SEND needs assessment - Cornwall Council · 2020-01-24 · strategic decisions, defining priorities and the allocation of resources to make the greatest impact. In Cornwall the SEND

Special Educational

Needs and Disabilities

Needs Assessment

Cornwall & Isles of Scilly

18/12/18 V0.9 Final

JSNA Special Education Needs and Disabilities 2

18/12/18 V 0.9 Final

Current Document Status

Version 0.8

Approving body SEND Board

Date Date of formal approval (if applicable)

Responsible officer

Review date

Location

Insert web address where document can be accessed.

Version History

Date Version Author/Editor Comments

08/06/2016

0.1

Linda Howarth

Working Draft

28/09/2016

0.2

Linda Howarth

Updated data

15/10/2017

0.5

Brian O’Neill

Update for SEND performance board

30/05/2018

0.7

Julie Moseley

Update from partners

07/09/2018

0.8

Brian O’Neill

Sign off changes from partners

18/12/2018

0.9

Brian O’Neill

Final amendments

Comprehensive Impact Assessment Record

Date Type of assessment conducted

Stage/level completed (where applicable)

Summary of actions taken decisions made

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Initial / Full

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NFA

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Joint Strategic Needs Assessment Special Educational Needs and Disability

Executive Summary 6

Recommendations 10

Scope 12

Purpose of Cornwall and the Isles of Scilly special education needs

and disabilities joint strategic needs assessment

Context for the JSNA

National Context 13

Definition of special educataional needs and disabilities 16 Special educational needs 16

Disability 17

What’s happening in Cornwall and the Isles of Scilly? 19 Cornwall context 20

Isles of Scilly context 20

Clinical commissioning group 21

Population profile 21

Trend overview (0-25) 21

Number of children and young people by age (0-25) 21

Births 22

Migration 24

Total number of pupils 25

Prevalence of SEND in Cornwall and the Isles of Scilly 26

Limiting long-term health problems and disabilities 26

Disability Living Allowance (DLA) 26

Prevalence estimates 29

Prevalence of SEN in Cornwall and the Isles of Scilly 29

Types of special educational need 31

Specific learning difficulty 31

Moderate learning difficulty 31

Profound and multiple learning difficulty 32

Social, emotional and mental health difficulties 32

Speech, language and communication needs 33

Hearing impairment 34

Visual impairment 35

Multi-sensory impairment 35

Autistic spectrum disorder 36

Other difficulty/disability 37

Educational attainment 37

Elective home education 42

Absences and exclusions from education 43

Youth offending 43


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NEET 44

Vulnerable children 45

Children on a child protection plan 46

Continuing care needs 47

Prevalence of children with SEN in areas of higher deprivation 47

Disability by ethnicity (aged 0-15), Census 2011 48

School census ethnicity – Cornwall state-funded primary, secondary and special

schools 48

SEND prevalence and language 48

SEND prevalence and gender and age 49

SEND prevalence and religion 50

SEND prevalence and gender reassignment 50

Health determinants 51

Older mothers 51

Young mothers 51

Smoking during pregnancy 52

Maternal diet 53

Maternal obesity 53

Low birth weight 53

Gestational age 54

Screening and immunisation 55

Antenatal and new-born screening 55

Child health records department 56

Vaccinations 57

Information from the health visitor needs assessment 58

Injuries to children and young people 59

Child poverty 61

Service provision – health 61

Health visiting 62

Community paediatrics 63

Speech and language 63

Community therapy department 64

CAMHS 64

Transition to adult mental health services 65

Special parenting service 67

Autistic spectrum disorder assessment team 67

Service provision – local authority 68

Transport 68

Equipment 69

Reccomendations 70


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Appendices 71

Appendix 1 Legislative and policy context Appendix 2 Risk Factors

Appendix 3 Population projections

Appendix 4 DLA claimants Appendix 5 Trends in types of SEND Appendix 6 Absenteeism and exclusions

Appendix 7 Prevalence of SEND by deprivation Appendix 8 SEND and ethnicity

Appendix 9 Prevalence of SEND by gender, age and religion


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Executive summary


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Scope

Purpose of Cornwall and the Isles of Scilly’s special

education needs and disabilities joint strategic needs

assessment

This needs assessment focuses on those children and young people in

Cornwall and the Isles of Scilly with an identified special educational need,

including those who have an education, health and care (EHC) plan, and

the families/carers of all the children and young people.

Children and young people with special educational needs and/or

disabilities (SEND) are a diverse group; Part 3 of the Children and

Families Act (2014)1 sets out the need for agencies and families to work

together, to ensure that children and young people receive support that

is timely and proportionate to their need.

This needs assessment aims to collate and analyse both national and local

information and data on the needs of children and young people with

SEND, to create a more comprehensive picture to support effective

activity to meet needs in Cornwall and the Isles of Scilly.

Context for the JSNA

The purpose of this needs analysis is to bring together and analyse all the

available relevant health, education and care data about children and

young people in Cornwall and the Isles of Scilly who are aged 0-25 and

have SEND.

The Joint Strategic Needs Assessment (JSNA) informs understanding of

needs in Cornwall and the Isles of Scilly. This document will inform joint

strategic decisions, defining priorities and the allocation of resources to

make the greatest impact.

In Cornwall the SEND JSNA is a key resource that informs the Cornwall

area self- evaluation for special educational needs and disability. The self-

evaluation is annually updated with the identified priorities for

development being considered by the multi- agency SEND Board, and

addressed in Cornwall’s SEND Strategy. This process enables partners

collectively to agree priorities and deliver change. Both the SEND self-

evaluation and the SEND Strategy are available on the Cornwall Council

website.

1 Children and Families Act (2014) http://www.legislation.gov.uk/ukpga/2014/6/contents/enacted

http://www.legislation.gov.uk/ukpga/2014/6/contents/enacted


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In the Isles of Scilly the JSNA feeds into the SEND Programme Board, and

raises key issues for consideration.

The main objectives of this needs assessment are:

To provide an understanding of the education, health and social

care needs of children and young people with SEND, at local authority level and across Cornwall and the Isles of Scilly;

To understand both current and projected needs for the next 5

years;

To understand the prevalence of specific disabilities/needs;

To raise key issues for consideration by Cornwall’s SEND Board, and

the Isles of Scilly SEND Programme Board.

National Context

Key Messages from the Children and Families Act, 2014

Children, young people and their families must be involved

in discussions and decisions about their care and

education.

Local authorities, health and care services are required to

co-operate and jointly commission the services needed.

There must be a local offer, which must be kept under review.

There must be clear information about available services.

Statements of special educational need were replaced by

education, health and care plans (EHC plans), which cover

ages 0-25.


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What do families tell us?

The 2018 SEND survey followed up on the 2016 survey in order to get an

up-to-date summary of people’s views, and measure change to date.

There was a significant increase in the number of respondents in 2018

compared with 2016. Respondents represented a wide range of special

educational needs, and came from a wide geographic spread of the

county.

A total of 566 people took part in the surveys or young people’s

engagement activities:

53 (30 in 2016) young people completed the young people’s

survey, and 115 took part in engagement sessions: one in a special

school, and three in local FE colleges.

398 (200 in 2016) people completed the surveys.

141 (100 in 2016) parents or carers, or family members and children

responded to the survey. For 59% of the respondents, their child’s educational needs included autism.

Key messages from the 2018 Cornwall survey of the views of families:

54% of families rate the current provision as good or very

good – this is up from 41% in 2016.

60% agreed that there were some high quality services –

this is up from 56% in 2016.

69% agreed that families are recognised as key partners,

making a difference to arrangements for children and

young people – in 2016 this figure was 24%.

77% of respondents agreed that there is much more to be

done to improve services and processes about SEND.

70% felt that outcomes for the children and young people

with the most complex needs need to be clearer in EHC

plans.

The importance of ease of access to information about meeting individual needs, and what support children, young people and their families can expect.

For the Isles of Scilly the Parent Carer Forum is the forum

that represents families; their views have not been canvassed

recently.


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115 young people took part in group engagement sessions about ‘Feeling

included in trips, clubs and activities’ and ‘Getting ready for adulthood’.

There was some positive feedback that the young people really enjoyed

having the opportunity to raise their thoughts and ideas for improvement.

Young people told us they feel happy and included at college: ‘I feel

included when the lessons include teamwork’, ‘I really enjoy college’, ‘I

feel happy in class’.

Based on feedback from young people, more resources will be developed to support inclusion of children and young people on school and college trips.

The feedback from young people will be used to develop resources to prepare young people for adulthood from an early age.


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Definitions of special educational needs and disability

Special Educational Needs (SEN)

Special educational needs are defined in the Special educational needs

and disability code of practice: 0 to 25 years, 20152 as follows:

A child or young person has SEN if they have a learning difficulty or a

disability which calls for special educational provision to be made for him

or her.

A child of compulsory school age or a young person has a learning

difficulty or a disability if he or she:

• has a significantly greater difficulty in learning than the majority

of others of the same age, or

• has a disability which prevents or hinders him or her from making

use of facilities of a kind generally provided for others of the same

age in mainstream schools or mainstream post-16 institutions.

Special Educational Provision means:

• For children aged two or more - educational or training provision

that is additional to or different from that made generally for

other children or young people of the same age by mainstream

schools, maintained nursery schools, mainstream post-16

institutions or by relevant early years providers.

• For a child under two years of age - educational provision of any

kind.

Paragraphs 6.27 – 6.35 of the 0-25 SEND Code of Practice3 expand on

this definition setting out four specific areas of SEN:

Communication and interaction – for example, where children

and young people have speech, language and communication

difficulties which make it difficult for them to make sense of

language or to understand how to communicate effectively and

appropriately with others.

2 Department for Education, Special educational needs and disability code of practice: 0 to 25 years,

January 2015, p15-16 3 Department for Education, Special educational needs and disability code of practice: 0 to 25 years,

January 2015, p15-16


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Cognition and learning – for example, where children and young

people learn at a slower pace than others their age, have difficulty in

understanding parts of the curriculum, have difficulties with

organisation and memory skills, or have a specific difficulty affecting

one particular part of their learning performance such as in literacy

or numeracy.

Social, emotional and mental health difficulties – for example,

where children and young people have difficulty in managing their

relationships with other people, are withdrawn, or if they behave in

ways that may hinder their and other children’s learning or that

have an impact on their health and wellbeing.

Sensory and/or physical needs – for example, children and

young people with visual and/or hearing impairments, or a physical

need that means they must have additional ongoing support and

equipment.

Many children and young people may have SEN across more than one of these areas.

National reporting is against a defined set of primary needs at a more

detailed level than these four areas of SEN.

Disability Children and young people who have SEN may also have a disability.

Disability has been defined by a number of statutory organisations but

there is no one commonly agreed definition. The SEND Code of practice

utilises the Equality Act 20104 definition which defines disability as follows:

A person is disabled, if he or she has a physical or mental impairment that

has a ‘substantial’ and ‘long-term’ negative effect on his or her ability to do

normal daily activities:

• ‘substantial’ is more than minor or trivial - e.g. it takes much

longer than it usually would to complete a daily task like

getting dressed

• ‘long-term’ means 12 months or more - e.g. a breathing

condition that develops as a result of a lung infection.

4 Equality Act 2010 http://www.legislation.gov.uk/ukpga/2010/15/section/6 - accessed May 2017

http://www.legislation.gov.uk/ukpga/2010/15/section/6


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In health, the definition of disability used is usually that of the World

Health Organisation (WHO)5 where it is explained that disability is an

umbrella term, covering impairments, activity limitations, and

participation restrictions, and is not simply a health problem. Specifically

it is stated that:

Disability is an umbrella term, covering impairments, activity limitations,

and participation restrictions:

• An impairment is a problem in body function or structure;

• An activity limitation is a difficulty encountered by an individual

in executing a task or action; • A participation restriction is a problem experienced by

an individual in involvement in life situations.

The risk factors associated with childhood disability are described in appendix 2.

5 WHO http://www.who.int/topics/disabilities/en/

https://www.who.int/topics/disabilities/en/


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What’s happening in Cornwall and the Isles of Scilly?

Key messages:

The geographical location of Cornwall and the Isles of

Scilly impacts on access to services and provision that

would be more readily available in parts of the country

with a higher population density

A high proportion of children and young people have their

needs met by mainstream schools and settings

Cornwall is a low-funded local authority, ranked 144th out of

150 per person for high needs block funding

The Ofsted and CQC area SEND inspection of Cornwall in 2017

found that ‘leaders are ambitious to improve action for

children and young people who have SEND and are delivering

improvements despite reducing resources and increasing

demand for services’. It also found that plans are in place to

improve autistic spectrum disorder provision, awareness and

assessment; CAMHS arrangements; children with SEND who

are electively educated at home; occupational therapy

provision; opportunities for supported employment; and

schools’ approaches to meeting needs at SEN Support

The Isles of Scilly are similarly disadvantaged in terms of access to

medical services. Families report that consultations with mainland

professionals frequently involve overnight stays and relatively

complex travel arrangements.

The islands have one school for students aged 3-16. The school is

committed to meeting the needs of all the children in the locality in the

knowledge that any appropriate mainland provision would require a

residential setting.


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Cornwall context

The population of Cornwall has been growing steadily since the 1960s.

Current estimates suggest that Cornwall’s population stands at around

553,687 and it is estimated to reach 635,900 by 20376, an increase of

82,213 (14.8%). This growth is predicted to be driven by migration,

largely due to more people moving in, but also importantly due to a

decline in the number of people leaving Cornwall.

A statistical summary for Cornwall and the Isles of Scilly with population

projections is provided later in this document.

Isles of Scilly context The Isles of Scilly comprise over 200 granite islands scattered across 200

km², set out in the Atlantic some 45 km south-west of Land’s End. Five

islands are permanently inhabited (St Mary’s, St Agnes, St Martin’s,

Tresco and Bryher) and each of these has their own unique character and

distinct identity. The occupied islands cover a total area of just over 14

km².7

The Islands support a resident population of around 2,3248. The

population of the islands declined in the 1980s, but has been slowly

increasing since then, with nearly all of the growth being on St Mary’s.

It is estimated that 1,758 live on St Mary’s, 210 on Tresco, 150 on St

Martin’s and 206 on Bryher and St Agnes. Population projections for

Scilly suggest an overall decline in population over the next 20 years with

estimates predicting a population of 2,122 by 2037 – a decline of 200

(8.7%).

The Council of the Isles of Scilly is an independent unitary authority and

oversees the administration of services. However, due to efficiencies a

number of services are jointly commissioned with Cornwall Council and

delivered by Cornwall Foundation Trust.

62014-based subnational population projections and 2015 Mid Year Population Estimates, Population

Estimates Unit, ONS 7 Natural England: National Character: Area Profile 158 Isles of Scilly,

publications.naturalengland.org.uk/file/6631520605306880 8 2015 mid-year population estimates, Population Estimates Unit, ONS


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Clinical Commissioning Group

Clinical commissioning groups (CCGs) have responsibility for

commissioning health services. Within Cornwall and the Isles of Scilly

there is one CCG, NHS Kernow.

Population profile

Trend overview (0-25)

The 0-25 year old group is expected to increase by nearly 14% by 2030,

which equates to an additional 20,500 children and young people. A

number of these children and young people will have additional and special

needs that require support9.

Historically Cornwall has experienced high levels of outward migration of

people between the ages of 16-24. However, the expansion in the higher

education infrastructure and better employment prospects has led to a

reduction in the number of young people leaving Cornwall and increasingly

greater numbers of young people moving to Cornwall. These trends are

neither fixed nor guaranteed, and are fragile but account in some part for

the increase in cohorts aged 16-24 since 2001.

Details of the population projections to 2030 can be found in appendix 3.

Number of children and young people by age (0-25)

In 2016 there were 148,926 children and young people aged 0-25 living in

Cornwall and the Isles of Scilly. Cornwall and the Isles of Scilly have a

lower proportion of children and young people than the average for

England; overall 27% of the population of Cornwall and the Isles of Scilly is

aged 0-25 compared with 30% in England.

9 ONS Migration Tool 2005-15. Migration Statistics Unit ©Crown Copyright 25th August 2016, and

Cornwall Small Area Population Projections, Edge Analysis


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Figure 3: 0-25 Age Structure for Cornwall and Isles of Scilly, and England, 2016 Mid-Year Estimates, ONS

Births The number of births has grown steadily in Cornwall and the Isles of Scilly

since 2001 with 4,463 live births in 2001 compared with 5,447 in 2014,

almost 1,000 higher.

However, there were reductions in both 2015 (to 5,417) and 2016 (to

5,313), with a further reduction in 2017 to 5,162.

6 4 2 0 2 4 6

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Cornwall & IoS Males England Males Cornwall & IoS Females England Females

23 JSNA Special Education Needs and Disabilities

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Figure 4. Births and Females of Childbearing Age (Cornwall) 1981-2031

The chart above reflects national patterns, which saw an overall fall in birth

rates during the 1990s due to declining fertility among women in their

twenties. In contrast, the overall rise in births since 2001 has been driven

by a faster increase in birth rates for women in their thirties and forties

(continuing the long-term trend that started in the late 1970s) and

increasing births among women in their 20s.

Older and younger parents are more at risk of complications that can result

in childhood disability. Babies born to women under 20 are more at risk of

poor nutrition and poor placental transfer of food and oxygen, whereas

those born to older mothers are more likely to have chromosomal

abnormalities.

The trend in Cornwall and the Isles of Scilly shows that the actual numbers

of births to women aged 20 to 24 has decreased between 2011 and 2016

by more than 26%; births to 35 to 39 year olds increased between 2009

and 2016 by 11%, with all other age groups remaining fairly static. The

most recent data shows that women over the age of 40 represent 3.8% of

all births in Cornwall and the Isles of Scilly10

The following chart shows the rate of live births in Cornwall and the Isles of

Scilly by age of birth mother (per 1,000 women).

