Behaviour and Discipline in Schools - Education Committee Contents

8  Specialist services

122. A theme running through much of the evidence to our inquiry was a concern that greater devolution to schools for commissioning alternative provision and support services could lead to some services currently provided centrally by local authorities, such as behaviour support, being outsourced or disbanded completely as increasing numbers of schools become removed from local authority control and as the demand for central services becomes less certain.[227] As Christine Blower of the National Union of Teachers told us:

if a number of schools can draw on that kind of facility and professional support, if there is a child who risks exclusion, we can usually manage to nip it in the bud. The more schools there are that leave the local authority, the less there is at the centre in order to be able to do that. We think that that is clearly a loss for the schools that remain with the local authority, but it is also something we don't think the academies will be able to do as effectively. If they need to buy in services, they will not be doing it on the same basis as local authorities.[228]

123. Ms Blower stressed that the rapid response provided by core services was "critical" in responding to immediate need.[229] John Dickinson-Lilley of the Special Educational Consortium explained the particular impact the "fragmentation" of central support services would have on pupils with more complex needs:

it is really difficult to disentangle mental health disability and behavioural difficulties. There is a real issue in schools about who is responsible for a child's mental health […] One of the key challenges for schools now, certainly with the changes to the structure of the system, is how to develop those partnerships. [...] One of our concerns at the SEC is that we are seeing significant fragmentation already in the traditional central support services provided by local authorities—such as educational psychologists and so on—because of the new academies programme. There is potential for further fragmentation with free schools, where schools will be required to commission services. If the money has already been taken away from local authorities, those services will be lost, and if they are lost, how will provision be made? It is an absolutely critical question, but it is one that we are going to find very hard to answer until the Government can give us an answer about how they are going to ensure that this provision will continue to be made while education is being changed in the way that it is being changed.[230]

124. The Government is currently considering the future role of local authorities in coordinating support to schools. As the Minister for Schools told us, "if you are asking about the role of local authorities in a world where an increasing number of schools are academies, the ministerial advisory group established by the Secretary of State[231] is looking at that to see what their role will be and how it is to be funded. There will always be a role for local authorities in the provision of education, and in the provision of central services. Because those services may be purchased by schools, it may be decided that local authorities will provide those services funded centrally—for example, low-incidence special needs. That is something that is being discussed at the moment with the local authorities".[232]

125. We await with interest the outcome of the ministerial advisory group's study of the future role of local authorities, in particular their role in co-ordinating support to schools for managing behaviour. There is a risk that, as schools go through the transition from being dependent on local authority-provided services to having greater autonomy in purchasing their own support and services, some local authority services may be decommissioned, leaving schools, and more importantly pupils, without access to critical support. We therefore recommend that local authorities should be required to maintain and resource a basic core of provision—particularly that which is targeted at responding to urgent or critical need—until schools' practice in commissioning and procuring their own support is well established.

126. In the remainder of this Report, we look more closely at two particular specialist services which are central to behaviour support for schools: educational psychology services and child and adolescent mental health services (CAMHS).

Educational psychology services

127. Of particular concern for our witnesses was the future availability and management of educational psychologists. The Association of Educational Psychologists (AEP) explained that "educational psychologists work on a daily basis across a range of educational settings that include schools, early years, Pupil Referral Units and within multi-disciplinary settings with close colleagues from the NHS and Children's Social Care. As such, they are uniquely placed to ensure consistency and continuity when managing challenging behaviour, which is the bedrock of any effective behaviour or discipline policy".[233] The Association also stressed the role which educational psychologists played in developing understanding of—and providing training to teachers on—child development and the "root emotional, wellbeing or social causes that precipitate challenging behaviour",[234] as well as advising on curriculum development and special educational needs.

128. During our visit to Beaumont Leys School in Leicester, staff told us that the support which they gave to pupils could be improved significantly if they had greater access to educational psychologists and interventions from therapeutic services. At present the school receives just 30 hours of support per year from educational psychology services. Difficult decisions have to be made about what to prioritise, particularly as processing one statement of educational needs can take up to six hours of an educational psychologist's time, even before a report is written. Educational psychologists therefore have very little capacity to support the school in carrying out preventative work in a more proactive way.  The school has considered establishing its own educational psychology service but has decided that this is not financially viable.[235] The Association of Education Psychologists told us that "the impact of educational psychologists is being undermined by the lack of resources on the frontline",[236] something which it attributed to "a lack of understanding about the range of work across educational settings that educational psychologists perform, and the unclear and unsustainable funding mechanisms for trainees that translate as a result".[237]

