Posted on: 30 November 2023
Mindworks Surrey, alongside Surrey Heartlands ICB and Surrey County Council, would like to update you on the current neurodevelopmental (ND) diagnostic assessment pathway for children in schools.
In October 2022, we piloted some service changes intended to be for an initial 6-month period followed by a review. At this time the Assessment of Need (AoN) form was distributed to schools accompanied by practical help, advice, access to consultation, information, and resources. The changes were intended to ensure that children and young people's needs were identified as early as possible so that the child, their family, and support network including education would receive support early on. Our evaluation of the pilot has identified that only two-thirds of the AoN requests received indicated that there may be a neurodevelopmental need. The audit also identified we could improve the extent to which an “assess, plan, do” approach had been implemented.
Since the launch of the AoN pilot, the team has received over 4000 requests for support. Total demand significantly exceeds the team’s contracted capacity. Alongside this, there has been an unexpected reduction in the workforce. We recognise that this situation is unsustainable, and we need to make some changes.
Children and young people’s needs should be appropriately supported, and this requires a range of actions to be taken wherever possible within schools, by families, and by healthcare professionals. As commissioners of this service, Surrey Heartlands and Surrey County Council have agreed to work with Mindworks Surrey, and other stakeholders including Surrey schools and families, to develop an improved pathway that helps to avoid children and young people across Surrey experiencing lengthy waits, and – by drawing on skills and capacity across the wider system – reduces demand for the ND diagnostic service to a level that is manageable for Mindworks to deliver.
Additionally, you will also be aware there is a national shortage of ADHD medication which we are now expecting to continue into at least April 2024, and national guidance is not to initiate new patients on ADHD medication until supply issues are resolved. There is currently an approximate 1 year’s wait for initiation of medication.
While the new pathway is developed with all key partners across education, health, and children's social care services, we are unable to accept any new AoN forms. We recognise this is an exceptionally difficult position to be in and not one we would want for our children, young people, and their families.
We have recently communicated to schools across Surrey to update them on the developments and highlight the contingency we have put in place to support them. Schools that are supporting a child or young person who is exhibiting challenging behaviours at school and is at risk of exclusion can contact the team on 0300 222 5856, to request a consultation appointment to discuss the case. Two pupils from each school (to ensure fair distribution of slots across all schools) can be discussed in each one-hour consultation appointment, and we have asked they prioritise the pupils of most concern for these sessions. We will also offer consultations to parents of young people whose school attendance is below 70% (this would trigger a safeguarding referral), that they've been referred or self-referred to Early Help, and engaged with any support offered, and where there is evidence that school and parent have worked together to support the young person back into school, but haven't been successful.
For requests for support made prior to September, the team are working their way through these and will be in touch in due course with the next steps. For those who have already implemented strategies and interventions, completed the forms, and are ready to make a request for support, please continue to utilise strategies and interventions to help meet the identified needs. We would recommend that you take a look at our Neurodevelopmental strategies and resources section on the Mindworks Surrey website for more information. These strategies and interventions are developed by our clinicians to support families and have recently been updated.
The Learners' Single Point of Access (L-SPA) offers help and support if you have a concern about the development and/or learning needs of a Surrey child. Both parents and practitioners working with children in Surrey are welcome to call the L-SPA. It is open from 9 am to 5 pm, Monday to Friday, all year round (except Bank Holidays) on 0300 200 1015 - https://www.surreylocaloffer.org.uk/lspa
If you are supporting a child who has severe mental health needs, you can continue to make requests for support via the online referrals portal - Secure Referral Forms by RIVIAM Digital Care (sabp.nhs.uk).
For families and carers, our out-of-hours advice line for ND runs from 5 pm to 11 pm, seven days a week, 365 days a year, and can be reached at 0300 222 5755. We also have a free 24/7 mental health crisis line for children aged from six years, young people, and their families or carers who are in crisis. The Crisis Line can be contacted on 0800 915 4644 to talk with a professional who will provide advice, support, and signposting to a range of community services. It’s open all day and all night, seven days a week.
This decision has not been an easy one to take and as a system we understand it is an exceptionally challenging situation, and collectively, we are working hard to ensure the new pathway is introduced as soon as possible.
We will provide you with a further update in the new year.