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Wolverhampton Information Network

Local Offer Feedback 2015

Local Offer Presentation - December 2015

Submitted: 30.12.2015

I am tasked with reviewing our Local Offer website, which like all authorities was launched in September 2014. I would like to simplify what we have at the moment into a more manageable and informative offering.

To this end I have been looking at other Council's Local Offers, and have come across yours, which I have to say is fantastic in its layout and straightforward detail provided to your audience. I am writing to request permission from yourselves to maybe use the headers you have established and replicate some of the general informative pages you have - Local Offer explained, Education, Health and Care Plan (EHCP) etc.? I realise that you refer to the Child Development Centre (CDC) for resources, but think that the way this is presented is most useful. 

Emotional Support before it reaches Crisis Level - September 2015

Submitted: 08.09.2015

Can you clarify what kind of support is available to offer children/young people emotional support before it reaches a crisis level?

I have been told my daughter cannot be referred to Child and Adolescent Mental Health Service (CAMHS) as her need is not as yet severe enough. I do feel there is a gap for children from the age of 5 upwards to find this kind of support to help them come to terms with their disability and to cope with the frustration and behavioural problems it can lead to and the effect it has on the family unit and particularly siblings. I know some support can be offered in school but it's more needed for home life. It would be better to have early intervention before it reaches that point where it is much more difficult to deal with and the long term effects that the child will already have suffered. Also we were told about parenting classes which I didn't feel was appropriate. There also seems to be a lack of or finding out where you can get support for siblings.

Response: 27.01.2016

 Thank you for your question.

The Wolverhampton Local Transformation Plan for Children and Young Peoples' Mental Health and Wellbeing has at its heart a commitment to getting the right service, at the right time and in the right place so that children and young people receive the support they need and can move seamlessly through services without repeated appointments and referrals.

This Transformation Plan includes service redesign, care pathway clarification, some increase in provision and the need to work much earlier with children and young people and their families to prevent a need for support reaching a Crisis point. More information regarding this Transformation Plan will be updated on the Local Offer as the work progresses.

We know that CAMHS needs to reach out to our children and young people and one vehicle to do just that is the HeadStart Initiative.

The HeadStart (Big Lottery) project aims to improve the resilience and lives of young people aged 10 - 16 years by working in four areas:

A child's time and experience in school

  • Their ability to access the community services they need
  • Their home life and relationship with family members
  • Their interaction with digital technology

HeadStart will work in schools and communities offering support in school, in the community and providing a place to go for children and young people to access early support to build resilience and prevent needs escalating. To complement this offer there will be Camhs Link workers also working in schools and community settings.

Plans are in place to provide this initiative to children younger than 10 years of age and more information regarding this will be included on the Local Offer as and when details are finalised.

Further information about HeadStart can be found at www.headstart.fm.

Further information regarding Platform 52 and Believe to Achieve is included on the Local Offer and can be accessed by a search on their names.

CAMHS Service - September 2015

Submitted: 09.10.2015

The template for the CAMHS service on the Local Offer reads well but my experience for the past four years is that I appear to be stuck in a loop of general referral being passed from one professional and department to another and we're no further forward.

Please can we have clarification published on the Local Offer to explain exactly what the pathways are for those young people experiencing significant anxiety issues that are impacting on everyday life who seem to fall below the eligibility threshold of being at the point of 'self-harming' as we were told needed to be the case to access CAMHS. The template for CAMHS reads " To access the Child and Family Service they must have a long standing mental health difficulty that impacts upon their day to day lives". This does not give the impression that you need to be a crisis point to access the service.

Parents need to have effective and efficient communication between departments and professionals and to have clear explanations of the choices available to them at each referral stage with the time frames to expect between appointments. Are there processes in place to make sure this happens i.e. does one professional oversee an individual case and act as a single point of contact for parents? It was suggested to me that I could pay privately for support outside of school as 'Platform 52' and 'Believe 2 achieve' are not bought in services at my daughter's school. The Local Offer should be clear about when this would be expected and what other support services are available. Early intervention is crucial. We need clarification on what early intervention is available for anxiety issues that impact on everyday life. A flow chart or diagram would be helpful. I was also signposted to the Early Team as they can sometimes offer early intervention for 0-5's. My daughter is in junior school so doesn't meet that criteria either. Is there a gap locally for early support and intervention in children aged above five years? 

