A “root and branch” rebuild of Education, Health and Care plans for Children and Young People
Read Stockton-On-Tees Borough Council's MJ Award winning Digital Transformation entry in partnership with Invision360
A “root and branch” rebuild of Education, Health and Care plans for Children and Young People at Stockton-on-Tees Borough Council
“From my son’s perspective, I’d hope that having this new digital tool in place will transform the way Education, Health and Care Plans are created entirely in Stockton, which, as parents, is what we’re all hoping for.”
Emma Zenaj, parent and Co-Chair of Stockton-on-Tees Parent Carer Forum (PCF)
By embracing new technology, we’re simplifying a complex planning process to make sure children, like Emma’s son, have a high quality Education, Health and Care Plan (EHCP) that meets their individual needs.
In 2022, 473,000 children and young people nationally and 2037 locally (Stockton-on-Tees) have an EHCP. An EHCP, is a hugely important statutory document for children with complex special education, health and care needs. It explains the extra help required to meet those needs and how that help will support the child or young person to achieve positive outcomes in life.
To understand our digital transformation journey, it’s important to realise the scale of the problem and how far we’ve travelled.
Firstly, the quality and consistency of EHCPs is a national issue and not just a challenge here in Stockton-On-Tees. Following all Ofsted & CQC Local Area SEND inspections (between May 2016 and March 2022), out of 440 areas of significant weakness identified ‘limitations regarding EHCP quality &consistency’ were among the three most common weaknesses.
We were not alone. An Ofsted and CQC Local Area SEND Services Inspection revealed, among other weaknesses, that the quality of advice within EHCPs was “too varied” and that “outcomes [for children and young people] were not sufficiently aspirational or measurable,” and we were issued with a Written Statement of Action to improve.
A big part of our EHCP improvement journey has involved digitising the quality assurance of new EHCPs, where we’ve seen:
EHCPs audited ‘Good’ increase from 14.7% to 87.6%
EHCPs audited ‘Inadequate’ drop from 29.4% to 1.7%
The percentage of new EHCPs quality assured increase from 20% to 100%
A 50% reduction in the time it takes to audit an EHCP.
Our improvements have not gone unnoticed by Ofsted and the CQC, who during a Local Area SEND inspection re-visit in July 2022, observed:
“Leaders have taken effective action to improve the quality of EHCPs. To this end, they have conducted a root-and-branch rebuild of the EHCP process and format.”
Our “root-and-branch rebuild” would not have been possible without the right technology solution (Invision360) and a new collaborative approach.
Transforming a complex process
Although we had introduced a new QA framework when we identified Invision360 as a partner, our processes were far from ideal. We had undertaken two big paper-based QA audits. It was a cumbersome, time-consuming process and the majority of EHCPs were redacted. We were manually piecing information together, which was inefficient and inconsistent. We were also taking things out of electronic files and reversing digital transformation in other areas.
When we decided to introduce Invision360, it was as if we’d found the key that would unlock everything.
As a pilot partner, we’ve helped coproduce a game-changing digital tool, which takes the bureaucracy and objectivity out of quality assuring EHCPs.
Invision360 is an online tool that our EHCP caseworkers and auditors access anywhere. Drawing from nationally recognised good practice criteria, it enables education, health &social care professionals and parents to audit EHCPs far more effectively.
Step-by-step guidance, criteria and examples of what ‘good’ looks like enable us to see whether the advice included within each EHCP Section (12 in total) is of an appropriate standard and meets a child or young person’s needs.
A huge time-saver
Invision360 automatically frees-up time. An audit now takes under half the time, resulting in considerable time efficiency savings. We no longer hold face-to-face multi-agency QA meetings, as everything is done online.
Crucially, timeliness of EHCPs has vastly improved. We quality assure a huge number of plans compared to similar sized local authorities. We’re in the top-ten local areas for timeliness, with 98% of new EHCPs completed within timescale.
The biggest benefit is drilling-down Section-by-Section. We analyse data within the tool on a weekly basis for Sections needing improvement – giving us a real-time window into performance.
Invision360is a partnership. Being involved in its development, we feedback on what could further enhance the tool.
The main benefit is consistency. Everyone is using Invision360 with the same understanding of what constitutes a ‘good’ EHCP.
As a ‘faceless’ process, you interact differently with Invision360 than with a person. If you’re sat together in room quality assuring a plan, it’s not subjective – it’s just a measure. As Invision360 guides you through each Section, it removes objectivity. Nobody adds information because they ‘know’ about a child.
Auditors use the tool to identify improvements. Rather than sitting together saying this is not great, Invision360 provides the evidence of where the issues are to address any knowledge gaps and training requirements.
Changing cultural dynamics
Within the SEND Code of Practice, there’s a shared ownership, but only through introducing Invision360 have we seen a cultural shift to shared accountability. All partners have a far deeper understanding of what the EHCP is about rather than being a document reviewed every so often.
Our digital journey has changed how partners talk about EHCPs. Before Invision360, caseworkers (EHCP writers) were judged for the quality of the final EHCP, regardless of the quality of the advice within a plan. There was little accountability or focus on advice quality. It doesn’t matter how good a caseworker is, they could be the best in the world, but if they do not have quality EHC advice, they’re never going to write a ‘good’ plan.
Judging the end-product was not enough. We needed to discover ‘why’ a plan was not meeting needs and ‘what’ improvements needed to be made, which Invision360 enables us to do.
