Sunday 1 December 2013

Can Brent provide for vulnerable young people amidst the cuts?

Local councils, faced with savage Coalition cuts to their funding, have often promised to make sure that the most vulnerable residents are protected. This is becoming more and more difficult, whatever the political complexion of the council. Alongside this councils are reducing the range of services to the core services required by statute. I have argued before on Wembley Matters that this may mean that services which are very beneficial to residents, and based on the council's recognition of a local need, may end up being cut: non-statutory doesn't mean not valuable or not needed. In addition, out-sourcing of some statutory services, muddies the water in terms of direct democratic accountability.

The December 9th Executive will be making decisions on a number of items that will have repercussion for services to the vulnerable.

They will be making a decision on procuring an Advocacy service for the following safeguarding 'clients'  to ensure they are safe from abuse:
  • older people with physical disabilities
  • young people (14-25 years old) with physical disabilities
  • adults with mental health needs
  • adults with learning disabilities
I am concerned that  'price' makes up 60% of the evaluation strategy for this procurement.

Another item is a change of provider for the Child and Adolescent Mental Health Service.  They propose to decommission services currently provided by Central and North West London NHS Foundation Trust.  In a key passage they state:
Information has been sought from other boroughs to determine what they commission. This work makes it very clear that while some boroughs do commission elements of training and systemic or early help provision, they do not fund direct therapeutic interventions. The proposed new provision,detailed in section 5 below, is therefore in line with that provided by other Local Authorities.
I hope the Executive will investigate that a little more. Rather than reduce services to match those of other boroughs, shouldn't Brent assess the value of direct therapeutic interventions?  I certainly found those useful for pupils and their families when I wa a headteacher and such interventions may save money in the long run. Officers argue that it is not possible to continue expenditure at current levels without jeopardising other services.

The proposals would reduce expenditure on children with disabilities by £50,000 to £146,000 and Looked After Children by £230,000 to £107,000.

Officers state:
The proposed change in the service could lead to an increase in support required through Care at Home and Direct Payments, and there is also the potential for some of these children/young people to become LAC. However, such pressures will be contained as the current service is supplementing a service already commissioned by the CCG and existing users will be able to access support from the CCG.
Clearly the first statement needs some discussion in terms of its implications for the individuals concerned. There is a possibility that too much responsibility is being shifted to the relatively untested CCG (Clinical Commissioning Group).

The report admits that there may be longer waiting time for Looked After Children requiring appointments but suggests that this will be dealt with by a requirement for the service to prioritise this group of young people. When I was familiar with this service several years ago waiting time was already a problem so I am sceptical that a notional prioritisation will address the problem.

More worrying also is a statement in the Equalities Impact Assessment that consideration had been given to consulting with users but that this was felt 'not to be in their interests to do so as it it would cause unnecessary anxiety'. The Assessment says it is intended to get views on the new service through the Care in Action forum for adolescents but it is not clear whether this will be before or after the changes are implemented.

A report on Higher Needs Student Eligibility is also tabled for November 9th.  This refers to educational provision for young people between 16 and 25 with a learning difficulty and/or disability. Arrangements have changed through new legislation and the local authority has to allocate appropriate provision:

The report states:
Council therefore needs to have processes in place to support this change and ensure that the allocated budget is not exceeded.
Funds allocated are about £18,000 per head for an estimated 140 people  next year.

The council will need to carry out a Learning Disability Assessment on young people who:

 Will be leaving school aged 16-19 and
• Is going on to further education, higher education or training and
• Is likely to need additional learning support to access education or training opportunities
• New children arriving from abroad who do not have a statement and have a learning difficulty or disability
• Children in mainstream schools that are supported by school action and school action plus support

Talks will be take place with further education colleges and other providers about provision whcih will enable 'young people with disabilities to live active, independent and fulfilling lives in the community.'

It will be important  to monitor the progress of young people and the quality of provision to see if fulfils these aims.

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