January 26, 2017

Review calls for urgent action to improve care and support for children and young people with complex needs

A review commissioned by the UK Department of Health into the care of disabled children and young people with challenging behaviour and complex mental health needs call for urgent action to prevent these children being institutionalised at an early age, at huge cost to the taxpayer and with low ambitions for improving their lives. 

The review, called These Are Our Children, was undertaken by Dame Christine Lenehan, a Director at the Council for Disabled Children.

Dame Lenehan's 37 page report states that "at least 2.5% of the general UK population has a learning disability that means they will need specialist services at some point in their childhood (Emerson & Hatton, 2008). Nearly 40% of this group will experience significant psychiatric disorder, compared with less than 10% of those without a learning disability (Emerson & Hatton, 2007). This seems to be a consequence of innate factors that confer vulnerability, compounded by a range of external factors".


The review includes 11 specific recommendations, which the Council for Disabled Children described as follows:

  • "Better human rights – The right to a childhood, conferred by the United Nations Convention on the Rights of the Child, must be upheld for disabled children with complex needs and behaviour that challenges, with these rights recognised by the NHS Constitution, Department of Education, Department for Health and local commissioners.
  • "Better understanding – The Review calls on the Department for Education to review provision in Special Schools and Colleges for this group of children. DfE has agreed and have commissioned Dame Christine Lenehan to conduct this work in 2017. The Department for Health and NHS England should also undertake an urgent review of the number of these young people aged 18-25 currently in inpatient provision.
  • "A model of care – The Department for Education work with Transforming Care Partnerships, the Association of Director’s Services and the Local Government Association to develop an effective model of what care for these children should look like.
  • "Professional responsibility – That every one of these children in an in-patient setting, or at risk of going into one, has a named keyworker from either health or local authority services to help the young person and their family navigate the system. Furthermore, the Royal College of Psychiatrists, the Royal College of Paediatrics and Child Health, the Royal College of General Practitioners and other royal colleges should clarify the responsibility of medical and other professionals for these children, and jointly develop guidance to ensure respective roles are widely and consistently understood.
  • "Alignment of national programmes and local commissioning – The Department of Health, Department for Education, Department for Communities and Local Government and NHS England should work together to align initiatives such as Transforming Care, Integrated Personal Commissioning, Continuing Care and SEND Reforms which apply to this group.
  • "Better commissioning of services – Local authorities and Clinical Commissioning Groups should commission services for these children in their local areas, that recognise the value of early intervention, are based on the needs and concerns of families, and that can respond to emergencies whenever they occur."

Further Reading and Sources

Council for Disabled Children

BBC News

Review Document: These Are Our Children