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Covid-19 NNPCF work Vaccination

NNPCF representations on the Covid 19 vaccination of children

The last few weeks have seen a lot of press and media comment on the subject of vaccination of children versus covid 19.

Advice to government on whether children should be vaccinated is being prepared by the Joint Committee on Vaccinations and Immunisations (JCVI). JCVI is an independent group that is not a part of the government and the NHS. Based on their advice, a government policy will be developed.

It is clear that Covid has little direct impact on children (see recent BBC article on UCL research Covid: Children’s extremely low risk confirmed by study – BBC News). This may suggest that they should not be vaccinated. In addition, there are ethical arguments about medicating someone that is for the benefit of someone else (i.e. the vaccination of children is primarily to protect more vulnerable older people from the spread of the virus) especially when they lack capacity to make that decision themselves (which is the case for children).

However, children are significantly indirectly impacted by the response to covid (e.g. needing to isolate). It is also clear that whilst the risk remains very small, some children are at increased risk from Covid such as those with severe neuro-disability and severe respiratory conditions. Many of these children will fall into the category of having SEND.

The NNPCF has been made the following representations on the subject of vaccinations:

1. If evidence suggests that vaccination of children is effective and safe, it should be made available to children who are at higher risk of severe illness

2. Any decision to give the vaccine must be coproduced with parent carers and children and young people. There should be no judgement or pressure to be vaccinated or not.

3. Reasonable adjustments should be made to enable children with SEND to access the vaccine where required.

For more on the impact of on children see the Royal College of Paediatrics and Child health website Message for paediatricians on children and young people and the COVID-19 vaccination programme | RCPCH

Also see the article in the Guardian by Professor Russell Viner who spoke at the joint NNPCF / Contact conference in December. Shall we vaccinate our children? We could start by asking them first | Russell Viner | The Guardian

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Covid-19 NNPCF work

Covid 19 – the medium and long term impact, risks and opportunities for children and young people with SEND

Introduction

The immediate impact of Covid 19 and the response to the virus have been well documented – missing school, difficulty in accessing medical services, and the impact of lockdowns have all had a detrimental impact upon many children and young people ranging from academic, social, emotional, and physical implications. It is well understood howmany of these impacts on children and young people with SEND have been exacerbated by the additional challenges they and their families face. These are very real and have been recorded by Parent Carer Forums during the pandemic. NNPCF steering group members have been working closely with the government and NHS to escalate and address these concerns[1]

However, many of the medium and long term impacts of Covid 19 and the response to the virus have not yet been felt or understood. Reflecting on feedback from our 151 member forums, the NNPCF steering group has started to review the medium and longer term risks and opportunities the last year has presented for children and young people with SEND and their families. Looking beyond what is already well documented, we have attempted to focus on what is different about the experience of CYP with SEND. We have compiled a list of what can be done in the wake of the pandemic to mitigate these, as yet, unseen risks and take advantage of some of the longer term opportunities.

[1] See the NNPCF website, news section for our frequent updates on our work during the Covid 19 pandemic. www.nnpcf.org.uk

Key findings

  • Catch up

Whilst the government has made significant additional funds available for catch up and to compensate for lost time, it will be very difficult to implement effectively for CYP with SEND. Many of the resources and skills SEND services rely upon (e.g. CAMHS, SALT, OT, Ed Pyschs) were already scarce before the pandemic with long delays and waiting lists. As we recover, these pressures are likely to grow. Therefore, creative solutions coproduced with families and PCFs are required to meet the additional demand for these resources that catch up will need. Families have expressed concerns that for many the quality of annual reviews were already poor prior to the pandemic and many fear that in the absence of recent assessments or contact they will suffer further.

  • New harms

As well as lost time, we are also aware that many CYP with SEND may have suffered new harms – these may result in new conditions or needs being evident. There needs to be an increased focus on early intervention to address these concerns before they escalate. In addition, we are mindful that issues may not manifest themselves in obvious ways – for example, with trauma or increased anxiety presenting as behaviours that challenge. Schools and services must be alive to these often-hidden harms and respond accordingly.

  • Remote learning

Whilst the majority of CYP with SEND found remote learning very challenging, a minority prospered. For some, the absence of the stresses of a school environment meant they were able to learn more effectively. We would like to explore how a more blended approach might benefit these children and young people as a reasonable adjustment. However, a note of caution – this should not be confused with part time timetables, home education or off-rolling. Pupils should be able to access the full curriculum but in a reasonably adjusted way that works for them. We are aware this will pose challenges for schools but would like to build on some of the excellent innovative practice in some areas to explore how it could be built upon.

The quality of remote learning will continue to be important if children need to isolate following positive covid tests or if further lockdowns are necessary as a result of further waves of infection.

  • Elective Home Education

There has been an increase in the numbers of families choosing to home educate their children. We support the right of any family to make this choice, however, need to ensure that parent carers are making fully informed decisions about the implications of this and that we do not see the same children (many of whom may have SEND) seeking re-entry into school in a few months. We are concerned that some families do not understand that the remote support and online curriculums from schools will not be available if the chose to home educate.

