Agenda item

The Scrutiny Panel is asked to consider its Draft Final Report in relation to Out of Area Specialist Provision, and to discuss and formulate its conclusions and recommendations at the meeting. 

The Panel was asked to consider the Draft Final Report on its review ‘Out of Area Specialist Provision’, a copy of which had been circulated to Members and contributors prior to the meeting.

The report set out the terms of reference and the subsequent evidence gathered by the Panel during the course of the review.

Following discussion, the Panel agreed that the following conclusions be included in its Final Report:-

SEND and Inclusion - Education

A)    The Panel acknowledges that out of area placements for children with SEND are sometimes necessary, for example, when there are gaps in local provision, the child’s needs can only be met through specialist expertise/therapies that cannot be met from within Middlesbrough’s resources or for consistency or parental preference.  In such cases, the Panel is satisfied that there are sound processes and procedures in place with regard to the commissioning of external provision, together with strong quality assurance (QA) processes to ensure providers meet required standards, including regulatory oversight from Ofsted and the CQC, where appropriate.

B)    The Panel notes the significant variation in cost between local and independent provision which contributes to ongoing pressures on the High Needs Budget and the Council’s financial resources, but recognises the positive efforts made to reduce the use of out of area provision which have been achieved by building strong, collaborative relationships with education and specialist providers to develop specialist expertise to increase capacity in Middlesbrough to better meet demand needs locally. 

C)    In addition, the Panel welcomes the news regarding secured funding to build a new secondary school in Middlesbrough for children with SEND which will continue to expand specialist provision for Middlesbrough children.

D)    The Panel notes that Middlesbrough has the lowest use of independent special schools within the Tees Valley (approximately 2.9%), compared to the national average of 4.64% demonstrating the impact of investment in local capacity and inclusive practice.

E)    The Panel received evidence of a well-developed and embedded workforce development approach, having regard to the SEND Code of Practice 2025.  This is recognised as a key driver in reducing reliance on specialist and out of area placements.  This approach is underpinned by a long-term strategic focus on workforce development across education, health and care services, supported by a structured training offer for internal staff, schools, settings and families.

F)     Workforce development in Middlesbrough includes:-

•         A comprehensive SENDCo development programme, with mentoring and networking opportunities, and has seen strong attendance across the local area.

•         Multi-agency training and collaboration across education, health and social care partners.

•         Annual conferences and knowledge-sharing events with local, regional and national expertise.

•         Development of accessible learning resources, including a SEND Learning Hub.

•         Strong focus on early intervention through a clearly defined local area graduated response.

G)   Areas of best practice within the SEND Workforce Development include the implementation of the Ordinarily Available Inclusive Provision (OAIP) and SEND Ranges framework, which provide clarity and consistency regarding the level of support expected across all settings.  These frameworks, co-developed with practitioners and partners, ensure that needs are identified earlier and met more effectively within mainstream provision, thereby reducing escalation to specialist placements.

H)    In addition to a strong workforce development ethos, there is also a strong quality assurance (QA) process for SEND and Inclusion which drives the learning cycle within workforce development.  The QA process includes learning from peer reviews, reviews of Education Health and Care Plans (EHCP), case audits and learning visits to providers with identified themes feeding directly into the workforce development strategies.

I)       As a result of the approaches being taken within the SEND and Inclusion Service, the Panel considers there is evidence of a measurable impact, including:

•         High rates of timely statutory assessments, with 98% of EHCP’s completed within the 20-week statutory timescale, significantly above the national average.

•         A strengthened graduated response, evidenced by a reduction in referral rates.

•         Lower levels of suspensions and exclusions compared to national and regional averages.

•         Tribunal rates remaining below national averages.

•         A lower proportion of Middlesbrough children requiring independent specialist provision when compared with regional and national averages.

J)     The Panel is aware of the Government’s recently published white paper “Every Child Achieving and Thriving”, setting out proposals to reform the SEND system in England and the concurrent consultation on the SEND proposals “SEND reform: putting children and young people first”, and acknowledges that this will inevitably influence the Council’s approach to workforce development and the new SEND and Inclusion Strategy 2026-2030, currently under development.