129. The Minister of State for Children and Families has stated that the current system for funding educational psychologists (whereby local authorities are allocated non-ring-fenced funding for educational psychology training which they voluntarily contribute to a central budget each year) is not sustainable.[238] These voluntary contributions have been decreasing over several years, with only 16 out of 150 local authorities contributing in the current financial year. This leaves the service with a significant shortfall in funding. The Government states that psychology services are "specialist […] and demand-led" and that local authorities need to improve their ability to "assess capacity in relation to local demand for the service" in order to advise forward planning.[239] The Association of Educational Psychologists expressed deep concern about the future of educational psychology services and recommends that "the previous funding model, which was to top-slice all local authorities rather than seek voluntary contributions, provided for a steady uptake of training places".[240]

130. Educational psychologists provide critical support and training to school staff on a wide range of educational issues including child development, curriculum development and special educational needs. Any diminution of their ability to help schools to maintain and improve standards of behaviour could have far-reaching consequences. The voluntary funding mechanism has proved to be unsustainable. The Government must find a way forward, and one option might be for local authorities to continue to be responsible for educational psychology services, funded through a compulsory levy on schools.

Child and Adolescent Mental Health Services

131. Evidence from the mental health charity Young Minds stated that "many children who have a special educational need, particularly those who are said to have behavioural, emotional and social difficulties will also have mental health problems".[241] Staff at Beaumont Leys School in Leicester estimated that mental health problems were a factor in "maybe 60%" of behaviour resulting in fixed term exclusions.[242] However, during our inquiry we heard widespread complaints about the difficulties which schools face in accessing Child and Adolescent Mental Health Services (CAMHS) and the speed with which this support is made available. During oral evidence, Sir Alan Steer said that the country faced a "national scandal on the issues of children's mental health", commenting that the situation in some parts of the country was "dire". He recounted a recent experience of a child waiting 18 months between referral and first appointment with CAMHS, with 9 months being reported as a 'normal' waiting time.[243] Liz Logie, Head Teacher at Beaumont Leys School, told us that she had not had any contact with CAMHS in 8 years of her headship and agreed with Sir Alan that her school's inability to access CAMHS was a "disgrace".[244]

132. Asked whether the situation would improve if schools were able to commission CAMHS directly, Liz Logie said this would only be effective if sufficient funds were made available. However, Charlie Taylor, Head Teacher at Willows Primary Special School and Acting Head Teacher of Chantry Secondary Special School in Hillingdon, pointed out the potential difficulties for schools in commissioning CAMHS:

We are supposed to be able to commission through CAMHS, but I thought education recruitment was complicated until you get into health recruitment […] The bureaucracy and everything else around it is such a complete nightmare that in the end you think it is better if we use the money on what we want. You have to pay them a huge […] pimping fee, I suppose, to get any services into your schools. You end up paying a tip to the NHS for bringing a worker into your school, so in the end we thought we would go direct to the workers and recruit our own people.[245]

133. Many young people with behavioural issues or SEN also have mental health problems. Schools face major challenges in securing specialist and therapeutic services in order to make accurate assessments of need and to implement appropriate interventions. Particular difficulties in accessing Child and Adolescent Mental Health Services were raised by a large number of our witnesses. Sir Alan Steer suggested that a national scandal "hovers around" children's mental health:[246] we are in no doubt that the CAMHS situation is scandalous and that there are very serious shortcomings in access. The Department for Education and the Department of Health must co-operate in order to find a way of allowing schools to have easier and speedier access to Child and Adolescent Mental Health Services. The Department of Health and the Department for Education should pilot with a number of Behaviour and Attendance Partnerships a mechanism by which they can commission CAMHS services accountable to them locally.

134. In our meeting with partners at Leicestershire County Council, CAMHS commissioner Liz Mair pointed out the commonly held misconception that all CAMH services are specialist.[247] The same point was made by the mental health charity Young Minds, which observed that "many of the services within the concept of the comprehensive CAMHS are provided by agencies other than the NHS e.g. social services, and the voluntary sector".[248] In Leicestershire, CAMHS believes that up to 35% of all young people referred to specialist CAMHS do not require specialist interventions (although non-specialist interventions may be required). However, as Young Minds concluded, the full range of CAMHS services—specialist and non-specialist—"need to be functioning effectively if the whole system is to work properly".[249]