I have often found appointments difficult if there isn't the opportunity to discuss issues privately to spare my daughter the added anxiety of hearing her story repeated many times.

I would also like to see more support available for parents and young people who are having similar experiences and a means of putting them in touch with each another.

I look forward to your response.

Response: 27.01.16

Thank you for describing your experience of the Child and Adolescent Mental Health Services. (CAMHS).

The Wolverhampton Local Transformation Plan for Children and Young Peoples' Mental Health and Wellbeing has at its heart a commitment to getting the right service, at the right time and in the right place so that children and young people receive the support they need and can move seamlessly through services without repeated appointments and referrals.

This Transformation Plan includes service redesign, care pathway clarification, some increase in provision and the need to work much earlier with children and young people and their families to prevent a need for support reaching a Crisis point. More information regarding this Transformation Plan will be updated on the Local Offer as the work progresses.

The CAMHS Transformation Plan is being presented to the SEND Partnership Board in March 2016 following which the Board will receive regular update reports re progress and how it fits with the SEND Agenda.

We know that CAMHS needs to reach out to our children and young people and one vehicle to do just that is the HeadStart Initiative.

The HeadStart (Big Lottery) project aims to improve the resilience and lives of young people aged 10 - 16 years by working in four areas:

  •  A child's time and experience in school
  • Their ability to access the community services they need
  • Their home life and relationship with family members
  • Their interaction with digital technology

HeadStart will work in schools and communities offering support in school, in the community and providing a place to go for children and young people to access early support to build resilience and prevent needs escalating. To complement this offer there will be Camhs Link workers also working in schools and community settings.

Further information about HeadStart can be found at www.headstart.fm

"Brighter Futures, No reference to habilitation - June 2015

Submitted: 16.06.2015

The publication 'Brighter Futures' indicates that nearly 50% of Local Offers do not include reference to habilitation, is the information on Wolverhampton's Local offer fully explained.

The publication 'Brighter Futures' indicates that nearly 50% of Local Offers do not include reference to habilitation, the mobility and independent living skills training for children with sight loss. Concerned around whether the information on Wolverhampton's Local Offer is thoroughly represented and clearly explained.

Response: 27.10.2015

Thank you for your comment which asked if the sensory team has a fully trained habilitation officer. At the time the Local Offer was being formulated, the term "habilitation" was not as well known or used locally, instead we referred to "mobility and orientation". Prior to 2013, we had a teacher of children and young people with visual impairments who was also a mobility specialist. When the staff member left the organisation in 2013 the service employed an "habilitation specialist".

As a result of your comment, the wording on the local offer has been changed to "offering habilitation (mobility and life skills) assessment and training for children and young people with visual impairment" in order to reflect the current activity and terminology.

Pathological Demand Avoidance, lack of expertise - May 2015

Submitted: 20.05.2015

As a parent of a child diagnosed with Pathological Demand Avoidance, I have been disappointed with the lack of expertise within the city on this subject.

Could consideration be given to creating a specialist combined Education, Social Care and CAMHS list of contact(s) within the city, dealing with this particular condition, that both Local Authority and Academy Schools could access?

Thank you

Poor provision of further education for young people with complex and severe learning disabilities - April 2015

Submitted: 27.04.2015

My son is currently going into transition and I was very disappointed to see what further education is available to young people with complex and severe learning difficulties in Wolverhampton.

This council is paying for young people to attend colleges outside Wolverhampton because their provision is very poor in comparison. I would like to suggest this city looks into providing their own facilities to meet the needs of a variety of young people with complex difficulties.