10South West Clinical Network Maternity Dashboard (2018) Online

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Projected figures 2018 - 31


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Figure 5. Live birth rates by age per 1,000 women

Migration

According to the 2011 census11 21,205 persons, of whom 2,642 were aged

1-15, moved into Cornwall and the Isles of Scilly from other areas; 14,321

persons moved out, 1,431 of whom were 1-15 years old. Overall, this

migration resulted in 6,884 more persons in Cornwall and the Isles of

Scilly. Movement within Cornwall and the Isles of Scilly accounted for

43,263 persons, of whom 8,252 were in the 1-15 year old bracket.

11

www.nomisweb.co.uk

45+

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http://www.nomisweb.co.uk/


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Migration of people into and out of Cornwall

Total number of pupils

The total number of pupils in schools in Cornwall and the Isles of Scilly are shown below:

Total Pupils in Cornwall and the Isles of Scilly12

2011 2012 2013 2014 2015 2016 2017

Cornwall 72,374 72,399 72,550 72,708 72,927 73,508 74,193

Isles of Scilly 274 277 273 274 274 279 266

NOTE: Includes maintained and direct grant nursery schools, maintained primary and secondary schools, city technology colleges, university technology colleges, studio schools, primary and secondary academies including free schools, special schools, special

academies including free schools, pupil referral units, alternative provision academies

including free schools and independent schools.

There are also children and young people who are electively educated at

home. At the beginning of 2018, 1,077 children and young people were being educated at home; 52 (4.8%) of these had an Education Health Care

plan in place.

On the Isles of Scilly, there are fewer than five pupils who are electively educated at home; none have been identified with SEND.

12

Department for Education https://www.gov.uk/government/collections/statistics-special-educational-

needs-sen

https://www.gov.uk/government/collections/statistics-special-educational-needs-sen



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Prevalence of SEND in Cornwall and the Isles of Scilly There are a number of different sources available to estimate the number

of children with special educational needs and disabilities. These include

pupils with special educational needs (SEN), children who had limiting long

term illness at the time of the 2011 Census, and those receiving Disability

Living Allowance (DLA), alongside various prevalence estimates.

There is no gold standard disability data source and no single definitive

measure of disability or chronic illnesses. Estimates of disability prevalence

and chronic illness vary between surveys according to the definitions of

disability that are used.

The various sources provide a very wide range of estimates, and children

and young people with SEND are not one group within the population – for

example, not all SEN children have disabilities and not all children with

disabilities will have SEN.

Limiting long term health problems and disabilities

The 2011 Census asked the question ‘Are your day-to-day activities limited

because of a health problem or disability which has lasted, or is expected

to last, at least 12 months?’ Responses were for all members of the

household. This is a very broad definition and is likely to include some,

but not all children, with special educational needs as well as those with

disabilities.

In 2011 there were 6,945 children and young people aged (0-24) whose

day to day activities were reported to be limited by a long-term health

problem or disability in Cornwall. This represents 4.9% of the 0-24 year

old population, which was higher than the regional and national average of

4.3%13.

Disability Living Allowance

To qualify for DLA, a child must have walking difficulties or physical or

mental disability sufficiently severe to need a lot more help or supervision

than other children of the same age with activities such as washing,

dressing or communicating. In order to determine whether a child is

eligible to receive DLA, they must have an assessment of their disability or

a statement from their GP14. These are quite stringent criteria, and it is

13

2011 Census © ONS 14

Gov.uk (2016) Disability Living Allowance (DLA) for children, Available:


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likely that some children who fail to qualify for DLA might still have special

educational needs. It is also likely that some families who would be eligible

for DLA may not be claiming it. This means that DLA only provides a

partial picture of children with special educational needs and disabilities.

In February 2015, there were 4,570 children and young people aged 0-24

claiming DLA in Cornwall15. This represents 3.1% of the 0-24 year old

population16.

The number of children and young people receiving DLA in Cornwall

increased by nearly 300 people or 6.1% between February 2012 and

February 2015, but reduced again in February 2016. During the same

period, the total 0-24 year old population in Cornwall increased at a

much slower rate, of 2.1% or 3,100 people17.

The following diagram breaks down the number of children and young

people receiving DLA by condition. It shows that learning difficulties is

the most common condition accounting for 44% of claimants.

https://www.gov.uk/disability-living- allowance-children/eligibility 15

Disability living allowance by disabling condition, DWP, [NOMIS 2016] 16

2014 Mid-Year Population Estimates © ONS 17

2012 and 2014 Mid-Year Population Estimates © ONS

https://www.gov.uk/disability-living-allowance-children/eligibility

https://www.gov.uk/disability-living-allowance-children/eligibility


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Disability Living Allowance is a benefit paid by the Department for Work

and Pensions to people aged under 65years ‘With a physical or mental

disability or both or with a disability that is severe enough to require help

caring or have walking difficulties’.

Disability Living Allowance is paid whether or not the person is in

employment. In Cornwall in February 2017 there were 24,290 people

claiming disability living allowance, 4,570 (19%) were in the age group 0-

24 years.

Further information about DLA claimants can be found in appendix 4.


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Prevalence estimates

Population forecasts over the next 20 years based on Office of National

Statistics projections can be used as a rough proxy for increases in the

disabled population, although they do not take into account higher survival

rates of babies and children with congenital anomalies, trauma or illness; a

trend towards more high risk pregnancies; and also more rigorous

diagnosis.

The number of children with disability may be expected to rise from 5,927

in 2013 to 6,486 in 2021, due to population increase alone, assuming

prevalence remains constant.

Prevalence of SEN in Cornwall and the Isles of Scilly

Children and young people identified by their educational setting as having

special educational needs are described as being at SEN Support. A small

proportion of children and young people have more complex special

educational needs. Upon request an education, health and care needs

assessment can be undertaken that may result in an education, health and

care plan being issued.

Before September 2014 pupils with complex needs could have a statement

of special educational need. After this date, education, health and care

(EHC) plans were introduced nationally. All statements were replaced by

EHC plans by April 2018. Therefore between these two dates, both types of

arrangement were in place for children and young people with complex

needs.

In 2017 there were 74,193 pupils in Cornwall. The percentage of pupils in

2017 who had an EHC plan was 2.4%18. The percentage of pupils in the

Isles of Scilly who have an EHC plan was 3.4%. For comparison, the

percentage for England was 2.8%, and for the South West was 2.7%.

Cornwall is slightly lower than both England and the South West, whereas

the Isles of Scilly are higher than both. However, small numbers of pupils

with EHC plans on the Isles of Scilly means that a change of one child can

make a big difference to the percentage.

Trends in numbers of children and young people with statements of SEN

and EHC plans are generally understood to be associated with changes in

18

Local Authority Interactive Tool https://www.gov.uk/government/publications/local-authority-

interactive-tool-lait

https://www.gov.uk/government/publications/local-authority-interactive-tool-lait



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legislation rather than changes in need of the population. However, for

completeness, details of changes in numbers of children and young people

with statements and EHC plans are shown in appendix 5.


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Types of special educational needs

In addition to the four main areas of special educational needs as set out in

the SEND Code of Practice 2015, national government collects data relating

to individual children and young people’s primary need. For a large

proportion of individuals, a primary need cannot reflect the full range of

needs that an individual has.

There are 449,905 (5.2%) of pupils in England with a learning difficulty.

For Cornwall, this figure is 3,671 (4.9%). Four types of learning difficulty

are recognised; these are specific, moderate, severe, and profound and

multiple learning difficulty.

Specific learning difficulty

In England as a whole, 32.6% of pupils with a learning difficulty have a

specific learning difficulty (SpLD), with the majority (84,143) attending

state-funded secondary schools, 61,123 attending state-funded primary

schools, and 1,607 attending state-funded special schools.

In Cornwall, 1,188 pupils have a SpLD as their primary need. This is

32.4% of all pupils with a learning difficulty, and 1.6% of all pupils.

On the Isles of Scilly the numbers are small so it is difficult to draw any

conclusions. However, there are 17 children identified as having a learning

difficulty, all of whom attend state-funded mainstream school. Children

identified as having a specific learning difficulty make up the majority of

children and young people with recognised learning difficulties (65%) – the

remainder have moderate learning difficulties. Pupils with a specific

learning difficulty make up 4.1% of all pupils on the Isles of Scilly.

Moderate learning difficulty Pupils with moderate learning difficulty (MLD) make up the largest

percentage of pupils with a learning difficulty in England; this is 259,713

(57.7%) pupils.

MLD also makes up the majority of pupils with a learning difficulty in

Cornwall. There are 2,071 pupils with MLD. This is 56.4% of all pupils

with an identified learning difficulty, and 2.8% of all pupils.

On the Isles of Scilly, six (35%) pupils with an identified learning difficulty

have a moderate learning difficulty. This is 2.3% of all pupils.


18/12/18 V 0.9 Final

Profound and multiple learning difficulty In England 10,981 (2.4%) of pupils with a learning difficulty have a

profound and multiple learning difficulty (PMLD). The majority (8,774)

attend state-funded special schools, although there are 1,783 attending

state-funded primary schools, and 424 attending state-funded secondary

schools.

In Cornwall there are 88 pupils with PMLD. This is 2.4% of all pupils with

an identified learning difficulty, and 0.1% of all pupils.

Number and percentage of pupils with learning disability/learning

difficulty 201719

Specific

Learning Difficulty

Moderate

Learning Difficulty

Severe

Learning Difficulty

Profound &

Multiple Learning

Difficulty

Number % Number % Number % Number %

STATE-FUNDED PRIMARY SCHOOLS

ENGLAND 62,123 9.7 147,684 23.3 4,346 0.7 1,783 0.3

SOUTH WEST 7,188 11.7 12,336 20.1 484 0.8 189 0.3

Cornwall 454 8.4 1,172 21.7 131 2.4 20 0.4

Isles of Scilly 0 0 0 0 0 0 0 0

STATE-FUNDED SECONDARY SCHOOLS

ENGLAND 84,143 21.1 95,738 24.0 2,020 0.5 424 0.1

SOUTH WEST 10,284 25.7 6,232 17.0 219 0.5 18 0.0

Cornwall 734 19.7 889 23.9 65 1.7 4 0.1

Isles of Scilly 11 26.8 6 14.6 0 0 0 0

STATE-FUNDED SPECIAL SCHOOLS

ENGLAND 1,607 1.4 16,291 14.5 25,972 23.2 8,774 7.8

SOUTH WEST 90 1.0 1,252 14.1 2,324 26.2 725 8.2

Cornwall 0 0 10 2.7 128 35.0 64 17.5

Isles of Scilly 0 0 0 0 0 0 0 0

Cornwall has particularly high percentages of children and young people

who have severe learning difficulty identified as their primary need.

Social, emotional and mental health difficulties

In England there are 186,793 (2.2% of all pupils, and 15% of all pupils

with an identified SEN) pupils with social, emotional and mental health

difficulties. The majority of these pupils attend state-funded schools;

99,475 (53.3%) attend primary schools and 73,325 (39.3%) secondary

19

Special educational needs in Cornwall January 2017 Government Statistics




18/12/18 V 0.9 Final

schools. There are also 13,993 (7.5%) pupils with these difficulties who

attend state-funded special schools.

1,857 (2.5% of all pupils, and 18.6% of all pupils with an identified SEN)

pupils within Cornwall have a social, emotional and/or mental health

difficulty as their primary need; this is a higher rate than both the South

West and England. Four pupils (1.1%) attend special schools, whilst the

figure is 12.5% in England. This may be a consequence of the types of

state-funded special schools in Cornwall. In Cornwall 1,038 (19.2%)

attend primary schools, and 815 (21.9%) secondary schools. On the Isles

of Scilly, three pupils were identified as having social, emotional and

mental health difficulties in 2017.

It should be noted that social, emotional and mental health difficulties was

added as a new type of classification in 2015; the previous classification of

behaviour, emotional and social development was removed. Behavioural,

emotional and social development and social, emotional and mental health

are not strictly equivalent descriptors.

Number and percentage of pupils with social, emotional and

mental health difficulties 20172021

ENGLAND SOUTH WEST Cornwall IoS

No % No % No % No %

STATE-FUNDED PRIMARY

SCHOOLS

99,475 15.7 11,517 18.8 1,038 19.2 0 0.0


73,325 18.4 8,121 20.3 815 21.9 3 7.3


13,993 12.5 1,302 14.7 4 1.1 0 0.0

Speech, language and communication needs

In England 234,076 (2.7%) of pupils have a speech, language and/or

communication need. Over 75% of these children, 183,769 (78.5%),

attend state-funded primary schools, 43,143 (18.4%) state-funded

secondary schools, with a further 7,164 (3.1%) attending special schools.

Within Cornwall, 1,850 pupils (2.5% of all pupils, and 18.6% of all pupils

with an identified SEN) have speech, language and communication needs

listed as their primary need; this is slightly lower than the regional and

national average. Eleven pupils on the Isles of Scilly have been identified

20


https://www.gov.uk/government/collections/statistics-special-educational-needs-sen 21






18/12/18 V 0.9 Final

as having speech, language and communication needs.

Number and percentage of pupils with speech, language

and communication needs 201721


No % No % No

% No %

STATE-FUNDED

PRIMARY SCHOOLS 183,769 29.0 17,259 28.1 1,487 27.5 0 0.0


43,143 10.8 4,334 10.8 395 10.6 11 26.8

STATE-FUNDED

SPECIAL SCHOOLS 7,164 6.4 509 5.7 20 5.5 0 0.0

Hearing impairment

The number of pupils with a hearing impairment in England is 21,167,

0.2% of the population. The majority of these pupils attend state-funded

schools; 10,665 (50.4%) attend primary schools, and 9,096 (43.0%)

secondary schools. There are a further 1,406 (6.6%) pupils with a hearing

impairment attending special schools.

In state-funded schools within Cornwall 158 pupils have a hearing

impairment as their primary need, whilst there is one attending a special

school. At 0.3% those attending special schools and 1.8% attending

secondary schools are below the national average. However, primary

schools at 1.7% are in line with both the South West (1.6%) and England

(1.7%). There are no pupils on the Isles of Scilly with an identified hearing

impairment.

Number and percentage of pupils with hearing impairment 201722



STATE-FUNDED

PRIMARY SCHOOLS 10,665 1.7 999 1.6 91 1.7 0 0.0


9,096 2.3 891 2.2 66 1.8 0 0.0


1,406 1.3 99 1.1 1 0.3 0 0.0

22





18/12/18 V 0.9 Final

Visual impairment

In England 0.1% (11,889) of pupils have a visual impairment. The

majority of these pupils attend state-funded schools; 5,904 (49.7%) attend

primary schools and 5,225 (43.9%) secondary schools, with a further 760

(6.4%) attending special schools.

In Cornwall 86 pupils who have a significant visual impairment attend

state-funded schools; as a percentage it is in line with the national

average. 51 (0.9%) pupils attend primary schools, and 35 (0.9%)

secondary schools. There are no pupils attending special schools. There

are no pupils on the Isles of Scilly who have visual impairment.

Number and percentage of pupils with visual impairment 201722

ENGLAND SOUTH WEST

T

Cornwall IoS


STATE-FUNDED

PRIMARY SCHOOLS 5,904 0.9 535 0.9 51 0.9 0 0.0


5,225 1.3 423 1.1 35 0.9 0 0.0


760 0.7 32 0.4 0 0.0 0 0.0

Multi-sensory impairment

In England 0.03% (2,719) of pupils have a multi-sensory impairment.

66.8% of these pupils (1,815) attend state-funded primary schools, 635

(23.4%) state-funded secondary schools, with a further 269 (9.9%)

attending special schools.

In Cornwall 48 pupils have a multi-sensory impairment as their primary

need, with a slightly higher than national percentage attending primary

schools. At 0.7% those attending primary schools are higher than the

regional and national average. There are no pupils on the Isles of Scilly

who have multi-sensory impairment.


18/12/18 V 0.9 Final

Autistic spectrum disorder

Within Cornwall there are 792 pupils recognised has having autistic

spectrum disorder as their primary need; again, as a percentage of pupils

within the region, this is higher than both the South West and England,

particularly those attending special schools. 332 (6.1%) pupils attend

primary schools, and 339 (9.1%) secondary schools, both of which are

comparable to the national average. 121 (33.1%) with autistic spectrum

disorder attend special schools, which is substantially higher than both

England (26.9%) and the South West (23.3%). This increased percentage

may be a reflection of the availability of state-funded special schools in

Cornwall. There are four pupils on the Isles of Scilly who are identified as

having an autistic spectrum disorder.

Number and percentage of pupils with autistic spectrum disorder 201724


No % No % No % No %

STATE-FUNDED PRIMARY

SCHOOLS 42,494 6.7 3,287 5.4 332 6.1 0 0.0

STATE-FUNDED

SECONDARY SCHOOLS 35,706 8.9 3,475 8.7 339 9.1 4 9.8

STATE-FUNDED SPECIAL

SCHOOLS 30,203 26.9 2,069 23.3 121 33.1 0 0.0

23

Special educational needs in Cornwall January 2017 Government

Statistics https://www.gov.uk/government/collections/statistics-special-educational-needs-sen

24



Number and percentage of pupils with multi-sensory impairment 201723

ENGLAND SOUTH WEST

T

Cornwall IoS Numbe

r % Number % Number % Number %

STATE-FUNDED PRIMARY SCHOOLS

1,815 0.3 223 0.4 39 0.7 0 0.0

STATE-FUNDED

SECONDARY SCHOOLS 635 0.2 80 0.2 8 0.2 0 0.0


230 0.2 21 0.2 1 0.3 0 0.0





18/12/18 V 0.9 Final

Other difficulty/disability

443 pupils in Cornwall do not fall within the above categories and are

placed in the other difficulty/disability category. These pupils all attend

state-funded mainstream schools. These values are slightly lower than

national and South West values.

Number and percentage of pupils with other difficulty/disability 201725



STATE-FUNDED

PRIMARY SCHOOLS 26,601 4.2 2,793 4.6 216 4.0 0 0.0

STATE-FUNDED

SECONDARY SCHOOLS 26,081 6.5 2,800 7.0 224 6.0 4 9.8

STATE-FUNDED

SPECIAL SCHOOLS 1,660 1.5 231 2.6 0 0.0 0 0.0

Educational attainment

Children with a low level of educational attainment are almost five times as

likely to be in poverty now and 11 times as likely to be severely materially

deprived in the future as those with a high level of education2628.