  • Use of remote technology

The acceleration of remote technology has been welcomed by families in many respects. The avoidance of waiting times, travel times, and the ability to participate in sessions that were previously not accessible has meant families are keen to continue remote appointments in some cases. This may not always be possible or appropriate and must be agreed in coproduction with families. We are also aware of the barriers families can face when accessing remote appointments and meetings. It is essential that all decisions to continue or move towards remote access are made with the families and explore all the potential risks and challenges that may present barriers to access and inclusion, with reasonable adjustments being available where required. There is ongoing work within some regions exploring the benefits and challenges of digitalisation of appointments that would be helpful to explore further.

  • Transitions

We have seen increased concerns from Parent Carer Forums about the risks of transitions. Because of lost time, many CYP with SEND are ill prepared for important changes (e.g., changing setting, leaving education, turning 25, and ceasing an EHCP). Children and young people who are not ready for a change are more likely to fail and this may not happen immediately but in months or years’ time. A range of coproduced measures (from extra time and effort from both settings to repeating years) should be available to families to support them.

  • Mental health

The potential toll the response to Covid 19 has had on children’s mental health has been well publicised including the compound impact on those with SEND. We welcome the focus on children, young people, SEND, learning disability, and autism in the government’s mental health recovery plan. The need for a joined-up system wide approach is understood by all. Parent Carer Forums value being part of conversations exploring local approaches that take into consideration the nuanced needs of the SEND community in respect of mental wellbeing and mental health.

  • Vaccinations of carers

The vaccination of carers has led to some identification of opportunities to improve record keeping and services to families with SEND. In particular, records of those performing the role of the carer have improved as well as records of those with a learning disability or autism. This presents the opportunity to better support these families, particularly through a primary care setting through things such as learning disability health checks. We are pleased to see the positive conversations this has stimulated but are hearing from Parent Carer Forums there is still a long way to go in establishing fully fit for purpose records and registers locally. We also see the advantages these discussions present in the improvement of local data systems, and specifically Joint Strategic Needs Analysis records.

  • Employment opportunities

Many employment opportunities traditionally available to young people with SEND in sectors such as retail and hospitality have been impacted by the pandemic. In addition, many young people have not been able to complete training or courses aimed at supporting them into employment. Conversely, other sectors such as logistics and care have seen some growth. We welcome the recent announcements on supported internships and ask that any government employment recovery plans should include specific support and strategies for young people with SEND.

  1. Individual and Strategic coproduction

We have referred to the importance of individual coproduction with families several times in this document. Where communication with families was open, transparent, and families were involved in decisions about changes to services for their child/young person, satisfaction was higher and the impact on children, young people, and their families was mitigated. Through the pandemic, government and NHS guidance consistently stressed the importance of coproduction time and time again but sadly it did not always happen at a time when it was more important than ever. It is essential the culture of coproduction is emphasised by all at every opportunity.

The pandemic has also seen more areas recognise the contribution and importance of Parent Carer Forums. As the Ofsted / CQC local area SEND interim visits in Autumn 2020 highlighted, those areas that coproduced effectively, responded to the pandemic most effectively. It is essential we learn the lessons and reflect the importance of strategic coproduction in the output from the SEND review, NHS Long Term Plan, and new local area joint inspection plans.


Appendix – detailed analysis

TopicOpportunitiesRisks
The impact of missed support  

The impact that missed school, therapies and appointments has had on our children.
There is great awareness of the impact of lost time on all children, including those with SEND. The very balanced focus of the government’s catch up planning had reflected the need to identify the holistic impact of lost time on children. We are pleased that the additional monies made available explicitly focus on enrichment and well being “catch up” as well as academic focus.The delivery of this catch up is going to be difficult in many respects for children and young people with SEND. In particular, disciplines such as CAHMS, SALT, OT and EP services were very stretched prior to covid and it is unlikely that there are enough resources to be able to “catch up”. As such, new and innovative models of delivery will need to be developed might include more group sessions, training and support for parents teachers and TAs, use of online resources and better use of community resources such as the voluntary sector. Clearly, this is only appropriate for some services – for example, missed operations cannot be delivered in alternative ways.

Local authorities, schools, CCGS and providers should actively partner with parents and parent carer forums to understand individual and local needs and develop innovative services to support catch up. Effective coproduction is critical to the recovery.  
New harms  

As well as “lost time”, it is clear that new harm has been done to many children including those with SEND. This may include new conditions developing but also be expressed through increased anxiety and more challenging behaviour.
 It may be some time before the “new harms” resulting from Covid 19 become apparent.   Evidence shows that referrals in some areas are already increasing but anecdotal evidence suggests that we may see a surge following the September return to school.  

It is important the system is prepared for new harms that may emerge. This might include: An increased focus on early help to identify and respond to concerns quickly to prevent them escalatingA recognition that the “new harms” may manifest themselves as anxiety, mental health or behavioural concerns. It is critical that a joined up approach is taken and any issues are not exacerbated by addressing the symptom (e.g. behaviour) rather than the root cause.A redoubling of efforts to coproduce solutions with families and parent carer forums.
Remote learning  

Remote learning was very challenging for the majority of CYP with SEND. A minority, have however, prospered. What can we learn from this?
For a small cohort of CYP with SEND, remote learning has worked very well. The absence of some of anxieties of a social environment and a changing physical setting has been beneficial to some CYP with ASD, SEMH and sensory needs.

