|Dawn Bowden AC|
|Hefin David AC|
|Jack Sargeant AC|
|Janet Finch-Saunders AC|
|Lynne Neagle AC||Cadeirydd y Pwyllgor|
|Michelle Brown AC|
|Sian Gwenllian AC|
|Suzy Davies AC|
|Claire Rowlands||Dirprwy Gyfarwyddwr—Cwricwlwm, Llywodraeth Cymru|
|Deputy Director—Curriculum, Welsh Government|
|Dr Liz Davies||Uwch-swyddog Meddygol, Llywodraeth Cymru|
|Senior Medical Officer, Welsh Government|
|Karen Jewell||Swyddog Nyrsio—Iechyd Atgenhedlol Menywod, Llywodraeth Cymru|
|Nursing Officer—Women's Reproductive Health, Welsh GovernmentWelsh Government|
|Kirsty Williams AC||Y Gweinidog Addysg|
|Minister for Education|
|Steve Davies||Cyfarwyddwr, Cyfarwyddiaeth Addysg, Llywodraeth Cymru|
|Director, Education Directorate, Welsh Government|
|Vaughan Gething AC||Y Gweinidog Iechyd a Gwasanaethau Cymdeithasol|
|Minister for Health and Social Services|
|Sarah Bartlett||Dirprwy Glerc|
|1. Cyflwyniad, ymddiheuriadau, dirprwyon a datgan buddiannau||1. Introductions, apologies, substitutions and declarations of interest|
|2. Hynt y gwaith gan Lywodraeth Cymru wrth ddatblygu Cwricwlwm newydd Cymru – Sesiwn dystiolaeth||2. Welsh Government's progress in developing the new Curriculum for Wales - Evidence session|
|3. Gwaith dilynol ar Adroddiad y Pwyllgor ar Iechyd Meddwl Amenedigol||3. Follow- up on the Perinatal Mental Health Committee Report|
|4. Papurau i’w nodi||4. Papers to note|
|5. Cynnig o dan Reol Sefydlog 17.42(ix) i benderfynu gwahardd y cyhoedd o weddill y cyfarfod a'r cyfarfodydd ar 16 a 30 Ionawr.||5. Motion under Standing Order 17.42(ix) to resolve to exclude the public from the remainder of the meeting and for the whole of the meeting on the 16th and 30th January|
Cofnodir y trafodion yn yr iaith y llefarwyd hwy ynddi yn y pwyllgor. Yn ogystal, cynhwysir trawsgrifiad o’r cyfieithu ar y pryd. Lle mae cyfranwyr wedi darparu cywiriadau i’w tystiolaeth, nodir y rheini yn y trawsgrifiad.
The proceedings are reported in the language in which they were spoken in the committee. In addition, a transcription of the simultaneous interpretation is included. Where contributors have supplied corrections to their evidence, these are noted in the transcript.
Dechreuodd y cyfarfod am 09:30.
The meeting began at 09:30.
Good morning, everyone. We have received apologies for absence from Julie Morgan, and I'm very pleased to welcome Jack Sargeant, who is substituting for Julie. Julie will not be rejoining the committee since her promotion to the Government, so I'm sure Members would want me to congratulate Julie and also that we'd want to place on record our thanks to her for her hard work as a very long-standing member of this committee. Can I ask if there are any declarations of interest, please? No. Okay.
Item 2 this morning is our session scrutinising Welsh Government progress in developing the new Curriculum for Wales. I'm very pleased to welcome Kirsty Williams AM, Minister for Education; Steve Davies, director of the education directorate at Welsh Government; and Claire Rowlands, deputy director of the curriculum at Welsh Government. Thank you all for attending. We're looking forward very much to hearing what you've got to say. If it's okay, as we've got a lot of ground to cover, we'll go straight into questions. The first ones are from Dawn Bowden.
Thank you, Chair, and good morning, Minister. Minister, can you confirm the current position on the development of the new curriculum? Are you still working on the design of the areas of learning and experience, or are we pretty much—? You know, is there still a lot of development work to be done or are we almost there?
Good morning, Dawn, and thank you for your question. I believe we're in a really good place with the development of the contents for the areas of learning and experience. All groups are on track for their work to be available for feedback from Easter. Four of the six areas have already completed their drafts. Two will be completed shortly. For the four that have already been completed, we are now in the process of a detailed, bilingual, editorial process to ensure that the material is of good quality in both languages prior to the publication for feedback in April. We expect the other two to be in a similar position.
Can I just say, there has been a huge amount of work undertaken by the profession in getting to this stage and I'm very grateful for all of that effort? We're looking forward to not only having the content available for feedback in April, but also what we'll be spending the next months doing is getting ready for the publication of the White Paper, which I hope will happen within the month, and also to be in a position, in April, when the AoLEs are published, that a great deal of preparedness has been undertaken with headteachers so that that just doesn't appear in April; there's actually work undertaken between now and April to prepare headteachers for the availability of those resources.
Okay, so will that be included in any of the further discussions that you have to have before the curriculum is actually published? Have you got any key milestones that you still need to be hitting before next April?
Well, as I said, four of the six are currently in the editorial process and we are absolutely confident that those will be complete. There is a little bit more work to do in two, but, again, we are absolutely confident that they will be available for publication at Easter. What will happen between now and Easter—there are a number of significant things. First of all, it is the publication of the curriculum and assessment White Paper, which, as I said, I hope we will be in a position to do within the month, and then there's a series of preparedness events, because what I don't want to happen is what happened in 2008, when literally vans arrived outside of schools with boxes of the curriculum and they were just handed over to teaching staff. Steve tells me he's still got them in his garage at home. [Laughter.]
So, we need to get the profession ready for that publication, so we'll be undertaking a series of engagement events, both large conferences but also smaller groups of headteachers to get them ready so that they know what to expect when those are published in April and they know clearly, and crucially for me, how they can engage in feeding back their views on what those AoLEs will look like. We will also be having a significant resource to support the profession available online. If Members are interested—. I know some Members have been able to take up the invitation to go and visit some of the pioneer schools and others have it in their diary to do so. I know that some members of the committee are new, and if Members would like to go and visit a pioneer school, we are happy to facilitate that. But if Members would find it useful to see what the schools are going to see on the online presence, then I'm happy to do a session with Members so that they will be able to see ahead of time what schools will be able to see on the internet, on the web, the supporting material, the AoLEs and how schools will be able to interact with and interrogate and, crucially, how they will be able to feed back their views on what is published.
Thank you for that. So, is there likely to be any further detail of the AoLEs prior to publication?
No, not prior to publication. As I said, we are in the editorial process, the bilingual editorial process, to make sure that there is coherence in both languages. It's not just simply a question of translation—that wouldn't be good enough. So, we have experts. I'm sure we'll come onto the issue of whether experts are important or not in this process later on, but we have experts, such as Mererid Hopwood, who are working very, very closely on the editorial process to ensure that they're high quality in both languages and that it's not just simply translation, and we will have those available. The feedback comes after April.
Okay. And my final question, Minister, is around the format of the draft curriculum. Are we going to be looking at a single document for the curriculum or individual documents around each of the AoLEs?
Oh, my goodness me. So, the draft curriculum will be available online as a single curriculum. It will comprise overarching guidance for all professionals as well as the six individual AoLEs. The AoLEs will be structured under—. If we think about it in a website format, the AoLEs will be structured under three tabs, which will be overview, learning for each 'what matters' within the AoLEs and planning for learning for 'what matters' in each AoLE. But, Claire, in terms of how it will appear, perhaps you can give some further detail.
I think that's a really good description of it. We've been working with another expert on the best way of presenting the curriculum in a web format, and they've done lots of user testing stuff with the pioneer schools and other schools to create a web presence. So, the idea is that you've got a coherent curriculum, because this curriculum should be—. The last thing we want is for it to be atomised in the way the current curriculum is. If you think of it more like the foundation phase, where they work, particularly on things like health and well-being—. You want to see them working with other areas of the curriculum. So, it's one, really, we're trying to create one, but, as the Minister says, there will be tabs and you can—. As a teacher, you can go in and look specifically at what you want to see. So, if you are going to be teaching maths in secondary, you could go in and have a look at the maths AoLE. If you want to get into more detail around something as a year 6 teacher, you can go in and look at that particular part through the progression steps. The accompanying supporting documentation is going to be key here, because this will set out the vision for how the curriculum will work.
So, the guidance that will be available alongside the AoLEs—we're not just publishing the AoLE; there will be guidance available as well—will have three main elements. So, the first will be developing a culture of learning, so setting out the expectations of professionals and developing that culture within their schools; outline of the curriculum model, so that describes the structure and the components of the curriculum, and the approach that is going to be taken to progression; and then we'll have the outline of the cross-curricula element, because of course what's also important to remember is that we have the AoLEs but we have important cross-curricula-cutting themes across it, such as literacy, numeracy, the digital competency framework, Wales and the world. So, there will be the AoLEs and supporting guidance, so professionals will be able to engage with both.
And that will be the trigger for professional learning too.
Just to add that what's critical to us is that, on this day in late April, the curriculum will land electronically on a headteacher's machine on a headteacher's desk, and they're going to want to engage with their school. So, part of our meetings and conferences with headteachers in engagement in the spring term is that they will see all of it as it's built, other than the fine detail of the AoLEs, but they will be able to access it quickly, know their way around it so they can engage in it quickly, literally from that day with their staff, and parents and governors.
