The Children, Adults, Health and Wellbeing Policy Development and Scrutiny Panel of Bath and North East Somerset Council met on Monday 16 December 2024 to discuss updates on the Independent Reviewing Officer (IRO) Annual Report, Education, Health and Care Plans (EHCPs), and the B&NES, Swindon & Wiltshire Integrated Care Board (BSW ICB) update. The meeting also included a review of the Panel's workplan.

Independent Reviewing Officer (IRO) Annual Report

The Panel was scheduled to review the Independent Reviewing Officer (IRO) Annual Report for 2023-2024. This report details the work of the IRO Service, which is responsible for monitoring and reviewing the care provided to children and young people for whom the Local Authority is the corporate parent. The report was intended to appraise members on the care provided to these children.

The report highlighted challenges faced during the reporting period, including changes in IROs for some children and instances where child in care reviews did not occur within statutory timeframes. However, it also noted that the service had returned to a full complement of staff and the substantive head of service had returned, leading to more consistent service delivery and an improvement in the timeliness of child in care reviews, with 98% being on time by Q2 of 2024-2025. The report also aimed to promote the role of the IRO, recognising the consistency and long-standing relationships they can offer to children in care.

The report detailed the legal and statutory context of the IRO role, stemming from the Adoption and Children Act 2002 and the IRO Handbook. It outlined the IRO's responsibilities, including ensuring review meetings are held, that the views of children in care are heard, that the Local Authority acts as a good corporate parent, and that concerns are raised through the Dispute Resolution Protocol.

The report provided a profile of children in care in Bath and North East Somerset, including data on the number of children in care, reasons for leaving care, and the timeliness of reviews and the distribution of review minutes. It also discussed the challenges of children placed at a distance from the local authority and the specific considerations for unaccompanied, asylum-seeking, and trafficked children. The importance of the child's voice in reviews and the effectiveness of the Dispute Resolution Protocol were also key themes.

Education, Health and Care Plan (EHCP) Overview

The Panel was scheduled to receive an overview of Education, Health and Care Plans (EHCPs) in Bath and North East Somerset (B&NES). This report, drawing from dashboards managed by the Business Intelligence team and data from the ISOS partnership, aimed to provide the Panel with an understanding of the current situation regarding EHCPs.

The report indicated an increase in applications for Education, Health and Care Needs Assessments (EHCNA) and the number of issued plans across all education phases, both locally, regionally, and nationally. In B&NES, 4.9% of children and young people (CYP) have an EHCP, which is comparable to national and regional figures. The report suggested that measures implemented to improve decision-making and panel processes had a positive impact on mitigating the increase in plans. The introduction of the SEND and Alternative Provision (AP) Advice service was highlighted as a strategy to support schools and professionals in meeting the needs of young people within existing school resources, with the expectation that this would reduce the number of CYP requiring an EHCP.

The report detailed the number of applications for Needs Assessments, new EHCPs, and total EHCPs over the past five years in B&NES. It acknowledged the statutory duty to complete a needs assessment within 20 weeks, noting factors affecting this, such as the availability of professional advice and caseworker capacity. The importance of high-quality plans, as emphasised by Parent Carers through the B&NES Parent Carer Forum (BPCF), was highlighted, alongside efforts to improve communication about plan progress, including the planned implementation of a portal for parents to access case notes. The report also addressed the process for resolving disagreements when agreement cannot be reached, including the use of mediation and the SEND Tribunal (SENDIST).

B&NES, Swindon & Wiltshire Integrated Care Board (BSW ICB) Update

The Panel was scheduled to receive an update from the B&NES, Swindon & Wiltshire Integrated Care Board (BSW ICB) on current issues. This update was expected to cover several key areas:

• Sulis Elective Orthopaedic Centre (SEOC): Information was to be provided on the nearing completion of the SEOC, a new facility at Sulis Hospital designed to increase capacity for NHS patients and reduce waiting times for orthopaedic operations. The report was expected to detail its environmental sustainability features, such as solar panels and ground source heat pumps, and its sustainable travel plan. The recruitment of approximately 100 new staff for the SEOC was also to be discussed.
• Vaccination Programme: An update was anticipated on the winter vaccination campaign, with over 450,000 vaccinations delivered locally for flu, Covid-19, and Respiratory Syncytial Virus (RSV).
• Physiotherapy Performance: Following a previous request from committee members, the Panel was to receive a detailed overview of the performance of community-based physiotherapy services in Bath and North East Somerset, in collaboration with HCRG Care Group.
• Pharmacy Provision: Data from the Community Pharmacy Workforce Survey was to be presented, offering a snapshot of staffing in community pharmacies. The ICB's analysis of this data and its review of local initiatives to address workforce challenges were expected. The report was also to outline pharmacy opening hours and the conditions under which pharmacies can reduce their hours.
• New Initiatives for Children and Young People: The ICB's work to support children and young people, guided by the national CYPCore20PLUS5 framework, was to be discussed. This included updates on the BSW Youth Worker Pilot in acute hospital emergency departments, an epilepsy specialist nurse pilot at the Royal United Hospital, the BSW Asthma Friendly Schools accreditation, and efforts to improve diabetes outcomes through obesity prevention and the adoption of NICE guidance.

Panel Workplan

The Panel was scheduled to review its workplan, with suggestions for further items or amendments to be logged and scheduled in consultation with the Panel's Chair and supporting officers. Potential future discussion topics noted included Community Support Contracts, the Integrated Community-based Care Contract (HCRG), the Suicide Prevention Strategy, Synthetic Opioids, Transport to Hospital Schools (HERS), the Music Service, and Home Education.