The following information gives a summary of the headline performance

measures for 2017. It includes all stages in education from early years

through to Key Stage 4 (KS4). The data comes from the Local Authority

Interactive Tool (LAIT), National Statistics, and Department for Education

(DfE) publications, such as Assessing Schools’ Performance.

The early years foundation stage profile (EYFSP) is a teacher assessment of

children’s development at the end of the academic year in which the child

turns five.

25

Special educational needs in Cornwall January 2017 Government Statistics https://www.gov.uk/government/collections/statistics-special-educational-needs-sen 26

Intergenerational transmission of disadvantage in the UK & EU

http://www.ons.gov.uk/ons/rel/household- income/intergenerational-transmission-of-poverty-in-the-uk---eu/2014/blank.html#tab-1--Key-points


https://webarchive.nationalarchives.gov.uk/20160105214416tf_/http://www.ons.gov.uk/ons/rel/household-income/intergenerational-transmission-of-poverty-in-the-uk---eu/2014/blank.html#tab-1--Key-points




18/12/18 V 0.9 Final

Achievement in EYFSP teacher assessments by SEN provision, 2017

A good level of development

England

Cornwall

Isles of Scilly

% achieving % achieving % achieving

All 71 69 -

No SEN 76 73 -

SEN Support 27 24 -

EHC plan 4 - -

It is recognised in Cornwall that outcomes for a good level of development

for children with SEN Support who do not have an EHC assessment are currently 3% lower than national. Our target is to be at least in line with

national outcomes and to move from a quartile band of C on the current LAIT to band A or B.

The phonics (word reading skills) screening check shows the percentage of

children meeting the expected standard for all children in year 1.

Achievement of expected standards in the year 1 phonics test, 2017

A good level of development

England

Cornwall

Isles of Scilly

% achieving % achieving % achieving

All 81 78.8 -

No SEN 87 84.3 -

SEN Support 47 39.9 -

EHC plan 18 17.1 -

In Cornwall, the percentage of pupils achieving the expected standards in

phonics has fallen from the previous reported year year and is now below

the national average for all pupils. The numbers are too small for the Isles

of Scilly for the data to be available.

Pupils take standardised tests in year 2 – this is the end of Key Stage 1.

The percentages of pupils achieving the expected standards are shown in

the following table.


18/12/18 V 0.9 Final

Percentage of pupils achieving the expected standards at KS1, 2017

Reading Writing Maths

England

Cornwall

IoS

England

Cornwall

IoS

England

Cornwall

IoS

All 76 74.2 - 68 65.1 - 75 71.2 -

No SEN 84 81.2 - 77 72.0 - 83 78.3 -

SEN Support 34 26.2 - 23 17.7 - 35 28.4 -

SEN statement or EHC plan

14 18.5 - 9 8.7 - 14 14.1 -

In Cornwall the percentage of all pupils achieving the expected standard in

reading, writing and maths is below the national average. The

performance in reading of pupils with a statement or EHC plan is better

than the national average, whilst the performance in writing and maths of

pupils with a statement or EHC plan is close to the national average. The

attainment of SEN Support in Key Stage 1 remains an area for

development.

There is no data for the Isles of Scilly due to the small numbers.

In terms of progress, this is measured by how much progress pupils make

in reading writing and maths between the end of Key Stage 1 and the end

of Key Stage 2, compared with pupils across England who had similar

results at the end of Key Stage 1.

Progress score for Cornwall from KS1 to KS2, 2017


All -0.09 0.01 -1.02 No SEN 0.22 0.64 -0.76

SEN Support -1.52 -3.13 -2.36 SEN statement or EHC plan

-3.00 -4.48 -4.00

A score above zero means that pupils have made more progress on

average, than pupils across England who got similar results at the end of

KS1. A score below zero means that pupils made less progress. A

negative score does not mean that pupils have made no progress.

The DfE ranks the performance of all local authorities. Upper quartile

banding (A and B) is better than national average, C is equivalent to

national average, and D is below national average.


18/12/18 V 0.9 Final

DfE performance score for Cornwall from KS1 to KS2, 2017


No SEN C C D SEN Support B C C SEN statement or EHC plan

C C D

The progress of SEN pupils is similar to the progress of SEN pupils

nationally. There are two areas of note: the progress of pupils with SEN

support in reading, which is ranked in quartile B; and the progress in

maths of pupils with an EHC plan, which is in the lowest quartile (D).

Attainment in mathematics is a priority area for development for pupils

with and without special educational needs in Cornwall and in the

neighbouring local authorities. Action is being taken through support from

School Effectiveness Cornwall for identified schools, and School

Improvement Fund bids through the Cornwall and East Devon Maths Hub –

a joint bid with Devon LA – and a Cornwall bid specifically targeted upon

SEN students’ progress in mathematics.

Percentage of pupils achieving the expected standards at KS2, 2017


England

Cornwall

IoS

England

Cornwall

IoS

Englan

d

Cornwall

IoS

All 71 71.8 82 76 76 41 75 71.5 71

No SEN 80 79.2 - 86 85.3 - 83 79.5 -

SEN Support 37 36.2 - 34 31.2 - 41 33.5 -

SEN statement

or EHC plan 15 18.9 - 13 11.5 - 15 12.3 -

In Cornwall performance data is in line with national outcomes for reading

and writing. The percentage of pupils achieving the expected standard in

maths is below the national average. SEN Support is below national

average, but has improved since 2016. The performance in reading of

pupils with an EHC plan is a strength in Cornwall.

The data for the Isles of Scilly is too limited to draw meaningful conclusions.

A new secondary school accountability system was implemented in 2016. Progress 8 measures the progress a pupil makes from the end of KS2 to

the end of KS4. However, due to the limited number of entries for some pupils with SEN, the Progress 8 measure does not reflect the full KS4


18/12/18 V 0.9 Final

population.

At KS4 there is significant variation in the number of qualifications pupils

with SEN are entered for. The number of entries for SEN Support pupils

has risen, although the number of entries for pupils on EHC plans remains

similar to 2016.

Average Progress 8 scores for pupils with no identified SEN ranks Cornwall

74 in the national ranking of all local authorities (quartile banding C).

Average Progress 8 scores for pupils at SEN Support are 82 (quartile

banding C). For pupils with an EHC plan, Cornwall’s rank is 61 (quartile

banding B), above average.

Average Progress 8 scores at KS 4, 2017

P8 English Maths

England Cornwall IoS England Cornwall IoS England Cornwall IoS

All 0 -0.03 -0.57 -0.03 -0.14 - -0.02 -0.11 -

No SEN 0.07 0.06 -0.53 -0.07 0.06 - 0.04 -0.05 -

SEN Support -0.43 -0.46 - -0.03 -0.45 - -0.02 -0.44 -

SEN statement or

EHC plan -1.04 -0.98 - -0.03 -0.99 - -0.02 -0.69 -

Attainment 8 measures the average achievement of pupils in up to eight

qualifications: English and maths (double weighted), three subjects fulfilling

the EBacc criteria, and a further three qualifications (open element).

Average Progress 8 scores at KS 4, 2017

P8 English Maths

England Cornwall IoS England Cornwall IoS England Cornwall IoS

All 0 -0.03 -0.57 -0.03 -0.14 - -0.02 -0.11 -

No SEN 0.07 0.06 -0.53 -0.07 0.06 - 0.04 -0.05 -

SEN Support -0.43 -0.46 - -0.03 -0.45 - -0.02 -0.44 -

SEN statement or

EHC plan -1.04 -0.98 - -0.03 -0.99 - -0.02 -0.69 -

SEN Support pupils do not do quite as well as the national average,

although the difference is not large. Pupils with a statement or EHC plan


18/12/18 V 0.9 Final

perform in line with the national average.

Average Attainment 8 scores for pupils in Cornwall with no SEN ranks

Cornwall 85 out of all local authorities (quartile banding C). Average

Attainment 8 scores for pupils with SEN Support is ranked 82 (quartile

banding C), whereas for pupils with a statement or EHC plan, Cornwall is

ranked 61 (quartile banding B).

The attainment summary shows that the percentage of 5 year olds who

finish the foundation stage at a good level of development is below

national average for all measures and standards of achievement. As a

population they continue to be below the national average level at KS1 in

phonics and the standardised tests in year 2.

However, by the end of KS2 Cornwall performance has caught up, and

overall performance is at, or above national standards in reading and

writing. Attainment of SEN Support pupils in reading, writing and maths

has improved now quartile C.

Standards and progress in maths remains an area of focus for Cornwall’s

Primary Schools for all pupils. This is the one area where pupil progress is

in the lowest quartile nationally for SEN Support pupils.

Progress and attainment in Cornwall’s secondary schools is similar to 2016

in terms of national rankings. Pupils with an EHC plan perform the best,

being in the upper quartiles for all local authorities for both progress and

attainment.

Elective home education

In May 2018 there were 1,077 pupils in Cornwall who are electively

educated at home (source: Capita One). Of these, 52 (4.8%) have an

education, health and care plan, although there are no SEN Support

figures. This percentage is higher than those not electively educated at

home (2.4%).

Of the pupils electively educated at home with an EHC plan, the largest

group is those with an autistic spectrum disorder (24, 46%).


18/12/18 V 0.9 Final

Absences and exclusions from education

Persistent absentees are defined as having an overall absence rate of

around 15% or more. This equates to 56 or more sessions of absence

(authorised and unauthorised) during the year for pupils aged between 5

and 14, and 46 or more sessions of absence (authorised and unauthorised)

during the year for pupils aged 15.

Absenteeism (both authorised and unauthorised) in Cornwall in 2013/1427

is in line with the South West and England, where all have a persistent

absenteeism percentage of 2.6%. The Isles of Scilly have a persistent

absenteeism percentage of 2.5%. The most noticeable percentage

difference is in those with SEN with a statement where it is 9.1% in

Cornwall as opposed to 11.0% in England. The numbers of pupils on the

Isles of Scilly are too small to be able to draw meaningful conclusions. It

should be noted that the data for absenteeism is old, and may not reflect

the current situation.

In terms of exclusions, the most recent data from the DfE school census for

the academic year 2016/17 shows that in Cornwall there were 84

permanent exclusions, with 48 (57%) of these being pupils with identified

SEN. Twenty (24%) of these exclusions were for pupils with social,

emotional and mental health difficulties.

The most recent data shows that since September 2017, 64 permanent

exclusions have been recorded, with 27 (42%) pupils having an identified

SEN, and six with no SEN, no permanently excluded pupil had an EHC

plan.

There were 3,165 fixed term exclusions in Cornwall, of which 1,956 (62%)

related to pupils with an identified SEN. Of those fixed term exclusions,

the largest percentage was for pupils with social, emotional and mental

health difficulties (1,016, 32%).

Youth offending

A significant proportion of detained children and young people (under age

19) have special educational needs; a Ministry of Justice document in 2014

stated that approximately 18% of those in custody have a statement of

special educational need compared to 3% of children and young people

overall in England. Over 60% of children and young people in custody

27

Department for Education https://www.gov.uk/government/publications/sen-absences-and-

exclusions-additional- analysis

https://www.gov.uk/government/publications/sen-absences-and-exclusions-additional-analysis




18/12/18 V 0.9 Final

have speech, language and communication needs28. To address these

needs the Special Educational Needs and Disability (Detained Persons)

Regulations 201529 build on the structure and principles set out primarily

in sections 70 to 75 of the Children and Families Act 2014.

The assessment tool for young offenders is AssetPlus. This assessment tool

looks at all needs and will trigger a referral to the nurses for a

Comprehensive Health Assessment. It is relatively new, so there is limited

data available. In Cornwall there are currently 260 assessments on

AssetPlus. Of these, 74 (28%) are recorded as having SEND

characteristics. However, the belief within the service is that this figure is

much higher.

Young people within the Youth Offending Service (YOS) have good access

to autism spectrum disorder (ASD) assessment, with a fast-track

arrangement ensuring they are all offered a referral within three months.

This service is currently only offered for under 16s, but the aim is to

include those who are 16+.

The screening includes physical health, mental health (including attention

deficit hyperactivity disorder (ADHD) etc.), traumatic brain injury

screening and an early help assessment initially and can then do further

assessments for SALT/communication, ASD, learning disability (LD) and

educational needs. As the data is limited, trend cannot be commented on

with any certainty. However, anecdotally, the belief is that there are a

high number of young people within the YOS who have speech, language

and communication difficulties.

NEET

Young people Not in Education, Employment or Training (NEET) cover the

age group 16-24; available statistics however cover the 16-18 age group.

In 2016 the Local Authority Interactive Tool30 showed that in Cornwall,

90% of KS4 students with EHC plans (including those attending special

schools) went on to or remained in education, employment or training.

This figure is in line with the England and South West average, which are

also 90%. The percentage of KS4 students in Cornwall with SEN Support

who went on to, or remained in education, employment or training

(including those attending special schools) was 87%. This is slightly below

28Ministry of Justice

29Government Legislation http://www.legislation.gov.uk/uksi/2015/62/contents/made

30Local Authority Interactive Tool https://www.gov.uk/government/publications/local-authority-

interactive-tool-lait

http://www.legislation.gov.uk/uksi/2015/62/contents/made




18/12/18 V 0.9 Final

England (88%), the South West (89%) and statistical neighbours (88.5%).

There were no figures available for the Isles of Scilly.

In year 12, the percentage of students with SEND who were also NEET fell

from 8.1% of the cohort in October 2017, to 5.6% of the cohort in

December. For those in year 14 with SEND who were also NEET, the

percentage rose over the same three month period from 9.8% to 13.2%31.

The Cornwall 2017/18 transitions data dashboard showed that in December

2017 for years 12-14 (aged 16-18), there were 639 young people with

SEND, with 62 (9.7%) of these being NEET. This is higher than the figure

for young people who have no identified SEND (4.4%).

Employability is a focus for Cornwall Council’s Preparing for Adulthood

work. The challenges that have to be overcome are the relatively high

proportion of small and medium sized enterprises in the Duchy and the

geographical challenges that the area presents. To address these

challenges there is an established Enterprise Adviser network, including a

specific appointment to work with special schools and area resource bases.

The successful Ambitions bid will fund Disability Access, and support posts

to work with employers and to increase opportunities. DfE funding for

Cornwall and the Isles of Scilly will be used to appoint a supported

internship coordinator to build and support a network that will extend

provision into ‘hard to reach’ areas.

Vulnerable children

Matched Capita and Mosaic data from spring 2018 shows that there were

2,668 children and young people who had an EHC plan in place. Of these,

102 children and young people were also in care, 925 identified as children

in need, and 24 had a child protection plan in place. This is shown in the

chart below.

31

CSW Group https://cswgroup.co.uk

https://cswgroup.co.uk/


18/12/18 V 0.9 Final

Chart showing the percentage of children and young people with EHC plans, and

those who are also identified as children in care, children in need, or the subject

of a child protection plan. Source: Children and Family Services

The most recent data for children in care who also have SEND is for the

spring term 2018. The total number of children and young people in care

in Cornwall from age 2 to the end of year 13 is 509. Of these children and

young people, there are 102 who have an EHC plan. The most commonly

identified primary need is social, emotional and mental health difficulty,

with 74 (63%) of children and young people having this as their primary

need. The numbers for the Isles of Scilly are too small to draw any

conclusions.

The total number of children and young people in care with an EHC plan is

23.0%. The equivalent national percentage is 26.7%.

Children on a child protection plan

As at 31st March 2018 there were 2,989 children in Cornwall identified as

children in need and 395 who were the subject of a child protection plan.

On the Isles of Scilly, Children’s Social Care work with many of the families

identified with SEND as they meet the local threshold of ‘Child in Need’. A

system of short break budgets supports families of children with disability

to access services and resources on the islands and mainland.

102, 4%

925, 35%

24, 1%

1617, 60%

children in care

children in need

child protection plan

EHC plan with no socialcare involvement


18/12/18 V 0.9 Final

Continuing care needs

In Cornwall there are around 40 children under 18 at any point in time with

Continuing Care packages. There are, however, far more children and

young people with high level needs who access targeted services.

Prevalence of children with SEN in areas of higher

deprivation

In the January 2017 Cornwall school census, 9,605 (13%) of school

children have an identified SEN. Of those children, 7,766 (81%) are from

the most deprived areas in Cornwall. In England, 889 (11%) of those

within the most deprived areas are in the most deprived 0-10% of LSOAs

(rank 1-3284). In the most deprived areas, 14% of children and young

people have an identified SEN, whereas for non-deprived areas, it is 11%.

Therefore, children and young people from deprived areas are more likely

to be identified as having SEN.

Of primary school children, 5,426 (13%) have SEN, of which 81% (4,418)

are within the most deprived areas in Cornwall. Of those in the most

deprived areas, 12% live in the most deprived decile for England.

Of secondary school pupils, 3,719 (13%) have SEN, of which 80% (2,967)

are within the most deprived areas in Cornwall. 11% of those within the

most deprived areas for Cornwall are also live in the most deprived decile

for England.

The Isles of Scilly are in the seventh decile nationally i.e. they are in the

30-40% least deprived LSOAs in England. They have 121 pupils with no

identified SEN; 27 at SEN support (10.4%); and 12 (4.4%) with either a

statement of educational need or an EHC plan.

A more detailed description of the prevalence of SEND in areas of

deprivation is given in appendix 7.

It should be noted that data from the school census has not been verified.


18/12/18 V 0.9 Final

Disability by ethnicity (aged 0-15), Census 201132 The child (0-18 years of age) population of Cornwall and the Isles of Scilly

is predominantly white with only 1.8% from the combined ethnic minority

groups.33

School Census ethnicity - Cornwall state-funded primary,

secondary and special schools

The comparison between 2011 and 2017 data, based on information

collected in the school census by local authority, shows that the number of

pupils in school within Cornwall has not changed significantly34, although

the number of pupils has increased in 2017. The percentage of white

pupils has decreased slightly, whilst ethnic minorities have increased.