Many families have reported that their CYP have done their best work whilst at home. In some cases, the change of environment has challenged the received wisdom about what a CYP can achieve – perceived limitations have been removed and new opportunities have become available.

Many families report that they are more engaged in their child’s learning and are more aware of the support they need to learn.

In addition many families have reported that their CYP has been happier, less anxious and exhibited fewer behavioural issues whilst learning from home.

The increased availability and quality of remote learning resources (e.g. BBC bitesize and Oak academy) has increased the opportunity for remote learning.

We would like to work with the DfE to explore how a more blended learning approach could be effectively used to support some CYP. For particular cohort, a blended learning offer might form a very effective reasonable adjustment.  

Potential collateral benefits would include reduced school exclusions, improved academic performance and better preparation for a word of work which may increasingly become based on remote or blended working.    
Our membership reports that remote learning was beneficial to a minority of children with SEND. The majority did not prosper and benefit most from being in school.   Moreover, PCFs have reported that there has been a huge variation in the quality of remote learning. Some schools have provided things such as specialist materials, support from specialist teachers, pre learning,1:1 time when appropriate and differentiated work. Many, however, did not, further disadvantaging  CYP with SEND.  

There are significant risks for remote learning from the point of view of the CYP and family:
Blended learning should not be confused with home schooling and part time timetables. CYP should be offered a full curriculum, some of it delivered to them whilst at home.
Strain on families – supporting blended learning may present an additional and unsustainable burden on parent carers. Some schools did implement innovative and effective ways of supporting SEND learners at home such as use of TAs, pre-learning support for parent carers, use of break out rooms. This support should form a part of any blended learning package.
Any blended learning approach must be developed in coproduction with families and CYP.
The risks of increased isolation, social exclusion and even bullying may need to be considered. There may be safeguarding concerns around some families.

We also appreciate that it may be difficult from a school resourcing point of view to support a physical and virtual learning offer at the same time  

We would like to work with the DfE to put in place some guidance on what constitutes a minimum standard for CYP with SEND in any blended learning offer. This would include safeguards to ensure it was used only when it was the best solution for the CYP and was developed in coproduction with them and their family.    
Individual Coproduction  

Coproduction with parents was very varied in many instances with some schools and settings doing it well whilst others hardly communicated at all with families.
Risk assessments, where they have been done well have been welcomed by families. Families have felt heard in these processes and many have improved trust between families and schools. These conversations have enabled schools to break down barriers with families that may have existed for some time and allowed a better understanding of what life is really like for families.  

Moreover, schools have started to recognise parents as the experts in their children. Schools have seen new value of having good quality relationships with families.  

Some characteristics of good risk assessments include:
-A clear explanation what the process is and what it entails
-Focussed on the needs of the child, not the schoolOpen honest conversation
-An equal and reciprocal relationship with families  

The experience of a good risk assessment is offers a template for improving individual coproduction with families. The SEND review offers an opportunity to enshrine some of these best practices into a new, clearer definition and practice of good coproduction.    
Many families felt great frustration as many services they were entitled to or relied upon were withdrawn during parts of the covid 19 response. Often these changes were made unilaterally with little or no discussion or understanding of the impact that this would have on families. It felt as if coproduction was optional at times.  

In many cases, education risk assessments were not done well. Too often, we heard that schools did not explain to families what they were doing and put their own risks first above that of the child. Risk assessments were often seen through a safeguarding lens -with vulnerable children not being offered places at school unless it was deemed that they were not safe at home.  

In these instances trust between families and services (including schools) has been eroded  

There may be some work to be done in repairing the damage to trust and relationships between families and services. The NNPCF have asked for an increased focus on developing the culture and practice of coproduction across the SEND system through the SEND review, this may be more important than ever.
Strategic coproduction  

Likewise, there was a huge variation in the extent and quality of strategic coproduction with parent carer forums during the pandemic. Those that did it well, responded more effectively to the needs of families.
The crisis has brought home the value and impact of parent carer forums. More people are aware of PCFs and the importance of coproduction. PCFs report that they have been involved in more meaningful strategic coproduction than ever before, gathering information, interpreting the impact of changes on families, coproducing solutions and providing feedback.  

Remote working has enabled improved coproduction – it is often more parent friendly and means PCFs can do more.  

It is essential that we consolidate the gains made in strategic coproduction through the covid 19 crisis and translate them into wider areas of working. Again, the SEND review, the NHS long term plan and the new ofsted / CQC local area inspection framework  offer an opportunities to embed improved coproduction through better definition, guidance, sharing of best practice and training.    
The volume and level of work required from PCFs have increased dramatically. Many are reporting issues with burnout and concerns about sustainability.  

Coproduction has not been universally good.  Where it has been poor historically, relationships have often further deteriorated. When managing a crisis, many local areas, commissioners and service providers have simply forgotten to coproduce.  

A continued focus on the importance of coproduction is required through the SEND review, the NHS LTP and the new local area inspection framework.  
Use of technology to support CYP with SEND   Remote therapy / medical appointments/ remote working  

Remote delivery of services accelerated massively over the last year. In many cases this has been well received by families but does have some pitfalls and limitations.  
The increased use of technology has been welcomed by most families.