K)    Overall, the Panel considers Middlesbrough Council’s SEND and Inclusion model reflects best practice through its emphasis on early identification, inclusive provision, workforce capability and system-wide collaboration, all of which contribute to reducing reliance on external specialist provision.

Social Care

L)     As of January 2026, approximately 29% of Middlesbrough’s children looked after were in external fostering placements and approximately 9% of children looked after were placed in external residential placements, highlighting the continued demand for external provision and the importance of effective placement management.

M)   The Panel recognises that some level of external social care provision will always be required but notes that the overall costs associated with external children’s residential placements are significant.  Whilst the external market is currently challenging, Officers have made significant efforts to build strong working relationships with providers and are actively negotiating and challenging costs and retainer fees to secure the best value for money.

N)    The Panel is encouraged by the work being undertaken in relation to 16+ supported accommodation and welcomes the shift from high numbers of ‘spot placements’ to an increase in the block occupancy rates which will deliver efficiencies.  Similarly with 18+ support, the Panel welcomes the increase in expanding its local provision to provide a pathway for young people leaving care and moving to independence, whilst supporting the Children’s Services sufficiency strategy.

O)   The Panel identified several best practice measures in Middlesbrough in relation to out of area social care placements for those with complex needs, which include:

•         Use of regional commissioning frameworks (such as NEPO603, with approximately 85% of fostering placements secured through framework arrangements), supporting consistency and cost control.

•         Block contract arrangements for residential provision, delivering 12 beds with high occupancy rates (94% - 99%) and achieving cost avoidance of approximately £792,000 compared to spot purchasing.

•         Active placement monitoring and review, including negotiations with providers to reduce costs and support step-down arrangements.

•         Ongoing sufficiency planning to increase local provision and reduce reliance on external placements.

P)    Evidence presented to the Panel demonstrates that proactive placement management has resulted in improved outcomes for children and significant cost avoidance.  Case study evidence highlighted successful transitions from high-cost placements (in excess of £7,000 per week) to more appropriate fostering or supported accommodation placements, delivering substantial financial savings and improved stability for children and young people.

Q)   Approximately half of external residential placements are located within the Teesside area, indicating efforts to place children closer to home where possible, although overall in-area placement levels remain below comparator averages.

Areas for Further Development

R)    Whilst strong practice is evident, particularly within SEND and Inclusion, the Panel notes that workforce development in children’s social care is less developed in comparison.  There is an opportunity to build on the successful SEND model by introducing a more structured and consistent workforce development approach across Children’s Social Care.

S)    The recruitment, retention and training of foster carers was also identified as a key area for further development.  Increasing the availability of in-house foster carers, alongside enhanced training and support - developed to meet identified gaps in provision - would strengthen local sufficiency, reduce reliance on independent fostering agencies and support more children to remain within, or closer to, their local community.

T)     In addition, continued investment in local provision including residential and supported accommodation, and strengthened regional collaboration, working towards a Regional Care Co-operative to manage regional sufficiency, will be essential to further reduce reliance on out of area placements and to meet the Council’s sufficiency duty.

U)    Overall, the Panel concludes that Middlesbrough Council is delivering effective and improving outcomes in SEND and Inclusion, underpinned by a clear strategic approach to reducing reliance on out of area education placements. Notwithstanding this progress, Children’s Social Care continues to face structural challenges, particularly in relation to local sufficiency and cost pressures, which will require coordinated strategic action and continued investment.

During the course of discussion, the following issues were raised: - 

•          The Panel noted that the report referred to improvements in relation to external residential children’s homes placements and clarification was sought on how such improvements were measured.  In response, the Corporate Director explained that the Council’s priority was to keep children as close to home as possible, whilst recognising that some exceptional placements were required.  It was outlined that progress was monitored through a range of measures, including data on placement proximity, which had been shared at the previous meeting, time spent in placement, and the ability to secure appropriate long‑term solutions within a timely manner.  It was acknowledged that although cost and distance were useful indicators, they did not provide the complete picture.  It was suggested that a recommendation be included for Members to receive regular performance information in order to monitor progress and provide ongoing oversight of improvements. 

