What does the NHS Long Term Plan mean for children and young people with SEND?

Designated keyworkers for children with learning disabilities and autism, greater access to mental health services, and improved support during the autism diagnosis process were among key promises made in the NHS Long Term Plan released earlier this week.

Designated keyworkers

The NHS Long Term Plan shows a keen awareness of the need to support children and young people with SEND and their families to navigate an increasingly fragmented system of support. Key to this is the NHS’s announcement that it will be providing a designated keyworker to work with children and young people with a learning disability and/or autism by 2023/24.

Initially, keyworker support will be provided to children and young people who are inpatients or at risk of being admitted to hospital, and will be extended to other vulnerable groups, including adopted and looked after children. This promise is especially important because it acknowledges the need for families to access a named individual who can act as an effective liaison between the various health and local services available for children and young people. With the keyworker provision, the Plan promises the presence of someone who can act as a ‘navigator’, or a ‘lead clinician’, showing a clear response to concerns expressed by professionals and families alike.

The provision of keyworker support was a key recommendation in the 2017 review These Are Our Children by the Council for Disabled Children’s Director, Dame Christine Lenehan, and is a welcome step in the right direction. The key to fully implementing the spirit of recommendations by leading professionals will be ensuring that the keyworkers are (i) based in the child’s home area, and (ii) are able to communicate effectively – and with the necessary authority - between health and local authority services. If this guidance is followed in the rollout of keyworker provision, young people and their families should be able to navigate services more easily, and hopefully fewer children will be allowed to become lost in the system.

Mental Health

Further to the above, another key development outlined in the Long Term Plan is the NHS’s commitment to greater funding for children and young people’s mental health services, which will grow at a faster rate than overall NHS funding, as well as total mental health spending.

Under the plan, the NHS will also continue to invest in expanding access to community-based mental health services, predicting that an additional 345,000 children and young people will be able to access support via NHS-funded mental health services and school or college-based Mental Health Support Teams, with the objective being that 100% of children and young people who need specialist care will be able to access it.

Therefore, the Long Term Plan therefore contains some important developments in the access to treatment of mental health conditions for children and young people. If delivered effectively, these will only help the much-welcomed drive towards establishing parity between the treatment of physical and mental health conditions.

Understanding and awareness of learning disabilities and autism

The Long Term Plan also promises a renewed commitment towards promoting a greater understanding of the needs of children, young people and adults with learning disabilities and autism.

NHS staff will receive further training and guidance on how to support people with complex needs, and over the next five years, the whole NHS will be implementing national learning disability improvement standards across all of its services, while also working with the Department for Education and local authorities to improve their support for children and young people with learning disabilities and autism.

Support during the autism diagnostic process

The 10 year plan also signalled the NHS’s commitment towards reducing the waiting times that children and young people often face before being able to access a full diagnostic assessment or specialist services for suspected autism.

In the Plan, the NHS has also pledged to support children with autism, or other neurodevelopmental disorders such as ADHD, and their families throughout the diagnostic process, by collaborating with local authority social care and education services, as well as leading charities.

Children and Young People’s Transformation Programme

The NHS has also committed to the creation of a Children and Young People’s Transformation Programme to oversee the delivery of the Plan’s commitments to care for children and young people.

Improving children’s transition to adult care services

The Long Term Plan also underlines the NHS’s commitment towards ensuring that children and young people are able to transition to adult care services safely, with service models to offer person-centred and age appropriate care that is tailored to individual mental and physical health needs rather than age alone.

While an important point, we note that the Plan does not specifically detail how this focus will be committed to action.

Sight, hearing and dental checks

The NHS Long Term Plan also contains a pledge to deliver hearing, sight, and dental checks for children and young people with a learning disability and/or autism in special residential schools.

The Plan from the Council for Disabled Children’s perspective

CDC welcomes the commitment to, and focus on the needs of children and young people with SEND in the long term plan. Our work in local areas gives us a rich insight into the dedication and hard work of teams working with and for children and young people; it also shows us that demand for services is beyond manageable, resources are diminished and capacity is over-stretched. Turning the long term plan into reality for children, young people and families, as well as the staff who work with them, will require strong leadership at all levels; true joint commissioning and planning, and an enhanced vision of what good outcomes are for all children and young people.