The Role of the Designated Medical/Clinical Officer in the SEND Reforms

What Guidance is available?

• Children and Families Act

• Regulations

• SEN Code of Practice

• Pathfinder Evidence

• Voluntary Sector Resources

• Developing Case Law

Implementing the Children and Families Act.

These are the:

WHY

WHAT

Each Local Area needs to develop the

WHO

HOW

Joint Commissioning Arrangements: The missing roadmap

The Children and Families Act is very clear that there MUST be formal joint commissioning arrangements in EVERY local area.(Section 25-30)

Between LA and relevant Clinical Commissioning Groups (CCGs) + link to NHS England for specialist services commissioned a regional or national level.

Joint Commissioning Arrangements are the detailed plans of how education, health and social care services will work together to deliver the Children and Families Act: The WHO and the HOW

Joint Commissioning Arrangements

• Outcomes• The availability of services• Identification of children and young people with

SEN and disability• Integration of provision• Improvement of services• Provision of information & advice• Process for EHC Plans• Dispute resolution & mediation

Joint Commissioning Arrangements must set out

• The Children and Families Act builds on the role of the Designated Doctor role and recommends appointment of a Designated Medical/Clinical Officer

• Joint Commissioning partners should ensure there is a Designated Medical Officer (DM/CO) to support the CCG in meeting its statutory responsibilities for children and young people with SEND.

• The DM/CO is the key point of contact between the local NHS and the Local Authority and Families

• Supports the delivery of Supporting Pupils with Medical Conditions at Schools

Role of the Designated Medical/Clinical Officer

• Takes part in strategic decision making in Joint Commissioning Arrangements

• Role in coordinating notifications of SEND from clinicians to Local Authority

• Coordinating medical information input into EHC Needs Assessments within statutory timeframe

• Carrying out assessments for EHC Plans where part of their clinical role and ensuring that assessments and planning is carried out

• Coordinating delivery of health provision specified in EHC Plans

Some Key areas of responsibility for the DM/CO

Legislation

• Health and Social Care Act 2012: HUGE Reorganisation of the NHS

• Care Act 2014: Integration of Health and Social• Academies Act 2010 + 2012: New school structures• Welfare Reforms

Policy:• Education Funding Changes• Working Together to Safeguard Children• Children and Families Act• Localism• Austerity

Joint Commissioning Arrangements Changing Context:

• Local areas have very different structures, processes across their services.

• Also different population demographics and policy priorities.

• No single model of implementation that can be applied across all areas of the country

• This is reflected in drafting of the Children and Families Act

Wider Changing Context Means:

The Children and Families Act requires professionals all levels of the system to contribute to the implementation of the reforms:

• System Leaders and Decision Makers

• Service Commissioners and Service Managers

• Frontline Professionals

What needs to be done at each level and how is this developing in your area

A lot of this is not new and builds on existing policy and duties.

Opportunity to Build on Existing Mechanisms

Joint Commissioning Arrangements in Your Area.

Joint Commissioning Arrangements

Who should be around the table?

CCG Lead Commissioner

for children/ disabled children

Local Authority

Officer responsible for schools

Designated Medical/Clinic

al Officer

Parent and Young People

Representatives

Local Authority

Head of SEN and

Disability

SEN Reform Implementation

Lead

SEND Joint Commissioner

Local Authority

Officer responsible for Post-16 Provision

NHS England Local Area

Team Representati

ve

Local Authority

Officer responsible

for early years

Director of Public Health

Director of Adult Social

Care

Schools Forum Representative

Youth Offending

Team

Implementation of Children and Families Act has focused on operational aspects(e.g. EHC Plans and maintaining a Local Offer) without Joint Commissioning Arrangements fully established in all areas.

BUT

Joint Commissioning Arrangements are required for strategic changes required to support this delivery.

Without JCA there will be increasing pressure on operational delivery and frontline professionals- potentially undeliverable.

So…..What’s Happening?

Joint Commissioning Decision Making Structures

• How my role is configured• Who employs me• Capacity/time allocation• JD• Key relationships• Involvement in strategic groups/funding panels• Involvement in overseeing the EHC Process• Plans for the role

DM/CO role in practice

Strategic Leaders and

Commissioners

 

 

 

 

 

 

 

 

 

Frontline Clinicians

Designated Medical/Clinic

al Officer

How do Joint Commissioning Arrangements involve each system level.

• You should be in three small groups• You each have three large circles on the wall and a pile of cards.

The colour of the cards has no meaning! On each card is a task or requirement of the Children and Families Act reforms which needs to be in place for implementation to work.

• Your job is to assign those tasks to the available workforce – Strategic leaders and Commissioners, yourselves (DM/Cos) or frontline clinicians. The circles are Venn Diagrams so you may decide that a job sometimes needs to be done by two groups.

• There are some blank cards for you if there are tasks or elements which you think are vital that we haven’t identified.

• If as you discuss what goes where you identify obstacles or solutions to those tasks getting done please write these on the blank card and put them in the bottom right hand corner

• The circles are sticky!!

Over to you:

Thinking about the previous exercise and the elements that need to be in place for the reforms to work; and any particular thorny obstacles , please identify one action that you will go back and prioritise.

Still with you: