Inspectors found that in both Brent and Telford and Wrekin, despite a number of positives, each area had issues with the way agencies worked together to provide support.
In Brent, the joint commissioning of services were found to be "at an early stage of development". The "fragmented approach" was causing gaps in services, and was highlighted as a "significant concern".
"The local area does not have a cohesive strategy to ensure that all children and young people who have special educational needs and/or disabilities and who need therapy services are assessed quickly and access treatment," a letter outlining the findings of the inspection states.
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