a)     

Good mental health was important for children and young people to develop and thrive. Emotional health and wellbeing influenced their cognitive development and ability to engage with learning. It also affected physical and social health;

b)     

Ofsted’s school inspection handbook set out what inspectors took account of to ensure schools provided high quality pastoral care to enable pupils and students to develop into resilient adults with good mental health. All schools had a statutory duty to promote the welfare of their pupils and students, including preventing impairment of health or development as set out in Keeping Children Safe in Education (updated 2023) statutory guidance;

c)     

The Special Educational Needs and Disability (SEND) Code of Practice defined Social Emotional Mental Health (SEMH) difficulties whereby children may experience a wide range of needs that manifest themselves in many ways. These included becoming withdrawn or isolated, as well as displaying challenging, disruptive or disturbing behaviour. These behaviours may have reflected underlying mental health difficulties such as anxiety or depression, self-harming, substance misuse, eating disorders or physical symptoms that are medically unexplained. Other children and young people may have had needs related to attention deficit, hyperactivity, or attachment (and/or trauma). The experiences and needs of children and young people should always be understood in the context of environmental factors within the home, community and school/setting. Children experiencing primary SEMH SEND need may have been impacted by other needs such as in the areas of communication and interaction and/or cognition and learning;

d)     

The Children and Families Act (2014) placed a duty on local authorities to ensure integration of education, health and social care to promote wellbeing and improve quality of provision for disabled young people and those with SEND;

e)     

The following plans supported EHWB in Plymouth for all pupils, as well as those with additional needs, are highlighted for reference:

· A Bright Future 2021-2026

· NHS Long Term Plan – focus on emotional mental health

· SEND Strategy

· Area SEND Inspection Priority Action Plan (in development)

· Inclusion Strategy task and finish group facilitated by the place-based plan

· Special Educational Needs graduated approach to Inclusion and iThrive frameworks.

f)      

The Emotional Health and Wellbeing Steering Group met quarterly and was chaired by a Plymouth city council Public Health Officer. Representatives attended from Education, Health and Independent Sector providers. The group provided a forum to support optimisation of the system through local organisations and agencies coming together. Updates and information sharing provided opportunity for partnership, collaboration and improved system effectiveness. The work supported the system to share and co-own the vision and ambition of a Bright Future;

g)     

The Trauma Informed Plymouth Network was an independent network where the ambition for Plymouth was to be a trauma informed city. It had an education branch providing a reflective learning space for mainstream, specialist and higher education staff to embed trauma informed practices throughout the education system;

h)     

EHWB was linked to mental health. The Plymouth Mental Health Select Committee held in March 2023 provided a summary of the national context regarding children and young people’s mental health. The following information was presented:

·         50% of mental illness (excluding dementia) is diagnosed by 14 years, 75% is diagnosed by 24 years

·         Rates of probable mental disorder continued to be significantly higher among 7-16 year olds

i)      

In Plymouth, Public Health undertook a biennial school survey. Each school had its own data and the Council aggregated data that provided intelligence at a population level. Plymouth expected to have a report covering emotional health and wellbeing from the most recent survey in 2022 completed in October. The report would reflect some of the findings linked to sub-populations e.g. SEND; Young Carers; Service Families etc. Overall trends were usually in line with national surveys;

j)      

In Plymouth the Council continued to see a steep rise in the requests for Education, Health and Care Needs assessments (EHCNA).In the academic year 22/23 to 31 July 2023, 793 requests for an EHCNA were received. This compared to 583 for the same period in 21/22 representing an increase of 36.02%, which was significantly above the regional (12%) and national (6.7%) increases. As 24.5% of current EHCPs had SEMH as their primary need, the rise in EHCNAs would see a rise in the actual number of children who had an EHCP to address SEMH needs;

k)     