And if I'm correct in saying, that website will also be able to have a feedback mechanism as part of it. So, that website will also be very clear about how people can give their views.
For the curriculum itself, that's the profession.There's a broader—
That's right—there will be a broader one, then, for the public. In talking about presenting the curriculum itself, the professional will be able to give their views on the website itself, as well as—
So, they will need to go to a different forum. They'll be able to use that one site to be able to view it and to feed back. Of course, the wider public will have an opportunity to engage with the curriculum and assessment White Paper. That's the overall opportunity, more generally, for people to engage in this process also. And that White Paper will also have a children-friendly version so that young people and children themselves can engage in feedback on the curriculum and assessment White Paper.
So, you don't see a public consultation as such on the draft curriculum? You're looking at—. You will have some public feedback, but you'll be waiting for people to have the opportunity to feed back through a consultation via the White Paper rather than just commenting on the draft curriculum.
There will be opportunities to comment on the draft curriculum, and a public forum, but the big consultation—formal consultation—will be by the mechanism of the curriculum and assessment White Paper.
Can I just clarify that, then? So, teachers will have all the detail in front of them and will be able to feed back? How will that feedback process work? If, say, they've got burning concerns about aspects of it, will it be tweaked then? How will you respond to that feedback?
Okay. So, the feedback window will be open until July. So, there will be the opportunity from April through to July for the profession to feed back on the individual details of the AoLEs. We will then take that back to the various working groups and the structures that are developing the curriculum to make amendments following that process, with a look, then, to a final publication in 2020.
Oes, os gwelwch yn dda. Bore da. Roeddech chi’n sôn bod pedwar allan o’r chwe maes dysgu yn barod, fwy neu lai—hynny yw, wedi mynd trwy'r broses olygyddol. Mae yna ddau, felly, ddim yn barod. Beth ydy’r amserlen ar gyfer cyhoeddi’r rheini a pha bit fydd yn rheini?
Yes, please. Good morning. You were discussing how four out of the six learning areas are ready, more or less. There are two, therefore, that are not ready. What's the timetable for publishing those, and what bit will be in those?
Let me be absolutely clear: four AoLEs are completed. They are simply in an editorial process to prepare them for publication. Two areas have some final completion—a content completion—to be finished, which will happen very, very shortly indeed. They will—[Interruption.] Sorry?
Beth yw’r ddau faes sydd ddim yn barod?
What are those two areas that are not ready?
Humanities, language, literacy and communication.
But let me be absolutely clear: those works will go into editorial completion shortly and they will be published alongside the four in April.
Chair, can I just add one very quick point?
You talked about schools giving feedback, and the public and teachers, but the middle tier—the rest of the organisations between Government and schools—will similarly be engaged during the spring term and be supported in terms of giving that feedback.
Okay, thank you. That's helpful to know. The next questions, then, are from Michelle Brown.
Thank you, Chair. The Association of School and College Leaders write that the methodology behind the new curriculum is radically different and something that not all schools have yet fully understood. They also say that the 'what matters' statements have been a useful tool but are calling for greater exemplification.
The National Education Union say that not enough practitioners understand what the new curriculum will mean to them and whether their school will be ready. So, to what extent are you satisfied that the publication of the draft curriculum will allay concerns that the vision of 'Successful Futures' was largely conceptual, and that practitioners on the ground still don't understand what the new curriculum is going to mean to them in practice?
Well, I think it's absolutely correct to say that those closest to the process, and those most professionally engaged in the process, will have the greatest level of understanding. What we've had to do is create a balance between the appropriate stage at which to make information available. Because the committee will be aware from reading the evidence of the National Association of Head Teachers, for instance, which I too have read, that headteachers have had the difficult balancing act of: when do you give people information, especially if that information is subject to change, and the balance between overloading people and levels of preparedness?
We've been very, very clear that, up until this stage, the majority of the work has been undertaken by our pioneer schools, but I believe that there have been improvements in the communication between pioneer schools and other schools in their particular cluster areas. I have certainly had that evidence fed back to me. And now that we have clarity over the contents of the AoLEs, whilst I am incredibly grateful for the work of the pioneer schools, the message is now clear that, from April, all schools have to be pioneers—all schools have to engage in this process, now that we have greater levels of certainty and we're in a position to share that information. So, there's been a balancing act and quite understandably, because of the process that has been involved, there will be some people with greater levels of understanding than others, but now is the time, in the run-up to the publication of the AoLEs and the publication themselves, for all practitioners and all schools to engage in this process. And that, of course, is one of the reasons why I took the decision to roll out the curriculum and delay its implementation—to give us the time for all professionals to be ready.
Thank you for that answer. At this point, for teachers who are not in pioneer schools, what kind of a level of understanding of the curriculum do you think that they have at this point? And do you think it's great enough for them to not have a big learning curve once you actually publish the curriculum? Because, obviously, the pioneer schools are going to be ahead of the curve, because they've been working on the curriculum. Those outside those pioneer schools haven't been, so if they're not—. They need a certain base of knowledge to be able to—
Yes, of course. And that base of knowledge, I would argue, has been there by the conversations that pioneer schools have been having with their non-pioneer colleagues. As I said, it is an inevitable part of the process that people will be at different levels, but the clear expectation is now that all practitioners will need to engage in this process. Steve.
One of the requirements of being a pioneer school is not just to produce the document, and these people are not going into a room and coming out and not speaking to people. They are engaged in clusters. And it's a requirement that the pioneer school takes back, not the fine detail, but takes back and engages with those schools, both to bring them up to date and keep them up to date, but also as a route to bringing their views back into the AoLE working groups.
So, we know, by region and by cluster, which pioneer schools are working with partner schools. Now, inevitably, some will be more effective than others; we can't police that, but the structure set up is to enable that flow of information. There's an inevitability that those who are involved in the very great detail will be ahead of the others.
So, why is the National Education Union saying that not enough practitioners understand what the new curriculum is going to mean? If those communication channels are effective, why is the union saying that?
Well, as the NAHT union says, there's a balance to be struck with overloading information on people when it's not complete, when they don't need to have it, and being in a position, now, to do that now that the content has been completed. So, there's that balance to be struck. I would argue that we have improved levels of communication and information to people. Again, the NAHT said that the Welsh Government's curriculum has been clearly explained via Welsh Government channels, so that particular union says that they feel that the communication has been very clear.
Hefin, when we first discussed the curriculum I think in this committee, cited the example of a primary school that he is very familiar with. He said that that primary school, when he had visited it, felt very left out of this process. I had the opportunity to visit that school with Hefin and I asked the headteacher about the experience that she had, and I'm sure that Hefin will confirm that she said that things had changed considerably, and, having gone through as a non-pioneer school that felt very ill-informed and left out of that process, she now found herself fully engaged with her pioneer schools in her particular network and felt in a better position.
And that's the experience I've had with other teachers. With my colleague Vaughan Gething—once a year he brings a group of headteachers from his constituency to see me, to ask questions of me. The first year we did that, I had similar feedback. I had similar feedback from schools that were non-pioneer schools that said that they had felt left out, they didn't feel that they were engaged, and they were unclear as to what was happening. A year later, I met with the same group of headteachers, and I specifically asked them whether things had improved, and they said 'yes'. In fact, in one case, the headteacher said she felt overloaded with the information that was coming forward. So,there is this balance to be struck.
Just very quickly: how closely are you involved in reviewing the content of the approach of the draft areas for learning experience to date?
I am very conscious that it is not necessarily for me wholeheartedly to have the opportunity to put my particular passions into the curriculum. I don't think that would be appropriate. Clearly, what I'm responsible for is ensuring that the process that we have engaged in is true to the principles that were outlined by Professor Donaldson in his design of the curriculum, and to ensure that this is delivered in a timely fashion in terms of the content of the curriculum, but also that the system is ready to deliver it. Obviously, I get regular advice from the AoLEs, and I listen to advice from stakeholders and I use that then to challenge officials. So, I keep an overarching view on it, but I certainly don’t look to particularly push any particular passions I have to ensure that they are listed. My job is to ensure that the vision, and the reason why we are doing this—. And that's what we've got to come back to all the time: why are we doing this change? What will this mean for our children and the future of our nation? And I believe that there is still the opportunity to feed back and get that balance between too little detail or too much detail, because that's one of the conundrums of this process, and I believe that we are making good progress, and I'm really excited to be in the position to get these AoLEs back and to have even greater feedback from people.
Rydw i wedi bod yn darllen trwy'r ymatebion i'r ymgynghoriad y mae'r pwyllgor yma wedi'i gynnal—33 o ymatebion i gyd—ac mae o'n ymddangos i mi fod y feirniadaeth sydd yna, a does dim gwadu bod yna feirniadaeth yna, yn rhannu i ddau faes: i ddechrau, problemau ynglŷn â chyfathrebu, ac ynglŷn ag ymgysylltu efo'r proffesiwn yn gyffredinol, ac rydych chi wedi amlinellu rhai o'r materion sydd gennych chi ar y gweill er mwyn mynd i'r afael â hynny. Ond yr ail faes—ac mae'r gymdeithas llywodraeth leol a Chymdeithas Cyfarwyddwyr Addysg Cymru yn arbennig o feirniadol o'r maes yma—ydy'r cynnwys ei hun. Yn sicr, mae yna feirniadaeth yn fan hyn, ac mae yna restru pam eu bod nhw yn teimlo bod cynnwys y cwricwlwm newydd yma yn gyffredinol yn ddiffygiol. Buaswn i'n licio, i ddechrau, jest cael eich ymateb chi i'r feirniadaeth gyffredinol ac yn benodol y feirniadaeth gan y WLGA ynglŷn â'r cynnwys?