Despite this increase, only 4.3% of pupils in Cornwall are from an ethnic

minority – this is an increase from 3.4% in 2011.

On the Isles of Scilly, 5.5% of pupils identify themselves as belonging to an

ethnic minority. However, the numbers are small, so it is difficult to draw

conclusions.

In Cornwall 14.5% of pupils have SEND. The majority are white (96.4% of

all children with SEND). This represents 14.5% of white pupils in Cornwall.

The proportion of pupils from an ethnic minority who also have SEND is

similar to the white population.

For a more detailed breakdown of prevalence of SEND by ethnic group, see

appendix 8.

SEND prevalence and language

The Special Educational Needs and Disability code of practice: 0 to 25 years

(January 2015)35 states – “Identifying and assessing SEN for young

children whose first language is not English requires particular care. Early

years practitioners should look carefully at all aspects of a child’s learning

and development to establish whether any delay is related to learning

English as an additional language or if it arises from SEN or disability.

32

Census 2011 https://www.nomisweb.co.uk/census/2011/lc3205ew 33

https://www.nomisweb.co.uk/census/2011/data_finder 34

National Statistics – Department of Education https://www.gov.uk/government/statistics 35

Department for Education, Special educational needs and disability code of practice: 0 to 25 years, January 2015 5.30

https://www.nomisweb.co.uk/census/2011/lc3205ew

https://www.nomisweb.co.uk/census/2011/data_finder

https://www.gov.uk/government/statistics


18/12/18 V 0.9 Final

Difficulties related solely to learning English as an additional language are

not SEN.” It is widely recognised that it can sometimes be very difficult to

recognise clearly the difference between the need for English as an

additional language (EAL) support and the need for SEN support.

There is a very small percentage (2.3%) of pupils in Cornwall whose first

language is not English. This percentage has risen, only slightly, from

1.7% over the past three years. Although small, there may be a wide

range of languages to consider.

86% of all primary and secondary school children with English as an

additional language have no SEN. A very high percentage (90.5%) of

pupils with English as a second language come from a black and minority

ethnic background and 37.9% are in the 30% most deprived areas.

For further information about SEND prevalence and language, see appendix

8.

SEND prevalence and gender and age

In terms of SEN, there are more males than females. 12% of boys are

identified as having an SEN, and 5% of girls. Boys make up 70% of those

identified with SEN. There are approximately three times as many boys

with EHC plans, and around 70% of pupils at special schools are boys36.

On the Isles of Scilly the large majority of EHC plans that are in place are

for boys.

Nationally, over all ages there are slightly more (51.5%) females with long

term health problems or disabilities37. Within Cornwall this percentage

changes; in the 0 to 15 year category with 51.4% male and 50.5% in the

16 to 24 age group.

There are more children in the 0 to 15 year age group with long term

health problems or a disability, 51.4% of whom are males. Overall there

are 8.8% males in the 0 to 15 year age group and 5% in the 16 to 24 year

group. 16.2% of females overall with long term health problems or a

disability are in the 0 to 15 year age group, with 9.5% in the 16 to 24 year

group.

36

Gender and education: the evidence on pupils in England

http://webarchive.nationalarchives.gov.uk/20090108131527/http://www.dcsf.gov.uk/research/data/uploadfiles/RTP01 -07.pdf 37

Long Term Health or Disability https://www.nomisweb.co.uk/census/2011/lc3302ew

https://www.gov.uk/government/organisations/department-for-education/about/research

https://www.gov.uk/government/organisations/department-for-education/about/research



18/12/18 V 0.9 Final

SEND prevalence and religion38

For information on SEND prevalence and religion, see appendix 9

SEND prevalence and gender reassignment

There are no local figures on gender variance and gender reassignment.

38

Census 2011 https://www.nomisweb.co.uk/census/2011/lc3207ew



18/12/18 V 0.9 Final

Health determinants

Older mothers

The trend in Cornwall and the Isles of Scilly shows that the actual numbers

of births to older mothers has increased between 2009 and 2016,

particularly in 35 to 39 year olds where it had increased by 11%. This

trend is seen nationally. As women get older this is an increased risk of

pregnancy-related complications and health problems both to mothers and

babies. There is an increased chance of having a baby with a congenital

abnormality. Women over the age of 40 represent 3.8% of all births in

Cornwall and the Isles of Scilly39. This is slightly lower than England

(4.3%) and the South West (4.2%). Age of carer will therefore need

consideration as a child’s support needs increase with age.

Young mothers Around 60% of babies who are subject to SCR (serious case reviews) are

born to mothers under the age of 21.

Babies born to mothers under the age of 21 have a 56% higher risk of

infant mortality and are at 3 times the risk of SUDI (sudden unexpected

death of an infant). They are also twice as likely to attend hospital with an

illness, accident or injury and have a 21% higher chance of a low birth

weight or premature birth which rises to 95% for subsequent children.

Premature babies are at increased risk of neurodevelopment impairments,

respiratory and gastrointestinal complications.

Cornwall and the Isles of Scilly have a slightly higher percentage of babies

born to mothers under the age of 20 (3.6%) compared with England

(3.2%) and the South West (3.0%).

39

South West Clinical Network Maternity Dashboard (2018) Online:

https://maternitydashboard.swscn.org.uk/

https://maternitydashboard.swscn.org.uk/


18/12/18 V 0.9 Final

Smoking during pregnancy

Babies from deprived backgrounds are more likely to be born to mothers

who smoke, and to have much greater exposure to second-hand smoke in

childhood40.

Smoking remains one of the few modifiable risk factors in pregnancy. It

can cause complications during labour and an increased risk of

miscarriage, premature birth, stillbirth, low birthweight and sudden

unexpected death in infancy, and placental complications that could lead to

disabilities41.

Children may also suffer from on-going health risks such as symptoms of

asthma and problems of ear, nose and throat if growing up in a home

where there are smokers.

Data from NHS Digital42 shows that 13.3% of women were smoking at the

time of delivery in 2017/18.

Known smokers at time of delivery

Total Maternities Known Smokers

England South

West* CIoS** England

South

West* CIoS**

2009/10 647,378 57,185 5,181 90,908 8,069 809

14.0% 14.1% 15.6%

2010/11 659,067 58,640 5,422 89,036 7,860 776

13.5% 13.4% 14.3%

2011/12 665,081 59,512 5,659 87,731 7,884 776

13.2% 13.2% 13.7%

2012/13 657,551 58,588 5,514 83,506 7,817 759

12.7% 13.3% 13.8%

2013/14 632,956 16,742 5,394 75,913 2,150 733

12.0% 12.8% 13.6%

2014/15 622,643 15,958 5,129 70,879 1,957 711

11.4% 12.3% 13.9%

2015/16 631,225 32,50

5 5,186 67,195 3,821 688

10.6% 11.8% 13.3%

2016/17 619,234 31,95

3 5,017 65,02

3 3,761 644

10.5% 11.8% 12.8%

2017/18 602,499 32,36

7 4,980 64,11

4 3,628 660

10.6% 11.2% 13.3% * South West becomes Devon, Cornwall & Isles of Scilly from 2013

**Cornwall & Isles of Scilly becomes NHS Kernow from 2013 Data from NHS Digital

40

Statistics on Women's Smoking Status at Time of Delivery, HSCIC 41

NICE, 2010, P22 42

NHS Digital (2017) Statistics on women’s smoking at time of delivery Online:

https://digital.nhs.uk/catalogue/PUB24222

https://digital.nhs.uk/data-and-information/publications/statistical/statistics-on-women-s-smoking-status-at-time-of-delivery-england/statistics-on-women-s-smoking-status-at-time-of-delivery-england-quarter-4-2016-17


18/12/18 V 0.9 Final

Maternal diet

Maternal diet plays an important role in the antenatal development of the

child. The ingestion of certain foods and supplements can offer benefits

to an unborn child. Folic acid has been identified as reducing the

incidence of major birth defects including spina bifida. All women are

recommended to supplement their diet with folic acid before pregnancy

and this dosage is increased if women have a BMI over 35, are epileptic

or have had a previous affected baby. However, as the cost of folic acid

over the counter is less than that of a prescription, it is not known how

many women actually purchase and use folic acid supplements.

Maternal obesity

Women who are obese when they become pregnant face an increased risk

of complications during pregnancy and childbirth. These include the risk of

impaired glucose tolerance, gestational diabetes, miscarriage, pre-

eclampsia, thromboembolism and maternal death (Centre for Maternal

and Child Enquiries and the Royal College of Obstetricians and

Gynaecologists 2010)43. Children of obese parents are also more likely to

be obese themselves.

Data for Cornwall and the Isles of Scilly from the Maternity Services

Statistics (2018) indicates that 22.9% of mothers are obese at the time of

booking their pregnancy leading to a higher risk of complications at birth.

Low birth weight

Low birth weight is closely associated with foetal and neonatal mortality

and morbidity, inhibited growth and cognitive development and chronic

diseases later in life. A baby’s low weight at birth is either the result of

preterm birth (before 37 weeks of gestation) or due to restricted foetal

(intrauterine) growth. Low birth weight has been defined by the World

Health Organisation (WHO) as weight at birth of less than 2,500 grams44.

Very low birthweight is defined as weight at birth less than 1,500 grams45.

43

Centre for Maternal and Child Enquiries and Royal College of Obstetricians and Gynaecologists (2010)

Joint Guideline: Management of Women with Obesity in Pregnancy. Online 44

NHS Digital (2017) Statistics on women’s smoking at time of delivery Online:

https://digital.nhs.uk/catalogue/PUB24222 45

UNICEF and WHO, 2004, p.21

https://digital.nhs.uk/data-and-information/publications/statistical/statistics-on-women-s-smoking-status-at-time-of-delivery-england/statistics-on-women-s-smoking-status-at-time-of-delivery-england-quarter-4-2016-17


18/12/18 V 0.9 Final

The main risk factors for low birth weight are nutritional status of the

mother, smoking in pregnancy, substance misuse, low uptake of prenatal

care and psychosocial factors causing stress and depression46

The rate of low birth weights across Cornwall and the Isles of Scilly over

the last 10 years has been generally below national rates, and largely in

line with rates in the South West47. This suggests that this is not a

particular factor for SEND in Cornwall and the Isles of Scilly.

Gestational age

The World Health Organization (WHO) defines prematurity as babies born

before 37 weeks from the first day of the last menstrual period48.

Premature babies are at increased risk of neurodevelopment impairments,

respiratory and gastrointestinal complications. The EPICure studies looked

at premature babies born in hospitals throughout England in 1995 and

2006, and found that 80% of babies born under 26 weeks gestation had

some form of impairment49.

Survival rates of pre-term babies have improved in recent years. The

EPICure study looked at survival rates and ongoing illnesses or

complications affecting babies born extremely prematurely (between 22

and 26 weeks of pregnancy) in England in 2006 and 199550. Their main

finding was that when comparing survival-to-discharge rates (meaning

babies were eventually thought to be well enough to leave hospital)

between 1995 and 2006, there was an increase from 40% in 1995 to 53%

in 2006. However, there was no difference in the level of ongoing illnesses

or disabilities affecting these surviving babies, i.e. more preterm babies

are surviving to be discharged from hospital with no increase in the

numbers with illness or disability.

46

NICE 2003 47

Fingertips tool https://fingertips.phe.org.uk/profile-group/child-health/profile/child-health-pregnancy 48

World Health Organisation (2013) Preterm births, Available:

http://www.who.int/mediacentre/factsheets/fs363/en/ 49

EPICure studies. BMJ 2012 50

Costeloe KL, Hennessy EM, Haider S, et al. Short term outcomes after extreme preterm birth in

England: comparison of two birth cohorts in 1995 and 2006 (the EPICure studies). BMJ. Published online December 4 2012

https://fingertips.phe.org.uk/profile-group/child-health/profile/child-health-pregnancy

https://www.who.int/en/news-room/fact-sheets/detail/preterm-birth


18/12/18 V 0.9 Final

Screening and immunisation

Antenatal and new-born screening

Screening is a way of identifying apparently healthy people who may have an increased risk of a particular condition. The NHS offers a range of

screening tests to pregnant women and their children.

This image explains how the screening process can be compared to putting people through a sieve

The sieve represents the screening test and most people pass through it. This means they have a low chance of having the condition screened for.

The people left in the sieve have a higher chance of having the condition. A

further investigation is then offered to them. Identification through this process can show that they have the condition screened for. The person

may need further confirmatory diagnostic tests.


18/12/18 V 0.9 Final

The UK National Screening Committee (UK NSC) currently recommends the offer of:

Antenatal screening:

Sickle cell and thalassaemia

Fetal anomaly (T21, T18, T13 & fetal anomaly ultrasound)

Infectious diseases (hepatitis B, HIV, syphilis)

New-born screening:

Newborn blood spot

Newborn and infant physical examination

Newborn hearing screening

Antenatal and neonatal screening programmes work well at a population

level with a high degree of offer to the population with quality monitoring

and appropriate failsafe programmes. They will generate referral into other

programmes for a small number of people including diagnosis and care.

They are not designed to report on outcomes.

Data for 2017/18 from Public Health England51 shows that population

coverage of the programmes in Cornwall is good, with all but one

programme meeting acceptable levels of coverage. The only one where

coverage was not as expected is for the newborn physical examination

(90.8% target 95%).

Child health records department

The Child Health Information Service (CHIS) works closely with the

screening team to ensure at all children who live in Cornwall receive their

new-born blood spot screening according to the national guidelines. CHIS

records the screening results that have been emailed by the laboratories in

Bristol onto the child’s health record. In addition to the screening team,

CHIS also monitors the child health system failsafe and the national

failsafe to ensure that children are not missed.

51

Public Health England (2018) NHS screening programmes: KPI reports 2017 to 2018. Online:

www.gov.uk/government/publications/nhs-screening-programmes-kpi-reports-2017-to-2018

https://www.gov.uk/government/publications/nhs-screening-programmes-kpi-reports-2017-to-2018


18/12/18 V 0.9 Final

Vaccinations

One thing that can help protect all children from ill health is ensuring that

they are vaccinated against infectious diseases. Vaccines work by making

our bodies produce antibodies that fight diseases, they do this without

infection. When a child who has been vaccinated comes in contact with a

disease their body will already be able to fight off an infection as they will

be able to quickly produce antibodies52.

It is important to ensure that as many children as possible are vaccinated

in order to prevent illness in children who cannot be vaccinated; this is

called “herd immunity”.53 Usually 95% of the child population need to be

vaccinated to protect against disease in the wider population.

A vaccination programme that protects children against 13 diseases is

offered during childhood. Some vaccinations require multiple doses to be

affective against specific diseases.

Evidence summarised by NICE (2016)54,55,56,57 show that children and young

people with risk factors associated with child poverty may also be at risk of

not being fully immunised, these children include:

• Looked after children

• Children with physical or learning disabilities

• Children of teenage or lone parents

• Younger children from large families

• Vulnerable children, such as those whose families are

travellers, asylum seekers or are homeless

• Those who have missed previous vaccinations (whether as

a result of parental choice or otherwise)

• Those not registered with a GP

• Children who are hospitalised or have a chronic illness

• Those from some minority ethnic groups

• Those from non-English speaking families

52

NHS Choices (2018) How vaccines work. Online: www.nhs.uk/conditions/vaccinations/how-vaccines-

work/ 53

NICE (2016) Quality standard topic: Vaccine uptake in under 19s. Online:

www.nice.org.uk/guidance/qs145/documents/briefing-paper 54

Department of Health (2005) Vaccination services: reducing inequalities in uptake. London:

Department of Health 55

Hill CM, Mather M, Goddard J (2003) Cross sectional survey of meningococcal C immunisation in

children looked after by local authorities and those living at home. BMJ 326: 364–5 56

Peckham C, Bedford H, Seturia Y et al. (1989) The Peckham report – national immunisation study: factors influencing immunisation uptake in childhood. London: Action Research for the Crippled Child 57

Samad L, Tate AR, Dezateux C et al. (2006) Differences in risk factors for partial and no immunisation

in the first year of life: prospective cohort study. BMJ 332: 1312–3

https://www.nhs.uk/conditions/vaccinations/why-vaccination-is-safe-and-important/

https://www.nhs.uk/conditions/vaccinations/why-vaccination-is-safe-and-important/

http://www.nice.org.uk/guidance/qs145/documents/briefing-paper


18/12/18 V 0.9 Final

Unfortunately, data is not available that tells us about which groups are missing out on vaccinations in Cornwall and the Isles of Scilly.

Information from the health visitor needs assessment (2018) The 2018 health visitor needs assessment58 reported on the three

questions that are asked in the early help assessment that are relevant

to this needs assessment. The three questions were about children with

special educational/medical needs; speech and language delay; and

developmental delay (other than speech and language).

Children from the health visitor survey identified with the following needs

2015/16 2016/17 2017/18 Number % Number % Number % Children with

special educational/ medical needs

0 0 328 1.6 417 2.4

Speech and language

delay

236 1.1 913 4.3 1,086 6.1

Developmental

delay (other than speech

and language)

533 2.5 1,028 4.9 1,155 6.5

Children from the most deprived LSOAs in Cornwall identified

with the following needs

Number % Number % Number % Children with special

educational/ medical needs

0 0 35 2.4 42 3.4

Speech and

language delay

19 1.3 76 5.2 100 8.0

Developmental delay (other than speech and language)

53 3.6 100 6.8 110 8.8

This table shows that children from the most deprived decile have higher

percentages of children with special educational/medical needs; speech

and language delay; and developmental delay other than speech and

language.

58

Public Health, Cornwall Council (2018) Health visiting needs assessment: 0-5 healthy child

programme


18/12/18 V 0.9 Final

Injuries to children and young people

Injuries to children and young people can lead to ongoing medical

problems and special educational needs.

Accidental injuries are a major health problem throughout the United

Kingdom59 and one of the most common causes of death in children

over one year of age. Every year they leave many children and young

people permanently disabled or disfigured.

