Inspectors criticise council’s SEND provision in damning report

Children face lengthy waits to access some health services, such as speech and language therapy, community paediatrics and neurodevelopmental pathways, an inspection report published this week has warned.

It adds that leaders are aware too many children and young people with SEND, including those receiving SEN support and children with education, health and care plans (EHCP) in place, wait an “unacceptable length of time to have their health needs accurately assessed and met in Oldham, but have not addressed these failures for some time”.

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As a result, the joint inspection carried out by Ofsted and the Care Quality Commission concluded that "children’s and young people’s needs are not met as quickly and effectively as they should be".

"There are widespread and/or systemic failings leading to significant concerns about the experiences and outcomes of children and young people with SEND, which the local area partnership must address urgently," states the report.

Oldham Metropolitan Borough Council and NHS Greater Manchester Integrated Care Board (ICB) are responsible for the planning and commissioning of services for children and young people with SEND in Oldham.

Inspectors note changes to the senior leadership of Oldham’s SEND services since its previous inspection in 2019, adding that responsibility for health services in Oldham passed from the Clinical Commissioning Group to a new Integrated Care System. In July 2022, NHS Greater Manchester ICB became responsible for the commissioning of health services in Oldham.

The report highlights the impact of the changes, including:

• Local partnership leaders not working collaboratively to fully meet their statutory requirements for joint commissioning.

• A legacy of commissioning arrangements which the local partnership continues to be tied up in.

• A failure to address historical and increasing waits in services.

• Poor partnership working, exacerbated by the move to the wider Greater Manchester ICB and the centralisation of the data store, meaning local performance data on SEND health services is unavailable.

• A lack of strategic oversight of the SEND priorities by local area partners.

• A lack of commitment across the partnership to work together to develop a shared approach to improving services and hold each other to account for delivery.

• Insufficient thought by leaders to the transition arrangements for children and young people with SEND.

"Unacceptable delays" in getting speech and language needs identified are experienced by some young people, with some children with complex SEND in nursery not having their speech and language needs assessed until the middle of their primary school education.

However the report highlights positive areas of work including “a new, well-thought out SEND and Inclusion strategy produced in collaboration with children and young people and partners, reflective of the current needs within Oldham”.

“Looked after young people with SEND have their needs assessed and met effectively,” inspectors add.

Their report urges council leaders to improve transitions between children’s and adults’ services in health, education and social care, and improve their strategy in relation to preparing children and young people with SEND for adulthood from the earliest years.

Processes for the quality assurance of EHCP plans should be embedded and improved and leaders across the partnership should improve annual review processes so that the finalised review documentation is completed and returned in a timely manner.

A joint statement from Oldham Council, NHS Greater Manchester and Oldham Integrated Care Board, Northern Care Alliance NHS Foundation Trust and Pennine Care NHS Foundation Trust welcomed inspectors’ recognition of progress made since its last inspection.

"We acknowledge that the report has identified some significant areas to improve that we, as a group of local partner organisations, must address as soon as possible. These improvements include urgently identifying and addressing delays and gaps in access to health services.

"We are now focused on delivering a priority action plan that will address the concerns outlined in the report. Progress against these action areas will be overseen by enhanced partnership governance arrangements to ensure that improvements are made as quickly as possible," the statement says.

The inspection was carried out between 26 and 30 June, with the report published this week (30 August). A monitoring inspection will be carried out within approximately 18 months with the next full reinspection taking place within approximately three years.