I've been reading through the responses to the consultation that this committee has held—33 responses were received in total—and it seems to me that there is criticism there, and you can't deny that, and that it splits into two areas: the first regards problems in communication and in engaging with the profession in general, and you have outlined some of the issues, or some of the actions, that you have to target those. But the second area—and the Welsh Local Government Association and the Association of Directors of Education in Wales have been specifically critical about this area—is the content itself. Certainly, there has been criticism in this area, and they have listed why they feel the content of this new curriculum is, in general, problematic. I would like to begin just by getting your response to the general criticism, and specifically the criticism from the WLGA about the content.
I have to say, Chair, it's been disappointing to read the evidence that has been submitted to the WLGA. As Members will be aware—
Can I just butt in there—evidence that has been submitted to the WLGA or the evidence that's been—?
Yes. The evidence that has been submitted by the WLGA and ADEW to the committee. It's disappointing to read.
I meet very regularly with Councillor Wilcox and partners in local government. Those of you who know Councillor Wilcox know that she is a robust individual who is not slow in coming forward if she thinks that things are not correct, and I have to say that, in my meetings with her, these concerns have not been raised. Prior to Christmas, I attended the WLGA/ADEW conference at Wrexham. At that event, the directors of education and lead portfolio holders—the cabinet members of all 22 local authorities are there—and they are able to ask me any question that they like and, believe me, as you can imagine, they have plenty they like to say to me, and they have plenty of issues they want to raise with me. Again, I have to say, the issues that have been raised in this paper were not raised with me. I have checked with the former Cabinet Secretary for local government to see whether these issues have been raised with him in a different format, because maybe they felt they wanted to raise it with him rather than me. Having checked with him, I can confirm that the issues outlined in this paper have not been raised with him either.
My big concern about it is that (1) it seems to me that the paper is based on details that were available in July, and doesn't seem to reflect the most current information and the current drafts. So, some of it, I think, is out of date. And I also think I am concerned that what seems to be suggested with regard to content is in danger of taking us to a situation where we have long, detailed lists of content, which is very much against the vision of what we're trying to achieve in the curriculum. Now, clearly, that is a matter of concern to me—that there may be a misunderstanding of what the vision behind the curriculum is. I'm clearly concerned that the criticism that has come in regarding the 'what matters' statements seems to misunderstand what the role of what the 'what matters' statements are in the curriculum.
Once I saw this and officials saw this, I asked officials to go back to ADEW to say, 'Look, we clearly need to sit down and engage to ensure that we are all on the same page in terms of our understanding of the purpose and of the structure and of the role of the purposes, of the 'what matters' statements and of the AoLEs, because I want to make sure, as crucial partners in this process, that they are aware. Of course, ADEW do have representation on the implementation board that Steve chairs.
You're clearly, therefore, saying that you're disappointed that you didn't know about their concerns beforehand, which clearly is a problem—there's a breakdown in communication there, it seems. But looking at the specific elements of what the WLGA are saying, it is pretty scathing, and it does present a problem so late in the day when you're thinking of publicising in the spring. You know, to have statements saying that it's not clear enough, it's too generalised, that some of the statements are too general and haven't been well defined, are weak, and that a lot of this will depend on the teachers and on their skills and information et cetera, et cetara—I mean, anybody who reads what the WLGA have said will come to the conclusion that there is a problem. The criticism is scathing.
Now, I'm sure you're going to try and defend what's happening, but surely—surely—you have to take into account what the Welsh Local Government Association is telling us and now you must urgently consider what they're saying and come up with a plan to address this major problem about the lack of substance in the content of the curriculum. I see your officer is shaking her head. So, in other words, you're denying everything that the WLGA are saying—there's no substance at all to what they're saying.
If I could just repeat what I've just said, I think it would be concerning if the comments and the criticisms were addressing the current position that we're in. What I'm saying is that it seems to me from the evidence that has been submitted that many of the comments relate to drafts that were available in July, and do not reflect the current situation that we have been in. Everybody else—
Why has that situation arisen? I mean, why? Is it communication, lack of transparency—that since July they don't know what's going on?
Siân, I think we need to let the Minister answer and then I'll bring you back in.
Well, why they based it on the availability of information in July is of concern to me, because I would have expected them to have been more up to date. Other organisations that have commented have been able to do so on the basis of the latest drafts and the latest feedback. So, why is that the case? Let's be absolutely clear—ADEW are formally part of the structures that are available to help us develop the curriculum. I think things have changed significantly from July, and that is not included in the evidence that has been submitted by ADEW. But, clearly, I would absolutely agree with you, Siân, that we need to ensure that these important organisations have a clear understanding of what we're trying to achieve, have a clear understanding of where we are at present, and we will redouble our efforts—. And as I said, officials have already been in touch with them to say, 'Clearly, we need to sit down', and we need to work even more closely together than clearly we have been able to in the past, to try and address their concerns so that they feel more confident.
Their evidence with regard to the content is in stark contrast to what the regional consortia have said and what Estyn has said. Clearly, there are pieces of evidence that have come into the committee that I think we need to take on board. So, when Estyn say, 'We need to evolve the curriculum and assessment group into something that looks now not at the 'what' but also at the 'how', I think that is a legitimate thing that this Government will have to do and we will take on board. When there are other people that have concerns about particular areas of content, officials will sit down and talk to them. So, this is not to say that everything is perfect, and I haven't come here this morning to say everything is perfect. That's why we've created the opportunity for feedback. But, Steve, I don't know if you want to add anything about engagement to date.
Before you add anything, Steve, are we absolutely confident that the WLGA were sent the latest draft, because, obviously, the committee hasn't seen any of this information, so we're slightly in the dark, because it's not been made available publicly, has it? So, are we certain that they were given the most up-to-date draft?
They've been invited to all our governance meetings where those things are—. I personally give updates on what the content is at those meetings.
Chair, none of the middle tier were sent in its entirety the detail of where it is because it actually hasn't been completed now. The key point here is that ADEW and the WLGA, each organisation, has a place in the governance structure, on the change board, which meets about four, five, six times a year to actually—. They are the ultimate group that can challenge the detail and can inform the Minister. There's the minutes of those meetings if they're not happy with anything. ADEW have had that seat at the table, and so has the WLGA. Over the past two years, the WLGA have been regular attendees of that meeting, and have fed back concerns in particular areas. We have had some challenges in terms of the engagement of ADEW for almost 12 months, from the middle of, I think, April, March 2017-18. When we registered those concerns with them, I'm pleased to say they increased attendance, and they came to the November 2017 meeting, where Claire was one of the key people delivering progress on that. And I would have expected any concerns, particularly of this gravity, to have been expressed.
Alongside that, clearly, there are the regions, because they are delivering on behalf of the local authorities, the improvements in education—this reform journey is part of that. The directors of education attend meetings and conferences that we hold with headteachers on the curriculum on a regional basis, and the regions themselves work with the directors of education.
So, that's why we were, if I'm honest, a bit shocked, but particularly disappointed that we haven't had that engagement. Now, rather than just criticising it, what we've done is that, before Christmas, when this was emerging, Claire has been in contact with them, offered further detailed briefing, and, clearly, perhaps because that communication has not worked, we will look to redouble our efforts to work with them, but we need them to properly engage.
Okay. I've got a few Members on this. I've got Dawn, then Hefin, and then I'll bring Siân back in.
Thank you Chair. My question, and I think you've both touched on this, is on the response from the WLGA and the response from the regional consortia. The regional consortia are saying they're making good progress. The WLGA—we know what they're saying. I just wondered if you've got any idea why the response should be so different, given that the regional consortia consist largely of the same people around the WLGA, and ADEW are also involved in the consortia, and they're saying two different things? So, have you got any idea? Are they answering the same question?
Well, I'm assuming they're answering the questions that were posed to them by the committee, because, of course, the questions they're answering are not our questions they're your questions. That's what makes it so disappointing to see that disconnect. And you're quite right, Dawn, the consortia are beasts of those local authorities. They are part of that middle-tier journey with significant ownership and involvement by local authorities. Clearly, as I said, we take this very seriously. These are important voices and we will, as outlined, sit down and redouble our efforts to try and get a level of engagement where there is a shared understanding, and where there are things that we need to improve in terms of the content then we will take those on board. This is not to say that we don't want to change anything. We're saying very clearly that we want to continue to engage with people, but we do need to have that level of engagement. Those concerns could have been raised with us earlier and it's a conundrum to me, when there were plenty of opportunities to do so, why that hasn't been done to date.
On that point, can I ask the director of education for some clarity about the dates of meetings of the change board that ADEW would have been invited to? How many meetings have there been in the last year or so?
I'll get the detail for you, but there have been in the range of about eight meetings, of which I think one has been attended by the ADEW representative.
One, I believe. I'll—
It's in that region, but I'll get you the detail about the dates and the arrangements.
Just as an idea, when would that one attendance have been? You said November 2017.
November 2017. The one prior to that, on our records, is March/April 2017.
So, what it seems to me that you're saying to the committee is that ADEW haven't taken the opportunity to raise these concerns in the forum that was appropriate and have used this committee to raise concerns that they could have raised appropriately in another forum and didn't?