I am the Mum of disabled twins in transition to adult services and I am dismayed at the lack of provision that this city has to offer. I desperately want to keep them at home and it's in Wolverhampton's best interest to help me do so particularly financially. I am not alone in this as there are numerous families in transition at Tettenhall Wood alone that want their young people to remain in their home environment. If they do go away to college the cost is staggering, and in my case, I'm not sure if I could cope with them after not doing it day to day for 3 years, so then there would be the financial burden on the authority to provide residential care. Wolverhampton College has made a good start but there are not enough places and it won't suit all the young adults.

When my children were first diagnosed, I was very proud to tell everyone how fantastic Wolverhampton was for its excellent provision and holistic approach. I felt so lucky to be living within an authority that offered such a good level of service compared to other surrounding authorities. Since then all we have seen are cuts after cuts, which long-term will have disastrous effects on families with disabilities and possibly put them at breaking point, where more resources will be needed than had the original amount spent on these services been retained, e.g. Windmill, Stowlawn, Multicare and cutting hourly rates of personal assistants on direct payments.

What has happened to that commitment to its young people now they are coming into adulthood? I have seen excellent provision out of the Borough and it seems that is where many of our young people end up. But WHY? This is not cost effective to Wolverhampton and the enormous cost of sending one person out of the Borough would probably pay for at least five places locally, including transport costs!!! So why can't the people holding the purse strings be a little more forward thinking and decide to invest in a large and comprehensive new college that can encompass ALL types of disability from Wolverhampton?

It certainly isn't rocket science to foresee that any investment and commitment now will be returned over a few years if we can proudly say to every young disabled person "no we cannot fund out of Borough as Wolverhampton can offer exactly what you require." All money could then be retained in Borough and we would have an outstanding provision that surrounding authorities would want to buy into.

Imagine a college so comprehensive in its provision that all of the Midlands would be looking to for examples of good practice! It could happen and now is the time, especially with the new EHC plans that are looking towards provision up until 25.  My vision is a college, possibly running alongside Wolverhampton College, but purpose built. It could provide for all students leaving from the 4 special schools and there could be inclusion into the college for those young people who were able to access this. There would be a "towards work" programme for the more able and involvement in the local community. There would be some residential places on offer but be predominantly offering day places and also respite and out of college activities and clubs for evenings, weekends and holidays. It would cater for all people on the autistic spectrum, profoundly disabled, moderate and severe learning disabilities. Students would be put into groups of similar abilities rather than age. There would be both swimming and hydrotherapy pools and access to the mainstream college gym. The pool could also be hired out to Girls High, St Peters and St Edmunds as there is no pool at these schools.

We need to be thinking BIG as there are more and more disabled children and numbers looking for college places will only be rising. This campus could also encompass the day centres so that after college students would have continuity of care in a familiar environment.

The Gem Centre has been such a success and a flagship of good practice as have Tettenhall Wood, Green Park and Penn Fields new schools; let's make our adult services outstanding too! I would welcome the opportunity to meet with decision makers to discuss this plan further.  I understand there is a newly formed SEND Partnership Board and I would like to request that this Board considers my request.

Response: 20.07.2015

Thank you for your comments and acknowledgement of the strength of our Special School provision within the City to 19 years.

The introduction of the 2014 Code of Practice places a duty on all of the stakeholders within the City to ensure we can now meet the needs of our Young People to age 25. In the chapter 'Preparing for adulthood from the earliest years' it is stated that Local Authorities have a strategic leadership role in fulfilling their duties concerning the participation of young people in education and training, working with schools, colleges and post-16 providers, as well as other agencies.  There is a link to published information on 'Participation of young people in education, employment or training' in the references section of the SEN Code of Practice, under Chapter 8.

The Department for Education (DfE) have specific guidance on how provision for 19-25 year olds with Special Educational Needs is best met, and in speaking with a DfE representative in response to your comments, they have advised that 19-25 education provision for Young People with Education, Health and Care Plans should have the core aim of preparing the young person for adult life within an adult environment, and it is felt that Special Schools do not meet this aim.

We have requested that the DfE provide the written form of this guidance for us to publish here, but have been advised that this may take 15 days to arrive.

Plans for future 19-25 provision for Wolverhampton's Young People will need to be part of an informed and realistic strategic plan, involving working partnerships between all stakeholders and agencies on an unprecedented level.