Those most at risk from a home accident are the 0-4 years age group.

Falls account for the majority of non-fatal accidents while the highest

numbers of deaths are due to fire. Most of these accidents are

preventable through increased awareness, improvements in the home

environment and greater product safety.

A&E attendances of children (0-4 years)60

England South West

Cornwall and IoS

2010/11 483.9 413.7 398.8

2011/12 510.8 427.0 420.3

2012/13 534.9 437.3 413.5

2013/14 525.6 431.7 400.6

2014/15 540.5 446.2 423.5

2015/16 588.1 469.3 458.2

2016/17 601.8 477.2 520.7

Attendances at A&E have been increasing – this is a national and regional

trend. However, the increase may be due to parents finding it difficult to

get appointments at their GP, so they take their child to A&E departments

as an alternative.

Hospital admissions have been dropping steadily since 2010. Admissions in

the 0-14 year age group have reduced by 21% and 15-24 years by 27%.

Cornwall and the Isles of Scilly are similar to both national and the South

West.

59

The Royal Society for the Prevention of Accidents http://www.rospa.com/home-safety/advice/child-

safety/accidents- to-children/ 60

Hospital admissions http://www.localhealth.org.uk/#l=en;v=map7

https://www.rospa.com/Home-Safety/Advice/Accidents-to-Children.aspx

https://www.rospa.com/Home-Safety/Advice/Accidents-to-Children.aspx

http://www.localhealth.org.uk/#l%3Den%3Bv%3Dmap7


18/12/18 V 0.9 Final

Hospital admissions caused by injuries in children61

0-14 years 15-24 years

England South West

Cornwall and Ios

England South West

Cornwall and IoS

2010/11 115.2 109.7 131.9 154.2 162.1 209.2

2011/12 118.2 114.9 116.1 144.7 152.7 188.5

2012/13 103.8 103.9 105.5 130.7 144.2 166.2

2013/14 112.2 110.6 103.7 136.7 147.0 153.4

2014/15 109.6 111.1 114.4 131.7 145.0 125.4

2015/16 104.2 105.0 101.0 134.1 153.2 139.7

2016/17 101.5 104.3 101.8 129.2 147.9 137.0

Further information about injuries to children and young people can be

found in the health visitor needs assessment62.

61


programme 62


programme


18/12/18 V 0.9 Final

Child poverty Children growing up in poverty experience many disadvantages, which

accumulate across the life cycle. An evidence review by Professor

Bradshaw63 and colleagues finds the following detrimental outcomes for

children to be associated with child poverty:

mortality, morbidity, fatal accidents, mental illness, suicide, child

abuse (but not sexual abuse), teenage pregnancy, poor housing

conditions, homelessness, low educational attainment and smoking

(mainly after childhood).

Research carried out by the Children’s Society estimates that 4 in every 10

disabled children in the UK live in poverty. This compares to 3 in 10 across

all children in the UK and shows that disabled children are more likely to

live in poverty and experience the associated problems than their peers64.

If a child has a disability both parents are less likely to work, leading to

higher incidence of poverty.

Service provision - health

There are five main providers of children and young people’s health

services in Cornwall and the Isles of Scilly:

Cornwall Partnership NHS Foundation Trust provides child and

adolescent mental health services and specialist children’s services,

including speech and language therapy, community nursing services

and learning disability services.

The Royal Cornwall Hospitals Trust, Plymouth Hospitals NHS Trust

and North Devon District Hospital provide acute care and general

hospital services as well as community paediatrics, and some

community services.

Peninsula Community Health provides services including specialist

dentistry; district nursing services and physiotherapy for 16+.

Further details can be found in Supporting Educational Achievement (2017)65.

63

Bradshaw (2011) The well-being of children in the UK 64

Children’s Society (2011) 4 in every 10 Disabled children living in poverty 65

Newman S, Corlett E, Lewis j, and O’Neill B (2017) Supporting Educational Achievement – the health

contribution for children and young people aged 0-25 years with special educational needs and disabilities


18/12/18 V 0.9 Final

Children and young people’s needs66 are met from a whole range of NHS

services; some are universally available such as GPs and health visiting

services, and some are more specialised and need an assessment or

referral from a health or social care professional to access.

In Cornwall there are a range of specialist services to meet the health

needs of children and young people with:

physical or sensory difficulties

developmental delay or impairment

maintaining a healthy weight

speech, language and communication needs

difficulties with eating, drinking and swallowing

epilepsy

diabetes

mental health issues

complex and technology dependent health care needs life limiting/ life threatening conditions

The majority of children with SEND receive the support to meet their health

needs locally. However, occasionally, due to the complexity of a child or

young person’s health need, they have to be referred to highly specialised

services based outside Cornwall and the Isles of Scilly.

For under 18s there is an assessment process called Children’s Continuing

Care which may indicate that more than one agency i.e. health, social care

or education need to be involved in the care. For young people over the

age of 18 there is a similar process called NHS Continuing Health Care.

The following services assess and diagnose children with additional health

and development need, disability or lifelong conditions and therefore

demand on these services are an indication of levels of need in the system.

Health visiting

The health visitors keep children with SEND on their caseload until the child

is five. Each health visitor has children on their caseload with complex

needs. A mandatory field in the database ensures that the needs of these

children are recorded to ensure their needs are addressed.

66

https://www.supportincornwall.org.uk/kb5/cornwall/directory/localoffer.page?localofferchannel=8

https://www.supportincornwall.org.uk/kb5/cornwall/directory/localoffer.page?localofferchannel=8


18/12/18 V 0.9 Final

Community paediatrics

The overall aim of the service is to provide a consultant-led locality-based

community child health service for children and young people who are

vulnerable due to disease, disability or disadvantage. With a particular

emphasis on improving access to health services for those vulnerable

groups of children and young people who are traditionally difficult to

engage, the service aims to deliver high quality, safe, flexible and holistic

care.

The types of conditions that are managed include: physical disabilities;

children at high risk of developmental problems (e.g. as a result of

premature birth or acquired brain injury); children with delayed milestones

(e.g. speech, motor, social communication or play) who are not yet at

school; developmental co-ordination disorder (dyspraxia); hearing or

visual impairment; social communication difficulties; concerns about

attention and hyperactivity; development and learning assessment in pre-

school children; and in patients with known learning difficulties for

investigation of a possible underlying cause.

Speech and language

Speech and language therapy supports children and young people in

Cornwall aged 0- 19 years who have difficulties with communication, or

with eating, drinking and swallowing. This can include children/young

people with delay in learning to talk, speech sound production difficulties,

learning difficulties, cleft palate, stammering, selective mutism, autism,

hearing impairment and physical disabilities.

Data from the speech and language department shows that the current

caseload (May 2018) comprises 2,486 children and young people. This

number has remained largely similar over recent years. Most of these

children and young people, by the fact that they have a communication

need, will be on the SEND continuum.

Speech and language therapists (SLTs) aim to help to develop the skills of

parents/carers and other people who support the child in their everyday

environments. This ensures that therapy can be non-intrusive, practical and

most effective for the child/young person.

Available data suggests that the number of children and young people

requiring alternative and augmentative communication (AAC) is increasing.


18/12/18 V 0.9 Final

Community Therapy Services

The Children’s Community Therapy Service (CCTS) and Community

Paediatrics work in partnership within the department of Community Child

Health at the Royal Cornwall Hospital NHS Trust, delivering Occupational

Therapy, and Physiotherapy treatment, to children and young people who

present with, or are being investigated for, neurological, neuro-

developmental, neuro-muscular conditions, atypical development and/or

disabilities.

There are occupational therapists (OTs) who assess the needs of children

and young people, aged from 5 years to 17 years 11 months, with

disabilities at home, school, and in respite settings. The OT’s role is to

enable children and young people to become as independent as possible in

daily living activities, and help find solutions to any barriers which are

preventing this.

CAMHS

Child and adolescent mental health services (CAMHS)67 helps children

and young people deal with emotional, behavioural or mental health

issues, including:

Emotional problems e.g. anxiety, depression, anger, mood

swings, low self- esteem.

Behaviour problems e.g. violence, destructiveness, self-harm,

hyper-activity, over-sexualisation and obsession.

Relationship problems, including difficulties in the family, with

friends or colleagues, in school or the community, as well as

difficulties associated with attachment and loss.

Problems with development or disability e.g. bed-wetting and

difficulties with eating, sleeping or talking.

Emotional problems linked to physical health issues e.g.

difficulties with taking medication as prescribed by a doctor.

NHS England has made a commitment that by 2020/21, there will be a

significant expansion in access to high-quality mental health care for

children and young people.

67CAMHS


18/12/18 V 0.9 Final

At least 70,000 additional children and young people each year across

England will receive evidence-based treatment – representing an increase

in access to NHS-funded community services to meet the needs of at least

35% of those with diagnosable mental health conditions.

NHS England has set targets regarding the percentage of children and

young people accessing NHS funded mental health services within 28 days

of referral. For 2018/19 this is 32% of the children with specialist mental

health service needs rising to 38% in 2022. The proportion of children and

young people receiving an assessment following acceptance of a referral

into specialist mental health services (CAMHS) is on an upward trend rising

with an average of 73.1% seen within 28 days between April and July

2018. There has been an 8% reduction in 28 day waiting breaches.

Transition to adult mental health services

Mental health services for teenagers are split between child and adolescent

mental health services (CAMHS) and adult mental health services (AMHS).

According to the TRACK study (2015)68 the time point when a young

person transfers to AMHS can lie between the ages of 16 and 18 years. As

adult services focus on severe mental illness, young people with other

ongoing mental health disorders, such as emotional, neurodevelopmental

(e.g. autism spectrum disorder, attention-deficit hyperactivity disorder

(ADHD)) or emerging personality disorders can fall through the CAMHS-

AMHS gap. There is concern that these young people have poor outcomes

(e.g. increased rates of attendance at accident and emergency

departments, employment problems, contact with criminal justice and

social care systems).They may present to adult services later, when in

crisis or having developed severe and enduring mental health problems.

In Cornwall and the Isles of Scilly there was not an organised system for

transition to adult services that worked in harmony with families and other

agencies.

Data tells us the number of young people who transfer to adult services but

this does not give a picture of the transition. The TRACK study found that

the most common outcomes were discharge to a general practitioner and

ongoing care with CAMHS with little indication of use of third sector

68

Islam Z et al (2015) Mind how you cross the gap! Outcomes for young people who failed to make

the transition from child to adult services : the TRACK study. BJPsych Blletin, 1-8


18/12/18 V 0.9 Final

organisations. Most of these young people had emotional/neurotic

disorders and neurodevelopmental disorders.

The clinical implications out of this study identified that GPs and CAMHS are

left with the responsibility for the continuing care of young people for

whom no adult mental health service could be identified. GPs may not be

able to offer the skilled ongoing care that these young people need.

NHS commissioning incentives have prompted a transition refresh project.

A checklist of timelines, who to speak to, and when to start has been

developed in conjunction with services and families.

The process will start at 17 with a referral to adult services and self-

assessment to understand what a young person’s transition goals are. At

17½ there will be a joint meeting with CAMHS and adult mental health

services, usually at school. Six months after transition another survey is

sent out to see if their transition goals have been met. Some goals e.g.

going to university may not be met but will be outlined at the meeting,

making the team around them aware of what is in their best interest.

A transitions webpage has been developed with a guide on where to go for

help. There will also be a second level for professionals with more detailed

information to help avoid unnecessary incorrect referrals.

Schools are keen to act as hubs for the transition meetings. The schools

have spent more time than any other agency with the young person. If

schools act as hubs they will be automatically included in the transition

process.

Transition generally happens at the wrong time for young people. For

health services this happens at 18 and can cause considerable stress.

CAMHS children services are pretty inclusive whereas adult services have a

narrower focus which causes anxiety about access to services. There are

no adult autism or ADHD services. The project is also looking for a better

connection with primary care to assist coordination of care and reduce

stress that may lead to a demand for adult services later on with the

development of mental health issues.


18/12/18 V 0.9 Final

Special parenting service

The special parenting service (SPS) supports parents who have mild to

borderline learning disability. The service is provided by a range of

professionals who work with families to improve parenting skills. Their role

is to help parents understand the needs of their children, and in particular,

how to keep their children safe; set routines for their baby or child; how to

manage their child’s behaviour; and how to access further support and

help.

The following chart shows the number of referrals to the SPS for three

complete years, and the referrals to date for this year.

Autistic spectrum disorder assessment team

The autistic spectrum disorder assessment team (ASDAT) is offered by

Cornwall Partnership Foundation Trust. It is a diagnostic service for

children and young people aged between 5½ and 16, who have complex

social and communication difficulties.

The ASDAT team is made up of the following disciplines: child and

adolescent psychiatry; child psychology; occupational therapy; and

speech and language therapy.

As of March 2018, data from ASDAT showed that there were 659 children

and young people who are waiting for an assessment for autism using

the ASDAT pathway (0-18). The waiting time for under 5s is 173 days

and for older children and young people it is 257 days. The ASDAT team

received 1237 referrals (approximately 65 per month) for the period

January 2017 to July 2018.

1st April - 31st March referrals

80

95 4

0

87 7

3 20

40

43 2

6 6 8 0

2018 current year

No of under 25s referred

Total number of SPS referrals


18/12/18 V 0.9 Final

Service provision - Local authority

Cornwall’s Local Offer and the Isles of Scilly’s Local Offer are the key

sources of up-to- date information about provision available to meet

SEND in our area.69,70

There are many different services that meet the needs of children and

young people; just some of the services provided by the local authority

and health include:

Schools

Speech and language therapy

Early years settings

Health visiting

Occupational therapy

Physiotherapy

Cognition and learning advice

Teachers of the deaf and the visually impaired

Social care

Child and adolescent mental health services

Special schools

The vast majority of children with SEND receive the support they need

locally, however, occasionally, due to complexity a child or young person

accesses highly specialised services based outside Cornwall and the Isles

of Scilly.

Transport

School Transport71 is generally limited to those children attending their

designated school or nearest school with a place available and when one of

the following apply:

The school is more than two miles from the home address for pupils under

69

https://www.supportincornwall.org.uk/kb5/cornwall/directory/site.page?id=aq6QKb5BEPE 70

http://www.scilly.gov.uk/childrens-services/isles-scilly-local-offer

71

Cornwall Council School Transport http://www.cornwall.gov.uk/schooltransport

https://www.supportincornwall.org.uk/kb5/cornwall/directory/site.page?id=aq6QKb5BEPE

http://www.cornwall.gov.uk/schooltransport


18/12/18 V 0.9 Final

the age of eight, and more than three miles for pupils over the age of

eight;

The pupil is unable to walk to school by reason of their special

educational need, disability or mobility problem;

The nature of the route is deemed by the Local Authority as being

unsuitable for pedestrian use.

Decisions are made on an individual basis for children and young people

with SEND. Some parents are happy to transport their child themselves,

and receive a mileage allowance for this – this is usually the most cost-

effective way of transporting children. However, other parents prefer to

have their child transported to school.

If possible, children will be grouped into the same transport. However, this

is often not possible, and there are lots of single-occupancy vehicles.

Some children and young people with less complex needs can be funded to

use public transport.

Some children and young people require a trained passenger assistant (PA)

to help manage their needs during the journey. PAs are usually provided

by the taxi companies that are used, although they can be provided by

schools, agencies, or the parents themselves.

An increasing number of transport providers have CCTV installed in their

vehicles. Any safeguarding issues are picked up by the Local Authority

Designated Officer (LADO).

Transport needs are not routinely reviewed, and changes often only

become apparent following an incident. Inclusion of a routine review would

be a better option, and aim for independence.

Data from the Transport Services Team shows that the cost of transport is

high. In 2017/18, there were 811 children and young people with SEND

under the age of 16, for whom transport has been provided at a cost of

approximately £5M. There were 316 young people with SEND over the age

of 16, for whom transport was provided at a cost of approximately £1.5M.

The overall budget for transport for 2017/18 was £13M, although this was

overspent by approximately £2.5M.

Equipment

There is a joint equipment store between education, health and social services. School are expected to provide certain items of equipment.


18/12/18 V 0.9 Final

Recommendations

Key issues Actions & recommendations

1. Outcome from the JSNA The Special Educational Needs and Disability Board and relevant partners work collaboratively to address the specific recommendations that

follow. 2. Data sharing Information collection and analysis within and

between services in relation to SEN needs to be

improved further.

3. Clarity and consistency about identification of SEN

A range of activity is required to improve accuracy and timeliness of identification of SEN.

4. Increasing demand. Predicted increases in SEND should be incorporated into forward planning of children’s

and adult’s services.

5. Transition to adult based services still requires further

improvement.

Transition between children and adult services requires continued focussed activity.

6. The level of health protection through

immunisations and screening needs further clarification.

Establish data to analyse the rate of immunisation uptake for those infants, children and young

people with a disability compared to the wider population and understand the reasons for any variance.

7. Wider determinants of

health in relation to SEND and access to services needs further research.

Further research is needed on lifestyle behaviours of children and young people with disabilities and how this impacts on their needs.

Further research is needed on housing and families with disabilities particularly those which require adaptations or have specific housing requirements.

8. Access and equity of services

Services are generally distributed well across Cornwall. However, these will need to be mapped to understand whether they are truly accessible and meeting local needs and informing planning for future demands.

9. Cornwall’s current education performance by children and young people with SEN is not in the top quartile nationally

Focussed activity by all partners, across the full

age range, to reduce the gaps in achievement between children and young people with and

without SEN in Cornwall, and the performance of pupils with SEN in Cornwall in comparison children and young people with SEN in other parts of the

country.


18/12/18 V 0.9 Final

Appendix 1 – Legislative and policy context

Improving the educational, health and wellbeing outcomes for children and

young people with special educational needs and disabilities has been a

focus for successive governments. This has been illustrated by a growing

body of evidence and government policies, such as:

Local area SEND inspection framework 201672

A new inspection framework for SEND (special educational needs and/or

disability) was published in April 2016. Local areas (including local

authorities, clinical commissioning groups, Public Health, the NHS, schools,

and other providers) will be inspected at least once every five years jointly

by Ofsted and the Care Quality Commission. Inspections assess how well

the local area as a whole is meeting the needs of children and young

people aged 0 to 25 with SEND.