And more widely, as I said, I meet regularly with the leadership of the WLGA. As I said, in the autumn term, I attended their conference—where all the directors of education are present, all the portfolio holders are present. They are allowed to ask whatever questions they see fit to ask. Questions ranged from the Welsh baccalaureate, which of course the committee has an interest in, through to GCSE reform, through to money, as you can imagine, through to whether the money for professional learning should have gone straight to them, as you'll recognise from the evidence from the NEU—they're very glad it's gone straight to schools. So, that was a perfect opportunity for anybody to raise any concerns, and this has not been raised with us.
Jest i nodi—y ffaith amdani ydy bod pryderon wedi cael eu codi efo'r pwyllgor, ac mae'n rhaid i ni fel pwyllgor fynd ar ôl hynny. Jest i ddweud hefyd—dim jest y WLGA sydd yn codi pryderon. Rydych chi'n sôn am Estyn—mae Estyn yn dweud bod angen
'Mwy o gysondeb rhwng y trefniadau ar gyfer cynllunio'r cwricwlwm, addysgeg, arferion asesu a’r cynnig newydd ar gyfer dysgu proffesiynol'.
Hynny yw, mae Estyn hefyd yn mynegi pryder nad ydy'r cwbl yn plethu at ei gilydd yn ddigon cadarn. Felly, mae'r feirniadaeth yn dod o fwy nag un cyfeiriad.
Just to note—the fact is that concerns have been raised with the committee, and we as a committee do have to chase that. Just to say as well—it's not only the WLGA who are raising concerns. Estyn, for example, say that we need more consistency between arrangements and scientific discliplines. So, Estyn also are raising concerns. They say that things aren't entwined. So, the criticism comes from more than one direction.
Yes, and as I've said, we will engage with the feedback that the committee has received. Estyn says that the Welsh Government has made very good progress in meeting this ambitious agenda. Estyn themselves have deployed resources to directly support the development of the AoLEs. Estyn says that there has been noteworthy progress made by the pioneer schools. Recently, the AoLEs—
[Inaudible.]—talking about that. I'm asking you about a specific point that Estyn have made.
Yes, absolutely, and as I said, with regard to stakeholder engagement, I think Estyn make a very valid point about how we want to push the curriculum and assessment group now into a different direction, and we will take that on board and we will action that. So, I think there are legitimate things that Estyn have said and that we will action.
Okay. Just before we go on to look at some specifics, one of the things that did particularly alarm me about what the WLGA said was that they were worried that pupils without strong family support were at risk of missing out most. Now, setting aside the fact that, clearly, there hasn't been the engagement that we would have wanted from ADEW, do you recognise that there is a risk, with something that is purely profession-led, of variation? And are you confident that we are going to deliver a curriculum that delivers for all our pupils and that doesn't see a situation where kids without good family support, which is often in our more deprived communities, will end up missing out?
Well, as you know, Lynne, closing the attainment gap and ensuring that all children in Wales have an equal chance is a cornerstone of my approach to education reform here in Wales. Clearly, that issue arises, not out of the content of the curriculum, but actually the application of the curriculum, and I think that sometimes we've seen a lot of that in the WLGA/ADEW paper. It is actually about the application of the curriculum where some of their concerns arise, and, clearly, we will need to ensure that that won't happen by getting our professional learning correct. So, there is a difference isn't there, I think, in approach to actually what the curriculum is, and then, crucially for me, how that curriculum is actually delivered within our school setting. And that's where our investment in professional learning, investment that will go directly to schools—something that ADEW and the WLGA have objected to, but I'm glad to see has been very much welcomed by the teaching unions—gives us the opportunity to ensure that that will not happen.
With regard to additional learning needs, because again, the curriculum needs to be accessible for all pupils, the work on additional learning needs to make sure that the curriculum meets the need of all our children has been a very important work stream and has been tested and challenged as we go through this process. So, there's a difference between the content and the application of this in our schools.
We have got some questions on ALN. Is that what you were going to come in on?
It was a couple of things. One is to say that, over the autumn, lots of work has been done on the supporting information that will go with the curriculum, so that's something. So, practitioners will have support in terms of designing curriculum and the like and, just to reiterate what the Minister says, in the autumn we did a huge amount of work on ALN and the foundation phase. So some of the issues around, 'Have we done enough on the foundation phase?'—that was a major focus for us, the ALN and foundation phase, over this last phase of work as well as that supporting under the 'what matters', the kind of help that teachers will have to interpret 'what matters' and create and be able to deliver the curriculum effectively.
Okay, We need to move on now to look at some specific areas of learning and experience and we've got some questions from Jack Sargeant.
Thank you, Chair. As the Chair rightly says, we're going to look at some specific areas of learning. I think it's quite pleasing that you've already alluded to that your officials will engage with organisations as well as the WLGA and so on. But, looking at the science and technology AoLE and what the Royal College of Chemistry say—that, as it currently stands, the science curriculum, and quote:
'does not present a clear identity for the scientific disciplines'.
And they go on to say that the key concepts could, I quote again, fall 'through the cracks’. What's your view on this, Minister, and what do you say to the Royal College of Chemistry?
Thank you, Jack. I think it is absolutely fair to say that science and technology pioneers have had the real challenge of balancing a wide curriculum area, a really, really challenging AoLE to be working in. And, understandably, there will be differing views on the appropriate level of detail. What I should highlight is that the draft science and technology AoLE will be organised on the basis of six high-level 'what matters' statements that will reflect the breadth of the curriculum
Again, what I am concerned that we don't do is develop a curriculum that is so broad that it precludes those individual students who want to pursue individual sciences at a higher level from doing so. So, I am, obviously, concerned that we work closely with the Royal Society of Chemistry to address these points, because we want a curriculum that, as I said, does not preclude anybody who wants to take separate sciences at A-level or who aspires to do science at degree level. We need to make sure that nothing in the pre-16 curriculum does not allow them to successfully transition to more specific detailed qualifications. So, officials will be meeting, as a result of this feedback, with the royal society to better understand and to feed those views into the AoLE group.
Thank you for that, and, again, it's pleasing to hear. Moving on to the health and well-being area and the concerns expressed by Sport Wales that swimming and water safety will not feature sufficiently in the draft, is that something that's been addressed in the editorial process, given swimming's status as a life-saving skill?
With regard to swimming, there is reference to swimming and water safety, so there is nothing to preclude schools from pursuing swimming as a physical activity within the curriculum. So, I would argue that that is there. Claire, I don't know if you've got any further details on swimming.
The health and well-being AoLE will mean that learners need to be able to be physically active in and around water—so, swimming—as part of being physically active, and to be able to make safe decisions around situations in environments, including water. So, it is there.
I think the thing that we'll probably need to look at again is the guidance that goes with it and interpreting that, but, again, this is something we'll keep in touch with Sport Wales on. Sport Wales have been really close to this process and have been really close to us developing that AoLE, so it is something we'll look at with them. But, I think our view, and the view of the AoLE, is that it's there. It might be that, actually, when we come out we'll need to be clearer in terms of the supporting information that goes with it.
As Claire says, Sport Wales has been part of the stakeholder group and has been closely engaged. Again, this comes back then to some of the interesting things that we've had in the WLGA/ADEW paper. So, Sport Wales have been very, very close to it, but you'll be aware that the WLGA and ADEW paper wants a long list of things that children will be able to distinguish between a winter sport and a racquet sport. If we get into that kind of level of detail in the AoLEs, we're really going to undermine the principles on which this entire curriculum is being founded, so I just want to reassure people that Sport Wales, and this area of physical activity and physical literacy, has been closely involved in helping to develop the AoLE.
Okay, thank you. Just moving back to WLGA and ADEW, to what extent are you surprised or disappointed that they say
'The well-established fields of oracy, reading and writing'
are not defined well in the languages, literacy and communication AoLE? I know you said earlier on that this is one of the areas that needs more content. Is this the reason behind their views on that?
Oracy, reading and writing are all reflected fully in the latest 'what matters'. I quote, if you don't mind, Jack—
The 'what matters' statement is:
Listening and reading effectively prepares us to learn throughout our lives. Speaking and writing effectively prepares us to play a full part in life and work.
So, the importance of those skills, I would argue, is fully reflected in the latest 'what matters' statements.
So, would you say that, again, their comments are on the previous draft or revision of the AoLE, or is there something that—
I'm assuming that they were referring to an earlier draft, because, as I said, the latest draft of 'what matters', I believe, clearly reflects the importance.
Yes, while we've been talking, I wanted to touch on the back of what you were saying with regard to the WLGA about their referring to the July papers rather than the most recent iterations of this. The reply I've had is from Robin Hughes, not from Debbie Wilcox, so I need to make that plain. His response is: two of the six AoLEs are not ready even for the editorial process. So, how could they be up to date? And the concerns are very specific regarding language and communications and humanities as the two areas lagging behind the others, and what's particularly difficult about curriculum development in those areas. So, I think the point he's trying to make is: what is the up-to-date position in those particular areas, as they've lagged behind development in the others—if they're not ready for the editorial process, even? I just wondered if you could comment on that.
I just said that at the beginning of the meeting, that those are to be completed. I was very clear to the committee that those are the two AoLEs that are to be completed, and I would argue that Steve has just said, in terms of sharing information, because things are changing all the time, that's why those engagements at the stakeholder meetings is really important. He hasn't said anything I haven't already said to the committee this morning.
No, I think it's focusing particular on those two areas of learning and that the remarks that the WLGA were making were primarily directed at those two areas of learning.
Health and well-being is complete and gone, actually.
As I said at the beginning, we've been very clear that those two AoLEs are due for completion shortly, and then to go into the editorial process. What you've just heard is no different from what I've just said at the beginning of the meeting.