As a result it is difficult to state a clear timescale for strategic review and future developments, or identify what this might look like in terms of future provision within City and beyond.

As with all future developments within the City, the SEND Partnership Board will ensure that consultation around current issues takes place with all stakeholders including Parents and Young People, and your comments are vital to the process of strategic review that is at its beginning here in Wolverhampton.

Service Level Agreements for Physiotherapy and Occupational Therapy - April 2015

Submitted: 22.04.2015

I have looked at the information contained within the Local Offer relating to Physiotherapy and Occupational Therapy and I would like to know if there is any kind of service level agreement which states how often a child should be seen by their therapist?

Pre-school my child was seen regularly but now it only seems to be at my request.  I think it is extremely important that your child is seen at regular intervals particularly whilst they are growing.  This would also help me as a parent to remain focussed on what physio activities to concentrate on with my child.

We used to attend a 'motor' group at the Child Development Centre each week at the Gem Centre which was brilliant!   I think something like this that older children could attend say every month would be fantastic.  It would be a chance to meet other parents, children to meet other children with similar needs and provide opportunities for therapists to discuss exercises you and your child could focus on until the next session. This way many children could be seen within a single session that may help with staffing resources if this is the issue.

I hope that you are able to provide some feedback.

Response: 12.08.2015

"Many thanks for taking the time to raise this query!

Yes, the Clinical Commissioning Group (which is the organisation responsible for commissioning the physiotherapy and occupational therapy services described in the Local Offer), does have a service level agreement with the therapy services and this describes what should be included in the services provided. However, it does not explicitly state the frequency of support to be provided for any individual child or young person or indeed the timescale for the support to be provided. This is because we would explect that the trained therapists decide what the needs are of each individual child/young person and then tailor the level of support given according to those assessed needs.

Your point about the function and purpose of the weekly group at the GEM Centre is valid, and having discussed your feedback with the relevant people within the therapy team, they are keen to look at new and creative ways of responding to your suggestion. I plan to meet with the team leader of the therapy services in the very near future to discuss this further and I will also extend this invitation to the Information, Advice and Support Service (formerly the Parent Partnership Service). Meanwhile many thanks for your feedback"

Children's Commissioning Manager at the Clinical Commissioning Group.

Pathological Demand Avoidance - April 2015

Submitted: 20.04.2015

As a parent of two boys with possible Pathological Demand Avoidance (PDA) and living in a Borough that doesn't recognise this condition, I have faced a hard battle and have to make some tough choices for my eldest son that I feel could have been avoided if the condition had recognition.

I'd like also to point out that PDA is now recognised as part of autism and hope we can raise awareness of this condition in Wolverhampton. Getting the professionals on board to see that this condition is real and to see the devastating affect it has on families including my own and most importantly the affect it has on the child.

I hope for the future to be more positive.

Response: 08.01.2016

Response to Local Offer comments: Pathological Demand Avoidance (PDA):

We are sorry this was your experience and I would like to reassure you that there is no policy in Wolverhampton of not recognising PDA.

Pathological demand avoidance (PDA) syndrome is not a distinct disorder that is recognised by national or international classifications systems. PDA refers to a cluster of behaviours or features which are believed to be part of the autism spectrum. As a possible autism spectrum condition, the route for assessment and diagnosis of PDA should involve referral to the Wolverhampton multi-agency ASD panel. This referral can be made via CAMHS, Paediatricians or Educational Psychologists.

With any psychological difference or condition, the aims of assessment and intervention should be to tailor support to an individual child or young person's needs, rather than to a specific diagnostic label.

Applied Behavioual Analysis (ABA) and Early Intensive Behavioual Intervention (EIBI)

Submitted: 05.03.2015

I write as a parent of a child with autism in relation to your Local Offer, specifically to request the inclusion of Applied Behavioural Analysis (ABA) and Early Intensive Behavioural Intervention (EIBI) together with information about the basis on which these types of therapies will be provided for children with Autism Spectrum Disorder.