135. Evidence to the inquiry highlighted the importance of joint protocols and multi-agency information sharing, in order to improve referrals between the various partners involved in supporting behaviour, SEN and mental health. Leicester City Council operates a comprehensive referral system to behaviour support services, underpinned by an 'Information Passport' which brings together all relevant information about a pupil being considered for referral to alternative provision or other forms of support. This single referral form avoids the need for all concerned agencies to make multiple separate referrals to support services and improves the quality of information shared between partners. CAMHS is not party to the Information Passport used by the Leicester Education Inclusion Partnership. CAMHS is, however, a recipient of information gathered through Common Assessment Framework processes and also shares information with schools about pupils accessing its services.[250] The case for common assessment and referral systems was supported in written evidence from NFER which stressed that "clear systems for referral and information sharing improve the decision-making process. A shared assessment tool can avoid duplication and promote early identification of need".[251]

136. There is a lack of agreement and understanding between schools, local authorities and health services as to how referrals to CAMHS should work and who should be referred. Having commonly agreed referral mechanisms would go some way to addressing this. Where Behaviour and Attendance Partnerships are in place, they should be directly involved in developing and agreeing these mechanisms.

137. Liz Mair told us that CAMHS workers feel that greater awareness of the differences between mental health problems and conduct disorders is required amongst front-line workers in order for young people and their families to get the help they need at the earliest opportunity.[252] Partners agreed that the Government-funded Targeted Mental Health in Schools (TaMHS) programme[253] had been helpful in improving the skills of front-line workers, and evidence to our inquiry also showed widespread support for the programme.[254]

138. Any programme which improves the skills of frontline workers in identifying mental health problems and encourages innovation should be supported. The Government should review the Targeted Mental Health in Schools programme and the SEN Green Paper should set out how it should be taken forward in future.

139. The children's communication charity I CAN attributed the failure of CAMHS to provide responsive and joined-up services to schools to the current split in commissioning budgets and priorities across the different agencies providing CAMH services.[255] The Schools White Paper The Importance of Teaching proposed that local authorities should continue to hold the role of "convenor of local services" as well as "champion for vulnerable pupils in their area".[256] Similarly, it proposed that local authorities would continue to ensure that disabled children and those with special educational needs (SEN) could have access to high-quality provision that met their needs. Local authorities would also be responsible for funding provision for pupils with statements of SEN. Mental health is dealt with separately in the White Paper, with a sole commitment to "work with the Department of Health to develop and publish a mental health strategy" by January 2011. It is not clear from these proposals how a 'continuum' of provision will be constructed to ensure that young people do not fall between the gaps where services are provided by different agencies and where different thresholds for interventions exist.

140. I CAN referred to a recent proposal made by a group of children's representative bodies to the Secretary of State for Health, which suggested fundamental changes to the way in which CAMH services are funded. The group suggested that the Government "builds on its plans to locate the public health commissioning function within local authorities, by also identifying the local authority (working closely with GP consortia) as lead commissioner and budget holder for all local children's community health services".[257]

141. We support the suggestion by I CAN and other children's representative bodies that the Government consider passing the responsibility for budgets and commissioning of all children's community health services (including CAMHS and Speech Language and Communication specialist services) to local authorities in order to provide a more streamlined service to young people and their families, bridging the gap between 'specialist' and 'non-specialist' interventions.

227   e.g. Ev 116 Back

228   Q 38 Back

229   Q 38 Back

230   Q 198-9 Back

231   The Secretary of State for Education wrote to all local authorities on 26 May 2010 inviting them to partake in a dialogue about how to make the vision for a new school system a reality. In July 2010 a Ministerial Advisory Group was established to consider the role of the local authority in relation to education and children's services, to enable ministers and local authorities to consider the future partnership between central and local Government.  Back

232   Q 298 Back

233   Ev 94 Back

234   Ev 94 Back

235   Annex 2 Back

236   Ev 94 Back

237   Ev 94 Back

238   HC Deb, 18 October 2010, col. 774 Back

239   HC Deb, 18 October 2010, col. 773 Back

240   Ev 96 Back

241   Ev 153 Back

242   Annex 2 Back

243   Q 91 Back

244   Annex 2 Back

245   Q 159 Back

246   Q 91 Back

247   Annex 2 Back

248   Ev 154 Back

249   Ev 154 Back

250   Annex 2 Back

251   Ev w152 Back

252   Annex 2 Back

253   TaMHS is a three-year pathfinder programme, started in April 2008, aimed at supporting the development of of innovative models of therapeutic and holistic mental health support in schools for children and young people aged five to thirteen at risk of, and/or experiencing, mental health problems; and their families. 25 local authorities and their Primary Care Trusts have worked together on the pathfinder. Back

254   For example see Ev 154, para 6.4, Q 190 Back

255   Ev 146 Back

256   The Importance of Teaching, para 5.40 Back

257   Ev 146 Back

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