Special educational needs and disability : Understanding local variation in prevalence, service provision and support

There is a growing recognition of the variation between local authorities in the proportions of children with SEN, the apparent composition of these groups, and the nature and quality of services provided to support them. Local area data collected on children with SEN, particularly the termly School Census and the annual SEN2 return by local authorities, show differences in the number of children with SEN, the nature of their recorded conditions and the Code of Practice level of support they are receiving. This variation was highlighted by the House of Commons Education and Skills Select Committee which commented on a ‘postcode lottery’ or a ‘lottery of provision’, and reports by the Audit Commission and Ofsted which also highlighted variation in provision and standards

What integrated working practices support or hinder effective referral pathways from health to education services for blind and partially sighted babies and young children? (Sharing our experience, Practitioner-led research 2008-2009; PLR0809/026)

Evidence indicates that young children and parents benefit from receiving specialist visual impairment (VI) education service support from an early stage following identification of a child’s sight condition. Early referral is key to this. Although there are screening protocols for some very specific eye conditions, such as retinopathy of prematurity, there is no vision equivalent to Universal Newborn Hearing Screening with its related referral guidance. The aims of the research were to identify the pathways for referring blind and partially sighted babies and children from Health to Education; and explore models of effective practice in three VI services, i.e. one inner city authority in the east, one rural authority in the west, and a consortium from the south. The first stage of the research was a literature review in order to identify the pathways for referring blind and partially sighted babies and children from Health to Education. The second part of the study sought to address the second aim: to identify models of good practice in a small sample of local authorities and where there were delays in referring from Health to Education to understand the reasons for these delays. As a result of the study, it is recommended that key factors should be in place to support integrated working practices between Health and Education to facilitate effective referral procedures. These factors should include: • an embedded Early Support or a Team around the Child approach; • established multi-agency groups with a focus on visual impairment; • the appointment of a paediatric ophthalmologist to lead on children's issues; • attendance by VI service staff or ECLO at paediatric eye clinics; • incorporating hearing and vision services into LA sensory support services. These should be set out in written agreed protocols between LA education services and Health

Prison health in NHS Greater Glasgow & Clyde : A health needs assessment 2012

Scotland has one of the highest rates of imprisonment in Western Europe and the prison population is rising [1]. In the last decade the average daily prison population in Scotland increased by 27% [1]. The burden of physical and mental illness in the prison population is high; disproportionately so when compared to the general population [2]. This has variably been attributed to socioeconomic disadvantage and lifestyle and behavioural factors such as substance misuse, smoking and poor nutrition which are common in the prison population [2,3]. Prisoners suffer from multiple deprivation [2,3]. Many are a product of the care system, have experienced physical, emotional or sexual abuse and have difficulties forming and maintaining relationships. Levels of educational attainment are low and unemployment high. Homelessness is common. Prior to incarceration prisoners rarely engage with health care services in the community; during imprisonment demand for health care services is high [3,6,7]. Traditionally health care services in Scottish prisons were provided by the Scottish Prisons Service (SPS). On 1st November 2011 responsibility for the provision of health care to prisoners was transferred from SPS to the National Health Service (NHS). The aim of the transfer was to ensure that prisoners received the same standard of care and range of services as offered to the general population according to need. The guiding principle is that of ‘equivalence’ of care. The aim of this Health Needs Assessment (HNA) was to provide a systematic baseline assessment of the health and health care needs of prisoners in NHS Greater Glasgow and Clyde (NHSGGC) and to identify gaps in the current service provision to inform service future planning and development. It focuses on the two operational publicly owned prisons within NHSGGC: HMP Barlinnie and HMP Greenock. A third prison, HMP Low Moss, falls under the remit of NHSGGC but it was under renovation at the time of this HNA. Information about the prison population was drawn from published literature and reports provided by staff from the Justice and Communities Directorate of the Scottish Government. Information about the prisons from HMP Inspectorate reports, direct observation and interviews with members of staff in each prison. To fully understand the level and nature of existing services a service mapping was undertaken jointly with nominated staff from the prison health teams using direct observation and extensive staff and prisoner interviews and focus groups. Overall the findings are in line with other national and international studies on prison health. Despite characteristic differences between the prisons within NHSGGC there was a high level of consensus amongst both prisoners and staff groups about health needs and priorities. The report acknowledges the thoughtful contribution of prison staff and the positive approach to improving health services that they expressed. This has impacted on the formation of recommendations that both validate existing approaches and identify opportunities and 10 priorities for health gain. In addition to more fundamental changes they identify opportunities for quick wins that do not require significant financial outlay

Review of equality statistics

The Equality and Human Rights Commission (EHRC) commissioned this review as part of its remit to map the equalities landscape across England, Scotland and Wales. The report examines the extent to which data are available for the following equality strands: sex; ethnicity / race; disability; religion or belief; age; sexual orientation; and also for socio-economic status (social class). The extent to which statistics are available at different levels of geographic classification (UK, GB, England, Scotland and Wales and regional and local areas within this) is investigated. The report addresses the ten domains of equality identified in the equality measurement framework in the Equalities Review.1 These are: Longevity Physical security Health Education Standard of living Productive and valued activities Individual, family and social life Participation, influence and voice Identity, expression and self-respect Legal securit

Transition to adult services for children and young people with palliative care needs : a systematic review

Objective: To evaluate the evidence on the transition process from child to adult services for young people with palliative care needs. Design: Systematic review Setting: Child and adult services and interface between healthcare providers. Patients: Young people aged 13 to 24 years with palliative care conditions in the process of transition. Main outcome measures: Young people and their families’ experiences of transition, the process of transition between services and its impact on continuity of care, and models of good practice. Results: 92 studies included. Papers on transition services were of variable quality when applied to palliative care contexts. Most focused on common life threatening and life limiting conditions. No standardised transition programme identified and most guidelines used to develop transition services were not evidence based. Most studies on transition programmes were predominantly condition-specific (e.g. cystic fibrosis, cancer) services. Cystic fibrosis services offered high quality transition with the most robust empirical evaluation. There were differing condition-dependent viewpoints on when transition should occur but agreement on major principles guiding transition planning and probable barriers. There was evidence of poor continuity between child and adult providers with most originating from within child settings. Conclusions: Palliative care was not, in itself, a useful concept for locating transition-related evidence. It is not possible to evaluate the merits of the various transition models for palliative care contexts, or their effects on continuity of care, as there are no long-term outcome data to measure their effectiveness. Use of validated outcome measures would facilitate research and service development