Thank you, Chair. Moving on to the final question from me, and the second AoLE that isn't complete yet, which is humanities, to what extent will that AoLE consolidate the advances that have been made since the changes to the GCSE and A-level specifications in 2015 and 2017 to incorporate Welsh history and the Welsh perspective in the study of history in schools? You rightly will know that this has been the subject of an Assembly petition and evidence to the committee as well.
Well, Jack, I'm really grateful that you acknowledge that there has been progress as a result of the changes to the examinations, because sometimes people aren't willing to acknowledge that progress at all. So, the fact that there has been progress as a result of the change of the specs to the GCSE and the A-level is very welcome, and I think demonstrates our commitment to getting this element of the curriculum right. I would fully expect to see Welsh history and Wales planned across all areas of the curriculum, and, actually, it shouldn't just sit in one particular area such as humanities. I think there are opportunities throughout the curriculum to talk about our nation.
The humanities AoLE working group has taken full account of the Cwricwlwm Cymreig report, as well as a range of experts, including Elin Jones, who of course was instrumental in outlining what the Welsh Government needed to change to ensure that both Welsh history and the Welsh dimension are reflected appropriately. And, of course, because we are moving away from a tick-box exercise of saying, 'You will do this' and 'You will do this' and 'You will do that', it allows, actually, schools and individual teachers to be able to bring in, I hope, lots and lots of local experiences and the lived experiences of children within their community setting, to bring these areas of learning to life.
Thank you, Minister, and the culture and Welsh language committee will be undertaking an inquiry on that, so I'm sure we're all looking forward to their report as well.
Okay, thank you. We've got some cross-curricular issues to explore now. The next questions are from Siân Gwenllian. Can I appeal for brief questions and brief answers, please?
Mae'r un cyntaf ynghylch hanes Cymru, ac a ydy o yn eich gweledigaeth chi y bydd hanes Cymru yn rhan naturiol, ganolog, integredig o'r cwricwlwm, ac felly nad oes dim, mewn gwirionedd, angen ystyried dimensiwn Cymreig fel atodiad i'r cwricwlwm.
The first question is with regard to history in Wales, and whether your vision with regard to history in Wales is that it is a central, integrated part of the curriculum, and that there is no need to consider a Welsh dimension as a supplementary issue in the curriculum.
As I just said in answer to Jack Sargeant, I am confident of the secure place of Welsh history in the curriculum, and, actually, I believe that an important cross-cutting that has been worked on significantly is ensuring a Welsh dimension to all aspects of the curriculum.
This particular point concerns me, about calling it 'a Welsh dimension', because really, aren't we talking about a Welsh curriculum? So, why does it have to have a Welsh dimension if it's a completely Welsh curriculum, if you get my meaning? I'll leave you to think about that. Okay?
Well, as I've said, what's been really important, and one of the cross-cutting themes that will be embedded across the curriculum, is ensuring that there is a Welsh dimension to it. So, in the past, the criticism has been, when looking at history, that the cliché is we spend too much time talking about the Nazis and not enough time talking about what has happened in our home nation. But, also, I see the Welsh dimension being far, far greater than just learning about local history. Why, for instance, when we're pursuing art, culture and dance that we don't reflect on the huge contributions that Welsh people have made to that particular area. When we're talking about science, we should be able to let our children know about the contribution that Welsh scientists have made. When we're talking about literature, I want children to be able to have access to the literature that has been written in both the English and Welsh languages by Welsh authors and poets. So, when we talk about a Welsh dimension, it's not simply related to one particular area; it's about having a Welsh dimension to all aspects of a child's learning and experience.
We share a vision, therefore, of having a Welsh curriculum, which—. So, the talk of having a Welsh dimension is irrelevant, really; we're talking about a Welsh curriculum rooted in all the aspects of the Welsh experience. Just to talk about the Welsh language—
—sut bydd un continwwm dysgu yn gweithio'n ymarferol ar gyfer astudio'r iaith Gymraeg? Hynny yw, sut mae'r ysgolion cyfrwng Cymraeg a'r ysgolion cyfrwng Saesneg yn mynd i ddygymod â'r newid mawr yma sydd angen digwydd o ran cael un continwwm dysgu?
—how will a single teaching continuum work, in practical terms, in terms of the Welsh language? That is, how will Welsh-medium schools and English-medium schools deal with this major change that needs to take place in terms of having that single continuum?
Well, as Siân Gwenllian rightly identifies, a common curriculum framework for Welsh within the languages, literacy and communication AoLE will replace the current Welsh first language and Welsh second language programmes of study. This means, in practice, that there will be one pathway. Achievement outcomes for Welsh will recognise the variation in pace of learning and the degree and depth achievable through different types of provision. So, progress, for instance, for children whose language of tuition is Welsh, obviously, will be inevitably different from those who attend a bilingual school or those who attend a school where the medium of tuition is English, but there will be a common pathway. Again, the challenge here, I believe, is not the development of the curriculum itself, but ensuring that the system is ready to be able to deliver that effectively, and that forms part of the work that we're doing with regard to preparedness for the curriculum and professional learning.
Fel rŷch chi'n dweud, mae hynny'n sialens, efallai, sydd angen sylw penodol. Mae yna bryder nad ydy'r cynnydd ddim yn digwydd yn ddigon cyflym yn y maes yma.
O ran y cwricwlwm newydd a tharged Cymraeg 2050 o sicrhau miliwn o siaradwyr, i ba raddau fydd y cwricwlwm yn golygu addysgu pynciau eraill—nid dim ond yr iaith Gymraeg—trwy gyfrwng y Gymraeg i ddisgyblion mewn ysgolion sy'n gweithredu ar hyn o bryd drwy gyfrwng y Saesneg? Hynny yw, a fydd yna bynciau'n cael eu cyflwyno rŵan mewn ysgolion sydd yn dysgu drwy gyfrwng y Saesneg drwy gyfrwng y Gymraeg er mwyn cyflymu'r broses o gyrraedd at y miliwn o siaradwyr?
As you say, that is a challenge that, perhaps, we need to put a particular focus on. There is concern that the progress isn't swift enough in this area.
In terms of the new curriculum and the Cymraeg 2050 target, to what extent will the curriculum mean that other subjects are taught—rather than just the Welsh language—through the medium of Welsh in schools that currently operate through the medium of English? Will subjects now be introduced and taught through the medium of Welsh in English-medium schools in order to accelerate the process of reaching that million Welsh speakers?
Well, obviously, Siân is absolutely correct to say that this is a really challenging area for us with regard to the provision of a high-quality Welsh language experience for those children who attend a school where the language of tuition is English, and there is a great deal of work going on to move that reform agenda forward. Of course, we're already part of—. That journey will lead us to reformed qualifications, but also to what I hope will be many, many more children leaving our education system as bilingual children with the ability to express themselves, to a greater or lesser extent, through both languages, and, therefore, it is an important part of the ability to reach the Welsh Government's 2050 target that we get this right. But I don't underestimate for one minute the size of that challenge. It is one of the most challenging aspects of the new curriculum to ensure that that experience in English-medium schools is a really, really strong and positive one and one that, we have to admit, will have to be better than it has been in the past.
And when do we get the detail of that plan? The implementation of what you've said—when do we get to see all of that?
Well, of course, the Welsh in education plan was published by the previous Minister.
No, I mean the aspects of developing Welsh-medium education in some subjects in English-medium schools. That has to be planned, there has to be workforce planning, which is part of the new curriculum, so when do we get to see the detail of that? Is that also being published in the spring with the curriculum?
Well, as I said previously, the previous Minister for lifelong learning has published a Welsh in education plan, and I've answered questions here in the Chamber before about—
But that doesn't actually address the issue that we're talking about now.
I would argue that it's the Government's attempt to do that. Siân can have a view on whether it's a good enough attempt or not, but that's what the plan has been published for. Workforce planning is an important part of that, and, again, Siân Gwenllian and I have exchanged questions across this very table to look at the recruitment and retention of staff with the ability to teach through the medium of Welsh, and the robustness of our scheme that allows teachers to take time off from the classroom to go and be immersed to improve their skills. So, these are all things that we have discussed around this table.
So, is there any intention of issuing any guidance when this particular AoLE is issued that might tackle some of these issues?
Yes, there will be guidance alongside the content of the individual AoLEs and support for staff on how they can achieve the purposes, the 'what matters' and how they can use those 'what matters' to help plan their activity.
Thank you. How will the new curriculum cater for learners with additional learning needs? Is the Welsh Government planning on issuing any additional learning needs guidance, alongside the areas of learning and experience, as called for by the third sector Additional Needs Alliance and the National Deaf Children's Society?
Thank you, Janet. As I said earlier, I'm very concerned to ensure that the curriculum is developed in a way that is inclusive and allows all children to be able to enjoy the benefits of this reform. The reform of the curriculum also sits alongside, of course, the reform of the ALN legislation and the transformation programme. You'll be aware that we are out to consultation on the ALN code at present, and it's difficult to separate both streams of work.
We are aware of the feedback that we've had from a number of voluntary organisations that look to support learners with specific needs, and we will be continuing to liaise with those particular groups to understand those concerns better and to see some of those issues potentially reflected in some changes. But, Claire, could you give an update?