Data from the Virtual School showed that children in care were more vulnerable than others. Children who were in care to the Local Authority were more likely to have suffered early life trauma having a significant impact on their overall EHWB. In Plymouth nearly 60% of children in care had identified SEN needs with 22% having an EHCP. This was nearly 8% higher than the national rate for children in care with EHCPs. Looked after pupils and those known to a social worker in Plymouth were between 2 and 3 times as likely as their non-social care linked peers to have SEN support, and up to 8 times more likely to have had an EHCP, and of these Social Emotional and Mental Health Needs were identified in over 80% EHCPs;

l)      

Anecdotal evidence and data suggested that children with SEMH needs were more likely to be subject to a reduced timetable, experience poor school attendance and be more likely to find themselves suspended or permanently excluded from school. Children missing out on education (CMOOE) was defined as a child or young person of statutory school age who did not or could not attend full-time school education in the usual way. Between 1st January 2023 and 10th February 2023 (term 3), severe absence (absence above 50%) data at a city level was reported at 2.4%. Comparative data for the previous year saw a severe absence rate of 2.13%. Social Emotional and Mental Health Needs were cited by the majority of schools as the primary driver for severe absence;

m)   

Plymouth city council collected data on part time timetables from schools and sought assurances regarding their implementation within an agreed framework. During 2022-23 of 335 part time timetables, 115 pupils (34.3%) had an EHCP, which represented 4.11% of the total EHCP cohort, and in addition, 126 pupils (37.6%) received SEN support. The remainder 94 pupils (28.1%) had no identified SEND need;

n)     

Feedback from school leaders indicated that transition points could be particularly challenging for children, with some children struggling to cope with the greater demands of a formal classroom; or, in the case of older children, as a result of a lack of provision that offered more bespoke programmes of learning which met the interests and aspirations of some young people. Feedback also indicated that there was demand for specialist training aimed at developing the skills of school staff as well as forms of alternative provision in order to meet need at an earlier point;

o)     

The main reasons for implementing a part time timetable in mainstream primary school in Plymouth across 2022-23 were SEND and behaviour, accounting for 78.3% of all part time timetables. Although the SEND area of need was not defined, local intelligence suggests that SEMH was likely to be the most prevalent need type within these cohorts. Within the secondary phase the reasons for implementing a part time timetable in 2022-23 related to reintegration 36.5%, medical needs (which could include mental health) 24.5%, behaviour 23%, and SEND 15.9%. School leaders reported increased levels of emotionally based school non-attendance and challenging behaviour post-pandemic which had been coupled with a rise in suspensions and exclusions across the city. The data suggested that part time timetables may have been implemented as a mechanism to reduce the likelihood of suspension or permanent exclusion, or to support children with anxiety based barriers to school attendance and build towards full time attendance;

p)     

The attendance rate across the city for children identified with SEND and an EHCP was 83.3%, and 92.8% for pupils receiving SEN Support (2022/2023 academic year). This was in comparison to 91.1% for all pupils for the same time period;

q)     

A whole setting approach was fundamental, with leadership and management that supported and championed efforts to promote EHWB. Key principles and guidance for good practice related to:

· Curriculum teaching and learning to promote resilience and support social and emotional learning

· The voice of the pupils/student to influence decisions

· Staff development to support their own wellbeing and that of pupils/students

· Identifying and monitoring impact of interventions

· Working with parents and carers

· Targeted support and appropriate referral

· An ethos and environment that promotes respect and values diversity.

r)     

A range of training and provision across the city was in place to support whole setting approaches;

s)      

Central themes and activities would be developed across Education, Health and Social Care partnership. Specific outcomes would be shaped and reported through the SEND Improvement and Inspection Priority Action Plan.

t)      

It was recognised that the waiting lists for the CAMHS provision was long, but children/young people would have some input whilst on the waiting lists, where they were in crisis. Waiting lists were set out in the Local Area Inspection Plan and was being monitored by the Health service regularly;

u)     

There was limited capacity at the ACE provisions which was being increasingly pressured by the number of exclusions in the city. Short term placements at ACE which would seek to provide intervention and therapy before the child returning back to mainstream education were limited;