As you know, the Local Authority is obliged to consult and seek comments on the content of its Local Offer, including the type and quality of provision that is included, or not included (as well as information about any criteria that must be satisfied before any such provision will be made). Those comments must be published, together with any responses, in accordance with the Children and Families Act 2014 and the Special Educational Needs and Disability Regulations 2014. Doubtless you will keep this obligation in mind when considering this letter, and your response.

I am concerned that in your Local Offer no mention is made of either ABA or EIBI as potential options for children with ASD, nor is there any reference to the basis/criteria on which any such provision would be made. Both ABA and EIBI are highly effective approaches when addressing the difficulties that ASD can present. Moreover, I am aware of children with ASD within the area of the Local Authority who actually receive these therapies but are having to privately fund them.

Why, then, is there no mention of them in your Local Offer?

ABA and EIBI are now widely regarded to be perhaps the most effective form of therapy for children with ASD, particularly if provided when a child is young, soon after diagnosis. Both approaches work so as to improve the behaviour of an autistic child, leading to improvements in cognitive and language skills, adaptive abilities, sociability and quality of life. Early intervention can significantly reduce the need, and therefore the cost, of other therapies at later stages of a child's life. http://www.ncbi.nlm.nih.gov/m/pubmed/22705454/

ABA and EIBI are widely used across the world, including extensively in the US, Australia and Canada. Indeed, litigation in both the US and Canada has resulted in favourable court findings about the effectiveness of this type of therapy, and rulings that it should be state-funded. Despite all of this, both ABA and EIBI are underused in the UK, which is both astounding and appalling considering the wealth of scientific research that establishes their effectiveness, and which also establishes that they are more effective than other forms of intervention, such as speech and language therapy, occupational therapy and portage, that are regularly funded without any evidence of particular benefit for children with ASD.

For example, Research Autism (the UK's impartial and NHS-accredited source of evidence on autism treatment and educational intervention) states as follows:

"There are thousands of scientific studies of the use of interventions which use the principles of applied behaviour analysis to help individuals with autism and others published in peer-reviewed journals. Most of these studies have been positive", and

"Interventions such as speech and language therapy, occupational therapy and physiotherapy are provided by health authorities free of charge...although there are very few studies that evaluate interventions provided by [such therapists]; most families wish their child to receive this assistance alongside appropriate educational and local authority provision. Some attempts are now being made to assess the value of these interventions but difficulties arise in designing appropriate research studies"

And the NHS itself has this to say about ABA:

"...there is good evidence to suggest early intervention programmes that integrate with education can be beneficial"

Such conclusions reflect an accumulation of research over the last 10-15 years which establishes that ABA is effective; indeed, more effective than other forms of treatment. One of the more recent reviews, undertaken last year by the US Agency for Healthcare Research & Quality (AHRQ), assessed the quality of evidence in relation to a number of different types of behavioural interventions. Of those assessed, the evidence established that ABA was the most effective intervention, and that there was good quality evidence which established that it can positively affect children with ASD. A number of both randomized and clinical control trials established that children receiving EIBI (an applied form of ABA) demonstrated improvements in cognitive, language, adaptive, and ASB impairments compared with children receiving other forms of behaviour interventions (see Therapies for Children with Autism Spectrum Disorder: Behavioural Interventions Update (AHRQ, 2014, published by NCBI).

It is this type of research which has resulted in ABA and EIBI becoming the preferred form of therapy in many states across the USA, and other countries around the world.

More concerning still is the fact that by not using such therapies money is being wasted over the long-term. Autism is the UK's costliest single condition, at £32billion per year; it costs more than heart attacks, stroke and cancer put together. Studies in other parts of the world such as the Netherlands, Canada and the US have demonstrated that huge costs savings can be made if high quality ABA provision is offered to remediate and improve aspects of autism that are both damaging to a child's quality of life and costly later to social care budgets. . Plainly, then, consideration should be given to the long-term savings that will result if appropriate and effective provision is made to autistic children when they are young.

Given that ABA and EIBI are effective, indeed more effective than other forms of treatment, and that they are widely used across the rest of the westernised world to help children with ASD, and will probably result in long-term cost-savings, they should be available to our own children here in the UK.