Yes. We will produce something that sits alongside the curriculum that describes our vision for ALN in the curriculum. I think the current curriculum wasn't really designed in a way that properly did that. This curriculum is designed to be inclusive. We've had specialist ALN help and expertise all the way through and we've had special schools in each of the AoLE groups, and, over the autumn, one of the things we did was draw out the people who have expertise in that and got them working on how this would work. The other thing is about getting the expectations right in the curriculum that teach progression steps.
So, there will be something that addresses ALN, and, as the Minister says, it's an area that we will continue to look to the specialists and experts to help in, and special schools. Special schools have really helped a lot directly on this, not only for themselves, but for other colleagues who need to do this effectively and in an inclusive way.
Okay. Generally, though, in more mainstream schools—. I know, when I trek round my schools, this is a huge concern, and many teachers and headteachers are feeling the pressures that come with trying to support children with additional learning needs. So, when you say you're going to be—. When are you likely to produce something?
Alongside the new curriculum, in terms of the guidance for practitioners around the curriculum, it will come out at the same time, so that will be April.
Okay. So, there's a strong emphasis on it, is there? Because it is something that is increasing; it's not something that is—
No, we're really clear—
And, Janet, as I said in answer, you have to see this alongside the ALN transformation programme. So, this is the curriculum, and we have to make sure that that curriculum is accessible, but then, in terms of day-to-day implementation and how we can improve the experience, the training and the support within schools, both mainstream and special, that comes from our ALN transformation programme.
And the committee's going to be doing more detailed work on the code in the weeks ahead.
Yes. Also, how will a whole-school approach to emotional and mental health be taken forward across the whole curriculum? And to what extent are the committee's 'Mind over Matter' report and developments since actually informing the design of the curriculum?
Again, Janet, this is absolutely crucial, crucial to me, and there are two aspects to it. It is actually content within the curriculum, so actually the ability for children to develop, learn about and develop their skills and understanding, but actually it's also about an ethos within the school as well, isn't it, which goes way beyond simply the content of a lesson. So, the school itself needs to be a place where well-being is regarded as important. So, the Mind over Matter group, which I co-chair with the health Minister, is important in terms of the structure and how we create that atmosphere within a school and the expectations in the school as well as the practical lessons and skills as part of the curriculum. I hope that, when people see the AoLE for health and well-being that there is a strong, strong emphasis on the issue of well-being, and not just on physical health—we've talked a lot about physical activity this morning—but actually recognising that well-being is more than just physical health but is about mental health also.
The other thing, of course, to remember is that having a whole-school approach is not just about the curriculum; it is about what we hold schools to account for and what Estyn holds schools to account for. So, to get the whole-school approach right, it can't be just left to an individual lesson plan, and nor can it be left to an individual AoLE. It's about how we view this important area in education reform as a whole, recognising that, if we fail to address well-being, we cannot expect children to do well. It is the basic foundation for a successful education experience. It doesn't have to be done at the expense of standards. This is about improving standards.
Yes. And my final one: what is being done to consider how the new curriculum will apply to pupils in the foundation phase? How are the principles of the foundation phase being used to inform the curriculum at these ages?
Yes. Very much so. In fact, I'm really proud of the foundation phase approach, and, actually, in some ways this is about extending some of their pedagogical principles of the foundation phase further into the curriculum. I think it has been fair that the feedback at the beginning of the summer—. There were concerns around the impact of the curriculum on the foundation phase. We've had to work really hard over the autumn term to address some of that, and I think that was a fair criticism, and we've tried to work very heavily on that area. So, the foundation phase is, hopefully, I believe—. You know, those principles are underlying the work further up the age groups, but, Claire, do you want to say just a little bit about what we've needed to do on the foundation phase over the autumn period?
So, again, we've got a foundation phase expert group, and we use them, really, to help critically evaluate how the curriculum was looking, particularly obviously getting the early progression steps right in the early years but then how that connects and works through the whole of the curriculum, and what we quickly found was that there was a lot in the foundation phase that we really needed to make sure pulled through across the whole age range. So, there's been a lot of work on it and it's really fed into the culture of learning, so the guidance that will accompany it, so that you get that child-centred feel for the whole curriculum, which is at the heart of all of this, and a good experiential-based approach. So, we've had quite an intense period of work, working with the foundation phase expert group and other organisations who have done a lot of work with areas like maths and science and tech, which are complex to draw down and get right in the early years, but I think they are there now. The latest advice we've got is that it's looking really good. But, yes, that area for us was really important because we wanted to build on the foundation phase, as Graham Southford said in the initial report—that it was important that we built on that approach.
Thank you. We've got some questions now on stakeholder involvement and governance from Hefin David.
To what extent do you share the concerns expressed by the children's commissioner that this has been a missed opportunity to involve children and young people in the design of the curriculum?
Well, the first thing to say, of course, is that the children's commissioner is part of the stakeholder group, and children are a part of our reform process. But, again, it's a question of what is the appropriate point to fully engage. So, for instance, in looking at—earlier on this week we looked at online assessments. Actually, children were involved in that process, so, asking them, 'What kind of information will be useful to you? So, if you're going to have an assessment, what kind of information would you like to have that will help you move your learning forward?' So, they have been a part of it.
Part of the new practice that we will see in schools are the e-portfolios, how we can gather evidence, or how can a teacher and child gather evidence of their progression in the school. And the e-portfolio will be a critical part of that, and children's views have been taken into consideration in the designing of the e-portfolio. As we go forward, now that we've got the AoLEs and we've got something concrete to go out to discuss, now, I think, is the really appropriate point where we can really engage with children and young people and they can feed back in.
So, we've re-established the sub-group and we'll be looking at—. Graham Donaldson has met with children, facilitated by the children's commissioner, actually, as part of the independent advisory group, so it's not true to say that children haven't been involved, but I think we're now ready with something of substance that we can go out with. With regard to the White Paper, as I said earlier, there will be a children and young people friendly version of that consultation paper for them to feed in.
But the children's commissioner is quite clear that you could have done more earlier, and she offered to facilitate that and it wasn't accepted. Also, you said you've re-established the sub-group, but she said that the sub-group was needlessly suspended for two years, which would have been a method for ensuring that facilitation happened.
Well, as I said, I think we are in a—. It's a question—. For me, it's a question of timing. At what point is it appropriate that we can get some meaningful consultation? And, as I said, we are not averse to hearing from young people at all. Where we are making changes, we wanted to hear them. We have taken up the opportunity from the children's commissioner to bring young people along to the group that Graham chairs.
We are now re-establishing the sub-group because we think that now there's a real opportunity for value to be added, and, as I said, we're committed to hearing the voices of children. When we think about, for instance, the place of relationships and sexuality education, and the fact that this will become a statutory part of this curriculum, those have been heavily influenced and guided by the voices of children and young people in that decision and that particular piece of work.
I think what we've got to accept is that there's a difference of opinion between you and the children's commissioner here.
You accept that. Okay. The Council for Wales of Voluntary Youth Services have also said that they feel that youth work is being sidelined, and the Principal Youth Officers' Group have said that they feel frozen out. Have you recognised those concerns?
Yes. Yes, we have. And we—. What's really pleasing, Chair, is that there is so much enthusiasm and there are so many individuals and groups and organisations that want to feed into this process. That's something very much to be welcomed, because I see that as a sign where people believe that this curriculum reform is something that they can feel proud of, enthusiastic about, and they recognise the difference that it'll make to children and young people. The flip side of that enthusiasm is: how do you make that a manageable process? How do you actually create a process that allows us to make progress and meet our timescales and move things along without having absolutely everybody that wants to be involved involved all of the time. So, sometimes we've had to bring groups in and out, individuals in and out, because that's been the challenge of managing this massive, massive process. But we will be recognising that there are specific skills that the youth service can work, and good practice that the youth service can work, particularly in the older end of the curriculum—so, engaging older children who perhaps are in danger of disengaging from the formal education process—and we will be working with them to understand the expertise and the assistance and the approaches and best practice, so we can incorporate that in their work. So, I think it's particularly important, as I said, for older children, and the expertise that youth workers have in particular of dealing with that age group.
So, what you're saying is the multiplicity of stakeholders makes it difficult to engage with all of them, and therefore they may sometimes feel that they're being directed to.
I have engaged with them, actually, but I suppose there are a couple of people more, aren't there? More direct.
So, what I've said to them is we will be coming back to them on things like helping us with the resources and helping us with pedagogy for older children. We were talking about the foundation phase earlier—older children haven't got that so much—and professional learning. So, that's—. It's a question of timing, and to what extent—what actually we do with them. So, they're probably impatient, aren't they, and they want to work with us.
And they feel that the strategic stakeholder groups tends to dictate to them rather than being a genuine, two-way communication process.
It's individual things as well.
No, I think it was a genuine challenge of organising this process when there are so many people who want to be engaged, and how we can make everybody feel that they have had the level of engagement they want while still making sure that this process is manageable, and that we actually get it done in the timescales we have said we will get it done. So, we don't want to exclude the youth workers. As I said, we think we have especially something to learn from them with regard to—
I think you've acknowledged the difference of opinion that you have with people, and also the fact that there are multiple stakeholders, so I accept that.
How are employers and further education providers being kept informed, and are they fully supportive of the direction of travel?
Yes, FE are represented on the groups so that we ensure—. The main concern that FE providers have is how does the content of the curriculum potentially impact eventually on the provision that they have. So, they are part of the group, as are HEIs as well, so that we can listen to them and ensure that there is a continuity and the provision that they do after the end of the statutory curriculum will not be impacted negatively by any changes that we make.
