1. The Role of the Designated Medical/Clinical Officer in the SEND Reforms
As facilitator can you please start by explaining that as the workshop is quite short we’re not going to go round the room at the beginning. However, as part of the exercise at the end we will be asking people to say who they are. So apologies that it’s back to front, it’s to save time!

2. Implementing the Children and Families Act.
These are the: WHY WHAT
What Guidance is available?
Children and Families Act
Regulations
SEN Code of Practice
Pathfinder Evidence
Voluntary Sector Resources
Developing Case Law
Each Local Area needs to develop the
WHO
HOW

3. Joint Commissioning Arrangements: The missing roadmap

4. Joint Commissioning Arrangements
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

5. Joint Commissioning Arrangements must set out
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

6. Role of the Designated Medical/Clinical Officer
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

7. Some Key areas of responsibility for the DM/CO
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

8. Joint Commissioning Arrangements Changing Context:
Legislation
Health and Social Care Act 2012: HUGE Reorganisation of the NHS
Care Act 2014: Integration of Health and Social
Academies Act : New school structures
Welfare Reforms
Policy:
Education Funding Changes
Working Together to Safeguard Children
Children and Families Act
Localism
Austerity

9. Wider Changing Context Means:
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

10. Joint Commissioning Arrangements in Your Area.
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

11. Joint Commissioning Arrangements
CCG Lead Commissioner for children/ disabled children
NHS England Local Area Team Representative
Local Authority Officer responsible for schools
Designated Medical/Clinical Officer
Local Authority Officer responsible for early years
SEND Joint Commissioner
Joint Commissioning Arrangements
Who should be around the table?
Local Authority Officer responsible for Post-16 Provision
Director of Adult Social Care
Parent and Young People Representatives
Director of Public Health
Youth Offending Team
Local Authority Head of SEN and Disability
Schools Forum Representative
SEN Reform Implementation Lead

12. So…..What’s Happening?
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.

13. Joint Commissioning Decision Making Structures

14. How my role is configured Who employs me Capacity/time allocation JD
DM/CO role in practice
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
Check this slide with your DM/CO!!!

15. Designated Medical/Clinic al Officer
How do Joint Commissioning Arrangements involve each system level.
Strategic Leaders and Commissioners
Designated Medical/Clinic al Officer
Frontline Clinicians

16. You should be in three small groups
Over to you:
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!!
Give the groups minutes for this exercise depending on how well it goes. We will try to ensure that each table has a facilitator. They will want to introduce themselves at this point, so make sure the facilitator keeps them brief, names and areas only!!
The purpose of this task is to get them to think through the elements of the reforms that they’re involved with and to start to draw out differences between the way it is operating in local areas. We are therefore expecting discussion about both roles and responsibilities of the DM/CO, progress with reforms, obstacles. The reason we are giving them the tasks on cards is because they have sometimes struggled at previous events to identify them! (don’t tell them that!)
We should end up with (if it goes to plan) three venn diagrams that look more or less the same.
In the discussion when we draw people back together identify any differences, we need the facilitators help here so this isn’t too slow a process if they can do a quick scan between charts before the end. We can then discuss any differences and also any key sticking points or solutions that people have discussed during the task. We’ve allowed 10 minutes for this.

17. Still with 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.
Give them a couple of minutes for this, this is really for them to think about what they’ve been doing and now they’ve had the opportunity to take a step back and think about the role from a distance whether or not they’ve been prioritising the right things!!
and then go round the room asking them to introduce themselves briefly and say what their action is. So we have about 8 minutes for sharing!!!! It is tight.