Benefits include:
-Saving time travelling and waiting for physical appointments that can be conducted remotely.
-Parents have been more engaged in allied therapy sessions – they can see and participate in remote sessions when physical sessions were often run 1:1
-It has been easier to get more people to engage in activities (e.g. annual reviews) because they do not have to travel.  

Guidelines around how and when remote technology can be used should be developed – these should aim to preserve the benefits whilst guarding against some of the risks and disadvantages.  
Not all interactions can be effectively conducted remotely. Some appointments do need to be face to face – e.g. physical tests and observations, some medication reviews, for families where there may be safeguarding concerns.  

Forums have also reported that the past year has highlighted the digital divide with access to technology being a barrier to services. In addition, gaps in the ability of CYP and families to use technology (e.g. not being able to type / being physically disabled) has further disadvantaged some of the most vulnerable. .    
Mental health  

There has been an increased focus and awareness of mental health issues. The implications for those with SEND have not yet been fully understood or felt.
The crisis has definitely raised awareness of More openness / conversations / awareness of mental health.      The mental health impact of covid 19 on all CYP has been well documented. trauma, isolation, loss and increase in anxiety.

In particular, those with SEND have experienced a wide range of potential mental health impacts such as heightened fear of C19 amongst some children, wearing (or not wearing) masks, testing and vaccines increases in isolation, OCD and eating disorders. In many cases covid conditions have accentuated existing issues.    

The crisis has also highlighted how fragile mental health services are for many of our children. Many areas were already seeing long waiting times for services  – these have been increased and interruptions in services may mean additional impacts  

In addition we have hear of increased instances of challenging behaviour  – often against parents and sadly of harm to other family members. In addition, we cannot forget the mental health of parent carers and other family members..  

We welcome the mental health recovery plan published by the government – in particular the focus on children, schools and those with SEND. We must ensure that a joined up approach is taken and the right support and reasonable adjustments are put in place for those with mental health concerns.    
Transitions  

Transitions are challenging at the best of times. During the pandemic, many CYP have not been able to prepare for important changes and as such are at increased risk of failing. This is particularly true of CYP with SEND.
Because of the disruption, there has been an increased focus on key transitions. People have recognised the need for earlier transition planning and are more aware of the need to support successful transitions.  

Government catch up funding can be used to support transitions. For example, the guidance on summer schools that proposes a focus on year 6 to 7 transitions is very welcome.    
We have been contacted by many parents who have been very worried about children and young people who are coming up to important transitions. Because of the disruption of the last year, many CYP have not been able to undertake or complete the programme of work that was planned in order to prepare them for an important transition. This could be a transition between key stages, schools or educational settings, leaving education or even coming up to the age of 26 when an EHCP will cease.  

We are concerned that if CYP are not properly prepared for a change (especially those with SEND) they are at increased risk of not transitioning successfully  -this may manifest itself in many forms such as academic failure, anxiety and mental health concerns or an inability to make the steps to independence that are required (e.g. getting public transport to college).  

We have asked the DfE to ensure that the right measures are put in place for these young people. These measures should be discussed and coproduced with the CYP and their parent carers and may include things such as:
Use of DfE catch up funding to provide additional educational or wrap around support
Closer working between the sending setting and the receiving setting (e.g. a very closely co-ordinated and graduated transition)
Delayed starts to allow CYP to develop the necessary skills and knowledge
Repeating years  


Opportunities for CYP in employment have been impacted – limited. Opportunities in retail and hospitality have fallen away  
Covid 19 Vaccinations

The roll out of covid 19 vaccinations offers opportunities to improve record keeping and delivery to services for those who are carers or have additional needs.    
The drive for covid 19 vaccinations may offer some opportunities for the support of families with CYP with SEND. I particular, the vaccination of carers may raise awareness with GP surgeries and provide an opportunity to improve record keeping (e.g. identifying carers, updating the learning disability register) and support (being able to provide support to carers, following up on annual LDA health checks)  

We would like to see the NHSE use opportunity that covid offers to further promote the needs for LDA registers, carers registers and annual LDA health checks.    
The vaccine roll out has again highlighted the “post code lottery” in parts of the NHS. Our membership have reported very different experiences in different parts of the country and with different GP surgeries (and even different GP receptionists!)  

The definition of “carer” has also been inconsistent with some areas taking a common sense approach and others only considering those in receipt of carers allowance.
Elective Home Education  

There has been a spike in those choosing to electively home educate and this represents an opportunity as well as a risk for families with SEND.
We have seen an increase in the number of families choosing to electively home educate their children. The experiences of home learning over lockdown and the increased availability of remote learning resources (e.g. BBC Bitesize, Oak Academy) have meant that more parents are confident to take this step for their children  

We would like to see local councils and the DfE support these parents and help them to give their children a high quality education.
We must ensure that families who are choosing to electively home educate their children fully understand the implications of their decision, for example:
-It is not an opt in / out system – that once they give up their school place it will no longer be available for them – they cannot easily change their mind
-Schools will not be providing them with remote support  
Employment opportunities  

Jobs in some sectors that have historically been employment opportunities for those with SEND (e.g. hospitality, retail) have been severely impacted by the pandemic.
Whilst some areas that have traditionally offered employment opportunities for CYP with SEND have been hard hit by the pandemic others (such as logistics and care) have boomed.

