Supplementary Memorandum from the Southern
Health and Social Services Board
SUPPLEMENTARY QUESTION 1
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)|
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
Medical evaluation100 per cent
Occupational Therapy16 per cent
Physiotherapy10 per cent
Speech and Language Therapy29 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
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 weeks||78 per cent|
|Percentage completed within eight weeks||89 per cent|
|Average duration||5.8 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
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
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 provided||Number of children||Proportion of total number of statemented children|
|Number of statemented children receiving support from Speech and Language therapistsSHSSB area (1998)|
| ||Pre-school||Special schools||Special Units||Community/Mainstream||Total|
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
The following table outlines the number of new children seen
|Number of new children seen by Child and Adolescent Psychiatric Service since 1991|
|Number new referrals seen||296||294||385||371||384||428||398|
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 PsychiatristsLearning 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
(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)|
of children in
|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
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 200001?
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