If I could just give a very quick example, I met Admiral insurance yesterday and they said that they had little knowledge of the development of the new curriculum. They're the kind of people who it would be very useful to know about these things. Would you have intentions to meet, for example, with Admiral in the future to talk to them about the future and how they can engage with it?
Yes, I've got no problems with that at all. One of the challenges that, if I'm honest, I've yet to come up with a satisfactory solution for, is how we can get better engagement from the business community—
Yes, well, not just individual companies, but more strategically. More strategically, there is some excellent work going on. Sony in Bridgend do amazing, amazing work with their schools on the digital competence framework. There are—. Airbus up in north Wales do amazing, amazing work with individual schools there. What I—and I'll be the first to admit that what I'm trying to grapple with is how, strategically, we can get better linkages between the world of work, business and the education system. That's a challenge that I admit I have not cracked.
I've look at your letter and you've got a whole load of different groups that are responsible for this. You've got the curriculum assessment group and the curriculum coherence group. Are you going to be rationalising these as time moves on, and are they are effective as they could be?
At this point, not necessarily rationalisation but evolution. As we talked earlier, some of the evidence that has come back to you from Estyn has been the need now for the curriculum and assessment group to really think about the how, and to transform now its focus from—you know, actually how are teachers going to do this. And so I think that's a legitimate question for us; I think it's a really good idea. So, not necessarily rationalisation, but, as the content work begins to slow down, that gives us then the opportunity to use those groups to do different things, and they will have to evolve as the nature of the work changes.
Okay, thank you, and the final questions are from Suzy, on assessment and accountability.
Okay, thank you, Chair. As you know, all parties are quite enthusiastic about Donaldson, and we all hope that it's going to succeed. Part of helping reassure us that it's going to succeed is an accountability framework, and even though all the signs are good at the moment, experience in Scotland means that the need for accountability is probably put into sharper focus even at this early stage than perhaps we would want it, because we all want it to work and we all want it to be seen to work as well. Now, we talked about the new pupil assessment—I'll try not to say 'tests' here, but the new assessments yesterday. I completely understand that they're about helping teachers understand how to help pupils, rather than accountability, but this accountability issue is still something we need some assurance on. Can you give us a bit of information about the work that you're doing on the new assessment and evaluation framework—just generally to start with, and I'll ask you a few more questions then?
Sure. First of all, can I say, with regard to Scotland—because often this is talked about, isn't it, about the experience in Scotland—some of the 'experts' that apparently we should not be listening to have been helping us to do precisely that—to understand the lessons from the Scottish experience, and to ensure that we address those in our curriculum planning? So, the overall assessment and evaluation framework will be published in April alongside the new curriculum and learning once it's finished, so once we've got to the final product there will sit alongside that the new assessment and evaluation framework.
It's my intention to publish the draft evaluation and improvement arrangements later this month. So, again, there's a process of consultation in draft form before it sits alongside a final version when the curriculum itself is published. The approach will be tested and evaluated with schools, so that there's sense testing and it's deliverable and it's workable within the classroom setting. At the heart of that new arrangement is something that we touched on in questions earlier this week, which is about the issue of self-evaluation and accreditation for self-evaluation. We're developing that at the moment with Estyn and with the OECD. So, again, the dreaded experts are helping us work together on developing robust assessment and evaluation and accountability because, of course, those things are sometimes slightly different. We do not want to undermine the ethos of the curriculum by an accountability regime where schools spend their time thinking about looking good, rather than doing good for the children.
So, there's an assessment regime and evaluation, but there is also then accountability, which sometimes sits slightly differently, so that we don't mix up assessment for learning with accountability, because that's where problems I think begin to emerge.
No, and I accept that. What I wanted to hear is where do AMs fit in this: when will we get to see that framework, and do we get a chance to scrutinise it before it goes live?
Yes, there'll be a draft. So, there'll be a draft this—. Yes, there's—. So, the—. Hopefully, the draft will be next month, and then Members will be able to see the draft before the final document that will be published alongside the final curriculum. So, just like you'll have a draft, essentially, of the AoLEs, there will be a draft of the assessment.
My specific point was we'll have time to scrutinise it, presumably, but will that scrutiny—? Will there then be time for the results of our scrutiny to affect the potential outcome?
No, no. If that happens, okay. Very specifically, obviously we talked about these assessments yesterday and I do understand the purpose of them, but part of evaluating how a school itself is progressing may include teachers' responses to those assessments. Of course, obviously, they'll be wanting to see children progressed through whatever the assessment looks like. There will be a tool in evaluating progress to a degree, even though that's not their main purpose. You mentioned earlier—I think it was you, Ms Rowlands mentioned—teachers interpreting the curriculum. They're going to need training to do that. I know the pioneer schools have been leading on this, but who's going to be training the teachers in this quite short period now?
So, obviously, professional learning and professional preparedness for the curriculum is the one thing that has been keeping me awake at night, because all of this discussion that we have had this morning about what a 'what matters' statement looks like, what's in the AoLE, what's not in the AoLE—if our teachers are not in a position to deliver this, then all of this will have been for nothing. And that's why I've been absolutely adamant, in the face of some strong criticism, that we will get the professional learning resource out to individual schools, because they themselves—. So, the headteacher themselves will be able to know the professional learning needs of their schools. And those programmes, and what they look like, come as a result of the work between the curriculum pioneers and the professional learning pioneers, who've worked clearly together, and that's why we've made the resource available.
So, in the first instance, there will be generic professional learning needed. So, in terms of understanding of the curriculum, understanding of the new pedagogical principles that underlie the curriculum. So, that's what will be available first. So, there's that generic learning and support, and then there will be specific, maybe AoLE support, specific subject support, and specific support and learning opportunities for curriculum development itself for the school, because, of course, a lot of what the actual curriculum will look like in individual schools will be down to those individual schools. So, skills to be able to do that are absolutely crucial and form a really important part of the professional learning.
Okay. I understand that those needs will be met, but who's meeting those needs? Who's training the trainer? [Interruption.] As quickly as possible; I'm ever so sorry.
Well, yesterday, we were sitting down with four regional managing directors, planning exactly how this is going to be delivered. We've identified the key areas in terms of professional learning, and one of them is around assessment and assessment for learning. So, what the regions are doing, using the pioneers within their region, is mapping the expertise across schools, as well as the internal expertise within the regions' staff. Putting that together, they will then start to plan what schools will have access to over the next six months, 12 months, 18 months going forward.
This is not a rush; we're not going to go rushing at it in a short period of time, but we are planning that. Primarily, the expertise is already in many of our schools. So, we will be identifying that, developing programmes—or the regions will—with those schools, and providing that range of opportunities for the schools within their regions. What we're doing with the Welsh Government is working across the four regions, so all schools will get an equal entitlement, and one region will not have a disproportionate amount.
And the nature of that learning is going to be very, very different. So, it could be something very formal like going to a training conference, or it could be the ability for schools to work together, identifying a school that has particular strengths in this one area, and the schools in that cluster working together for knowledge transfer. So, there's a whole variety of ways. But this old-fashioned way in which we've done professional learning in the past, where people are dragged to a conference, they sit there all day listening to the sage on the stage and then go back to school and are left all on their own to try and implement that in their own setting—that's a very old-fashioned way of looking at professional learning. So, there will be a whole variety of ways in which professional learning can be delivered, within the next classroom, within the next schools, within the next county. So, there's a variety of ways in which that professional learning will be on offer to meet the needs of individual practitioners in individual schools.
Okay. I've really got to do this quickly: so, the evaluation framework will also evaluate the success of this knowledge transfer, in this more modern way, if I can say—
Well, absolutely. One of the things that we would expect a school to look at is what professional learning opportunities are being made available for their staff. And, of course, a headteacher has a moral responsibility to provide those professional learning opportunities, and the failure to do so would mean that they were in breach of their leadership standards. And, of course, the new teaching standards also place an expectation on professionals to engage in professional learning, and to capture that in their professional learning passport, which is hosted by the Education Workforce Council.
Okay. Well, that brings me very neatly to my final question, if that's all right, which is about Estyn. I wonder if you can just give us an indication of where Estyn is going to be on this sort of gap year that they're having. I understand the reason for it, but I'm quite interested to know what's going to happen to schools that are either in special measures—. I think they're probably still monitored during this potential year out, but what's going to happen to the schools that are in follow-up measures, or—I can't quite remember the names of them now—the lesser interventions?
Can I just say that any school that is in an Estyn categorisation will continue to be subject to Estyn evaluation?
If it's going to happen, yes, they will. What is a really important part of the curriculum reform programme is to ensure and to give confidence to practitioners and schools that every part of the system is geared up and ready for the delivery of this curriculum. Because if we have Estyn inspectors going into schools who themselves are not familiar with, do not know and do not understand how this works, how can they make proper judgments? So, actually, there is a professional learning need for all parts of the system; not just practitioners, but regional consortia challenge advisers and inspectors themselves. Because if inspectors—if schools think that inspectors are just going to evaluate them on the old curriculum, we won't see that change. So, we actually need to make sure that Estyn themselves are ready for these changes.
That sounds to me as if you've made a decision that they are going to get the year out.
Well, I will be making an announcement shortly on how we will take forward the recommendations of Graham Donaldson's review into Estyn. Because, of course, it's not simply my report, it was the report that was done for Estyn.
Okay, thank you. Have we got time to ask the Qualifications Wales question?
It was just to ask, really, how this fits in with how Qualifications Wales are regulating the exams that will follow from this.
