CAPITULO II: MARCO TEÓRICO
2.3. Base Legal
Partners should actively consider the economies of scale and other benefits that come with information sharing, strategic planning and commissioning across groups of authorities, or at a regional level.
This collaboration offers four main advantages:
1) it can offer parents and young people more choice, enabling them to access a wider range of services or educational settings if they wish to do so;
2) for areas where there is a great deal of movement across LAs (e.g. London), looking at how regional support can better meet family needs can offer greater efficiencies and better continuity for children and young people;
3) there are some groups of children and young people for whom the local
authority and CCG has responsibility where there may not be enough children or young people living locally to make a service sustainable, for example, children and young people with severe and complex learning disabilities and behavioural issues, or dual-sensory disabilities; and
4) it can provide opportunities for securing better value for money through greater cost transparency and more effective management of costs.
Children with health needs living outside their home authority
Local authorities have a legal duty under Section 19 of the Education Act 1996 to make arrangements for any pupil of compulsory school age who is not at school and would not otherwise receive suitable education. The education arranged must be full time unless the local authority judges that, for reasons which relate to the physical or mental health of the child, it would not be in the child's best interests for full time education to be provided. Where a pupil is normally resident in a local authority but is, for example, receiving medical treatment elsewhere, it is still the duty of the ‘home’ local authority to arrange suitable education if it would not otherwise be provided.In order for the home local authority to meet its legal duties it is important that they are involved in decisions about a pupil’s education from the start. This will also help ensure that there is clarity over how educational provision will be funded. Local authorities’ duties do not require them to commission a particular educational provider. It is important, however, that decisions about educational provision do not unnecessarily disrupt a pupil’s education or treatment and take account of their
The Department for Education has issued statutory guidance to local authorities on the education of pupils who cannot attend school because of health problems, which is available at the Department’s website.
4.5 Joint Delivery
Delivering support
Partners will need to decide how best to implement and deliver the actions agreed at the planning stage. This could include continuing existing provision, re-designing or decommissioning existing services, or procuring new or alternative provision. The governance arrangements established by partners should enable them to track progress against the commitments for delivering services made at the planning stage, and resolve any disputes that arise between partners.
At a strategic level partners should consider:
• The workforce implications of moving to a more integrated, personalised working style. Partners should consider whether training or a common set of key skills will help professionals and providers adapt to meeting the needs of children and young people with SEN in a more personalised way, with a renewed focus on children and young people’s outcomes. Joint training and professional development for the various professionals dealing with children and young people with SEN should be encouraged. Some local areas have used specialist staff to train the wider workforce so they can better identify need and offer support earlier (e.g. using educational psychologists or speech and language therapists to train professionals such as teachers or GPs to identify mental health problems or speech and language delay, respectively).
• The opportunities to engage children and young people with SEN and their parents in commissioning decisions - to give useful insights into how to
improve services, and improve outcomes. LAs, CCGs and NHS England must develop effective ways of harnessing the views of their local communities so that commissioning decisions on services for those with SEN are shaped by people’s experiences and aspirations. LAs and CCGs will want to engage with local Healthwatch organisations, patient representative groups, Parent
Partnerships, Parent Carer Forums, groups representing young people with SEN and other local voluntary organisations and community groups to do this.
• Aligning, integrating and pooling budgets: Under Section 10 of the Children Act 2004 and Sections 14Z1 and 75 of the National Health Service Act 2006, local authorities and CCGs have a statutory duty to consider the extent to
which children and young people’s needs could be more effectively met through integrating services. Health and wellbeing boards and SEN partners should consider the extent to which such budgets might be pooled in order to offer greater value for money, improved outcomes and/ or better integrated services for children and young people with SEN.
• Personal Budgets: Young people and parents of children who have EHC plans have the right to request a personal budget, which may contain
elements of education, social care and health funding. Partners must set out their arrangements for agreeing personal budgets and should develop and agree a formal approach to making fair and equitable allocations of funding.
The health commissioning duty
As health service commissioners, CCGs are under a duty under section 3 of the NHS Act 2006, to arrange health care provision for the people for whom they are responsible, to meet their reasonable health needs.3 This is the fundamental basis of
commissioning in the NHS. CCGs have to exercise discretion as to what services should be commissioned, and will draw on local Joint Strategic Needs Assessments and Joint Health and Wellbeing Strategies, as well as other data on local needs, in drawing up their commissioning plans. They must also consult with their local population on those plans. However, where there is provision which has been agreed in the health element of the EHC plan, health commissioners must have arrangements in place to secure that provision. This issue is explored in more detail in Chapter 7.