Select Committee on Northern Ireland Affairs Minutes of Evidence

Supplementary Memorandum from the Southern Health and Social Services Board


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

Number of children referred to SHSSB Trusts

Total number of referrals made to SHSSB Trusts (1993-94 to 1997-98)
Number referred317343377403429

Type of professional assessment:

  While the individual professional assessments undertaken for each child are recorded within the child's clinical casenotes, such data are not routinely abstracted and collected in an aggregate fashion at Trust/unit level. However, a recent area-wide audit, investigating SHSSB Trust contributions to the "statementing" process, demonstrated that, on average, children received the following assessments:

    —  Medical evaluation—100 per cent

    —  Occupational Therapy—16 per cent

    —  Physiotherapy—10 per cent

    —  Speech and Language Therapy—29 per cent

  The above data demonstrate that each child is assessed by the designated Trust medical officer (or deputy) who, based upon this initial assessment, requests the opinion of other health professionals, thus enabling the completion of a comprehensive and appropriate baseline evaluation.


"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 SHSSB has now evaluated the interval between the time that the Southern Education and Library Board issues a request to Southern Health and Social Services Board (SHSSB) Trusts for formal medical advice and the return of completed assessments. This "time lapse" was evaluated for the 18 months between 1 January 1997 to 30 June 1998 by assessing a random sample of 90 records.

  Performance was assessed in terms of:

    —  Percentage completed within six weeks, i.e., the "maximum" recommended interval for the statementing process (also evaluated over eight weeks).

    —  Average duration for assessment process.

Statementing process: SELB request for medical advice from SHSSB Trust:
Percentage completed within six and eight weeks
Percentage completed within six weeks78 per cent
Percentage completed within eight weeks89 per cent
Average duration5.8 weeks

  In general, formal medical advice for the purposes of the statementing process has been largely provided to the SELB within the "recommended" time interval (6 weeks).

  Explanations for exceeding the recommended time interval included:

    —  Child/parent not attending for medical appointment.

    —  Delays attributable to requesting parental consent for medical examination.

    —  Wide variation in referral rates over time, i.e., large number referrals within a short period.

    —  Delays attributable to child relocating between different schools, e.g., moving from primary to secondary education.


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 5 years, in total, and broken down by type of support?

  On average, there were around 1,385 statemented children within the SHSSB area in 1998. The number (and proportion) receiving medical-type support is outlined in the table below.

  Although each statemented child has undergone a specialist medical assessment, a considerable number are found not to have a recurrent/long-term need for ongoing specialist medical therapy/treatment. In such cases, ongoing "routine" medical care is provided by the normal primary health care service provision.

Specialist support provided to statemented children
in the SHSSB area (1998)
Therapy providedNumber of childrenProportion of total number of statemented children
Per cent
Speech therapy54839.6
Occupational therapy287 20.7

Number of statemented children receiving support from Speech and Language therapists—SHSSB area (1998)
 Pre-schoolSpecial schoolsSpecial UnitsCommunity/MainstreamTotal
Ongoing treatment618218749424
Review only8712421124

  Given that the needs of individual children are not constant, and also the gradual movement of children into adult-orientated services, the numbers provided in this table will vary over time.


What clinical psychology/psychiatry services does the SHSSB 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?

  These services are organised along service provision for children/young people with (i) predominantly mental health problems, and (ii) those with predominantly learning difficulties.

Mental Health service provision

  Services are provided via multi-disciplinary teams lead by consultants in child and adolescent psychiatry supported by nursing, clinical psychology, and social work professionals. The following human resources are available across the SHSSB area:

    —  2 Child/adolescent psychiatrists

    —  3 Nurses

    —  3 Social Workers

  The following table outlines the number of new children seen since 1991:

Number of new children seen by Child and Adolescent Psychiatric Service since 1991
Number new referrals seen296294385371384428398

Children with Learning Difficulties

  Services for individuals with learning difficulties are organised, in common with elsewhere, along teams that provide care to both adults and children. However, in terms of diagnosis/assessment, services are largely provided to children (new referrals from adults being infrequent).

    —  2 Consultant Psychiatrists—Learning Difficulties;

    —  3 Clinical psychologists;

    —  8 full time + 4 part time Social Workers (providing a service to children only);

    —  16 full time + 4 part time Nurses ( + 2 full time Assistants).
  (Number of referrals seen is not available).


How many children in residential care in the Board's area had SEN statements in each of the last five years, and what percentage was this of the total population?

  This is outlined in the following table:

Statemented children in the SHSSB area in residential care (1994-98)
YearNumber of
Total number
of children in
residential care
Proportion of
children in
care statemented
per cent
Total number
of children
looked after
n/a = not available.


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 SHSSB and SELB have had a number of meetings regarding training in relation to the requirements of the Education Order and the SEN Code of Practice. As in other topic areas such as the Children Order and child protection, the SHSSB will be working collaboratively with the SELB in respect of training. The training will, in addition, take account of the implications of the service level agreements between Education and Health and Social Services Boards, which are currently being finalised by a regional working group.

  As in other initiatives, training will be both unidisciplinary and multidisciplinary and will involve social workers and other relevant health and social services staff.


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, 1999-00 and 2000—01?

  Unfortunately it is not possible to provide the financial information requested as the information we have relates to programmes of care (e.g., Maternal and Child Health, Mental health, Physical Disability). With our existing information systems we would not be in a position to disaggregate the data to provide figures relating to assessing and meeting SENs.

13 January 1999

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