Children 'being held back more and more' by NHS 'underinvestment'

Councillors in Wirral have criticised what they see as an “underinvestment” in NHS services to improve waiting times for children with special education needs and disabilities (SEND). Wirral Council is currently trying to improve services for those with SEND following a government notice issued earlier this year.

The Department for Education published an improvement notice on May 15 ordering the local authority to take action due to “poor progress” in addressing 10 areas of "significant concern” highlighted in a 2021 inspection by Ofsted and the Care Quality Commission. The 2021 report said the council had been “too slow,” its plans lacked “sufficient detail” while families and carers said “the system is broken.”

Wirral Council has been told it should have improved services by October 2025 or sooner but the notice will not be withdrawn “until sufficient progress has been evidenced.” If the council does not comply with the government’s notice, this could lead to government intervention to direct the council on how to improve services.

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However for things to improve, more investment is needed both on the council side but also in the NHS to boost the size of the teams needed to assess whether a child needs extra support in school. The local authority recently invested £1.1m into SEND services but criticisms continue to be levelled at NHS Cheshire and Merseyside for its rejection of an additional request for funding.

Councillors previously said they were “disappointed” that the Cheshire and Merseyside Integrated Care Board, an NHS body, had not agreed to extra funding to support the council to cut waiting lists. Wirral Council has raised this with NHS England and the Department for Health after the ICB refused a request for funding as it “cannot worsen its financial position.”

At a children's and education committee meeting on September 23, Cllr Chris Carubia, vice-chair of the committee, pointed to figures presented to the committee that showed the level of investment the NHS is planning to put into neurodevelopmental services for families needing help with SEND issues.

This showed that for a backlog in cases to be sorted in a year, this would cost the Wirral University Teaching Hospitals NHS Foundation Trust just under £1.3m. However, over two years this would cost £650,743 a year, while the Wirral Community Health and Care NHS Foundation Trust has requested £533,761 until the end of the year.

Cllr Carubia questioned why addressing the backlog over two years was being considered given some children have been waiting for 12 or 18 months, adding: “That's actually holding back the children more and more when you have got kids on these lists that are 12 to 18 months ahead. It galls me to see that the NHS has gone for a smaller cost and a longer time for these kids.”

Other reports said £250,000 more will be needed to tackle waiting times in speech and language therapy while an extra £200,000 is needed for council-run educational psychology services. James Backhouse said the council had invested significantly in its educational psychology service, some of which comes from the £1.1m approved by councillors on September 11.

In response to Cllr Carubia's comments, Cllr Stephen Bennett said it was a good point and something the council needed to look at, adding: “I think it comes back to what I was saying before about the underinvestment from the NHS partners which is a concern.”

Council officers said the local authority had made progress since the notice was issued earlier this year and it had secured significant funding from the government to improve services. Officers also said assessments for Education, Health and Care plans were expected to rise to over 1,200 every year but a new and expanded team is expected to be in place by January.

Simon Banks, NHS Cheshire and Merseyside’s Place Director for Wirral, said: “Working alongside local partners as part of a whole system approach, we continue to be committed to making improvements so that Wirral’s children and young people have access to high-quality SEND services and support.

“As well as making better use of existing resources, we've provided additional investment into Wirral's Children and Young People's SEND services and are introducing a new model of care to reduce the number of patients waiting for assessment and waiting times and are already seeing early signs of improvement from this work.”

Elsewhere during the meeting, councillors reviewed reports about the children under the council’s care as well as attendance rates in schools. Officers also said they believed no children under the local authority’s care were currently homeless, a statistic praised by councillors.

Wirral Council is also looking to continue to promote and expand its foster case service in an effort to cut down costs for children under its care. There are currently 747 children in care but 92 children are currently in residential care is leading to a budget overspend of £5.8m.

The council had planned its budget with an expectation there would be a maximum of 68 children in residential care placements. Some of these placements cost thousands of pounds per week.