  The Medical Officer is the only professional who must see every child referred for the purpose of statutory assessment.

  At present information in relation to date referral issued and assessment returned is recorded on individual files held by SEELB and BELB. It is not broken down into type of professional assessment by the Trust staff.

  SEELB have commenced recording and monitoring of the time frame for the return of assessments from September 1998 onwards but not previously.

Q3. What has been the total number of children with statements of special educational needs to whom the Board has provided support in each of the last five years in total and broken down by type of support?

  Children with statements of Special Educational Need receive services and support from a variety of disciplines throughout the various stages of the child's life and in keeping with their changing needs.

  The range of support services provided to these children from Social Services includes specialist child minding, foster care, shared care, summer schemes, befriending, Breakaway Schemes, Crossroads Care Attendant Schemes, respite care, psychology and treatment services which include child or adolescent psychiatry for children with severe learning difficulties. A variety of mainstream children's services are offered within Trusts through the Child and Family Programme.

  The table below indicates the number of children from the EHSSB area who are receiving therapy at special schools.

  We cannot quantify this information on a five year basis although it may be possible for both Education and Library Boards to do so.
PhysiotherapySpeech and
Language Therapy
Killard House82 82
Clifton5145 56
Glencraig00 0
Rathmore PHU00 N/K
Brookfield10 74
Parkview (SLD)6347 90
Knockevin (SLD)5730 60
Knockmore Diag Unit2 25
Knockmore S and L Unit0 023
Downpatrick Unit (MLD)0 016
St Colmcille's Unit0 09
Castlewellan Unit (MLD)0 06
St Malachy's Unit (MLD)0 05
Fleming Fulton140138 89
Tor Bank9849 85
Greenwood221 37
Longstone64 55
Mitchell House6349 42
Harberton Primary43 63
Cregagh Primary PHU0 013
Orangefield PHU00 4
Cedar Lodge2425 37
St Gerard's ERC02 52
Glenveagh10791 97
Oakwood4641 61
St Francis de Sales0 013
Ballygolan S and L Unit0 02
Holy Trinity Unit00 5
St Rose's Sec PHU00 1
Corpus Christie PHU0 00
Total692529 1,082
Whole Time Equivalent (WTE) Therapists 19.0521.0923.63

  The number of children, however, with statements in 1997-98 is as follows:
Schools and UnitsNumber
SEELBSpecial Schools and Units 1,730
Mainstream Schools692
BELBSpecial Schools and Units 963
Mainstream Schools438
TotalSpecial Schools 2,693
Mainstream Schools1,130

  The number of children attending school in EHSSB area is 134,489 and the percentage of children statemented[8] is 2.84 per cent.

Q4. What clinical psychology/psychiatry services does the EHSSB provide for children and young people of school age; what resources are committed to this; to what extent are the services provided separately from services for adults; and how many persons have such services been provided in each of the last five years?

  The above services are commissioned on the following basis:

    (i)  Child and adolescent mental health services.

    (ii)  Services for children with learning disabilities.

Child and Adolescent Mental Health Services

  The Board currently invests £2.278 million in commissioning a range of in-patient, day care and out-patient child and adolescent mental health services. These services are provided separately from adult provision. During 1996-97, the following levels of service were provided:


In-patients6,869 beds
Day Care1,846 attendances
Out-patients7,434 attendances

  The service was provided by the following numbers of staff:
Consultant Psychiatrist5.4
Associate Specialist1.0
Senior Registrar2.0
Senior House Officer3.5
Clinical Psychologist4.525
Senior Social Worker3.0
Social Worker5.0
Senior Care Assistants5.0

  During 1996-97, 170 children and young people were admitted for in-patient care (54 of whom were admitted to adult accommodation) with approximately a further 1,100 being seen on an out-patient basis.

  The EHSSB Community Trusts are unable to fully quantify the number of referrals to child and adolescent psychiatry services from 1993-1996. The Board will continue to work with Trusts to identify this information.

  The EHSSB has recently carried out a comprehensive review of child and adolescent mental health services in its area and has identified the following main strategic recommendations:

    —  Services should be community-based with "in-reach" services to hospitals, e.g., in relation to deliberate self harm.

    —  Services should be integrated into child health and care services at community level.

    —  A tiered model of care should be implemented as recommended by the NHS Health Advisory Service and the House of Commons Health Committee. This model includes the development of the role of mental health workers with specialist skills to work closely with GPs, health visitors, school nurses and others to enhance the delivery of mental health services at primary care level.

    —  Mental health promotion and the delivery of primary level mental health care should be recognised as a key function of health visitors and school nurses.

    —  Appropriate training and continuing professional development as well as specialist support are essential to enable primary care professionals to meet the mental health needs of children and young people.

    —  Joint working across health, social services, education, juvenile justice and the voluntary sector is essential at all levels including the planning and delivery of services.

    —  Specialist tiers of services should include a multi-disciplinary team at community level and specialised services provided on a area-wide basis, including in-patient services and substances misuse service.

    —  Age-appropriate in-patient facilities for children and young people should be provided in close proximity, preferably on the same site.

    —  Family support and prevention services should continue to be developed as a priority.

Children with Learning Disabilities

  The Board has undertaken an extensive review and analysis of the needs of children with learning disabilities in order to inform its commissioning and expenditure priorities. An action plan is now in place to implement the strategy within available resources between 1999 and 2002.