SEND Code of Practice January 201573

The SEND Code of Practice provides statutory guidance on duties, policies

and procedures relating to Part 3 of the Children and Families Act 2014

and associated regulations across England.

72

Local area SEND inspection: framework https://www.gov.uk/government/publications/local-area-

send-inspection- framework 73 Statutory Guidance - SEND code of practice: 0 to 25 years

https://www.gov.uk/government/publications/send-code-of-practice-0-to-25

Key Messages

There is a wide range of legislation creating powers and

duties in relation to children and young people with

additional needs.

All public bodies have statutory duties to have due regard

for those with disabilities. All organisations (voluntary or

commissioned) working within this sector must be clear in

terms of the extent to which they promote disabled

children's human rights and give due regard through

services delivered.

https://www.gov.uk/government/publications/local-area-send-inspection-framework



https://www.gov.uk/government/publications/send-code-of-practice-0-to-25


18/12/18 V 0.9 Final

Children and Families Act 201474 Part 3: Children and young

people with special educational needs and disabilities

The Children and Families Act 2014 provided for an overhaul of the system

for identifying children and young people in England with special

educational needs (SEN), assessing their needs and making provision for

them. It places a specific duty on local authorities to identify all children in

their area who have SEN or disabilities.

The Act introduces Education Health and Care assessments and plans

which replace statutory assessments and statements of special

educational need. Many of the legal requirements for EHC assessments

and plans are the same or similar to those required for statements.

There are also some significant differences, including:

EHC plans do not necessarily cease when a young person leaves

school and can be maintained when a young person is in college,

undertaking an apprenticeship, or not in education, employment or

training;

EHC plans can be maintained up to the age of 25;

There are enforceable elements of health and social care that must be

recorded in EHC Plans.

The overarching aim is to give families and young people a greater

involvement in decisions about their support and to encourage social

care, education and health services to work together more closely.

Local authorities must pay particular attention to:

the views, wishes and feelings of children and their parents, and young people;

the importance of them participating as fully as possible in decision-

making and providing the information and support to enable them to

do so; and

supporting children and young people’s development and helping

them to achieve the best possible educational and other

outcomes.

74




18/12/18 V 0.9 Final

As part of the changes local authorities are required to publish a ‘local

offer’ setting out what support is available to young people with SEN and

families with children who have disabilities or SEN. The local offer also

explains how families can request personal budgets, make complaints

and access more specialist help.

The Act also sets out requirements for all Early Years providers to have

arrangements in place to support children with SEN or disabilities75. Every

local authority must also have a SEN inclusion fund to support early

years providers in meeting the needs of individual children with SEN.

A more comprehensive summary of the legislation is available from the

Council for Disabled Children76.

Special Educational Needs and Disability Regulations 201477

These Regulations set out the detailed requirements on local authorities for

assessing children and young people’s education, health and care needs

and where necessary drawing up Education, Health and Care plans. They

set out requirements on schools for identifying and supporting children and

young people with special educational needs and also the arrangements

for resolving disagreements, including mediation and appeals to an

independent tribunal where parents or young people do not agree with

decisions made by their local authority.

They also set out the way in which local authorities and health bodies

should review support for children and young people with SEND and how

local authorities and schools must publish information concerning the

support which is available.

75Early years: guide to the 0 to 25 SEND code of practice, Advice for early years providers that are

funded by the local authority.

_Code_of_Practice_-_02Sept14.pdf 76

Children and Families Act http://www.councilfordisabledchildren.org.uk/resources/summary-of-the-children-and- families-act 77

The Special Educational Needs and Disability Regulations 2014

http://www.legislation.gov.uk/uksi/2014/1530/pdfs/uksi_20141530_en.pdf

https://councilfordisabledchildren.org.uk/help-resources/resources/summary-children-and-families-act

https://councilfordisabledchildren.org.uk/help-resources/resources/summary-children-and-families-act

http://www.legislation.gov.uk/uksi/2014/1530/pdfs/uksi_20141530_en.pdf


18/12/18 V 0.9 Final

Special Educational Needs (Personal Budgets) Regulations

201478

These regulations provide a framework as to how local authorities can

assign personal budgets to young people with SEND or their families. This

applies to the use of personal budgets for children and young people with

SEND who have an EHC plan and the regulations set out the criteria and

detailed provision for the use of personal budgets, including direct

payments for special educational provision.

The Care Act 201479 The Care Act 2014 sets out carers' legal rights to assessment and support.

It came into force in April 2015. The Care Act relates mostly to adult carers

– people aged 18 and over who are caring for another adult. However, the

Act also contains new rules about working with young carers or adult

carers of disabled children to plan an effective and timely move to adult

care and support.

The Act says adult social services need to be involved in planning the

support a young carer may need once they reach 18. This also applies to

adult carers of children where it appears likely that the adult carer will

have needs for support after the child turns 18.

The Breaks for Carers of Disabled Children Regulations 201180

In order to meet the requirements of the regulations, Local Authorities

must have regard to the needs of carers in respect of their capacity to care

for, or continue to care for, their disabled child, and must provide a range

of services designed to meet this need. The following summarises the key

duties introduced under these regulations:

Duty to make provision

Local authorities must take into account the needs of carers who

would be unable to continue caring for their child unless breaks from

caring were given; or who would be able to give more effective care

78

The Special Educational Needs (Personal Budgets) Regulations 2014

http://www.legislation.gov.uk/ukdsi/2014/9780111114056 79

Care Act 2014 http://www.legislation.gov.uk/ukpga/2014/23/contents/enacted 80

http://www.legislation.gov.uk/uksi/2011/707/made

http://www.legislation.gov.uk/ukdsi/2014/9780111114056


http://www.legislation.gov.uk/uksi/2011/707/made


18/12/18 V 0.9 Final

if breaks were given to allow them to, for example, attend

educational classes or work, meet the needs of other children in the

family, or carry out necessary day-to-day tasks in the household.

Types of services which must be provided

Local Authorities must, so far as is reasonably practicable, provide a

range of services sufficient to meet the needs of carers to care, or

care more effectively, including:

Day care in the child’s own home or elsewhere

Overnight care in the child’s own home or elsewhere

Educational or leisure activities for children outside their own

homes

Services in the evenings, at weekends and during school holidays

Short breaks services statement Local Authorities must prepare a statement for carers in their area

setting out the range of services available;

any eligibility criteria for these services; and

how the range of services is designed to meet the needs of carers

Equality Act 201081

The Equality Act 2010 replaced various anti-discrimination laws (for

example the Disability Discrimination Act and the Race Relations

Amendment Act) with a single Act. It simplified the legislation, removing

inconsistencies and making it easier for people to understand and comply

with it. It also strengthened the law in important ways to help tackle

discrimination and inequality.

The Act introduced new public sector equality duties for organisations such

as county and district councils and the NHS. Organisations that perform

‘public functions’ are also covered by these duties to:

eliminate unlawful discrimination, harassment or victimisation

advance equality of opportunity between people who share

a protected characteristic, and those who do not

foster good relations between people who share a protected

characteristic, and those who do not.

81

http://www.legislation.gov.uk/ukpga/2010/15/contents



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Special Educational Needs and Disability Act 200182

The Disability Discrimination Act (DDA) 1995 legislated that it is against the

law for goods, services and facility providers to discriminate against

disabled people by treating them less favourably due to their disability. If

someone is adamant that this sort of discrimination is justified, they would

be required to show why such action should be regarded as reasonable.

The DDA 1995 did not, however, extend as far as encompassing education

providers. The Special Educational Needs and Disability Act 2001 was

created in order to tackle discrimination in this sphere and extend the DDA

1995.

Under the Special Educational Needs and Disability Act 2001, schools,

colleges, universities, adult education providers, statutory youth services

and local education authorities were required to make the same sort of

reasonable adjustments for disabled people as stipulated in the DDA 1995.

The aim of including these groups, organisations and bodies in the Act was

to ensure that disabled people were offered the same opportunities and

choices as those in mainstream society. It was also designed to make sure

that where possible, disabled people have the right to be able to work at

their fullest capacity and have the chance to fulfil their potential.

Education Act 200183

The Education Act makes provision about education, childcare,

apprenticeships and training, schools and the school workforce, institutions

within the further education sector and Academies; to abolish the General

Teaching Council for England, the Training and Development Agency for

Schools, the School Support Staff Negotiating Body, the Qualifications and

Curriculum Development Agency and the Young People’s Learning Agency

for England; to make provision about the Office of Qualifications and

Examinations Regulation and the Chief Executive of Skills Funding; to make

provision about student loans and fees; and for connected purposes. This

Act included criteria for statements of special educational need, although

statements were replaced with education, health and care (EHC) plans

from September 2014, the criteria for assessment remains unchanged.

82

http://www.legislation.gov.uk/ukpga/2001/10/contents 83

Government Legislation http://www.legislation.gov.uk/ukpga/2011/21/introduction/enacted


http://www.legislation.gov.uk/ukpga/2011/21/introduction/enacted


18/12/18 V 0.9 Final

Human Rights Act (HRA) 199884

In the UK, human rights are protected by the Human Rights Act 1998. The

Act came into full force on 2 October 2000 and gives effect to the human rights set out in the European Convention on Human Rights (ECHR).

Under the Human Rights Act, everyone is entitled to expect that the

government, and all public agencies and organisations should have respect

for their basic human rights. If they consider that their rights have been

ignored, they can bring a case in the UK courts to challenge an action or a

decision by any public authority on the grounds that it interferes with their

rights.85

NOTE: The Disability Discrimination Act is no longer in use - it is now

known as the Equality Act 2010. From 1 October 2010, the Equality Act

replaced most of the Disability Discrimination Act (DDA). However, the

Disability Equality Duty in the DDA continues to apply.

NICE (National Institute for Clinical Excellence)86

The National Institute for Clinical Excellence provides national guidance and

advice to improve outcomes for people using the NHS and other public

health and social care services. As part of its suite of products, NICE

produces guidelines. These are evidence-based recommendations for health

and care in England and set out the care and services suitable for most

people with a specific condition or need, and people in particular

circumstances or settings.

In the last few years NICE have released the following guidance

documents relevant to children and young people with disability and

special educational needs:

NG62 Cerebral palsy in under 25s: assessment and management, Jan 2017

QS140 Transition from children’s to adults’ services, Dec 16 NG61 End of life care for infants, children and young people with life-

limiting conditions: planning and management, Dec 16 QS128 Early years: promoting health and wellbeing in under 5s, Aug 2016 NG43 Transition from children’s to adults’ services for young people

using health or social care services, Feb16

84Human Rights Act 1998 http://www.legislation.gov.uk/ukpga/1998/42/schedule/1

85"A Guide to the Human Rights Act 1998: Questions and Answers" (PDF). JUSTICE. December

2000. https://web.archive.org/web/20020312081934/86

National Institute for Clinical Excellence https://www.nice.org.uk/

http://www.legislation.gov.uk/ukpga/1998/42/schedule/1

https://www.nice.org.uk/


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QS102 Bipolar disorder, psychosis and schizophrenia in children and young people, Oct 15

NG1 Gastro-oesophageal reflux disease in children and young people: diagnosis and management, Jan 15

QS51 Autism, Jan 14

QS48 Depression in children and young people, Sept 13

CG170 Management of autism in children and young people, Aug 13

QS39 Attention deficit hyperactivity disorder, July 13

GDG Challenging behaviour and learning disabilities, May 13

CG158 Conduct disorder in children and young people, Mar 13

QS27 The epilepsies in children and young people, Feb 13

CG155 Psychosis and schizophrenia in children and young people, Jan 13

(Updated Oct 15)

PH20&40 Social and emotional wellbeing in early years (PH40) and in

secondary education, Oct 12

CG145 Spasticity in children and young people, Jul 12 (Updated Nov16)

CG128 Autism in children and young people, Sept 11 (NICE 2013)

Throughout all of these there is strong focus on: access to services;

accurate diagnosis and its clear documentation and communication; annual

specialist reviews; comprehensive treatment options (including non-

pharmacological and non-surgical); a ‘life-course’ perspective to

management; child-focused planning with involvement of parents and

carers; addressing the social, physical and psychosocial environments; and

transition to adult services and adult life.

Safeguarding in schools

The Department for Education’s report Keeping Children Safe in Education

July 2015 is statutory guidance issued the Education Act 2002, the

Education (Independent School Standards) Regulations 2014 and the

Education (Non-Maintained Special Schools) (England) Regulations 2011.

This guidance contains information on what schools and colleges should do

and sets out the legal duties with which schools and colleges must comply

and should be read alongside statutory guidance Working Together to

Safeguard Children 2015 and departmental advice What to do if you are

worried a child is being abused 2015. The designated safeguarding lead

should be alert to the specific needs of children, those in need, those with

special educational needs and young carers.


18/12/18 V 0.9 Final

Appendix 2 – Risk factors associated with childhood disability

There can be many reasons for disability or developmental delay. These

can begin anytime during the developmental period and whilst many begin

before a baby is born, some can happen after birth because of injury,

infection, or other factors.

Factors known to influence disability or developmental delay amongst

children include genetics; parental health and behaviours (such as

smoking and drinking) during pregnancy; complications during birth;

infections the mother might have during pregnancy or the baby might have

very early in life; and exposure of the mother or child to high levels of

environmental toxins, such as lead.

For some developmental disabilities, such as foetal alcohol syndrome,

which is caused by drinking alcohol during pregnancy, we know the cause.

But for most, we don’t87.

The following provide examples of known specific risks:

Before birth

Before birth the health of a baby is significantly influenced by the health

and wellbeing of their mother88. Prenatal risk factors include:

Preconception factors – relate predominantly to genetic conditions or

syndromes such as Down’s syndrome and fragile X syndrome – around

one in every 1,000 babies born in the UK will have Down’s syndrome89.

Older and younger parents are more at risk of complications that can

result in their child experiencing a disability. Those under 20 are more

at risk of poor nutrition and poor placental transfer of food and oxygen,

whereas those who have children later are more likely to suffer from

chromosomal abnormalities90.

Maternal physical injury – injury or impact to the mother’s abdomen

87

Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers

for Disease Control and Prevention [Accessed January 2017]

https://www.cdc.gov/ncbddd/developmentaldisabilities/facts.html 88

M. Marmot, 'Fair Society, Healthy Lives. The Marmot Review', Strategic review of health inequalities in England post - 2010 (2010).

89 http://www.cdc.gov/ncbddd/birthdefects/downsyndrome.html

90 Blomberg M, Tyrberg RB and Kjølhede P. Impact of maternal age on obstetric and neonatal

outcome with emphasis on primiparous adolescents and older women: a Swedish Medical Birth Register Study. BMJ Open 2014; 4:e005840

https://www.cdc.gov/ncbddd/developmentaldisabilities/facts.html

https://www.cdc.gov/ncbddd/birthdefects/downsyndrome.html


18/12/18 V 0.9 Final

during pregnancy can result in disabilities when the child is born.

Infections – a number of viral and sexual infectious diseases suffered by

mothers during pregnancy can cross the placental barrier and cause

disabilities including: toxoplasmosis, herpes, gonorrhoea, chlamydia,

invasive Group B strep, listeria infection or bacterial infections.

Exposure to toxins – foetuses being exposed to drugs and/or

alcohol,91,92radiation, certain prescription drugs, and environmental

pollutants can cause birth defects.

Maternal chronic illness – conditions such as asthma, diabetes,

epilepsy, cancer, hypertensive disorders (e.g. pre-eclampsia and

eclampsia), phenylketonuria, sickle cell anaemia, systemic lupus

erythematosus, thalassaemia, and thyroid problems can all result in

complications in pregnancy and pose a threat to the unborn baby.

Maternal nutritional deficiencies – deficiencies in key vitamins and

minerals can lead to disabilities, for example hydrocephalus and

spina-bifida.

Incompatible blood type – when a mother’s blood type is different to the

baby’s, there is risk that the mother’s body forms antibodies that can

attack the baby’s blood causing disabilities, such as cerebral palsy and

deafness.

At the time of birth

The process of labour and delivery can also present complications. The

following sets out the potential risks of difficulty in delivery:

Premature birth and/or low birth weight babies – babies who are

born early and/or have a low birth weight have an increased

risk of health and developmental problems.93,94,95,96 Premature

91

NICE. Antenatal care CG62. London: National Institute for Health and clinical Excellence 2008.

Available from: https://www.nice.org.uk/guidance/cg62 92

NICE. Pregnancy and complex social factors: A model for service provision for pregnant women with complex social factors CG110. London: National Institute for Health and clinical Excellence 2010. Available from: https://www.nice.org.uk/guidance/cg110 93

deRegnier RA. Neurophysiologic evaluation of brain function in extremely premature newborn infants. Seminars in Perinatology. 2008; 32:2–10. 94

Zwicker JG, Harris SR. Quality of life of formerly preterm and very low birth weight infants from preschool age to adulthood: A systematic review. Pediatrics. 2008; 121: e366–e376. 95

MacDonald H. Perinatal Care at the Threshold of Viability. Pediatrics. 2002; 110: 5. 96

Hack M, Klein NK, Taylor HG. Long-term developmental outcomes of low birth weight infants. Future

of Children. 1995; 5:176 –96

http://www.nice.org.uk/guidance/cg62

http://www.nice.org.uk/guidance/cg110


18/12/18 V 0.9 Final

birth and low birth weight can be caused by maternal lifestyle

choices, for example smoking97 or poor nutrition. However, for

the majority of women who have preterm births, the causes are

unclear98.

Birth trauma – such as breech presentation, operative vaginal

delivery or small maternal size and maternal pelvic anomalies

that may contribute towards temporary stoppage of oxygen

supply to the brain of the baby or damages nervous tissues.

Multiple births – have a higher rate of obstetrical complications

during the pregnancy and at time of delivery, resulting in

higher risks of serious health problems99.