There’s now a shared ownership. All partners are interested in supporting caseworkers and making the process and outcome better.
Everyone is quality assuring each other’s work. Senior management using the tool, ask “How can we mirror the improvements our colleagues are making?”
Far more accountability
We’re not just marking our own homework. Invision360has brought our QA framework together, as Ofsted recently noted:
“Quality assurance involves a range of stakeholders, including the Parent Carer Forum (SPCF), and includes checks on the quality of EHCPs by senior staff from different multi-disciplinary teams.”
It’s virtually unheard of that Directors of Children’s Services, the Lead Commissioner for SEND Health Services, and the Chair of the PCF quality assure EHCPs, but it’s important that they do and Invision360 makes this possible.
We rarely report on the quality of a whole plan. We use the tool to report on each Section to measure the quality of advice and links.
During our progress visit, Ofsted noted that we now have an in-depth understanding of what a ‘good’ plan looks like:
“There is clarity and detail in the information provided. Provision, timescales, responsibilities and outcomes are precise. Contributions from professionals are reflected robustly throughout the plans.”
Invision360 helps us focus on only including relevant information. Senior caseworkers and case managers review the quality of the plan Sections online. They identify commonalities where things need improving and feed this into weekly training. Likewise, if advice is preventing a Section from being ‘good’, this is shared with the advising practitioner. If the issue is with plan writing, peer-to-peer caseworker training is offered, which enables our caseworkers to confidently improve their plan writing.
The tool also enables us to evidence need. For example, The Council for Disabled Children wanted to mirror the role of the Dedicated Clinical Officer in health within social care. We used Invision360 to analyse the need and justify the spend. We could see that other Sections were improving much quicker, and that a Designated Social Care Officer would likely have the same impact in social care, and so a role was created, which is having a positive impact.
A consistent picture
There is a lot of internal change - new EHCPs, a new assessment process, and a high turnover of SENCOs, social care and healthcare practitioners. In a changeable environment, Invision360 is the constant for maintaining EHCP quality. New employees are trained, from day one, on providing quality advice/plan writing, and with Invision360, we’ve quickly onboarded double the number of caseworkers within the team.
Comparing the first six months of us using Invision360 to the six months leading up to 30 November 2022, the transformation in the quality of EHCPs is remarkable.
Plans scoring as ‘Inadequate’ has dropped from 29.4% to 1.7%.
Plans ‘Requiring Improvement’ has seen a huge drop from 55.9% to 10.7%
Plans audited as ‘Good’ have increased dramatically, from just 14.7% to 97.6%
As partners take more accountability, there have been vast improvements to health and social care advices.
Comparing the quality in health and social care advice of EHCPs audited in Quarter 1 2021(Jan to March 2021) to Quarter 4 2022 (Oct – Dec 2022) illustrates this. The percentage of audit gradings of ‘Good’ or higher for Section C (health) has increased from58.9% to 94.6%. The percentage of audit gradings of ‘Requires Improvement’ or ‘Inadequate’ for Section D (social care) has also reduced from 44.3%% to 6.2%.Both comparisons highlight the huge progress we have made using the tool.
It is the children and young people who are benefitting the most. Every new assessment is quality assured, meaning children referred for an EHCP have one that meets their needs from the start.
Invision360 has been created collaboratively, with parents and carers to ensure that the voice of the child, and by extension the family, is at the heart of EHCPs. The largest Section within the tool, Section A, details the child and family’s views. It’s owned by the child and for the child, as Emma Zenaj, parent and Co-Chair of the PCF shares:
“Invision360 places the child at the centre of the plan. The plan is the child’s – it doesn’t belong to the SEND team, education, health, social care or the parent. There’s a massive difference in how children are discussed – there’s a positive focus on what a child ‘can do’ rather than what they can’t.
“As an example, a little girl from an EHCP audit I recently completed will stay with me forever. I’ve never met her and don’t know her name, but through her EHCP I feel as if I really know her. I hear her voice, understand her needs and the provisions that need to be in place for her to thrive.”
We were the first in our region to introduce Invision360, and now others are following. This is hugely beneficial for children moving within the wider area and enables us to benchmark our performance.
Our collaboration with Invision360 is an example of local authority innovation. It’s the first and only standardised digital EHCP audit tool used by multiple local authorities and enables benchmarking.
By comparing our EHCPs, we now have a wider context on how we perceive the data and outcomes. For example, our Section J was slightly underperforming and so we contacted other local authorities to explore what they were doing differently. It was a simple thing that needed changing, but we would never have got there without Invision360.
Our quality journey is never complete, and so it’s how our new digital landscape takes us onto the next stages.
Our focus has been on new EHCPs. Now we’re concentrating on transferring 1800 older existing plans into the new format. Invision360 will be crucial in bringing them up to standard.
The new SEND Ofsted framework, published November2022, states that there will be a focus on: 'The local area partnership’s approach to the development, oversight and quality assurance of EHC plans’and Invsion360 will be instrumental in helping us make the required changes.
We’re also now utilising the Invision360 EHCP Annual review tool to audit the quality and consistency of the entire EHCP annual review process, including the progress towards outcomes.
We are changing the goalposts for children and young people. What is ‘good’ is not good enough anymore, it’s what’s ‘outstanding’ now!
Our transformative technology improves efficiency and secures positive outcomes, through a focus on quality and facilitating new thinking for organisations that are committed to improving their services.