SUMMARY

Introduction
 
The Support Needs System (SNS) is a sophisticated electronic system that records information about children with additional support needs. Its aim is to monitor their progress and ensure they have access to services or support they require.
 
The system has been enthusiastically implemented in ten of Scotland's NHS Boards. Its use has however been interrupted in some local areas because of administrative / medical staffing shortages.
 
Although primarily a highly valued clinical tool, it is possible to extract data for analysis from the SNS. Local analysis has been done since implementation, but figures for all participating NHS Boards were not published before December 2005.
 

Interpreting these data
 
The SNS has not been fully implemented in all NHS Boards across Scotland and implementation and utilisation vary in the NHS Boards currently using it. Also, the SNS holds data on a particular group of children identified as requiring support over and above that routinely given, and their data will only be recorded on SNS with the explicit permission of their parents / carers. For these reasons SNS figures cannot be used as direct indications of the prevalence of particular conditions or factors in the wider population and should not be used to make comparisons between NHS Boards.
 

Children being assessed as part of the SNS programme
 
Overall in the ten participating NHS Boards, 14,579 children and young people had assessments recorded on SNS. Grampian, who make extensive use of SNS, had the highest number of children recorded on the system (4,373). However, this does not indicate that Grampian has more children with additional support needs than other NHS Boards but rather is a reflection of the extensive clinical use of SNS in Grampian.
 

SNS recording - disability
 
The SNS assessment form contains a detailed disability recording page that is used to describe each child's individual disability characteristics. Each type of disability is categorised for severity, outlook and whether or not these are fluctuating.
 

• 81.4% of children being assessed on SNS have at least one mild, moderate or severe disability recorded. For 18.6% of children on SNS, no details were recorded on the disability page.
• the percentage of children with at least one disability recorded varied from 8.1% for 'Hearing' disability to 65.6% for 'Communication and Learning' disability.
• the majority of disabilities recorded on SNS are assessed as 'mild' disabilities.
• the highest proportion of 'profound' disability recorded is for 'Hearing' disability.

 

SNS recording - services
 
The services that a child or young person requires are recorded on the SNS under four separate headings : 'Professional referral'; 'Equipment needs'; 'Social or family needs' and 'Educational needs'. The availability, take-up and source of service are also recorded.
 

• 36.8% of children being assessed in SNS are recorded as requiring at least one type of service in at least one of the main service categories and 63.2 % of children did not have any service requirements at the time of their most recent assessment.
• 'Professional referrals' were the most commonly required service, 35.1% of all children on SNS required this service. Of the 'Professional referrals' required, 95.8% were fully available and 82.3% of these were taken-up.
• Requirement of equipment or services outwith the health service (such as 'Social'  or 'Educational' services) are less frequently recorded. This is perhaps a reflection of the medical assessor's perspective.

 

SNS recording - indicator conditions
 
The conditions and problems of children whose assessments are on SNS are classified using Read coding (a national standard coding system for recording clinical information). Groupings of Read codes that describe five major indicator conditions have been developed for the purpose of analysis (and the intention is to develop further groupings that will allow analysis for a greater number of conditions in future). The indicator conditions are Autistic Spectrum Disorder, Cerebral Palsy, Down's Syndrome, Sensinoneural Hearing Loss and Neural Tube Defects.
 

• 29% of children on SNS have at least one of the five indicator conditions. Some of these children may have more than one of these indicator conditions and may have other coded problems or conditions.
• 51% of the indicator conditions recorded on SNS are Autistic Spectrum Disorders; 26% are Cerebral Palsy; 12% Down's Syndrome; 9% Sensinoneural Hearing Loss and 2% are Neural Tube Defects.

Children in SNS with Multiple and Complex Disabilities (MCD)
 
In NHS Boards such a Grampian or Argyll & Clyde, children with MCD  make up a relatively low proportion of all those being recorded on SNS (13.5% and 12.9% respectively), whereas in NHS Boards such as Tayside or Lanarkshire, children with MCD make up a relatively high proportion of those recorded (23.5% and 33.7% respectively). This is thought to reflect the different way that NHS Boards use SNS and whether the use of SNS is focussed on all children with a mild, moderate or severe disability or only those with more complicated or severe needs.
 

Conclusion
 
The SNS is a highly valued clinical tool which contributes to the assessment and care of children and young people with additional support needs. The SNS is already providing useful data for this group of children and its adoption by other NHS Boards will increase its utility.

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ADDITIONAL NOTES:

Argyll and Clyde NHS Board ceased to exist on 31st March 2006 and the administration area was split into two sub-areas that now fall under the administration of NHS Greater Glasgow & Clyde and NHS Highland respectively. However, since neither of NHS Greater Glasgow & Clyde or NHS Highland use SNS, figures for the former Argyll and Clyde area have been presented as before.

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MAIN CONTACTS:

Dr Jim Chalmers (Consultant in Public Health Medicine)
Head of Programme
Women and Children's Health Information Programme
Tel : 0131 275 6136
Jim.Chalmers@isd.csa.scot.nhs.uk
 
Anne Leigh-Brown
Programme Principal
Women and Children's Health Information Programme
Tel : 0131 275 6481
Anne.Leigh-Brown@isd.csa.scot.nhs.uk
 
Judith Tait
Child Health Information Team Manager
Tel : 0131 275 6833
Judith.Tait@isd.csa.scot.nhs.uk

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PRE-RELEASE ACCESS TO THIS PUBLICATION WAS GIVEN TO:
Scottish Executive Health Department Staff, Representatives of the Support Needs System National User Group, NHS Board Chief Executives


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GLOSSARY:
SNS - Support Needs System. A sophisticated electronic system that records information relating to children with additional support needs.
MCD - Multiple and Complex Disabilities
Read codes  - a national standard coding system used for recording clinical information.


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HISTORY OF THIS PUBLICATION:
Last Published: 12th December 2005    -    Next Due:  December 2007     -      First Published: Dec 2005


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KEY WORDS:
Support needs, Special needs, Disabilities / disability, Impairment, Multiple and complex needs, Multiple and complex disabilities, Autism / autistic spectrum disorders, Down's syndrome, Neural tube defects, Sensorineural hearing loss, Cerebral palsy

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Child Health Information Team Newsletter  (2 to 4 times a year)
Breastfeeding statistics (annually in May)Childhood Obesity statistics (annually in December)
Support Needs System (SNS) statistics  relating to children with additional support needs (annually in December)
Immunisation statistics (quarterly in March, June, September and December)

Child Health Statistics are available on the ISD website at :
http://www.isdscotland.org/child_health

CHIT is part of the Women and Children's Health Information Programme (WCHiP). Related statistics are available at :http://www.isdscotland.org/woman_child

For further information on perinatal conditions, please see the  Scottish Perinatal and Infant Mortality and Morbidity Report (SPIMMR)