iHV submits response to the Government’s special educational needs and disabilities (SEND) review consultation

Yesterday, we submitted the Institute of Health Visiting’s response to the Government’s SEND Green Paper consultation. Our response was led by Georgina Mayes, our Policy and Quality Lead, in collaboration with a range of stakeholders from across the sector and based on the best evidence of what works. We support the ambitions of the Green Paper’s policy proposals to end the postcode lottery of SEND provision, and our response aims to ensure that the needs of babies, young children with SEND and their families are recognised as early as possible and effectively addressed.

The Government commissioned the SEND Review in September 2019 as a response to the widespread recognition that the system was failing to deliver improved outcomes for children and young people and that parental and provider confidence was in decline.

The review sets out the Government’s proposals for a system that offers children and young people the opportunity to thrive, with access to the right support, in the right place, and at the right time, so they can fulfil their potential and lead happy, healthy, and productive adult lives.

Alison Morton, iHV Executive Director, says:

“Nobody can argue with the aspirations set out above – what we now need is sufficient resource and the action that will be needed to make the difference for babies and children with SEND, and their families. There is no dress rehearsal for the earliest years of life which lay an important foundation for lifelong health and wellbeing – what happens during this time matters for all children, and it really matters for children with SEND who are currently being let down.

“If we are serious about improving outcomes for children with SEND, we need investment to reverse years of cuts to prevention and early intervention services. This includes rebuilding the health visiting workforce. Cutting this universal safety-net of skilled professionals, that reach all families to identify the early signs of SEND, has been a false economy as any short-term savings are quickly offset by increased delayed treatment costs and, for some, the consequences have been catastrophic”.

In our response to the consultation, we have sought to provide constructive feedback on the proposals and to suggest areas that we think the Department for Education and the Department of Health and Social Care should explore further. We have not responded to all the questions in this comprehensive consultation – we have specifically responded to the consultation questions that are relevant to the health of babies, young children, and their families.

We remain committed to ensuring that babies are not overlooked in national policy – we were therefore disappointed to see the lack of focus within the Green Paper on prevention and the early identification and support for babies and young children with SEND. Early intervention relies on the early identification of babies and young children at risk of poor outcomes – without an acceptable universal mechanism of identifying these children who are often invisible to services, all strategies will struggle to reach underrepresented groups and reduce inequalities.

Babies and young children are citizens in their own right and they are entitled to the same access to health and social care as older children and young people, but they rely on the adults around them to be their voice when their parents or carers are unable to speak for them. It is vital that their voice is heard in this consultation.

We recommend that the scope of the forthcoming policy is ambitious and extends beyond the Department for Education, with clear commitments and lines of accountability that extend across the multiple government departments that contribute to SEND outcomes. In particular, our response has focused on the vital contribution that health visitors bring to the success of the SEND programme. The need to improve the coordination of care for these families is well documented – health visitors are a skilled workforce who can support parents to navigate the complex systems of support.

It is widely recognised that parents of children with complex health needs are at increased risk of experiencing additional stress; parenting a disabled child goes beyond ‘ordinary’ parenting. It is not surprising, therefore, that parents of children with SEND are more likely to require support than parents of non-disabled children. Services which are accessible and offer a partnership approach where parents are involved in decision making result in improved parent satisfaction, decreased parental stress, and an improvement in child outcomes.

Services need to be flexible and promote individualised care which requires that joint working is coordinated between the family and all practitioners involved. Health visitors also play a crucial role in supporting access to wider support (such as improving uptake of Early Years provision, relevant disability and income-related benefits, and reducing parental conflict), as well as effective transition to school and the school nursing service.

Fundamentally, the success of any SEND plan hinges on having the right workforce with the right skills and in sufficient numbers to address the level of need. Current workforce challenges are significantly hampering improvements in the quality and amount of care and support that families receive and cannot be ignored. We have specifically highlighted how cuts to health visiting services have had a direct impact on the timely referrals to specialist services with many services reporting problems with late identification of SEND and wider vulnerabilities.

Georgina Mayes, iHV Policy and Quality Lead says:

“Unless workforce shortages are addressed, then no amount of planning, strategy, partnership working or understanding of need is going to work. A well-resourced national health visiting workforce plan is needed as part of a whole system’s approach to improving the lives of babies, children, and young people with SEND. We need more health visitors!”