Both the Local Authority and the Health Care Service should be endeavouring to provide ABA and EIBI. As a starting point, both should be in your Local Offer, together with details of the basis on which they may be offered.

I look forward to your response within 14 days, confirming that ABA and EIBI will be included within the Local Offer, failing which I would be grateful for an explanation of why you have refused to include such therapies despite their clear efficacy and cost-effectiveness. I will be seeking legal advice if I do not receive a reply, plus I would respectfully ask that this letter be included in the statutory comments section of your Local Offer website?

Response: 20.08.2015

Behavioural analysis is offered as part of the City of Wolverhampton Council's outreach provision. This provision includes a 1:1 programme of behavioural analysis overseen by a suitably qualified person a specific number of hours per week.

Whilst the review has not been completed, a review of the position as to ABA provision has been completed.  The Council has resolved to enhance its outreach provision.  This provision includes a 1:1 programme of behavioural analysis overseen by a suitably qualified person for a specified number of hours per week.  Specially trained staff at Tettenhall Wood and Broadmeadow School will provide such outreach services to Wolverhampton.  These services will be overseen and monitored by the Council's educational psychologists who are highly trained and experienced in behavioural analysis.

Whilst the starting point will be to consider the Council's enhanced outreach provision, where a child's EHC Plan stipulates that a particular child requires ABA over and above the Council's proposed outreach provision a personal budget will be provided.  If such plan specifies ABA in a mainstream setting or at home (i.e. outside of Tettenhall Wood / Broadmeadow) the Council would be content for such personal budget to be used to fund ABA in a mainstream or specialist setting.

Leisure Facilities for Disabled Children - February 2015

Submitted: 03.02.2015

It would be useful to have more information within the Leisure section of the Local Offer detailing which of these services specifically cater for children and young people with additional needs. Are there dedicated sessions? If so, please can we see the details and times published within the Local Offer? In terms of poolside accessibility at Bentley Bridge, it would be helpful if a parent/carer viewing area was available alongside the fun pool. The coffee bar viewing area is behind sealed glass and, as such, hinders access to children and young people who are safe to be in the pool without an adult but still require close adult supervision or monitoring for their care needs during their swim.

Response: 20.07.2015

Response to Local Offer comments: Use of leisure facilities for disabled children:

Following the comments received regarding the access Leisure facilities. We are currently working with Leisure management to look at how these issues can be addressed. Leisure services are keen to look at how they can make their services more accessible to families with disabled children and further meetings are planned to meet with parents to gather and discuss these view further. 

We have also met with our cultural services department to start to look at how provision in our variety of museums and visitor attractions can be improved to for disabled children and young people.

Thank you to Wheelchair Services - February 2015

Submitted: 03.02.2015

My daughter recently had to change her wheelchair and I just wanted to say how pleased we are with the excellent service we have received from wheelchair services. They were very helpful with advice they gave and took their time to explain everything to us in a lovely kind manner. Also, my daughter only had to wait a couple of weeks for her wheelchair and when I said to them I was really surprised how quick it had come especially over the Christmas period. They told me they always do their best to rush these orders through especially with children as they realise how important and vital it is. I found this very reassuring.

Many thanks for taking the time to tell us of your positive experience and we are pleased that the service worked so well and so promptly for your daughter. We will pass your comment on to the service".

Leisure Activities aimed at Children and Young Pepole with Disabilities or Special Needs - January 2015

Submitted: 13.01.2015

On the leisure section under the local offer I think it would be more beneficial to see more leisure activities aimed at children with disabilities or needs. Or even more advice on how accessible an activity is to meet the requirements of children/ young people with disability or needs.

Following the comments received regarding the access Leisure facilities. We are currently working with Leisure management to look at how these issues can be addressed. Leisure services are keen to look at how they can make their services more accessible to families with disabled children and further meetings are planned to meet with parents to gather and discuss these views further. 

We have also met with our cultural services department to start to look at how provision in our variety of museums and visitor attractions can be improved to for disabled children and young people.

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