Further Memorandum from the Eastern Health
and Social Services Board
RESPONSE TO SUPPLEMENTARY QUESTIONS
SUPPLEMENTARY QUESTION
1
How many children have been referred to the EHSSB
for assessment for the purposes of SEN statements in each of the
last five years, in total and by type of professional assessment?
The four Community Trusts in the EHSSB area
which provide services in regard to the assessment of children
for SEN statements have been unable, in the time available, to
provide the information required. This information will be provided
at a later date.
SUPPLEMENTARY QUESTION
2
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?
The four Community Trusts in the EHSSB area
which provide services in regard to the assessment of children
for SEN statements have been unable, in the time available, to
provide the information required. This information will be provided
at a later date.
SUPPLEMENTARY QUESTION
3
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?
The Board is currently unable to provide information
on a five year basis. The number of children with statements in
1997-98 is as follows:
| | Schools and Units | Number |
| SEELB | Special Schools and Units | 1,730 |
| | Mainstream Schools | 692 |
| BELB | Special Schools and Units
| 963 |
| | Mainstream Schools | 438 |
| Total | Special Schools and Units
| 2,693 |
| | Mainstream Schools | 1,130 |
| Total | 3,823 |
Children attending school in EHSSB Area = 134,489
Percentage of Children Statemented = 2.84 per cent.
In this regard, the number of children who receive a therapy
service within special schools and units and the number of therapist
staff who provide this service are detailed in the attached Table.
Children with a statement who attend mainstream schools receive
therapy services in the community setting. It is not currently
possible to identify the level of service provided to these children.
The Board will however continue to investigate this issue further.
| Children at Special Schools and Units receiving a Therapy Service |
| | Occupational Therapy | Physiotherapy | Speech and Language Therapy |
| Killard House | 8 | 2 | 82 |
| Clifton | 51 | 45 | 56 |
| Glencraig | 0 | 0 | 0 |
| Rathmore PHU | 0 | 0 | N/K |
| Brookfield | 1 | 0 | 74 |
| Parkview (SLD) | 63 | 47 | 90 |
| Knockevin (SLD) | 57 | 30 | 60 |
| Knockmore Diag Unit | 2 | 2 | 5 |
| Knockmore S&L Unit | 0 | 0 | 23 |
| Downpatrick Unit (MLD) | 0 | 0 | 16 |
| St Colmcille's Unit | 0 | 0 | 9 |
| Castlewellan Unit (MLD) | 0 | 0 | 6 |
| St Malachy's Unit (MLD) | 0 | 0 | 5 |
| Fleming Fulton | 140 | 138 | 89 |
| Tor Bank | 98 | 49 | 85 |
| Greenwood | 22 | 1 | 37 |
| Longstone | 6 | 4 | 55 |
| Mitchell House | 63 | 49 | 42 |
| Harberton Primary | 4 | 3 | 63 |
| Cregagh Primary PHU | 0 | 0 | 13 |
| Orangefield PHU | 0 | 0 | 4 |
| Cedar Lodge | 24 | 25 | 37 |
| St Gerard's ERC | 0 | 2 | 52 |
| Glenveagh | 107 | 91 | 97 |
| Oakwood | 46 | 41 | 61 |
| St Francis de Sales | 0 | 0 | 13 |
| Ballygolan S&L Unit | 0 | 0 | 2 |
| Holy Trinity Unit | 0 | 0 | 5 |
| St Rose's Sec. PHU | 0 | 0 | 1 |
| Corpus Christie PHU | 0 | 0 | 0 |
| Total | 692 | 529 | 1,082 |
| WTE Therapists | 19.05 | 21.09 | 23.63 |
SUPPLEMENTARY QUESTION
4
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 for 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 & 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 inpatient, day case and outpatient Child and Adolescent
Mental Health Services. These services are provided separately
from adult provision. During 1996-97, the following levels of
service were provided:
Inpatients = 6,869 bed days
Day Case = 1,846 attendances
Outpatients = 7,434 attendances
This service was provided by the following numbers of staff:
Consultant Psychiatrist — 5.4 Wte
Associate Specialist — 1.0 Wte
Senior Registrar — 2.0 Wte
Senior House Officer — 3.5 Wte
Nurses — 35.13 Wte
Clinical Psychologist — 4.525 Wte
Senior Social Worker — 3.0 Wte
Social Worker — 5.0 Wte
Senior Care Assistants — 5.0 Wte
Support — 8.0 Wte
During 1996-97, 170 children and young people were admitted
for inpatient care (54 of whom were admitted to adult accommodation)
with approximately a further 1,100 being seen on an outpatient
basis.