Also the opportunities offered by fewer migrant workers following Brexit may offer opportunities for employment opportunities for young people with SEND in areas such as agriculture.  
The impact of the pandemic has impacted job prospects for many young people with SEND in key sectors such as retail and hospitality.   Many young people have been unable to finish courses and training as a result of the pandemic (see transitions point above)    

Any government employment recovery efforts and plans should include specific mention of employment support and opportunities for young people with SEND
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Covid-19 DfE guidance

All the latest Govt. guidance in one place

We felt that, as so much has happened of late with changes to guidance, that it would be good to share the links to all pertinent documents here in one place.

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Covid-19 Education

NNPCF representations on catch-up learning

In the last few weeks there has been a lot of comment in the press about how children and young people who have missed out on school and learning over the last year will be supported to catch up. Some of the ideas that have been discussed include summer schools, extending the school day and making terms longer by two weeks.

There are three broad areas of focus for catch up – these are:

· The quality of education

· More teaching time for children

· Curriculum

At the start of the new year, the NNPCF asked parent carer forums for their views on how well the catch-up funding announced by the government last year was being deployed in their area. Based on your feedback we have made the following representations to the government on this matter:

1. There has been a huge variability of experience for children and a “one size fits all” approach is not appropriate. The impact of lock down has been very different for each child and family.

For example, some children with SEND have been in school whilst the majority have not. The quality of remote education for children with SEND has been very variable – some schools have provided training for parents, pre-learning for children, used break out rooms in video conferencing tools to provide 1:1 support and have sent specialist materials and equipment home. Other schools have not differentiated their offer for SEND at all and are just sending out links to Oak academy or BBC Bitesize lessons. Moreover, some children have adapted well to remote learning whereas many more have struggled without the clear structure and support offered by school.

2. Any catch-up must be holistic and not just academic. Children have not just lost a year of learning, many have lost a year of their childhood including the physical, mental, emotional and social development that they would have enjoyed. These factors are amplified for children with

SEND and a focus on mental health and therapy services is essential in any catch-up proposal. Absent this, many children will not be ready to learn because of the broader impact of lockdown on their well-being.

3. Any schemes to offer additional teaching time must be structured in a way that will be appealing and accessible to children with SEND. For example, extending the school day may provide challenges for some children with SEND and summer school may not be possible or attractive for many families. We have asked the DfE to look at a wider range of providers for example sports schemes and summer respite schemes to see if additional funding can be used to make these activities (many of which are targeted at children and young people with SEND) a part of a holistic catch-up programme.

4. Coproduction – any catch-up programme should be coproduced with individual families to make sure that what is offered meets their particular needs. In addition, parent carer forums should be involved in designing local area solutions to catch up and helping to determine how money can be spent most effectively. We have seen excellent examples of PCFs coproducing creative solutions to supporting SEND catch up in some local areas.

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Covid-19

Covid 19 Vaccinations and SEND

Whilst great progress is being made to vaccinate people, NHS staff and some care workers, parent carer forums are raising issues about the position of SEND families and services with regard to vaccinations.

Forums have described a “post code lottery” across three clear areas related to SEND which is causing confusion and anxiety. These are

1. Vaccinations for vulnerable children – Covid vaccinations are currently not authorised for use on children. However, we are hearing that clinically vulnerable children have been vaccinated in some localities. The guidance from the Royal College of Paediatricians and Child Health outlines circumstances in which vaccinating children might be considered whilst making clear that these vaccinations would be “unlicensed use.” Message for paediatricians on children and young people and the COVID-19 vaccination programme | RCPCH

2. Vaccinations for unpaid carers – Unpaid carers are eligible for vaccination as priority 6 cases. Parent carers should contact their GP to ensure they are identified as such on GP records. Our partners at Contact have done a lot of work on this and you can find their guidance here: Covid-19 vaccination: your questions answered | Contact

3. Special school staff – in some areas special school staff have been vaccinated. In others, they have not. We have asked local authorities, healthcare systems and school to ensure that staff are vaccinated as soon as possible to enable special schools to reopen fully

The NNPCF have raised these areas to NHSE and to the Department for Education in a call for more clarity and a consistent approach across the country. However, much of this is down to local implementation and policy in particular local authorities and even GP’s surgeries.

The NNPCF will continue to highlight these concerns at a national policy level and local parent carer forums should continue to raise them at a local implementation level.

Categories
Covid-19

Ofsted, COVID-19 series of reports

Ofsted has produced a series of reports on the impact of COVID.

Ofsted: Children hardest hit by COVID-19 pandemic are regressing in basic skills and learning

Ofsted’s headlines from second report on the effects of the COVID-19 across the sectors it inspects and regulates:

• children hardest hit by restrictions have regressed in some basic skills and learning

• young children, previously potty-trained, have lapsed, particularly where parents unable to work flexibly

• Older children lost stamina in reading, writing, physical fitness

• Some signs of mental distress, increase in eating disorders and self-harm

• Concerns about children out of sight during school closures, falling referrals to social care, fears about potential undetected domestic neglect, exploitation or abuse

From Amanda Speilman’s overall commentary:

Across all age groups, children with SEND have been seriously affected in both their care and education, as the services that families relied on – particularly speech and language services – were unavailable.