Post birth

In the days and weeks following birth, there are common conditions that, if

left untreated, can lead to an infant developing a disability or SEN:

Untreated new-born jaundice (high levels of bilirubin in the

blood during the first few days after birth) – can cause a type

of brain damage known as kernicterus. This can result in

involuntary and uncontrolled movements (athetoid cerebral

palsy), hearing loss and improper development of tooth

enamel.

Hypoglycaemia (low blood glucose) – which if severe or prolonged

may result in a risk of seizures and serious brain injury.

Over the longer term risks linked to disability and SEN are much the same

as the wider population including:

Accident or injury – including falls, poisoning, suffocation

and road traffic accidents. Evidence suggests these to be

closely linked with social deprivation100.

97Larsen, L.G. et al. Stereologic examination of placentas from mothers who smoke during pregnancy.

Am J Obstet & Gynecol. 2002; 186: 531-53798

Bull, J et al (2003) Prevention of low birth weight: assessing the effectiveness of smoking cessation and nutritional interventions. Evidence Briefing July 2003 Health Development Agency

99Improving outcomes for fertility patients: multiple births 2015, Human Fertilisation and Embryology

Authority, 100

WHO. World report on child injury prevention. WHO. 2008. Available at http://apps.who.int/iris/bitstream/10665/43851/1/9789241563574_eng.pdf – accessed May 2017

https://apps.who.int/iris/bitstream/handle/10665/43851/9789241563574_eng.pdf;jsessionid=9F7AC2CB83AB9B9F28CB6E3FFF875277?sequence=1

https://apps.who.int/iris/bitstream/handle/10665/43851/9789241563574_eng.pdf;jsessionid=9F7AC2CB83AB9B9F28CB6E3FFF875277?sequence=1


18/12/18 V 0.9 Final

Infectious diseases – lack of immunisation increases the risks

associated with infectious diseases such as mumps,

meningitis or measles all of which can cause disability101.

Malnutrition – nutrition and disability are intimately linked:

malnutrition can directly cause or contribute to disability and

disability to malnutrition. Malnutrition as a result of a poor

diet is rare in the UK, however, nutritional deficiencies can

result in a variety of physical and mental disabilities including

growth deficiencies, bone malformation and blindness102.

National estimates vary from 10% (Emerson, E. and Hatton, C. 2005); 7%

(Office National Statistics 2004103); 3% OPCS (1989) and 1.2% (estimate

of young people with severe disabilities, DCSF 2007).

The Office of National Statistics report suggested a 62% increase in the

number of disabled children between 1975 and 2002, in part due to

medical advances and increased diagnosis and reporting; this is an

ongoing trend. The vast majority of families (98%) care for their children

at home. Those children and their families have needs that are various and

wide-ranging.

101

WHO. 2011. World Report on Disability. Ibid. 102

Groce.N, et. al., Stronger Together: Nutrition-Disability Links and Synergies (Briefing Note), UNICEF,

https://www.unicef.org/disabilities/files/Stronger-Together_Nutrition_Disability_Groce_Challenger_Kerac.pdf - accessed May2017 103

The Health of Children and young people, Chapter 10,: Disability, March 2004, ONS

https://www.unicef.org/disabilities/files/Stronger-Together_Nutrition_Disability_Groce_Challenger_Kerac.pdf

https://www.unicef.org/disabilities/files/Stronger-Together_Nutrition_Disability_Groce_Challenger_Kerac.pdf


18/12/18 V 0.9 Final

Appendix 3 – population projections

Population projections for the 0-25 age group The following maps introduce the scale of forecasted population change

across Cornwall. It utilises population projections commissioned by

Cornwall Council from Edge Analytics (POPGROUP) which incorporate the

Council’s housing growth targets set out within the Local Plan.


18/12/18 V 0.9 Final


18/12/18 V 0.9 Final

The population projections show that there is expected to be an increase in

the population of children and young people in the Falmouth area as a

result of the presence of the university. There is also expected to be an

increase in the Roseland.

There are few special schools in Cornwall and the Isles of Scilly, so children

and young people tend to travel large distances to access the school that is

most suitable for their needs. Therefore, local population changes are

unlikely to impact on the numbers of children and young people attending

special schools.


18/12/18 V 0.9 Final

2015 2020 2025

Cornwall [M]

Cornwall [F]

Cornwall [M]

Cornwall [F]

Cornwall [M]

Cornwall [F]

0-4 15,022 14,257 0-4 15,109 14,298 0-4 15,637 14,797 5-9 15,048 14,279 5-9 16,367 15,414 5-9 16,414 15,429

10-14 14,432 13,575 10-14 16,147 15,289 10-14 17,427 16,383 15-19 16,180 15,354 15-19 15,105 14,147 15-19 16,890 15,892 20-24 15,599 14,897 20-24 15,750 14,867 20-24 14,779 13,903 25-29 13,810 13,307 25-29 15,267 14,442 25-29 15,190 14,119 30-34 13,417 14,178 30-34 14,173 14,498 30-34 15,412 15,344 35-39 13,596 14,410 35-39 14,246 15,530 35-39 14,987 15,862 40-44 15,819 17,582 40-44 14,427 15,528 40-44 15,159 16,705 45-49 18,377 20,313 45-49 16,460 18,489 45-49 15,053 16,439 50-54 19,280 20,354 50-54 19,102 21,253 50-54 17,169 19,382 55-59 18,087 19,687 55-59 20,071 21,480 55-59 19,946 22,348 60-64 17,682 19,213 60-64 18,841 20,470 60-64 21,017 22,505 65-69 20,776 21,881 65-69 17,861 19,337 65-69 19,182 20,690 70-74 15,318 16,526 70-74 19,501 20,849 70-74 16,981 18,546 75-79 10,926 12,301 75-79 13,491 14,967 75-79 17,348 18,997 80-84 7,590 9,502 80-84 8,685 10,527 80-84 10,993 12,993

85+ 5,982 10,991 85+ 7,404 11,703 85+ 9,280 13,420

266,941 282,607 278,007 293,088 288,864 303,754


18/12/18 V 0.9 Final

Appendix 4 – further details about Disability Living Allowance

The main categories for claimants for Disability Living Allowance (DLA) are

shown in the following charts.

Disability Living Allowance in 0-24 years for conditions that have risen since 2011

Disability Living Allowance 0-24 years 2,500

2,000

1,500

Emotional and Behavioural disorder

Hyperkinetic syndrome

Learning Difficulties

Mental Health

Nervous system

1,000

500

0

Disability Living Allowance 0-24 years - rising

2,000 EmotionalandBehaviouraldisorder

Hyperkinetci syndrome

Unknown

1,500 LearningDi iculties

1,000

500

0


18/12/18 V 0.9 Final

The following table shows the comparison between DLA claimants in

2012 and 2017. The greatest change was in emotional and behavioural

disorder.

DLA benefit claimants 0-24 Comparison104

Category Feb 2012 Feb 2017 Difference

+/-

Alcohol and drug abuse 0 0 0

Chronic fatigue 40 20 -20

Circulatory 70 40 -30

Diabetes 200 160 -40

Disease 240 160 -80

Emotional and behavioural disorder 210 590 380

Frailty 0 0 0

Hyperkinetic syndrome 480 380 -10

Learning difficulties 2110

2,00

0

-

110 Mental health 340 130 -210 Multi system disorders 0 0 0

Multiple allergy syndromes 10 0 -10

Musculoskeletal 230 180 -50

Nervous system 610 410 -

200 Respiratory 50 20 -30

Sensory loss 220 170 -50

Terminal illness 10 0 -10

Trauma 40 20 -20

Unknown 110 270 160

Urinary system 30 20 -10

TOTAL* 5,00

0

4,99

0

-10

*Figures are rounded

104

Disability living allowance by disabling condition, DWP, [NOMIS 2016]


18/12/18 V 0.9 Final

Appendix 5 – trends in numbers of children and young people who have SEND

Pupils with or without statements of special educational needs (SEN) or education,

health and care (EHC) plans (January each year) 2007-17105

Total pupils

Pupils with statements Pupils without statements

ENG SW C’wall ENG % SW % C’wall % ENG % SW % C’wall %

2007 8,167,715 771,615 74,983 232,760 2.8 20,820 2.7 2,060 2.7

2008 8,121,955 767,260 74,250 227,315 2.8 20,620 2.7 2,063 2.8

2009 8,092,280 762,685 73,178 225,400 2.8 20,565 2.7 2,032 2.8 1,447,205 17.9 130,345 17.1 12,027 16.4

2010 8,098,360 759,470 72,648 223,945 2.8 20,580 2.7 2,130 2.9 1,481,035 18.3 132,535 17.5 12,585 17.3

2011 8,123,865 759,690 72,374 224,210 2.8 20,470 2.7 2,023 2.8 1,449,685 17.8 131,975 17.4 13,007 18.0

2012 8,178,200 761,960 72,399 226,125 2.8 20,710 2.7 2,054 2.8 1,392,215 17.0 128,825 16.9 12,179 16.8

2013 8,249,810 764,655 72,550 229,390 2.8 20,885 2.7 2,051 2.8 1,316,220 16.0 122,085 16.0 11,688 16.1

2014 8,331,385 768,995 72,708 232,190 2.8 21,285 2.8 2,035 2.8 1,260,760 15.1 120,285 15.6 11,010 15.1

2015 8,438,145 775,755 72,927 236,165 2.8 21,580 2.8 1,948 2.7 1,065,280 12.6 104,110 13.4 9,110 12.5

Pupils with or without statements of special educational needs106

As can be seen from the table below Cornwall has been in line with national

and regional numbers during the 2011 to 2017 period. Both specific and

moderate learning difficulties showed a decrease in the number of pupils

up to 2014 and there has been a substantial increase since. In both the

severe learning, and profound and multiple learning difficulty categories

there has been a steady increase during this time period. In 2017, there

were 266 pupils on the Isles of Scilly. Of these, 32 (12.0%) had SEN but

no EHC plan, and a further nine (3.4%) had EHC plans.

However, the small numbers on the Isles of Scilly make it difficult to draw

conclusions.

Number of pupils with learning difficulties107

105

Special educational needs in Cornwall January 2017 Government Statistics https://www.gov.uk/government/collections/statistics-special-educational-needs-sen 106

Special educational needs in Cornwall January 2017 Government statistics



18/12/18 V 0.9 Final

2017 2016 2015 2014 2013 2012 2011

Specific Learning Difficulty

ENGLAND 147,873 151,153 135,505 67,555 70,655 74,575 78,135

SOUTH WEST 17,562 17,919 16,060 6,490 6,825 7,060 7,340

Cornwall 1,188 1,314 1,370 55

5

588 683 70

8 Isles of Scilly 1

1

1

3

12 X X 3 X

Moderate Learning Difficulty

ENGLAND 259,713 273,627 241,125 129,830 138,350 149,520 160,750

SOUTH WEST 19,820 21,398 17,385 7,865 8,210 8,980 9,525

Cornwall 2,071 2,183 1,867 860

958 1,065 1,142

Isles of Scilly 6 5 7 4 3 5 9

Severe Learning Difficulty

ENGLAND 32,338 32,304 32,090 31,040 30,440 29,935 29,270

SOUTH WEST 3,027 3,088 3,035 2,920 2,855 2,800 2,700

Cornwall 324

344

334 327

308 282 277 Isles of Scilly 0 0 0 0 0 0 0

Profound & Multiple Learning Difficulty

ENGLAND 10,981 10,914 10,910 10,590 10,525 10,255 9,895

SOUTH WEST 932

952

970 940

955 940 895 Cornwall 8

8 80

68 70

61 64 62 Isles of Scilly 0 X X X X 0 0

X – Numbers redacted

In the table below it shows there were decreases in the number of pupils

with social, emotional and behavioural difficulty between 2010 and 2014.

Cornwall is very much in line with the national and regional trend, with a

decrease from 1,492 in 2011 to 1,213 in 2014 and then an increase up to

1,771 in 2017. The numbers for the Isles of Scilly are too small to give

meaningful information about trends.

Number of pupils with social, emotional and mental health difficulties106

2017 2016 2015 2014 2013 2012 2011

ENGLAND 186,793 184,930 169,110 138,655 143,050 151,150 158,015

SOUTH WEST 20,940 20,221 17,370 13,090 13,085 13,485 13,785

Cornwall 1,857 1,771 1,535 1,213 1,363 1,400 1,492

Isles of Scilly 3 5 5 X X X 4

The table below shows the steady increase from 2011 to 2017 in the

107





18/12/18 V 0.9 Final

number of pupils with speech, language and communication needs.

Cornwall is in line with the national and regional figures having

increased from 1,191 to 1,902. Whilst the numbers of pupils on the

Isles of Scilly with speech, language and communication needs are too

small to draw firm conclusions, there is a suggestion that the numbers

may be increasing, with 11 pupils having been identified in 2017.

Number of pupils with speech, language and communication

needs108

2017 2016 2015 2014 2013 2012 2011

ENGLAND 234,076 221,456 190,475 138,905 132,205 125,635 120,610

SOUTH WEST 22,102 20,921 17,655 12,610 12,135 11,760 11,605

Cornwall 1,902 1,850 1,653 1,231 1,270 1,286 1,191

Isles of Scilly 11 5 5 4 4 X 0


The table below shows the increase from 2010 to 2017 in Cornwall from 106 to 158; this is in line with national and regional numbers. Since 2012,

there have been no pupils on the Isles of Scilly who have a hearing

impairment.

Number of pupils with hearing impairment107

2017 2016 2015 2014 2013 2012 2011

ENGLAND 21,167 20,499 19,350 16,470 16,270 16,135 15,980

SOUTH WEST 1,989 1,967 1,855 1,455 1,410 1,390 1,330

Cornwall 158 150 157 132 130 120 109

Isles of Scilly 0 0 0 0 0 0 X


The table below shows that within Cornwall and the South West the

numbers of pupils with visual impairment was steadily declining from 2010

but has increased over the last two years. The national figures, however,

show a steady increase. There have been no pupils on the Isles of Scilly

since 2011 with visual impairment.

Number of pupils with visual impairment107

108





18/12/18 V 0.9 Final

2017 2016 2015 2014 2013 2012 2011

ENGLAND 11,889 11,592 10,840 9,115 9,070 8,900 8,775

SOUTH WEST 990 959 875 730 700 755 770

Cornwall 86 86 84 61 67 68 70


The number of pupils with multi-sensory impairments has increased substantially over the six year period shown in the table below. Cornwall

has been in line with the national and regional increases.

Number of pupils with multi-sensory impairment109108

2017 2016 2015 2014 2013 2012 2011

ENGLAND 2,719 2,302 1,845 1,115 1,025 965 935

SOUTH WEST 326 309 275 125 110 90 80

Cornwall 47 42 37 16 17 17 3


The table below shows how the number of pupils with a physical disability

has increased steadily from 2010 to 2016 with England and the South

West. This has not been the pattern within Cornwall where it decreased in

2013 to 258 and is increasing slightly to 283 in 2016.

Number of pupils with a physical disability108

2017 2016 2015 2014 2013 2012 2011

ENGLAND 33,686 32,897 30,790 26,760 26,685 26,620 26,970

SOUTH WEST 3,263 3,202 2,945 2,560 2,525 2,545 2,595

Cornwall 292 283 277 265 258 282 297

Isles of Scilly 2 2 X X 0 0 0

X – Numbers have been redacted

The table below shows there have been substantial increases in the number

of pupils with Autistic Spectrum Disorder in the 2010 to 2017 timescale. In

line with the national and regional trend, Cornwall has increased from 549

to 792.

Number of pupils with autistic spectrum disorder108

109





18/12/18 V 0.9 Final

2017 2016 2015 2014 2013 2012 2011

ENGLAND 108,403 100,012 90,775 76,015 70,780 66,200 61,575

SOUTH WEST 8,831 8,272 7,665 6,400 5,985 5,610 5,240

Cornwall 792 779 751 703 636 583 557


X – Numbers have been redacted

The table below shows the number of pupils with other difficulties or disability. The number of pupils has increased from 2011 to 2017;

however, this has not been a steady increase.

Number of pupils with other difficulty/disability108

2017 2016 2015 2014 2013 2012 2011

ENGLAND 54,342 55,196 50,210 29,040 29,020 29,485 30,475

SOUTH WEST 5,824 5,932 4,965 2,605 2,580 2,700 2,685

Cornwall 440 443 397 231 256 287 312



18/12/18 V 0.9 Final

Appendix 6 – absenteeism and exclusions

Absence rates and pupils defined as persistent absentees by special educational needs 2013/14110

England South

West Cornwall IoS

No

Identified SEN

Number of pupil enrolments 5,221,040

492,130

50,363

199

Sessions missed due to overall absence (%)

4.1 4.2 4.3 4.6

Percentage defined as persistent absentees (%)

2.6 2.6 2.6 2.5

SEN

without a statement


5

103,90

5

10,23

3

22

Sessions missed due to

overall absence (%) 6.1 6.0 6.0 6.1


7.0 6.7 6.4 0

School

Action

Number of pupil enrolments 683,11

5

68,89

0

6,70

0

12


5.7 5.7 5.8 6.0


5.9 5.8 5.6 0

School Action Plus


5

35,01

5

3,53

3

10

Sessions missed due to

overall absence (%) 6.7 6.7 6.5 6.4

Percentage defined as

persistent absentees (%) 8.8 8.5 7.8 0

SEN with

a statement


5

17,70

5

1,83

0

5


7.5 7.4 6.6 3.8


11.0 10.7 9.1 0

All pupils


617,345

62,715

225


4.5 4.6 4.7 4.8

Percentage defined as

persistent absentees (%) 3.6 3.5 3.4 2.2

School Census 2014

The number of excluded pupils by SEN stage is expressed as a percentage

of the total number of all pupils of the same SEN stage at the time of the

January 2014 School Census. For fixed period exclusions, pupils' SEN

status at the time of their most recent fixed period or permanent

exclusion, the number is expressed as a percentage of the number

(headcount) of all pupils of the same SEN stage. Permanent exclusions,

SEN is recorded at the time of exclusion.

