Innovative use of student specialists has revolutionised our schools’ SEND therapy and cut assessment waits to just 10 days

by Conrad Bourne, Mercia Trust

Our post earlier this year, ‘No specialists = no support’ highlighted a severe shortfall in the number of speech and language therapists and other specialists in the educational system, as well as not enough people training, or being supported by their councils to develop. The pandemic has only made this worse, leading to growing numbers of children with SEND not getting the help they need to progress. It also means ever-increasing backlogs in statutory assessments because there aren’t enough specialists to carry them out. It’s a big factor in parents being forced to fight for specialist schools to help their young people achieve their potential.

A campaign about the issue, by a coalition of voluntary organisations, including SNJ, is continuing. It’s led by the Royal College of Speech and Language Therapists, the National Deaf Children’s Society, Speech and Language UK and Voice 21. While the government is increasing funding and places for specialists, training takes time and in the meantime, more are leaving for private practice or retiring.

“…increase the capacity of specialists, including by investing a further £21 million to train two more cohorts of educational psychologists in the academic years 2024 and 2025; and, in partnership with NHS England, as part of our £70 million Change Programme, pioneering innovative practice through running Early Language and
Support For Every Child (ELSEC) pathfinders to improve access to speech and language therapy for those who need it

SEND Improvement Plan P 12

The article caused Conrad Bourne, Director for SEND at The Mercian Trust and Deputy Regional Lead Whole School SEND to get in touch about an innovative project he’s created to speed up access to specialist support for his pupils. He says his scheme has “produced some excellent outcomes for children and young people in our Trust.”

Creative thinking and a freedom to innovate means our children get the support they need -by Conrad Bourne

Student referral to assessment in under 10 days? No, this isn’t something I’ve written on top of a wish list, data from another country or taken from the blue sky policy objectives of a think tank. This is how we meet the needs of our learners at The Mercian Trust group of schools.

Each day the news for parents awaiting clinical assessment for their child appears to get worse. Increased waiting times, rationalised provision. A system creaking to the core, leaving parents caught in the vortex of a postcode lottery of commissioned services, often left reaching for private assessment lifelines. Schools having to find additional money while the local processes grind along in the hope of a resolution at some date in the future.

Moving into a newly-minted role, as a Trust lead for SEND learners, the challenge remained the same, but I knew that a different approach was needed. As the saying goes, “In the confrontation between the stream and the rock, the stream always wins; not through strength, but through persistence.” [H. Jackson Brown Jr.] My original remit was to re-establish locally lost support capacity—and at no additional cost. I’d like to say I had one bright idea, but this is a story about persistence and perseverance, dead ends, wrong turns, but not giving up.

A mutual need sparks a bright idea

Luck or coincidence provided a breakthrough when I met the allied clinical therapies course lead at a local university and we quickly realised we had a common need. For the university, we could offer a new type of contemporary school-based placement, as many therapist students normally undertook these in clinical settings. In return, our schools could get on-site therapy provision to support our students.

Thus began a journey that has facilitated almost 70 student therapists ranging from occupational, speech and language, music, drama and art therapy, children and young person, and mental health nursing. Having the on-site provision also enabled us to embed support and see the longer-term positive impact on students, their confidence, happiness, resilience and well-being, beyond the review, report and discharge that had characterised much of the rationed local service offer.  

We have also learned much about how school systems can build barriers by unpicking why, for some students, school was a place of high arousal and anxiety. We learned that often small adaptations to the school day can make a significant difference to a pupil’s well-being, progress and experience.

Conrad Bourne
Conrad Bourne

More support — but cutting assessment waiting times brought new challenges

Having met the goal of creating improved student support capacity and provision, we could now address the challenge of clinical assessment waiting time. Student therapists had provided a significant improvement in provision and early identification of need, but we recognised that students worked within their training competencies. Paradoxically, the increased support had the knock-on effect of increasing the number of students we were now referring for external assessment, which still had a waiting time of around 14 months!

The only way to address this was to create our own clinical team. Again, not an easy task. Most therapies have staff shortages, but what we had was drive and a vision that enabled me to show clinicians they’d have the chance to develop a holistic student provision from start to end point, where they would be free to innovate develop and carry out new approaches.  

The team of OT, SaLT and music therapists, has had a significant impact. Indeed, our latest data shows that we have been able to reduce referral to assessment timelines from an average 14 months to less than 10 days! Through the processes of clinical triage for referrals and pre-referral consultations, the team has been able to provide essential early advice and guidance, ensuring greater precision in identifying and responding to pupil needs.

We have further to go—and offer a model for others

We have come a long way in a brief period, but we know we have much further to go. Our trust of schools continues to grow, with three large secondary schools recently joining us, almost doubling our student body. Thus, to maintain the sustainability of provision, we are now introducing an additional layer of support provision by developing a team of occupational and speech and language therapy assistants.

Considering some of the challenges faced in local areas around commissioning clinical services, there may be a creative partnership opportunity here for more local authorities and school trusts to develop sustainable support capacity for our most vulnerable students.

Our provision is fairly unique in a mainstream school system. We are learning all the time and shaping what we provide and how we do it. Our achievements have been underpinned by a clinical team that has adapted to, and embraced, working across our schools. Also, our schools have in a short time developed an alignment of systems and processes.

Some thoughts for your own practice

If those reading this are considering pathway, I would offer the following thoughts;

  • Therapy provision will supply a fresh perspective and could be quite different from your existing provisions. Therefore, be adaptive, creative, and prepared to change your working methods.
  • Therapists provide schools with a terrific opportunity to build added capacity but they provide specialist, not general pupil support. Developing a clear understanding of what your pupil’s needs are will enable a greater opportunity for achieving successful outcomes.

About Conrad Bourne

Conrad Bourne is Director for Special Educational Needs, at The Mercian Trust. He is also a Deputy Regional Lead for Whole School SEND, in the West Midlands. He has previously been a senior leader and SENCo. He is also a Specialist Teacher and Assessor (SpLD)

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