Ofsted’s series of reports covers:

• schools

• further education and skills

• early years

• social care

• local areas’ SEND provision

Headlines from the local areas’ SEND provision:

Briefing on local areas’ special educational needs and disabilities provision:

Evidence from visits to six local areas between 5 and 14 October 2020 https://www.gov.uk/government/publications/covid-19-series-briefing-on-local-areas-send-provision-november-2020

Ofsted briefing answers four broad questions based on evidence from the visits:

1. How have children and young people with SEND experienced the pandemic so far?

2. What has worked well in supporting children and young people with SEND?

3. What have the challenges been and what has not worked so well?

4. What are the plans for supporting these children and young people in the future?

Main findings

Many of the families found the first COVID-19 restrictions challenging:

• coping got harder as time went on

• struggled without established routines, support networks, specialist services

• challenges linked to children’s regression, own mental health difficulties, explaining restrictions to children, risks the virus posed to their child’s health.

Nevertheless, some children and young people had positive experiences:

• at least in some respects

• Those in education benefited, flourished with smaller class sizes and more support

• Others enjoyed being at home and made progress.

Some area leaders wanted to focus planning on CYP with SEND and their families

• aimed to keep services accessible, adapted when necessary

• Some practitioners described steps to ensure service continuity

• Families spoke about benefits of multi-agency practitioners together online

• Families valued online resources for education or therapy programmes

• But, short breaks, physiotherapy, occupational therapy, more difficult or impossible to deliver at distance

• also concerns about access because of technology or E2L

Relationships with families before March 2020 affected support during restrictions:

• Positive relationships meant support more likely to continue and be adapted to needs

• families referred to those who had gone ‘above and beyond’ and how this had benefited them

• weak relationships deteriorated further with serious consequences

• some families reported little or even no contact from practitioners, no learning support, no access to health, therapeutic services

• In some cases children’s health had deteriorated, children lost learning, communication skills.

Looking ahead:

• Local area leaders facing challenging circumstances

• increase in COVID-19 cases anticipated

• concern about staff burnout: months of significant change, high workloads

• priorities: support mental health, well-being of teams and CYP and families worked with

• enhance communication between services and users

Categories
Covid-19

Working list of NNPCF representations on Covid 19

Risk assessment and return to school

  1. We are hearing very concerning examples where risk assessments have been used to prevent a child returning to school because of the additional support that a child with SEND needs in relative to others in the same year group. This is a perversion of the reasonable adjustments requirement that should be used to enable children with SEND to be treated on an equal footing with their peers. We are concerned that the focus of risk assessments remains the school, not the child in many cases. Too often, risk assessments do not place the child, young person, and their family at the heart of the exercise, instead prioritising the challenges of the school.
  1. Coproduction of risk assessments with families is often poor or non-existent. Risk assessments are often not discussed with parents and the criteria for decision making are not transparent. For example, a family were told their child ” does not meet their criteria ” to return to their placement. More often, parents are not being told about risk assessments and what their rights are – schools are using conversations with parents as the basis for input into risk assessments without telling parents that this is what is happening – many families think they are just having a catch up chat.
  1. We are hearing that some schools are placing unnecessary barriers in the way of children and young people with complex needs returning to school. For example, we have been told of examples where schools have demanded a GP’s letter stating that a child is not clinically vulnerable, or where a negative Covid 19 test is required. Some schools have told families that their child cannot return if they dribble or spit or if they need help with toileting. This clearly discriminates against those with the most complex needs who may often need support most urgently.
  1. Greater clarity on what level of information is needed for risk assessment records. Anecdotally parents report this ranges from a quick call to see if child is OK through to others writing War & Peace.
  1. We would like the DfE to put in place closer monitoring of risk assessments and are calling on the inspectors (Ofsted and CQC) to review the quality of risk assessments and the extent to which they have been coproduced.

Restoration of health services

  1. The community health services guidance issued on 3rd June is welcome and we are pleased to see so much mention of SEND throughout. However, the caveats to the guidance and the absence of clear timelines have meant that it has had limited impact to date.
  1. We are pleased to see that health guidance is incorporating the need to make reasonable adjustments for children and young people with SEND. An example of this, is the guidance on wearing of facemasks that explicitly references exemptions for people with disabilities and children which was raised by local forums and the NNPCF to NHSE and DHSC.