The percentage of fixed period exclusions and pupils receiving at least one

fixed-term exclusion, as a percentage of the school population is

110







18/12/18 V 0.9 Final

considerably lower in Cornwall in comparison with both the South West

and England. However, the percentage receiving a permanent exclusion is

slightly higher than both the regional and national average.

Permanent and fixed-term exclusions by special educational needs 2013/14111

England South West

Cornwall IoS

No

identified SEN

Number of pupil enrolments 6,298,520 578,840 57,480 235

Number of fixed period exclusions as a percentage of school population (%)

1.73 1.63 1.09 X

Percentage receiving at least one fixed term exclusion (%)

1.08 1.00 0.71 X

Percentage receiving a permanent exclusion (%)

0.03 0.03 0.03 0

SEN without a statement

(6)



10.79 10.52 6.61 0


5.17 5.07 3.88 0


0.25 0.27 0.33 0

School Action

Number of pupil enrolments 724,690 73,190 7,023 18


7.17 6.97 4.19 0


3.78 3.74 2.69 0


0.13 0.15 0.17 0

School Action Plus



16.53 17.43 11.26 0


7.38 7.67 6.16 0


0.43 0.50 0.63 0

SEN with a statement



15.19 19.12 11.41 0


6.42 7.74 5.66 0


0.15 0.19 0.35 0

All pupils



3.50 3.51 2.23 X


1.86 1.83 1.33 X


0.06 0.07 0.09 0

School Census 2014 Further information is available in the "Guide to absence statistics". X = redacted

111







18/12/18 V 0.9 Final

Appendix 7 – prevalence of SEND in areas of higher deprivation

Children with SEN in primary schools in Cornwall

2015 IMD Decile

No SEN School Support (K)

% School Suppor

t

SEN stateme

nt or EHC plan

% with stateme

nt or EHCP

All SEN

% of

all SEN

Total NOR

Mo

st

Dep

riv

ed

of

LS

OA

s i

n

En

gla

nd

0 - 10% (rank 1 - 3284)

2,319 459 10 53 8 512 9 2,831

10 - 20% (rank 3285 - 6568)

3,408 554 12 67 11 621 11 4,029

20 - 30% (rank 6569 - 9853)

5,788 818 17 110 17 928 17 6,716

30 - 40% (rank 9854 - 13137)

10,046 1,245 26 162 26 1,410 26 11,456

40 - 50% (rank 13138 - 16422)

6,929 837 17 110 17 947 17 7,876

Least

Dep

riv

ed

of

LS

OA

s i

n

En

gla

nd

40 - 50% (rank 16423 - 19706)

4,002 407 8 51 8 458 8 4,460

30 - 40% (rank 19707 - 22990)

2,722 242 5 49 5 291 5 3,013

20 - 30% (rank 22991 - 26275)

1,861 202 4 30 4 232 4 2,093

10 - 20% (rank 26276 - 29559)

X X 0 X 0 X 0 278

0 - 10% (rank 29560 - 32844)

X X 0 X 0 X 0 5

Grand Total

37332

4,790

100

635

100

5,426

100

42757

DfE Schools Census Spring 2017 Pupils Single or Main dual Registered. Includes

ARB/CDC Pupils Data supplied by Education, Health and Social Care, Cornwall Council X – numbers redacted to avoid disclosure, including by subtraction

Children with SEN in secondary schools in Cornwall

2015 IMD Decile

No SEN School

Support (K)

% School

Support

SEN statemen t or EHC

plan

% with statemen t or EHCP

All SEN

% of all SEN

Total NOR

Most

Deprived o

f

LSO

As in E

ngla

nd

0 - 10% (rank 1 - 3284)

1,432 271 9 55 8 326 9 1,758

10 - 20% (rank 3285 - 6568)

2,050 352 12 79 11 431 12 2,481

20 - 30% (rank 6569 - 9853)

3,847 541 18 107 15 648 17 4,495

30 - 40% (rank 9854 - 13137)

6,799 719 24 177 25 896 24 7,695

40 - 50% (rank 13138 - 16422)

5,137 537 18 129 18 666 18 5,803

Least

Deprived o

f

LSO

As in E

ngla

nd

40 - 50% (rank 16423 - 19706)

2,751 253 8 69 10 322 9 3,073

30 - 40% (rank 19707 - 22990)

1,841 212 7 52 9 264 7 2,105

20 - 30% (rank 22991 - 26275)

1,204 121 4 27 4 148 4 1,352

10 - 20% (rank 26276 - 29559)

X X 0 3 0 X 0 184

0 - 10% (rank 29560 - 32844)

X X 0 0 0 X 0 X

Grand Total 25231 3,013 100 698 100 3,719 100 28949


18/12/18 V 0.9 Final

Appendix 8 – SEND and ethnicity

Data is from the 2011 Census.

0-18 year old ethnicity

Ethnic group/age

Age

0 - 2

Age

3 - 4

Age

5-7

Age

8-9

Age

10-11

Age

12-14

Age

15-16

Age

17-18 Total

All Ethnic Groups

16,385

10,961

15,698

10,342

11,325

18,559

12,071

8,468 103,809

White: Total

16,037

10,724

15,400

10,179

11,141

18,245

11,869

8,337 101,932

White: English/ Welsh/ Scottish/ Northern Irish/ British

15,438

10,369

14,921

9,890

10,834

17,781

11,572

8,127

98,932

White: Irish

61

45

70

38

50

56

48

38 406

White: Other White

538

310

409

251

257

408

249

172 2,594

Mixed/multiple ethnic group

119

70

100

60

77

118

71

47

662

Asian/Asian British

118

105

109

63

70

113

97

57 732

Black/African/ Caribbean/Black British

63

40

43

28

23

52

14

20

283

Other ethnic group

48

22

46

12

14

31

20

7 200


18/12/18 V 0.9 Final

Pupils by ethnic group

2011 2012 2013 2014 2015 2016 2017

White 60,905 60,590 60,695 60,583 60,347 60,526 61,444

White British 59,366 59,023 59,090 58,843 58,524 58,582 59,397

Irish 102 111 110 103 116 112 120

Traveller Of Irish Heritage 12 11 4 15 13 13 9

Gypsy/ Roma 124 119 113 123 115 113 128

Any Other White Background 1,293 1,322 1,375 1,498 1,579 1,706 1,790

Mixed 925 1,025 1,100 1,206 1,285 1,362 1,408

White And Black Caribbean 217 234 237 249 264 276 290

White And Black African 85 108 127 135 143 167 170

White And Asian 297 314 335 378 421 450 459

Any Other Mixed Background 324 368 398 444 457 469 489

Asian 165 350 300 262 232 228 217

Indian 30 38 36 38 40 40 44

Pakistani 11 13 13 12 7 7 14

Bangladeshi 42 48 52 54 49 45 45

Any Other Asian Background 84 252 200 161 136 136 114

Black 55 55 60 65 62 62 53

Caribbean 7 8 8 5 10 7 10

African 20 23 27 35 31 34 30

Any Other Black Background 26 27 23 24 21 21 13

Chinese 70 80 95 91 90 89 100

Any Other Ethnic Group 125 135 140 145 157 165 212

Classified 62,245 62,240 62,385 62,362 62,173 62,432 63,434

Unclassified 773 711 758 660 659 730 756

All pupils 63,019 62,955 63,150 63,018 62,832 63,162 64,190

Pupils by ethnic group extracted from School Census

*number sufficiently small to warrant redaction

Of the 219 pupils on the Isles of Scilly in 2017, 214 had their ethnic group

classified. The majority of pupils identified themselves as white (207, 94.5%). For the remaining pupils, numbers were too small to be identified

separately.


18/12/18 V 0.9 Final

Note: 0-15 is the only age category available *number sufficiently small to warrant redaction

Ethnic Group

Day-to-day activities - %

Cornwall South West England and Wales

Limited

a lot (%)

Limited

a little (%)

Not

limited (%)

Limited

a lot (%)

Limited

a little (%)

Not

limited (%)

Limited

a lot (%)

Limited

a little (%)

Not

limited (%)

All categories 1.57 2.49 95.94 1.45 2.27 96.28 1.56 2.22 96.23

White 1.59 2.51 95.90 1.45 2.29 96.25 1.56 2.29 96.15

Mixed/multiple ethnic

group 0.95 2.26 96.80 1.39 2.33 96.28 1.62 2.32 96.06

Asian/Asian British 0.70 0.87 98.43 1.20 1.48 97.32 1.48 1.75 96.76

Black/African/Caribbean

/Black British 3.85 0.96 95.19 1.72 1.97 96.31 1.58 1.94 96.48

Other ethnic group 0.61 2.44 96.95 1.31 1.53 97.17 1.58 1.86 96.56

4.1% of children in the 0-15 year old age group in Cornwall have limited

day-to-day activities, 1.57% of whom are limited a lot – 1.56% of these

are white. In the mixed/multiple ethnic group 0.95% and 0.7% of Asians

are limited a lot. Although there are only 104 in the

Black/African/Caribbean/Black British group, the percentage (3.9%) is

higher than in other ethnic groups.

Ethnic Group

Day-to-day activities

Long-term

health problem

or disability

Limited a lot Limited a little Not limited

All categories: Ethnic group 89,941 1,415 2,239 86,287

White 87,413 1,390 2,191 83,832

Mixed/multiple ethnic group 1,685 16 38 1,631

Asian/Asian British 575 4 5 566

Black/African/Caribbean/Black British 104 4 1 99

Other ethnic group 164 1 4 159


18/12/18 V 0.9 Final

Pupils with SEN in Cornwall

No SEN

School

Support

(K)

State-

mented (S)

Education,

Health &

Care Plan

(EHCP)

With Stat (S)

or Educ,

Health &

Care Plan (E)

Total NOR

White 49631 6817 1075 536 1611 58043

White British 48014 6620 1059 518 1577 56195

Irish 95 8 X X 5 108

Traveller Of Irish Heritage X X X X X 15

Gypsy/ Roma 78 X X X X 111

Any Other White Background 1430 158 12 14 26 1614

Mixed 1154 140 18 6 24 1316

White And Black Caribbean 218 43 X X 6 267

White And Black African 145 X X X X 164

White And Asian 398 32 X X 5 433

Any Other Mixed Background 393 47 X X 12 452

Asian 200 17 3 1 4 221

Indian X X X X X 40

Pakistani X X X X X X

Bangladeshi 42 X X X X 47

Any Other Asian Background 118 X X X X 130

Black 55 2 0 1 1 58

Caribbean 6 0 0 0 0 6

African X X X X X 34

Any Other Black Background X X X X X 18

Chinese 76 X X X X 85

Any Other Ethnic Group 124 X X X X 158

Classified 51159 6989 1097 546 1643 59773

Unclassified 589 88 13 6 19 696

All pupils 51748 7077 1110 552 1662 60469


18/12/18 V 0.9 Final

SEND prevalence and language

Number and percentage of pupils by first language112

First language

known/ believed to

be

2014 2015 2016 2017

ENG SW C’wall ENG SW C’wall ENG SW C’wall ENG SW C’wall

Other than

English

No 1,123,195 35,685 1,210 1,185,960 39,303 1,307 1,249,070 43,478 1,439 1,306,829 47,052 1,545

% 16.6% 5.6% 1.9% 17.3% 6.1% 2.1% 18.0% 6.7% 2.3% 18.5% 7.1% 2.4%

English No 5,634,120 605,155 61,874 5,658,801 606,724 61,914 5,687,573 608,923 62,081 5,732,647 612,971 62,631

% 83.2% 94.3% 98.1% 82.5% 93.8% 97.9% 81.8% 93.2% 97.6% 81.3% 92.8% 97.6%

Un classified No 14,325 720 8 13,923 645 45 14,099 757 94 11,889 761 14

% 0.2% 0.1% 0.0% 0.2% 0.1% 0.1% 0.2% 0.1% 0.1% 0.2% 0.11% 0.0%

Total 6,771,630 641,560 63,090 6,858,684 646,672 63,266 6,950,742 653,158 63,614 7,051,365 660,784 64,190

There were 219 pupils on the Isles of Scilly, all of whom had English as

their first language.

English as an additional language (EAL)

Pupils Total

% of

Total

Head

count

Fem

ale

Ma

le

No

SE

N

SE

N:

SE

N S

up

port

SE

N:

Sch

oo

l A

cti

on

SE

N:

Sch

oo

l A

cti

on

Plu

s

SE

N:

Sta

tem

en

t o

r E

HC

Pla

n

Free

Sch

ool

Meals

Free

Sch

ool

Meals

ov

er

6

In t

he 3

0%

mo

st D

ep

riv

ed

Area

s

In C

are

Ad

op

ted

Fro

m C

are

Bla

ck

& M

inorit

y E

thn

ic

Gy

psy

, R

om

a a

nd

Tra

vell

er

Servic

e C

hil

dren

Primary School 911 2.3% 436 475 782 86 23 11 9 42 92 338 0 0 815 0 12

Secondary School 527 1.8% 267 260 455 35 25 6 6 21 55 207 <5 <5 487 0 5

Produced by the Directorate Support Team (Data and Statistics), Cornwall Council using CAPITA One Database January 2015 School Census

Gypsy Roma and Traveller Children

Children who are from Gypsy Traveller families may have specific

educational and social needs relating to their interrupted learning113. Gypsy

Traveller pupils are more likely to be identified as having special

112Department for Education https://www.gov.uk/government/collections/statistics-school-and-pupil-

numbers 113

Chimat

https://www.gov.uk/government/collections/statistics-school-and-pupil-numbers

https://www.gov.uk/government/collections/statistics-school-and-pupil-numbers


18/12/18 V 0.9 Final

educational needs (SEN). This may be the result of families lacking

information or experiencing problems accessing appropriate health care, or

schools failing to respond appropriately to cultural difference. Gypsy

Travellers have significantly poorer health than other UK-resident English-

speaking ethnic minorities and economically disadvantaged white UK

residents. They also have one of the highest maternal death rates in the

UK.

The number of traveller and gypsy pupils has changed only slightly since

2010.

Traveller and Gypsy families in Cornwall114

2011 2012 2013 2014 2015 2016 2017

Traveller Of Irish Heritage 12 11 * 15 13 13 9

Gypsy/ Roma 124 119 11

3

12

3

11

5

11

3

12

8


There were no Traveller or Gypsy families on the Isles of Scilly in 2017.

ONS analysis, based on data from the 2011 Census, exploring the

characteristics115 of the Gypsy and Irish Traveller community, identified

that they had the highest proportion with no qualifications of any ethnic

group (60%) – almost three times higher than for England and Wales as a

whole (23%). Gypsy or Irish Traveller ethnic group was among the

highest providers of unpaid care in England and Wales at 11 per cent (10

per cent for England and Wales as a whole) and provided the highest

proportion of people providing 50 hours or more of unpaid care at 4 per

cent (compared to 2 per cent for England and Wales as a whole).

According to the census 47% of 16-24 year olds had no educational

qualifications. Four per cent of Gypsy or Irish Travellers who spoke a main

language other than English could not speak English well or at all – double

the proportion for the whole of England and Wales.

114

National Statistics – Department of Education https://www.gov.uk/government/statistics 115

What does the 2011 Census tell us about the characteristics of Gypsy or Irish travellers in England

and Wales? http://www.ons.gov.uk/peoplepopulationandcommunity/culturalidentity/ethnicity/articles/whatdoesthe2011censustellu saboutthecharacteristicsofgypsyoririshtravellersinenglandandwales/2014-01-21

https://www.gov.uk/government/statistics

https://www.ons.gov.uk/peoplepopulationandcommunity/culturalidentity/ethnicity/articles/whatdoesthe2011censustellusaboutthecharacteristicsofgypsyoririshtravellersinenglandandwales/2014-01-21




18/12/18 V 0.9 Final

Appendix 9 – prevalence of SEND by gender, age and religion

The information in this section is from the 2011 Census.

Long-term health problem or disability by gender

All persons Males Females

Age 0 to 15 89,764 46,163 43,601

Age 16 to 24 51,498 26,023 25,475

All categories: Age 523,432 253,965 269,467

Long term health or disability


Long-term health problem

or disability


All categories: Age 523,432 49,392 59,352 414,688

Age 0 to 15 89,764 1,408 2,234 86,122

Age 16 to 24 51,498 1,251 2,052 48,195

Male 253,965 23,035 27,408 203,522

- Age 0 to 15 46,163 903 1,389 43,871

- Age 16 to 24 26,023 670 1,001 24,352

Female 269,467 26,357 31,944 211,166

- Age 0 to 15 43,601 505 845 42,251

- Age 16 to 24 25,475 581 1,051 23,843

Long-term health problem or disability by gender

All persons Males Females

Age 0 to 15 89,764 46,163 43,601

Age 16 to 24 51,498 26,023 25,475

All categories: Age 523,432 253,965 269,467


18/12/18 V 0.9 Final

In Cornwall 3654 (4.1%) of children with long term health problems or

disability in the 0-15 year old age group have limited day-to-day activities,

1.6% of which are limited a lot. Only 0.8% identify themselves as

Christian, with many not identifying a religious preference.

Data for the Isles of Scilly is insufficiently detailed to allow analysis by

religion.

Note: 0-15 is the only age category available


Religious group


Long-term

health problem

or disability


All categories: Religion 89,941 1,415 2,239 86,287

Christian 43,466 695 1,060 41,711

Buddhist 171 1 2 168

Hindu 110 2 1 107

Jewish 53 0 4 49

Muslim 210 2 3 205

Sikh 16 0 0 16

Other religion 240 2 11 227


18/12/18 V 0.9 Final

Author/s

Rebecca Cohen

Julie Moseley

Linda Howarth

Brian O’Neill

If you would like this information

in another format or language please contact:

Cornwall Council

County Hall Treyew Road

Truro TR1 3AY

Telephone: 0300 1234 100

Email: [email protected]

www.cornwall.gov.uk

mailto:[email protected]

Documents

SEND needs assessment - Cornwall Council · 2020-01-24 · strategic decisions, defining priorities and the allocation of resources to make the greatest impact. In Cornwall the SEND