Select Committee on Northern Ireland Affairs Minutes of Evidence

Further Memorandum from the Eastern Health and Social Services Board



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.


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.


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 UnitsNumber
SEELBSpecial Schools and Units1,730
 Mainstream Schools692
BELBSpecial Schools and Units 963
 Mainstream Schools438
TotalSpecial Schools and Units 2,693
 Mainstream Schools1,130

    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 TherapyPhysiotherapySpeech and Language Therapy
Killard House8282
Rathmore PHU00N/K
Parkview (SLD)634790
Knockevin (SLD)573060
Knockmore Diag Unit225
Knockmore S&L Unit0023
Downpatrick Unit (MLD)0016
St Colmcille's Unit009
Castlewellan Unit (MLD)006
St Malachy's Unit (MLD)005
Fleming Fulton14013889
Tor Bank984985
Mitchell House634942
Harberton Primary4363
Cregagh Primary PHU0013
Orangefield PHU004
Cedar Lodge242537
St Gerard's ERC0252
St Francis de Sales0013
Ballygolan S&L Unit002
Holy Trinity Unit005
St Rose's Sec. PHU001
Corpus Christie PHU000
WTE Therapists19.0521.0923.63


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.


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.


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.


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
ProfessionGradeGreenpark WTES & E WTEUCHT WTEN & W WTEDL WTETotal WTEUnit cost £Cost £
Occupational TherapistHead III1.00    1.0026,71826,718
 Senior I4.251.610.793.301.6011.5522,852263,941
 Senior II1.00  2.000.503.5019,13166,959
 Basic2.00 1.00  3.0016,94050,820
PhysiotherapistHead III2.00    2.0026,71853,436
 Senior I3.581.,852221,893
 Senior II2.90  0.73 3.6319,13169,446
 Basic2.00   0.252.2516,94038,115
 Assistant3.000.50   3.5010,54136,894
Speech and Language Grade 3 0.50 0.50 1.0033,24833,248
 Grade 1 0.45   0.4515,1756,829
 Assistant 0.900.841.50 3.2411,10735,987
 Co-ordinator1.00    1.0015,17515,175
Total Investment = £1,291,829
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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Prepared 14 April 1999