Disabled children and young people up to 25 with severe complex needs: integrated service delivery and organisation across health, social care and education

Resource impact summary report

The guideline covers support for disabled children and young people with severe complex needs, from birth to 25 years. The recommendations will help practitioners in all 3 sectors put the best available evidence into practice in a way that is consistent with the requirements of the special educational needs and disability (SEND) code of practice. There are also recommendations for local authorities, health commissioners and individual services, to help them work together and provide more coordinated support to children and young people.

Most of the recommendations reinforce existing statutory requirements (SEND code of practice) and current best practice across health, education and social care. However, experts suggest that practice is not consistent across the country; therefore, some local areas may require additional resources to implement the guideline recommendations.

Based on current practice, additional resources may be needed for the following:

• to establish processes to share information and to allow more coordinated and joined-up working
• additional staff time and training, for example, to communicate with children and young people who do not communicate verbally or to support communication through alternative means. Interagency training may also be needed to ensure that practitioners understand relevant policies and processes and the role of other practitioners and services
• additional staff time for follow-up and discussions of education, health and care (EHC) plans with children and young people and their families and carers
• to implement a key working approach that will ensure caseloads are manageable and practitioners have dedicated resources to deliver effective key working
• to provide preferred communication media for children who are non-verbal and who might use alternative and augmentative communication technology.

Implementing the guideline may:

• result in efficiencies and productivity that can contribute to offsetting any potential costs
• enable children and young people to effectively participate and engage in discussions and decisions about their care and support. Engagement with care will positively impact their care and outcomes and may outweigh any additional costs
• enable families to engage with services early. This may result in fewer queries, complaints and problems and may save time later in the care pathway
• enable services to provide better coordinated and joined up support that improves quality care for children and young people. This may reduce healthcare related costs further down the line
• Help prevent children and young people from getting to a crisis point, which is detrimental to their quality of life and costly to address.

Health services for disabled children and young people up to 25 with severe complex needs are commissioned by NHS England and Improvement, integrated care systems/clinical commissioning groups and local authorites (public health/social care commissioners). NHS Enlgand and Improvement commission for very vulnerable children and young people whose mental healthcare require highly specalised services.

Providers are NHS hospital trusts, community providers, mental health trusts, primary care providers and social care, schools and education service providers, charity and third sector providers.