Lincolnshire County Council and Lincolnshire Integrated Care Board told to improve services for vulnerable children

Vulnerable children are being let down as they can’t get to see doctors or dentists, a damning inspection report has found.

Lincolnshire County Council and Lincolnshire Integrated Care Board have been told to improve services for youngsters with Special Educational Needs and Disabilities (SEND). These children have poor access to healthcare and there are inconsistent plans for their education, health and care being offered at the moment.

Both the council and care board are responsible for planning and commissioning services for SEND children and their families - who are said to struggle to navigate the complex system of services available too them.

Lincolnshire has a school population of 108,725, of which 18,549 children — more than one in six — have been identified as having a special educational need. Inspectors have highlighted the need for more special school places to cater for them.

New county council leader Sean Matthews (Reform) has called for SEND system to be reformed in order to meet the challenges of the ‘ever-increasing demand for support’ — while health leaders promised that they have made more appointments available.

The inspection report, by Ofsted and the Care Quality Commission stated: “The local area partnership’s arrangements lead to inconsistent experiences and outcomes for children and young people with special educational needs and/or disabilities (SEND). The local area partnership must work jointly to make improvements.”

It added: “Some children and young people with SEND experience difficulties when accessing primary care services, such as doctors and dentists. This causes frustration.

“Furthermore, this results in some children’s and young people’s health needs not being met at the right time. In addition, the online triage system for accessing general practice health care is a barrier to some children and young people because their needs make accessing the system difficult.

“Children and young people with SEND experience swift specialist support for their health needs. This includes physiotherapy, occupational therapy and mental health support. They receive effective support for their mental health through the child and adolescent mental health services, Healthy Minds Lincolnshire, and through mental health support teams.

“However, in contrast, children and young people with SEND wait too long for neurodevelopmental assessments, speech and language assessments and related therapies. The partnership has plans for service transformation to reduce waiting times.”

Inspectors praised the county’s authorities for its public health and families nursing service, in which calls are triaged by a trained children’s nurse and a rapid response community respiratory service which aims to stop youngsters with chest infections being admitted to hospital.

But a number of serious issues have been raised with plans for youngsters.

EHCPs (education and health and care plans) were introduced after the 2014 education reforms and are a legal document outlining a child’s specific educational, health, and social care needs.

It states: “The overall quality of education, health and care (EHC) plans is inconsistent. Some children’s and young people’s EHC plans do not reflect their views and aspirations consistently well. Equally, EHC plans do not represent the child’s or young person’s needs effectively. In addition, some children, young people and their families are not sufficiently included in all decision-making around the child’s or young person’s individual needs.”

It goes onto state that transition planning is unclear, an online EHC hub has yet to demonstrate a positive impact and that there are some gaps in the data.

The report stated: “Despite the partnership’s investment in provision, the need for special school places exceeds the number of available places. Due to the high demand for places, some special schools receive a significant number of consultation requests for places. This is a challenge for special schools to manage when many consultation requests are made at once when determining which school can best meet a child’s or young person’s needs.

“Children with SEND in primary schools receive more exclusions than national averages for England. In addition, children and young people with SEND in secondary schools receive more suspensions than national averages for England. There is a reducing number of suspensions and exclusions year on year. However, the numbers do not meet the partnership’s expectations.”

The report has also highlighted that some children have to travel long distances to attend an appropriate school.

Coun Matthews has thanked staff for their efforts and noted the areas for improvement.

He said: “These include key challenges relating to health services, and we will be meeting with health partners to discuss how best to address the challenges we face. However, while we are committed to playing our part, it is widely recognised that the SEND system needs to be reformed at a national level. We need to see action from government if local authorities are going to be able to meet the challenges created by the ever-increasing demand for support that has been seen in recent years.”

An ICB spokesman said it has commissioned more appointments in both dentistry and primary care.

He said: “We welcomed the opportunity to share with inspectors the good work we have done as a partnership for children and young people with SEND, and we were pleased to see this recognised and reflected in the report. Whilst we recognise there is still more to do, we remain committed to improving services and improving access.

“It is recognised accessing primary care services can be frustrating, especially for some children and young people. Waiting times for Speech and Language Therapy and autism diagnosis remain longer than ideal, reflecting national trends. However, work to address this and other areas highlighted in the report was already underway with our partners before the report’s publication and will continue.”

Lincolnshire has varying rates of dental decay in children — with 40% of Boston five-year-olds have had tooth decay compared with the Lincolnshire 25% average.

The Community Dental Service, which has bases in Spalding and Grantham, supports patients who have additional needs.

The ICB added: “Ten thousand additional urgent dental appointments have been commissioned for 2025-2026, and plans for a Lincolnshire Institute of Dental and Oral Health are also in development, with a view to attracting, upskilling and retaining locally the dental professionals we need to improve access to dental services in the county.

“GP practices in Lincolnshire have increased the number of appointments available year-on-year, 5.68 million appointments were provided from April 2024 to March 2025. The ICB works with practices to continue improving access and patient experience through opportunities like the General Practice Improvement Programme. GP practices offer contact in-person and by telephone as well as through online consultation systems and will make adjustments for people with particular access needs.”