  The needs of children with disabilities, have been given further impetus by the Children Services Planning Sub-Group for children with disabilities and the resulting plan for the Board's area will address, on an inter-agency basis the prioritised needs of this group.

  Services to children with learning disabilities are largely provided in conjunction with those for adults. Diagnosis and assessment services are however largely geared towards children. Some Trusts are now attempting to separate more closely services provided to children and adults.

  There are currently five WTE consultant psychiatrists employed by North and West Belfast Trust who cover in-patient and community services. In addition, increased community clinical psychology and more recently behaviour nurse therapy services have become available within Trusts which have assisted in reducing the number of children referred to specialist hospitals for treatment and behaviour management programmes.

  The number of referrals to the service is not fully available from the Trusts in the Board's area.

  The following clinical psychology services provided for children and young people of school age are, however detailed below,

    —  Behavioural assessment/treatment.

    —  Development assessments.

    —  Assessment of autism and other developmental disorders in conjunction with medical professionals.

    —  Psychometric and attainment assessments especially pertinent for decision-making regarding the extent of learning disability.

    —  Specialist advisory services to children learning disability team regarding issues of childrens personal development needs—e.g., assessment of risk of sexual vulnerability of clients/emotional well-being/training/regarding sexual awareness etc.

    —  Non-medical mental health assessment and advice/treatment.

    —  Planning of services for children along with other senior members of programme.

    —  Attendance and input to educational reviews and statements as necessary.

    —  Development of support groups for parents of autistic children.

    —  Attendance at referral meetings for the Learning Disability Programme.

    —  Liaison with learning disability hospital as necessary.

    —  Management of Behavioural Support Team.

  In one Trust area, a behavioural clinic is now being run by a Community Medical Officer, Education Welfare Officer and an educational psychologist on a weekly basis for primary age children.

Q5. How many children in residential care in the Board's area had an SEN statement in each of the last five years and what percentage was this of the total population.
Number of children statemented in residential care
19941995 199619971998
North and West Belfast HSST1 n/an/an/a n/an/a
South and East Belfast HSST
 (as percentage)
Down Lisburn HSST32 612
Ulster Community and Hospitals Trust
 (as percentage)
1 Information was not provided by North and West Belfast Trust.

Q6. What training has been given to Social Services staff (and social workers in particular) regarding the requirements of the Education Order and the SEN Code of Practice, and what financial and other resources have been devoted to this?

  The ethos and principles of the Children (NI) Order 1995, Education (NI) Order 1996 and Disabled Persons Act 1989 are included in qualifying training within the Colleges of Further Education and Universities in Northern Ireland. Under the post-qualifying training arrangements, in order to obtain post-qualifying credits, or awards, staff must demonstrate a knowledge of all relevant legislation pertaining to children, including the above legislation and how it applies in practice.

  A completed portfolio of evidence is required which demonstrates how staff have integrated theory and knowledge of legislation and how it applies in practice.

  The senior management who professionally supervise social work staff in Trusts are responsible for identifying the training needs of their staff which can be met either within the Trust by the Trust's training team or by attending specific courses.

  One of the values which underpins social work training is inter-organisational and inter-sectoral working arrangements regarding children with a disability.

  EHSSB have produced a Children Services Training Plan 1997-2002 for the EHSSB area. This Plan identifies a need for joint education and social services training.

  Needs assessment training has been put in place across children services, e.g., early years, family support, child protection, family PLacement, leaving care and after care.

  Cross reference to the Education Order and Code of Practice will have been made in the Children Order training as the Children Order identifies children with a disability as children in need.

  The EHSSB are currently in the process of confirming training plans for 1999-2000 and training in the requirements of the Education Order and SEN Code of Practice will be included in this plan.

  An agreed protocol will be drawn up between Trusts and Education and Library Boards to operationalise this and will take account of the service level agreements between Education and Library Boards which are currently being finalised by the Regional Working Group.

  As in other areas such as the Children Order and Child Protection, the EHSSB will be working collaboratively with Education and Library Boards in respect of training.

  The South Eastern Education and Library Board held a half-day Awareness Session for Health and Personal Social Services staff in the Ulster Community and Hospitals Trust covering the Education (NI) Order 1996 and the Code of Practice to appraise Trust staff of statutory responsibilities and to inform about the Boards policy for pupils with SEN.

Q7. What has been the Board's actual expenditure related to assessing and meeting special educational needs in each of the last three financial years, and what is your projected spend in 1998-99, 1999-2000 and 2000-01?

  The Board is unable to provide information requested above as financial information is gathered in line with Health and Social Services Executive programme definitions (e.g., Maternal and Child Health, Learning Disability, Physical Disability) and these cannot be easily disaggregated and related to special educational needs.

  Budget profiles reflect the focus of care provision that is holistically meeting the identified health and social care needs of children, irrespective of whether or not they have a statement of special educational needs. The Board would require a very specific information technology programme to capture this information pan-Trust and Board as it encapsulates a full range of professions in a variety of settings.

  The Board has however been able to estimate its investment in therapy services to children who attend special schools and units in its area as being approximately £1.291 million (see Annex 2). It has not yet been possible to quantify medical, nursing or dental input in this regard.

8   Information on Statemented Children was provided by Education and Library Boards. Back

previous page contents next page

House of Commons home page Parliament home page House of Lords home page search page enquiries

© Parliamentary copyright 1999
Prepared 19 April 1999