Committee Update: HCAN December 2018

The Health, Care & Additional Needs Policy Committee met in London on 28 November. The group was joined by a rep from Children and Young People’s Mental Health at NHS England, who provided an update on the recent developments arising out of the ‘Transforming children and young people’s mental health provision’ Green Paper. A number of ‘trailblazer areas’ for Mental Health Support Teams are being set up, with four week waiting periods due for imminent announcement. Training for Designated Senior Leads is being commissioned by the Department for Education (DfE), and recruitment is underway for Mental Health Support Staff. The group suggested that greater flexibility was needed around service delivery; the whole system needs to be collaborative and holistic if we are to navigate successfully some of the complexities of children and young people’s individual circumstances. Some concern was raised about workforce issues, and also how best to support young people when they transition from secure placements. Additional issues were discussed about funding arrangements; which it was felt often gets in the way of providing a positive service. The issue of ‘crisis care’ was raised, and there was agreement that improvements in ‘joined up’ working were needed. It was felt that further thought is needed on how to develop and improve working together on SEND transitions, and how to improve assisting young people moving from secure hospitals, to appropriate placements before returning home. The group agreed there are issues where Children in Care who are placed out of area, are struggling to get priority service in the area in which they live, and that this needs to be corrected.

The group went on to discuss a review of recent NHS England reports on secure placements. Whilst it was agreed that placement availability is becoming increasingly scarce, there is an emerging plan from the DfE to boost the number of welfare beds. Concern was raised about the lack of information and understanding about the use of unregulated placements: priorities for further work are unregulated placements, and the join up between secure welfare, justice and health placements. Key messages from Safeguarding Pressures Phase 6 saferelating to the HCAN remit, specifically around placement costs, were also discussed.

The group was then joined by two reps from the DfE who provided an update on plans for the adoption register, Regional Adoption Agencies (RAAs), and improving outcomes in fostering. The adoption register has been paused, and discussions are still being held with Coram about how the service will close down when the contract ends in March 2019. The group emphasised the importance of Ofsted understanding the DfE’s position regarding the LA’s ‘duty to refer’, to avoid unfair penalties. With regards to RAAs, the group noted that still relatively few are up and running, and the general view was that RAAs work better for some LAs than others; dependent on whether they are a net importer/exporter of adopters. Feedback from the DfE was that every LA must be in an RAA by 2020, and by Easter next year two-thirds will have gone live. In terms of developments in fostering, the DfE are trying to identify areas of good practice where LAs are doing things differently. In the New Year, seed-funding will be available to ‘fostering partnerships’, where the potential to develop better partnerships to meet local need is identified. There is a focus on how support can be provided to LAs to avoid high cost IFA placements. Concern was raised by the group about lack of flexibility in the system regarding Shared Lives arrangements, and there was discussion about how to bring relationship-based social work into the recruitment of foster carers, and how to support children and young people into arrangements with matching to people who are not necessarily in the system (eg, wider family and friends).

Key messages from the Family Justice Observatory’s inaugural research report on infant removals was provided by Research in Practice. The group agreed that one of the striking findings was that 54% of newborns removed were ‘first-borns’. A marked regional difference was noted; with the North West having a higher number of infant removals than elsewhere. This raised discussion around what is happening regionally at pre-proceedings level, and that further understanding is needed about practice during pre-birth assessment and the PLO process.

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