Nottinghamshire County Council and the local NHS have been ordered to urgently address “widespread failings” with their services for children with special needs.
It follows an inspection by watchdogs which found long waits for assessments, with some children with complex needs waiting as long as 37 weeks.
Nottinghamshire County Council and NHS Nottingham and Nottinghamshire Integrated Care Board (ICB) are responsible for arranging services for children and young people with Special educational needs and disabilities – known as SEND – in Nottinghamshire.
The service was inspected in an unannounced visit by Ofsted and the Care Quality Commission (CQC) over three days from the end of January to the start of February earlier this year.
The inspection found children and young people are waiting too long to receive specialist educational health care assessments (EHCs) and specialist help such as speech and language therapy.
Colin Pettigrew, Director of Children’s and Families Services at Nottinghamshire County Council, apologised and said “Undoubtedly families have been let down”.
He said the report marked the first time Nottinghamshire services had been inspected under a new framework by Ofsted and the CQC.
Amanda Sullivan, Chief Executive of Nottingham and Nottinghamshire Integrated Care Board added that the report has given staff “renewed determination to improve things as quickly as we can”.
An education, health and care plan is for children and young people aged up to 25 who need more support than is available through special educational needs support.
EHC plans identify educational, health and social needs and set out the extra support to meet those needs.
But the report stated: “There are widespread and/or systemic failings leading to significant concerns about the experiences and outcomes of children and young people with special educational needs and/or disabilities (SEND) which the local area partnership must address urgently.”
A monitoring inspection will take place in 18 months’ time, and a full inspection will follow in three years.
There are currently 16,000 children and young people in Nottinghamshire with SEND – around 4,000 of those have ECH plans, and 300 are currently going through the assessment process.
Over the last five years, the number of requests for Education Health and Care assessments has more than doubled.
The Government target states children should not wait more than 20 weeks for an ECH – but in Nottinghamshire, four out of five children are waiting more than 20 weeks.
And some children with “particularly complex needs” wait for around 37 weeks.
A Nottinghamshire SEND Partnership Improvement Board has been established to oversee the improvement actions, which will be chaired independently by Dame Christine Lenehan, Director of the Council for Disabled Children.
The board will be in place for at least the next 18 months.
Ofsted and the CQC stated in the report: “Leaders, NHS Nottingham and Nottinghamshire Integrated Care Board and education, health, and care providers should cooperate to urgently identify, assess and provide for the needs of children and young people with SEND.
“This includes assessment of needs, timely issuing of EHC plans and holistic oversight of these plans through annual reviews.”
It added: “Leaders’ plans and actions have not resulted in noticeable or sustained improvements to this situation.”
They added that managers should act urgently to address the delays in access to speech and language therapy, neurodevelopmental pathways and equipment services.
They have also been told to use available performance data to identify where gaps exist and whether actions taken to address these are effective.
There was also criticism of partnership leaders, who “cannot effectively challenge and support one another at present”.
It added that “leaders are unclear about the challenges that children and young people with SEND and their families face in Nottinghamshire”.
Colin Pettigrew, Director of Children’s and Families Services at Nottinghamshire County Council, said he was “sorry that too many families have waited too long”.
He said: “Since the last inspection, we’ve seen a doubling of demand for EHC plans and something called Covid happened during that period.
“We know that children’s health has taken a downturn, particularly around the emotional health and well-being of children and young people.
“That comes together with demand across the country in recruiting into some of these specialists posts, particularly of educational psychologists. The code of practice requires the need to be signed off by an educational psychologist.
“So there’s a lag between the increase in demand and the capacity to meet that demand.
“I think the report will help us make better outcomes for children with disabilities and special educational needs in Nottinghamshire.
“We are confident that in 18 months’ time, inspectors will find a very different experience for children, young people with SEND in Nottinghamshire.”
When asked who needs to take accountability for the filings, Mr Pettigrew added: “The system has literally hundreds of leaders. There are 350 schools alone, and they play their part in reviewing ECH plans in a timely way.
“So there are literally hundreds of leaders that all need to play their part.”
Amanda Sullivan, Chief Executive of Nottingham and Nottinghamshire Integrated Care Board, which is responsible for the delivery and oversight of commissioned services such as speech and language therapy, added: “I am very sorry that people have to wait too long for their assessments and for treatments or therapies that they need.
“I welcome the increased profile this process has brought onto this group of individuals and it gives us renewed determination to improve things as quickly as we can.”
She said the service has seen “significant increases in demand”.
She added that 400 children are currently waiting more than 13 weeks to access therapies provided by the NHS.
“We recognise and are sorry that families will find it frustrating and difficult when they’re not getting the all of the assistance that they need. We completely understand that that is difficult and concerning for parents”, she said.
“I think people with SEND have a right to expect that they will have their needs assessed and met in a timely way.
“And that is what we’re committed to do.”
The report added: “For those children and young people with the most complex needs, EHC plans do not identify health and social care needs, outcomes, or services well enough. This means children and young people are not consistently getting the help they need at the right time. This is compounded by a lack of health and social care input at annual reviews for these children.
“Children and young people are positive about how their views and aspirations are reflected in their individual EHC plans and the support they receive.
“However, many parents and carers feel less informed and involved in decision-making for their children. They feel they must fight to get the support their children need to make progress towards their EHC plan outcomes.”
However, the report added that “for many children and young people with SEND, alternative provision is a positive experience”.
It added children and young people are supported to remain in education and leaders have also increased their engagement with children and young people with SEND to gather their views about services.
A spokesperson for the Nottinghamshire Parent Carer Forum (NPCF) which is run by parent carers of children or young people with an additional needs or disabilities, said there was a “considerable amount of work to be done”.
The forum’s lead, Georgina Palmer said: “Sadly, the findings of the inspection reflect the experiences and concerns that families of children and young people with special educational needs and disabilities (SEND) often communicate with the forum. Prompt action must be taken to address the issues raised in the report.”