Strengths-based working in a complex system to deliver financially sustainable stronger patient outcomes and improved operational outcomes.
Strengths-based working in a complex system to deliver

Transforming the lives of children with SEND - ensuring the best educational placement to meet their needs
The national High Needs system is in crisis.
Disproportionately high numbers of children with special educations needs are subject to exclusion from mainstream schools, and in almost all areas there is a prolific increase in demand for specialist support through Education, Health and Care Plans (EHCPs) and for specialist school placements.
Meanwhile outcomes for children and young people with Special Educational needs remain inconsistent and at best unclear.
In 2019 Lincolnshire was also experiencing rising demand for both EHCPs and specialist school placements which was creating operational and financial pressures – with limited evidence that increased spend was contributing to better outcomes for children and young people.
Heather Sandy, now Director of Children’s Services, contacted IMPOWER as she had identified that the growth in demand for statutory support was unsustainable. If Lincolnshire did not change course, the growth in demand would rapidly outstrip the increase in funding and resources, requiring difficult decisions about provision in the county.
Since August of that year, IMPOWER have worked collaboratively with Lincolnshire stakeholders to help them to understand the factors driving this trend and identify key opportunities to do things differently to deliver better outcomes for children and young people at a lower cost, what we call ‘good savings’:
Our experience shows that the most important step to take across a High Needs system is changing the behaviours which create dependence on specialist support (which is usually higher cost). To do this successfully, it is critical to work from the outset with frontline staff from the council and partners, and of course with parents and carers.
Our EDGEWORK© methodology, which includes behavioural science, gives a framework of flexible approaches that can support complex needs and help bring about long term sustainable change. We look at different intervention points with children and young people accessing support for SEND, and together identify opportunities across the child’s journey to drive better outcomes and reduce costs by meeting and reducing needs earlier.
We use a set of innovative tools (co-produced with a range of partners and professionals including parents, SENDCos and colleagues from health and local authorities) to demonstrate the actual level of need and whether the right resources are in place to meet them.
These approaches provide unique insights that positively challenge and support local practice. For example, they can show cases where children’s needs could be better supported in mainstream settings (delivering better outcomes in the process) or where minor adjustments to provision could prevent the need for a move to more specialist support and increase fairness and consistency.
Most importantly, we then support the delivery of these changes so that there is tangible positive impact. Along the way we transfer skills and build resilience so that, when the project ends, the change is sustained.
A local authority cannot change a local High Needs system by itself. However, local systems have often not set out what their ambitions are, which can prevent them from working effectively together with partners to meet outcomes early and ensure value and fairness.
If a shared ambition is set out in a clear and specific way, it can be measured. The more it can be demonstrated that the ambition is being achieved, the more confidence and momentum will be built across partners and parents. However, first we need to unpick the evidence of how well the local system is performing in relation to demand, cost and outcomes, in order to understand the level of ambition to strive for and to enable everyone involved to align around a common goal.
In Lincolnshire, the DCS felt there wasn’t a clear enough ambition amongst all organisations in the system as to how to respond to rising demand and costs. Working with the council and its partners, we carried out analysis together to better understand opportunities to reframe and rebalance the High Needs system. This showed that:
We fed this analysis into system ambition sessions with system partners (including parents, and representatives from both the health and education sectors) and asked ‘what is it that we want to achieve for children with additional needs with the resources we have, and how are we aspiring to be different in five years’ time?’. The outcome was a specific, measurable, inclusive ambition for the children and families in Lincolnshire’s High Needs system.
From 2020 to 2021, IMPOWER supported Lincolnshire to implement a range of interventions at scale with a focus on delivering better outcomes by responding earlier and/or differently at lower cost.
Crucially these interventions were targeted at three key ‘demand points’ across the child or young person’s journey.
This approach was taken in recognition of the complexity of the High Needs System, in which so many different teams, agencies and influences are at work. In such a complex landscape there are no silver bullets; no one organisation or intervention alone would be enough to deliver the impact required.
Delivering early impact is key to building momentum and scalability, so we moved quickly to pilot new ways of working. We used applied behavioural science to increase the focus on strengths and aspirations, including reframing decision making.
These early changes resulted in an 8% reduction in the number of plans that were approved compared to levels before trial, while also improving the response to need and parent confidence in the system.
This was just one intervention point but the result created energy and momentum to quickly scale these changes across other intervention points, testing and learning as we went.
For example, a new SEND advice line was set up, and an assessment sign off panel was introduced to better signpost and divert SENDCo’s to currently available support.
Valuing SEND, a new approach to needs codification and setting provision mapping was rolled out to all schools. This has helped to build confidence of families, SENCos, and other professionals who support children with SEND in meeting their needs as early as possible and better understand the match between children’s needs and the provision required to meet these.
Supported by Valuing SEND, Lincolnshire then trialled a new approach to annual reviews of EHCPs and supporting reintegration of pupils within mainstream settings.
One SENDCo told us that Valuing SEND “is straightforward and captures all the information in a succinct, meaningful way. It’s enabled us to sit down with parents and say, ‘We’ve tried this, but not explored these areas of support, so we’re not ready to apply for an EHC plan yet.’”
Sustainable change requires building ownership and momentum within the council, and within the wider High Needs system, alongside deliberate skills transfer.
This extensive transformation programme was underpinned by a 24-month transformation plan thoroughly co-produced with stakeholders to sustain impact.
The first step was to create an integrated change team, and to develop their capacity through training and coaching in our unique EDGEWORK approach, so that they would be able to continue delivering positive change after our support ended.
The second step was to co-produce a 24-month transformation plan with key stakeholders to ensure that the collective interventions would rebalance High Needs spend and deliver better outcomes over the longer term.
The key to achieving organisational resilience was also to embed a performance culture – what we call Primed Performance Management.
This involved gathering and using performance information as a day-to-day activity, enabling everyone across the SEND service from the locality caseworkers to the Director Management Team to understand how individual actions and decisions impact the High Needs system as a whole.
Alongside this it was important to change the way that the council was measuring impact and activity. This involved a shift from looking at historical month-on-month data, to looking into the future – what we call Trajectory Management. This enabled the council to set an ambition for the next month, quarter or year, and then to actively measure how various interventions were impacting on those trajectories.
Since trajectory reporting began in September 2020 Lincolnshire has seen a sustained and significant reduction in new EHCPs as compared to both the baseline and ambition trajectories. For the academic year 2020/2021 there have been 414 fewer new plans than the ambition trajectory.
The reduction in plans for the academic year of 2020/2021 alone has delivered potential cost avoidance of £5.3 million from September 2020 to August 2021, relieving pressure on the statutory process and enabling a greater focus on early intervention.
The result of our work is that outcomes are improving, specialist demand and spend has been reduced, and partners and parents are increasingly positive about the change in culture and support that the approach has brought – and all this during a pandemic where most of the change has had to be delivered remotely.
The IMPOWER work has had a huge impact – “that golden ticket [of the EHCP] doesn’t seem to be quite as golden as it used to be” Special School Headteacher, Lincolnshire
Get in touch if you’d like to discuss the challenges your organisation is facing.