Coronavirus Act Easements

  1. With schools open for children with EHCPs and with the guidance around restoration of community services, we believe that the easements should be lifted as soon as possible. At a national level, as recovery planning and implementation continues, we must ensure that all areas understand the need to prioritise SEND services in their restoration work. The easements offer a reason to delay this. At a local level, the onus needs to be on local areas to justify why the provision in a child or young person’s EHCP cannot be delivered with if they are at school and community health services have been restored.
  1. A huge variability in the way in which local areas are applying the Coronavirus Act easements. Some Local areas are withdrawing services in a blanket fashion. and not involving families. There seems to be little tracking, follow up or enforcement to protect families.
  1. There is little or no coproduction with families around how easements are applied. It is rare for families to have had a meaningful conversation about the provision their young person will be receiving during this period. At best, many have just been informed about a change or suspension of service.
  1. We believe better monitoring is needed from the DfE to improve quality and accountability of easements. When Ofsted and CQC resume inspections (schools, services, and Local Areas), we would call on them to look at coproduction of easements as a priority area.

SEN support and reasonable adjustments

  1. We must not forget pupils with SEND in mainstream schools. So far, the focus has been overwhelmingly on those with EHCPs and in specialist settings. The majority of SEN pupils are in mainstream and on SEN support – we need to make sure their needs are supported in this period too.
  1. Schools must make reasonable adjustments to accommodate those with SEN (EHCPs and SEN support) to ensure they can re-integrate effectively. For those who may need time to return to school (either a delayed, phased, or part-time return) parents would appreciate reassurance that this will not impact their school place in any way. This may also include support with transitions being tailored to the needs of children and young people with SEND (including SEN support)

Support for families whilst children are at home

  1. Need for a greater focus on supporting families whilst they are at home. Many families report that they are getting little help and support – again particularly those without a social worker and on SEN support. This need grows more marked and urgent the longer that children remain out of school. This support should cover the child’s educational and medical needs as well as the respite and social support required by the family. This must be a joined-up response by the local area education, health, and social care teams.
  1. Many families report that children with SEND are not getting a differentiated curriculum. This means that the schoolwork being set is often not appropriate for them and as a result many children with SEND are falling further behind and being further disadvantaged. This is not only those with EHCPs but also those on SEN support. Without more tailored support parents report they do not have the teaching skills or resources to enable their children to continue to learn.

Guidance

  1. Timeliness of guidance – sometimes the guidance has been behind events (e.g. risk assessments and the easements guidance both came out 3-4 weeks too late – guidance on secondary schools and special schools / SEND pupils is already way too late for 1 June)
  1. Some obvious areas of guidance for CYP with SEND and specialist settings are missing. For example, families would appreciate more clarity on areas such as:
    • How children who may spit or bite are to be integrated into school – what should they expect from the school to avoid these children being omitted?
    • How should social distancing and bubble arrangements work for school transport?
    • How should children who must stay at home (because they or a member of their household is clinically vulnerable) be supported both from an educational, medical, and social (respite) point of view?
    • How should the needs of children who require physical contact to support educational, emotional or therapy be met? This may include help with day to day activities such as mealtimes.
    • Clarity around what sort of assessments of children are reasonable in this period. Many parents are anxious that assessments carried out in this period will not give a fair reflection of their children and may disadvantage them in the future.

Perhaps the DfE can explore issuing an addendum Q&A document that addresses these questions.

  1. We fear the sheer plethora of recent guidance has left many LAs, schools & parents overwhelmed and, in some instances confused. “One la felt that they needed to coproduce and rewrite every EHCP with the new changes and what do they do if the families won’t sign off.” The regional briefings with the DfE adviser have helped but given there have been a number of questions raised at each of these we are wondering how these will be shared wider. We understand that the guidance is under regular review, so it is helpful to when DfE clearly state where amendments have been made.
  1. Co-ordination across govt departments (e.g. NHSE guidance on community services pulling back from therapies clashed with DfE guidance that easements had not been applied yet).
  1. People are forgetting to ensure that reasonable adjustments are made for disabled children in guidance issued (e.g. have to keep pressing for changes to behaviour policies in schools).

Messages on schools re-opening

  1. We have identified four communication challenges to convincing parents that it is safe for their children to return to school:
    • There is an unclear “top down” national message. The “stay home” message is still overwhelming and the argument of WHY it is safe to return to school has not been made in a convincing way for many parents. This has to be led by the science. Contradictory messages from bodies such as the BMA are confusing parents and if they are unsure, most will keep their children at home. Complex and nuanced messages do not land well through much of the national press and social media.
    • Local messages (“bottom up”) are also mixed. Schools have struggled to explain to parents HOW they have interpreted and implemented national guidance (e.g. class sizes, PPE, cleaning, staffing, social distancing) to ensure that their individual settings are safe. Schools need to be giving clear messages about what they have done to maximise the safety of children (and staff).
    • Many parents still report that the “tone” of communication from schools often dissuades them from returning. The implication is that if you are doing OK at home, you should stay at home.
    • There is a perception amongst some parents that you are a “bad parent” if you are considering sending your child back to school. There are two things underpinning this. Firstly, there is the understandable concern about Covid 19. Secondly, there is a stigma associated with sending your child into school because this implies they are not safe at home for some reason. The language in the DfE guidance which talks about a child being “safer at school” does not help.
    • Parents are also concerned about staff who may be required to cross “bubbles”. This includes health and therapy staff. Any communication needs to be clear what is being done (e.g. testing, PPE) to ensure that those who work across bubbles do not spread infection.
  1. Some sort of “myth buster” from the NHS (the most trusted source) for parents and for schools is necessary before September. Parents and the people that they trust (e.g. teachers, TAs, health practitioners) should be provided with accurate information about Covid 19 and its impact on children.