We would like to thank the health visitors, parents and charity organisations who have contributed to our response to this consultation. We really value their time, commitment, expertise and knowledge.

We look forward to seeing the publication of the Government’s SEND Green Paper consultation. For more information, read the iHV’s consultation response (PDF).

If you would like to stay updated on and get involved in this work, please contact [email protected]

The Government is seeking views on their green paper about the changes they want to make to the special educational needs and disabilities (SEND) and alternative provision (AP) system in England.

The Government commissioned the SEND Review in September 2019 as a response to the widespread recognition that the system was failing to deliver improved outcomes for children and young people and that parental and provider confidence was in decline. The SEND review green paper sets out the Government’s proposals for a system that offers children and young people the opportunity to thrive, with access to the right support, in the right place, and at the right time, so they can fulfil their potential and lead happy, healthy and productive adult lives.

The SEND Review highlights key areas for the case for change:

  • Children and Young People with SEND and those in alternative provision have consistently poorer outcomes than their peers
  • Experiences of the SEND and AP provision system are negative
  • The SEND and AP system is financially unsustainable
  • There is too much inconsistency across the SEND system in how and where needs are assessed and met
  • A vicious circle is driving these challenges

The Government has opened a consultation to improve outcomes for children and young people in England with SEND and those in alternative provision.

To achieve this ambition, the Government wants to work with and hear from:

  • children and young people
  • parents and carers
  • those who advocate and work with the SEND sector
  • local and national system leaders

We have 13 weeks to get this right, so please consider the proposals set out in the Government’s  green paper and respond to their consultation.

Together, we can ensure that every child and young person with SEND and those in alternative provision can thrive and be well prepared for adult life.

iHV is collating a response to this consultation – please contact us (via email to [email protected] by 10 June 2022) if you have comments that you would like us to consider as part of our submission.

This consultation closes at 11:45pm on 1 July 2022.
If you have comments that you would like iHV to consider as part of our submission, please send via email to [email protected] by 10 June 2022


  • A separate summary covering the SEND and AP green paper and responding to the consultation is also available.
  • A British Sign Language (BSL) version and an easy-read version of the green paper will be available in early April.
  • If you would like a Braille or audio version of the green paper or an accessible format that is not listed, email [email protected].

 

iHV is delighted to publish its response to the Prevention Green Paper: Advancing our health: prevention in the 2020s.

We have provided a response to the online consultation. In addition, we have made some further points which we believe will strengthen the positive proposals in the Green Paper to give every child the best start in life – and sent via letter to the Secretary of State for Health & Social Care, Rt Hon Matt Hancock MP.

Overall, we welcome the government’s commitments outlined in the Green Paper. In particular, its desire to put prevention at the centre of all decision-making, with a focus on the importance of investing in our health throughout life – starting in the early years.

Investing in the earliest years saves money in the long run and, more importantly, ensures that every child is supported to achieve the best start in life with foundations for good health throughout the life-course. As inevitable from a Green Paper, it lacks the detail needed to determine whether the ambitions will be supported by a real funding uplift and the workforce support required to implement the recommendations in full. We are hopeful that this will be addressed in the stated commitment that national and local government will work together to ensure the plans succeed.

In light of the publication of the Government’s green paper on Transforming Children and Young People’s Mental Health Provision (in February 2018), iHV is delighted at the decision of the House of Commons Select Committees on Health and Education who have agreed to launch a joint inquiry to scrutinise the proposed scope and implementation of the green paper. Key recommendations include: considering the role of health visitors and children’s centres in promoting emotional wellbeing in the early years.

Institute of Health Visiting raises their concerns that the Green paper proposals for Transforming Children and Young People’s Mental Health Provision are a missed opportunity to reduce the number of children and young people ever experiencing mental illness.

In a letter to Secretary of State Jeremy Hunt MP, the Institute sets out the evidence for the green paper to address the opportunities for building emotional resilience in childhood from pregnancy onwards, and reducing the incidence of mental illness in childhood.  It also highlights the critical contribution of the health visiting service to early intervention, through full delivery of the Healthy Child Programme as a gateway to appropriate levels of support for children and, where needed, specialist services.