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:
— CAMHS should be community-based with "in
reach" services to hospitals e.g., in relation to deliberate
self harm.
— CAMHS 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 schools 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 CAMHS should include a multidisciplinary
team at community level and specialised services provided on an
area-wide basis including inpatient services and substance misuse
services.
— Age-appropriate inpatient facilities should be
provided for young people up to the age of 18.
— Inpatient mental health services 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
Services to children with learning disabilities are provided
in conjunction with those for adults. Diagnosis and assessment
services are however largely geared towards children.
There are currently four WTE consultant psychiatrists employed
in this area.
The number of referrals to the service is not currently available
from the Trusts in the Board's area.
SUPPLEMENTARY QUESTION
5
How many children in residential care in the Board's area have
had SEN statements in each of the last five years, and what percentage
was this of the total population?
The four Community Trusts in the EHSSB area which provide
services in regard to the assessment of children for SEN statements
have been unable, in the time available, to provide the information
required. This information will be provided at a later date.
SUPPLEMENTARY QUESTION
6
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
with their 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.
This is to ensure a child receives a quality service and
an individually tailored package of care to meet its needs.
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.
SUPPLEMENTARY QUESTION
7
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 the information requested
above as financial information is gathered in line with HSS 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.
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 £1.292 million (see
Table attached). It has not as yet been possible to quantify medical,
nursing or dental input in this regard.
| Investment in PAM's Services in Special Schools and
Units—Total Board Investment |
| Profession | Grade | Greenpark WTE | S & E WTE | UCHT WTE | N & W WTE | DL WTE | Total WTE | Unit cost £ | Cost £ |
| Occupational Therapist | Head III | 1.00 | | | | | 1.00 | 26,718 | 26,718 |
| | Senior I | 4.25 | 1.61 | 0.79 | 3.30 | 1.60 | 11.55 | 22,852 | 263,941 |
| | Senior II | 1.00 | | | 2.00 | 0.50 | 3.50 | 19,131 | 66,959 |
| | Basic | 2.00 | | 1.00 | | | 3.00 | 16,940 | 50,820 |
| Physiotherapist | Head III | 2.00 | | | | | 2.00 | 26,718 | 53,436 |
| | Senior I | 3.58 | 1.25 | 1.14 | 2.15 | 1.59 | 9.71 | 22,852 | 221,893 |
| | Senior II | 2.90 | | | 0.73 | | 3.63 | 19,131 | 69,446 |
| | Basic | 2.00 | | | | 0.25 | 2.25 | 16,940 | 38,115 |
| | Assistant | 3.00 | 0.50 | | | | 3.50 | 10,541 | 36,894 |
| Speech and Language | Grade 3 | | 0.50 | | 0.50 | | 1.00 | 33,248 | 33,248 |
| Therapist | Grade 2 | 3.00 | 4.05 | 2.76 | 5.00 | 3.12 | 17.93 | 20,768 | 372,370 |
| | Grade 1 | | 0.45 | | | | 0.45 | 15,175 | 6,829 |
| | Assistant | | 0.90 | 0.84 | 1.50 | | 3.24 | 11,107 | 35,987 |
| | Co-ordinator | 1.00 | | | | | 1.00 | 15,175 | 15,175 |
Total Investment = £1,291,829 |
Note:
Unit Cost = Mid point of pay scale + 7 per cent NIC + 10 per cent Goods and Services.
WTE = Whole Time Equivalent. |
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