Coproduction with families

  1. Communicate with parents and engage them in making decisions about what is right for their child. They must feel like they “own” the decision for their child to return to school or why the provision in their EHCP is changing. They must understand why it is safe and why it is appropriate– it is NOT just a letter. Doing this up front will save hours of time later and give schools a much better idea of who is returning and what support they might need.
  1. Risk assessments and reasonable endeavours decisions are not being effectively coproduced with the majority of families. Many parents do not even know that these decisions are being taken, let alone feel involved in them. Both are formal processes and too many families are unaware that they are happening and do not know their rights. Most have not seen risk assessment or reasonable endeavours documentation about their child.

Joined up working

  1. If there is provision or support that a young person needs to return to school (either as a part of their  ongoing schooling of through this period),  schools should work with local authorities, health and other providers to understand how this will be put in place. If it cannot because of C19, then what alternative arrangements can be reached.
  1. Work with local areas to make sure schools know how to access early help offers for things like anxiety, abuse, behaviour….
  1. We would also appeal to local areas to ensure that communication from local authorities, schools, social services, health commissioners and health providers are aligned. We have had examples of different messages coming from different local sources which has caused confusion and anxiety for families.

Behaviour and exclusions

  1. Schools should think support, not discipline, in this period. In particular behavioural policies need to be changed to reflect the stress many children will feel. Disciplining and excluding those that act out will doubly penalise the most vulnerable.
  1. We have concern that some schools are already anticipating exclusion for CYP who struggle to conform with social distancing etc. One policy shared on social media is clearly taking a zero-tolerance approach which quickly escalates to school exclusion. Others are taking a more understanding approach. It would be helpful to share this as an example:

“All incidents are centrally logged on a computer system. This allows the Positive Behaviour Support (PBS) team to monitor all activity from across the school and hub and they will continually assess the risks posed by behaviours. If a behaviour poses too high a risk to others, then it may require the young person to remain at home. We would always make this decision in conjunction with the parent.”

  1. We feel whilst it may be appropriate for a few CYP who cannot maintain social distancing etc to be kept home, this should not result in a formal exclusion. We would also like there to be recognition that some CYP will be highly anxious upon return to school and that they may need a flexible approach to engaging with schoolwork. Just the transition back to school and finding the layout/procedures have been changed will be enough for some to cope without the extra pressure of schoolwork expectations.

Exams

  1. It is apparent that some changes in approach will be required for exams in 2021 but it is important that the needs of children and young people with SEND are taken into consideration. We would not support narrowing the curriculum to cut non-academic subjects and ask that reasonable adjustments are made for those with SEND when marking and assessments are carried out.

Transport

  1. We are concerned about SEN transport arrangements. Many of our SEND CYP who use SEN transport are in the vehicle for a significant amount of time. This makes it almost impossible to social distance and may be a barrier for return to school where the family have members who are clinically vulnerable or extremely clinically vulnerable. In addition, some guidance is needed on how social bubbles should be implemented on school transport. Some of our steering group did raise questions with DfE adviser on SEN transport issues and were signposted to their LAs policies around supporting SEN transport. This is less than ideal as SEN transport is often one of those perennial areas of contention between LA’s & parents. It would be helpful if Gov’t could give clear guidance around temporary arrangements & approaches for SEN Transport.

Some issues based on concerns or past experiences:

  • A very low mileage rate being offered where parents offer to drive
  • Mileage only paid for journey whilst CYP in the car i.e. only 50% of journey
  • Mileage worked out by A to B rather than actual route.
  • Concern over ability to social distance and if PPE will be used
  • Concern that future transport request will be declined if parent either keeps child home or opts to drive for a period

Inspections

  1. Currently school inspections and local area inspections are suspended. Whilst we would not support a resumption of full inspections at present, we would support a form of “light touch” inspections for both local areas and schools to be implemented during this period.
  1. The areas we would like to see inspections focus on are:
    • How well have schools and local areas supported children and young people with SEND to return to school settings? Have they been prioritised, have reasonable adjustments been made to ensure they are not disadvantaged to return to school?
    • How well has the well-being and health of CYP with SEND in this period been understood and supported?
    • How well have risk assessments been carried out? Have the needs of CYP with SEND been placed at the centre of the process? Has the risk assessment been coproduced with families?
    • How well have local areas made “reasonable endeavours” to deliver the provisions

set out in EHCPs. Have these changes in provision been coproduced with families?

National Tuition Service

  1. We welcome the announcement of a national tuition service to support the most disadvantaged children catch up with lost learning. We would like to ensure that the service makes provision for children and young people with SEND.
    • Can we have explicit mention of SEND in any guidance when more details are issued
    • Learning should be directed and designed by schools who know and understand the learning needs of SEND pupils
    • Schools should have flexibility in how the money can be used to meet the bespoke learning needs of SEND pupils – this should include being able to commission additional support for things such as dyslexia, speech and language therapy, occupational therapy
    • A principle that catch up learning should be coproduced with parents (especially SEND families in line with the principles of the children and families act)

A pdf version of this article is available to download from this link.