•          The Panel considered the increase in the number of children with an Education, Health and Care Plan, as referenced within the report.  It was suggested that one factor may be improved assessment processes and increased awareness and understanding of SEND, which could be contributing to higher identification rates.  Members noted concerns around potential disparities, including that children from more privileged backgrounds may be assessed more quickly.  The Panel was advised that, although Middlesbrough benefitted from a strong educational psychology assessment service, there was no single, definitive explanation for the increase and that this remained a national challenge.  In response to a query regarding the impact of the COVID‑19 pandemic, it was acknowledged that there was evidence to suggest it may have contributed to the increase, however, it was not possible to be fully certain, and trends may fluctuate over time. 

•          A Member noted the range of reasons for the use of out of area provision, including parental preference, and queried whether cost factors were taken into account.  In response, it was explained that parents had a legal right to express a preference for a particular provision and that such requests were considered in accordance with statutory requirements.  Members were advised that cost was taken into account alongside the individual needs and best interests of the child, with other relevant factors and considerations also being assessed as part of the decision‑making process. 

•          Members discussed workforce development within Children’s Social Care and noted that further work was required in this area.  

•          Reference was also made to block contract arrangements, with Members noting that the level of block‑contracted provision was positive.  In response, it was explained that this reflected effective work by the Commissioning Team in identifying placements that were both appropriate and met children’s needs. 

•          In relation to quality assurance arrangements, Members sought clarification on how often children were visited by the local authority.  It was explained that the frequency of visits depended on the individual child and the setting, and that where children had care plans, visit frequency by social workers would be increased as required.  Members were advised that a multi‑agency approach was adopted, with regular visits taking place and being appropriately recorded.  It was noted that, on average, visits took place approximately once every fortnight, although this varied depending on the child’s circumstances and who was providing day‑to‑day care.  The role of the Virtual School was also highlighted, including its responsibility for hosting virtual Personal Education Plan meetings, with oversight managed by service managers to ensure arrangements remained proportionate to need. 

•          Members also raised questions regarding the development of Regional Care Co‑operatives and how the current pilot arrangements were operating, together with how the model may apply in Middlesbrough.  The Panel was advised that work continued regionally in relation to foster care arrangements.  It was reported that the North East region was submitting an application for the next wave of the programme, with a deadline of late May or early June, and that a decision was expected within the following few months.  It was further noted that fostering services had been increasingly regionalised and that a meeting was scheduled with Minister Josh MacAlister to clarify expectations at a national level. 

The Panel formulated recommendations to be included in its Final Report based on the evidence provided throughout the review, and its conclusions, as follows:-

A)    That the Panel be provided with regular updates (every three to six months) on Children’s Residential Placements using key performance indicators to benchmark and monitor improvements in reducing the use of out of area provision – including distance of placement from home, length of time in placement, cost of placement and the long term solution plans together with targets to achieve this.

B)    That the revised SEND and Inclusion Strategy 2026-2030, which should align with the Government’s SEND reforms, be presented to a future meeting of the Children’s Scrutiny Panel, within the 2026/27 Municipal Year, setting out how this will impact on Middlesbrough.

C)    That Children’s Services introduces a structured Workforce Development Programme across Children’s Social Care Teams, aligned to the SEND and inclusion model, and that this be presented to a future meeting of the Children’s Scrutiny Panel within the 2026/27 Municipal Year.

D)    That the Panel be provided with an update, within the next six months, on the Regional Care Co-operative pilots, setting out how this will shape Middlesbrough’s transitional arrangements to a Regional Care Co-operative.

E)    That, in the shorter term, Children’s Services continue to develop a regionalised approach, working with relevant partners in the region, to attract new foster carers and enhance training opportunities for new and current carers to improve local sufficiency, and that the Children’s Scrutiny Panel be provided with an update on activity within the next six months.

AGREED as follows:-

1.     That the proposed conclusions, as set out above, be included in the Final Report.

2.     That the proposed recommendations, as set out above, be included in the Final Report.

3.     That the Final Report be submitted to the next available meeting of the Overview and Scrutiny Board for consideration.

As it was the Panel’s final meeting of the Municipal Year, the Chair wished to thank all Panel Members for their participation and contribution throughout the year and to thank all officers and attendees who had contributed to the Panel’s work.