Transcript Document
The Role of the Designated Medical/Clinical Officer in the SEND Reforms Implementing the Children and Families Act. What Guidance is available? • Children and Families Act These are the: WHY WHAT • Regulations • SEN Code of Practice • Pathfinder Evidence • Voluntary Sector Resources • Developing Case Law Each Local Area needs to develop the WHO HOW Joint Commissioning Arrangements: The missing roadmap Joint Commissioning Arrangements The Children and Families Act is very clear that there MUST be formal joint commissioning arrangements in EVERY local area.(Section 25-30) Between LA and relevant Clinical Commissioning Groups (CCGs) + link to NHS England for specialist services commissioned a regional or national level. Joint Commissioning Arrangements are the detailed plans of how education, health and social care services will work together to deliver the Children and Families Act: The WHO and the HOW Joint Commissioning Arrangements must set out • Outcomes • The availability of services • Identification of children and young people with SEN and disability • Integration of provision • Improvement of services • Provision of information & advice • Process for EHC Plans • Dispute resolution & mediation Role of the Designated Medical/Clinical Officer • The Children and Families Act builds on the role of the Designated Doctor role and recommends appointment of a Designated Medical/Clinical Officer • Joint Commissioning partners should ensure there is a Designated Medical Officer (DM/CO) to support the CCG in meeting its statutory responsibilities for children and young people with SEND. • The DM/CO is the key point of contact between the local NHS and the Local Authority and Families • Supports the delivery of Supporting Pupils with Medical Conditions at Schools Some Key areas of responsibility for the DM/CO • Takes part in strategic decision making in Joint Commissioning Arrangements • Role in coordinating notifications of SEND from clinicians to Local Authority • Coordinating medical information input into EHC Needs Assessments within statutory timeframe • Carrying out assessments for EHC Plans where part of their clinical role and ensuring that assessments and planning is carried out • Coordinating delivery of health provision specified in EHC Plans Joint Commissioning Arrangements Changing Context: Legislation HUGE • Health and Social Care Act 2012: Reorganisation of the NHS • Care Act 2014: Integration of Health and Social • Academies Act 2010 + 2012: New school structures • Welfare Reforms Policy: • Education Funding Changes • Working Together to Safeguard Children • Children and Families Act • Localism • Austerity Wider Changing Context Means: • Local areas have very different structures, processes across their services. • Also different population demographics and policy priorities. • No single model of implementation that can be applied across all areas of the country • This is reflected in drafting of the Children and Families Act Joint Commissioning Arrangements in Your Area. The Children and Families Act requires professionals all levels of the system to contribute to the implementation of the reforms: • System Leaders and Decision Makers • Service Commissioners and Service Managers • Frontline Professionals What needs to be done at each level and how is this developing in your area A lot of this is not new and builds on existing policy and duties. Opportunity to Build on Existing Mechanisms Designated Medical/Clinic al Officer CCG Lead Commissioner for children/ disabled children NHS England Local Area Team Representati ve Local Authority Officer responsible for schools Local Authority Officer responsible for early years SEND Joint Commissioner Director of Adult Social Care Joint Commissioning Arrangements Who should be around the table? Parent and Young People Representatives Local Authority Head of SEN and Disability Local Authority Officer responsible for Post-16 Provision Director of Public Health Youth Offending Team Schools Forum Representative SEN Reform Implementation Lead So…..What’s Happening? Implementation of Children and Families Act has focused on operational aspects(e.g. EHC Plans and maintaining a Local Offer) without Joint Commissioning Arrangements fully established in all areas. BUT Joint Commissioning Arrangements are required for strategic changes required to support this delivery. Without JCA there will be increasing pressure on operational delivery and frontline professionalspotentially undeliverable. Joint Commissioning Decision Making Structures DM/CO role in practice • • • • • • • • How my role is configured Who employs me Capacity/time allocation JD Key relationships Involvement in strategic groups/funding panels Involvement in overseeing the EHC Process Plans for the role How do Joint Commissioning Arrangements involve each system level. Strategic Leaders and Commissioners Designated Medical/Clinic al Officer Frontline Clinicians Over to you: • You should be in three small groups • You each have three large circles on the wall and a pile of cards. The colour of the cards has no meaning! On each card is a task or requirement of the Children and Families Act reforms which needs to be in place for implementation to work. • Your job is to assign those tasks to the available workforce – Strategic leaders and Commissioners, yourselves (DM/Cos) or frontline clinicians. The circles are Venn Diagrams so you may decide that a job sometimes needs to be done by two groups. • There are some blank cards for you if there are tasks or elements which you think are vital that we haven’t identified. • If as you discuss what goes where you identify obstacles or solutions to those tasks getting done please write these on the blank card and put them in the bottom right hand corner • The circles are sticky!! Still with you: Thinking about the previous exercise and the elements that need to be in place for the reforms to work; and any particular thorny obstacles , please identify one action that you will go back and prioritise.