Q. Why did you not realise earlier in the year that you needed to make changes?
We have been monitoring take-up weekly so have been aware that the volumes were rising, but wanted to see whether take-up reduced over the summer period before deciding whether mitigating action was necessary.
We also wanted talk to the sector about the challenge and options for managing the Fund during the remainder of this financial year. Inevitably, this takes time but we have acted as quickly as possible to address the problem and have allocated a further £2m to the Fund in recognition of the level of demand.
Q. What were the underlying assumptions made about the demand?
Assumptions about the level of demand were based on the prototype phase in 2013-14 and the first few months of National rollout from 1 May 2015. However this year the demand for the Fund has been unprecedented – it is currently being consumed at a rate of approximately £500k per week – this is twice the level of demand experienced last year.
Seventy nine percent of children supported so far are aged between 6 and 15 and so we now surmise that there has been latent demand for therapeutic support prior to the ASF.
Q. Why did you choose a limit of £5k per child?
The majority of applications to the fund fall within this limit. Since May 2015, the average spend per child has been around £4k since May 2015.
Q. How long will this limit be in place?
The fair access limit will be introduced with immediate effect and remain in place until end of March 2017. During that time we will be consulting with the sector; adoptive/eligible SGO families and providers on future funding and operating model options. Our aim will be to produce a system which continues to be easy to access but is also sustainable in the long run.
Q. What will happen to the families in urgent need whose support costs over £5,000?
In exceptional cases, where there is urgent need for higher cost support, councils may be asked to match-fund to ensure families receive the support they need.
Q. Isn’t this is a further blow to hard-pressed councils at a time of tightened budgets?
It will be up to local authorities to decide how many cases to put forward above the £5k fair access limit. For these exceptional cases, the absence of support may lead to adoption breakdown and the children returning to care which would place an even greater burden on council budgets.
Q. What evidence do you have that this type of therapeutic support actually works?
Evidence from families is that many have found that the support that they have received from the ASF of immense benefit in a range of ways e.g. improving relationships, helping child deal with trauma, improving education outcomes.
However, as the provision of support services develops across the country, we need to strengthen the evidence base of ‘what works’ in terms of preventive and therapeutic adoption support. This will build on the independent evidence review of post adoption support interventions carried out by the Tavistock Institute of Human Relations.
This work will be in partnership with the Department of Health and supported by an ASF Research Steering Group, made up of voluntary sector, health and research partners.
Q. Why did you extend the fund to SGOs and others when you didn’t have enough funding?At the time the decision was made, the level of demand from adoptive families was not as high as it is now. There have only been a small number of applications from SG and ICA families – representing less than one per cent of applications overall. These children and families often face the same significant challenges that domestic adoptive families do and the government is committed to supporting families who children have been in the care prior to living with their new families.
Q. Will these changes mean you will keep within the budget?An additional £2m has been made available this financial year and we are asking local authorities to share the responsibility for supporting these families through match funding support above the Fair Access Limit.
If demand continues to outstrip the available resources we will continue to approve applications but may defer payments until next financial year.
Q. How many children will not get services as a result of these changes?All children should be able to access some therapeutic support. Over 80% of applications to the Fund are for under £5k per child.
There have been a very small number of applications since the Fund was launched nationally where there appears to be a significant level of need. During the 15/16 financial year there were 18 applications valued at over £30k, four of which were for over £50k per child. So far this financial year we have had four applications valued at over £30k per child, two of which were for over £50k per child.
We have said that we will make funding available for exceptional cases, up to a maximum of £30k per child, where local authorities agree to match-fund these cases.
Q. How much are you spending on administrating the budget?The contract with our delivery partners, Mott MacDonald, represents approximately 6% of the total ASF budget. They process a large volume of applications on our behalf (almost 7,000 since the Fund was launched), reviewing and approving applications that meet the criteria within 5 working days - often faster. This speed and quality of the service has been much appreciated by families and local authorities.
Q. What therapy has the fund been used on?A wide range of therapeutic support has been accessed including creative therapies and multi-disciplinary packages. The kind of support most frequently provided are therapeutic parenting (27%), specialist assessments of need (21%), psychotherapy (20%) and creative therapies (15%).
Q. Which providers have received funding; how much?In terms of proportion of services provided to families, these are as follows:
· Independent providers (commissioned via local authorities) – 61%
· Voluntary Adoption Agencies – 14%
· Adoption Support Agencies – 13%
· Local authorities – 10%
· CAMHS – 2%
Q. What is the most expensive therapy provided?Multidisciplinary packages of support are the most expensive and often cover a range of therapeutic needs in families including giving parents the skills they need to parent their children therapeutically, regular child and family therapy sessions, therapeutic life story work and work with schools and others working with the child and family to ensure a joined up approach.
Q. Will these changes impact on children with the highest need the most?
The Government is making an additional £2m available to the Fund in this financial year. We have worked with the Association of Directors of Children's Services to develop an approach that aims to maximise the number of families that are able to access support whilst recognising there are exceptional cases whose needs are so great that local authorities and government should join forces to ensure that they can access the support they need.