Well, Qualifications Wales are important stakeholders in this process and I note from some of the consultation responses that people have been very pleased to see the positive role that Qualifications Wales is playing. Because obviously, potentially, the curriculum changes will have consequences for end-of-school final assessments and qualifications.
Okay. Well, we've come to the end of our time. We've had a very full and wide-ranging discussion. So, can I thank the Minister and her officials for attending? As usual, you'll be sent a transcript to check for accuracy following the meeting. Thank you again for your attendance. The committee will break until 11.15 a.m.
Gohiriwyd y cyfarfod rhwng 11:02 ac 11:20.
The meeting adjourned between 11:02 and 11:20.
Welcome back, everyone. Item 3 this morning is a scrutiny session with the Minister for Health and Social Services on the implementation of the recommendations of our perinatal mental health report. I'm pleased to welcome Vaughan Gething AM, Liz Davies, who is senior medical officer at Welsh Government, and Karen Jewell, who is nursing officer, women's reproductive health at Welsh Government. Thank you for attending and for the further written response that you issued to the committee. As you can appreciate, we've got lots of questions we want to ask you on that response, and the first ones are from Dawn Bowden.
Thank you. Your written update to the committee refers to the work under way to establish a managed clinical network. Stakeholder organisations have welcomed the development. They've also recommended that those affected by perinatal mental health conditions, as well as relevant third sector organisations, should be represented on the MCN. Will this be the case?
Yes, we're looking to draw people in. Actually, in a positive step, we've appointed a clinical lead for the managed clinical network—that's Sharon Fernandez. She's a health visitor with experience in perinatal mental health. She's a former health visitor of the year. Do you want to give some detail on the make-up and how we're going to take that forward?
So, at the moment, there's community of practice that users have already been involved with and third sector representation, and within the managed clinical network we will be ensuring that that network includes some of those representations. So, it will be taking forward the work that's already happened through the community of practice, together with the third sector and with families being affected by perinatal mental health illness.
Thank you. Any—? No. Okay, thank you. In relation to the guidance for the delivery of integrated perinatal mental health services in Wales that was published in July 2018, can you confirm that this guidance has outcome-based performance measurements for perinatal mental health services and can you provide examples of these?
There are eight guidelines within that document and six of them have a mixture of outcome data and service user experience, so it's qualitative and quantitative. And we certainly will be using those guidelines.
It is me. Thank you, Chair. Good morning. Can you outline what information health boards are now formally being required to collect and publish regarding their perinatal mental health services?
We're not formally requiring them to collect and publish data regarding perinatal mental health services at this time. However, in the guidance, they provide suggestions for what information health boards should collect, and, as you just heard, that's a mix of qualitative and quantitative, but we haven't made that a formal requirement yet. We're still working, of course, on the mental health core data set and that will incorporate perinatal mental health information. So, it's a work in progress, and it's before we get to that point of having something that is, if you like, for official medical publications, but we do expect health boards to collect that information in the run-up to actually implementing that.
And there's something also about how the data's going to be captured by the Welsh community care information system. Now, this has taken longer than the third sector want, longer than users want and, actually, frankly, longer than the service and the Government want as well, but we're trying to get it right. [Inaudible.]—1000 Lives are going to be requesting our referral to assessment and outcome data. That won't be mandatory, but even if it's not mandatory, I will expect it to be collected and provided. And if the committee want to see that, then I'm quite happy to share the information that we do have available to us with the committee, to see the information that is coming in from across the service.
I suppose the problem with it not being mandatory is that you might not get it. Although I hear what you're saying—that you're expecting it, but you might not get it. How can you ensure that what you do get is going to be consistent, because that's going to be important for an accurate measure, isn't it? How are you going to monitor that?
That's exactly one of the things that we're testing and looking at to make sure that we do get something that is collected in a way that is consistent between health boards. What I don't want to do is start publishing data and saying, 'This is the official data,' and then, actually, we say, 'However, it comes with a big warning note that we haven't assured ourselves and run through this with every health board about what they're collecting and how they're doing it.'
That's quite normal—when you start collecting new data sets for publication, you have a period of time to say, 'This is what we expect: you don't make it mandatory, but you test it to make sure that it is being collected in a way that is consistent.' So, that is the work that we're doing before we start publishing formulae, and it exactly takes on board your point to make sure it is properly consistent and comparable.
We're looking at the work being taken through the Welsh information standards board. That's fairly normal—to take it through that process. It'll be monitored by officers here in the Government, but also by health boards actually working with each other, as well, to understand what they're doing between each other.
So, it would be your intention, some way down the line, presumably, once you've started going through this initial exercise, of making it a mandatory data set for collection at some point in the future.
Yes, absolutely. The mental health core data set is going to be mandatory. When I meet the Wales Alliance for Mental Health, it's a regular topic of conversation with them about the progress that we've made and about the speed with which that progress is being made, and they regularly and understandably say, 'We want you to do it quicker.' But, they do understand that we're engaged in a process where we are going to have mandatory information being collected and published.
What kind of data are you going to be publishing at this stage? It's a kind of phased implementation, isn't it? I think you've talked about—you're not going to be in a position to fully report on the level of data until about 2022. So, what kind of data are you expecting to be published at the moment?
Do you want to deal with that—run through the type of data? We've talked about it briefly.
Yes, so there'll be the broad data that's relevant to any service—so, numbers referred, time from referral to assessment and time from assessment to treatment. But, then, we start to get a little more specialised within the area we're looking at. So, there are particular outcome measures that are nicely outlined in that document that our colleague was talking about—the guidance document. They're very specific, so the woman's experience and the woman's improvement as measured by recognised data tools. It will be quite sophisticated.
Are you actually measuring the numbers of women who are having to be placed in adult psychiatric wards without their babies because there isn't a mother and baby unit available?
Yes, that is being gathered too.
And you'll be in a position to share that information with the committee relatively soon, then.
What might make sense, Chair, as we come to the end of the 2018-19 year, is to share some of the information that we have about the numbers of people going through the perinatal community service—perinatal mental health community service—as well as the assessed numbers going through into more specialist care as well, so you can see at the end of this financial year what that looks like for Wales.
We can probably have some information for you on a health board level as well to try to make sure that is in the easiest and most helpful way and providing part-year figures to give you a whole year of figures to show, actually, the number of women who are being supported in the service and where they're being supported, including if they're not being supported in the way that we'd want them to be supported and the areas in which women will be supported in the future.
So, you will measure, then, as well, the numbers of women who have had to turn down a hospital bed in an adult psychiatric ward or a mother and baby unit because they didn't have a placement that was appropriate for them.
Yes, we do know, and the reason we know is because the community teams are so closely involved with every one of these women. So, they're not plucked from a community mental health team and put in an adult bed—they're being supported by the community team throughout, the placement in the adult bed—that can be for a variety of reasons—and then following that, placing her back into her home in the community. So, there's a really good trail for every woman.
Okay, thank you. We've got some more detailed questions now on in-patient care, and the first ones are from Michelle Brown.
Thank you. Could you explain to the committee why there's been such a delay in establishing in-patient mother and baby services in Wales, especially when figures confirm that a number of patients are being sent out of area for treatment?
I recognise that we would all have wanted to have moved faster since the committee's report, and the recommendations that we accepted on developing a mother and baby unit, particularly in south Wales, but also the north Wales position as well.
So, in south Wales, within the integrated plans from each health board and Welsh Health Specialised Services Committee, it was not within their plans to create a mother and baby unit. It was a recommendation that we accepted, and then we expected WHSSC to move forward with that work. So, it had to be planned in at that point in time, rather than being, if you like, in a longer run plan. So, they've had to try and do that, in any event. It's then been, in reality, about getting everyone in the same place to actually agree not just where it might be in the first place, but then how that might be created too. So, we're now in a position where, initially, two health boards in south Wales were interested in potentially hosting a mother and baby unit. That's now been reduced to one. There's been agreement on that in the December meeting—the management meeting that WHSSC had. So, it's going to be the current ABM health board area, and it will be within the successor health board that it will be physically located. So, geographically, you're relatively within the middle of, if you like, south Wales, between east and west.
Within north Wales, there's been a conversation with NHS England. We're not in a position where we have agreement on a detailed way forward, and the reason is that there has been an assessment of five women who would have needed to be supported within a mother and baby unit to date this year, and that isn't enough to actually create a unit within Wales solely for Wales. There have been active conversations with NHS England, though, about provision together with them—either provision in Wales, where they would actually make use of beds in Wales, or indeed the potential to purchase bed space in England for women from Wales. That hasn't been concluded, because NHS England themselves are in a position where they are not—. They either don't agree to purchase beds in Wales or to create extra capacity closer to north Wales, because they say that they think that they have enough capacity, because they think that with the extra capacity they've created within the system in England, they actually say that they've seen a reduction in assessed demand for those spaces. Now, we're not in the space where NHS England are in understanding why that is—why, despite creating more units, they've actually had less assessed demand. They've also suggested to WHSSC that the option is there to block purchase beds in England. The challenge with that is—and it's not completed—that their expectation would be that you block purchase beds regardless of the use of them. So, the bed space could be vacant, but NHS Wales would still be expected to pay for it. So, that's a conversation that is not concluded. That is where we still are.
So, there's been—. It hasn't been a one-off conversation. It hasn't been an exchange of letters or one telephone call and that's it. There is still an active conversation about what to do, in addition to the work that's being done to actually try and improve the service within north Wales in any event. So, I was trying to give an honest view about where we are.
I'm expecting that in the March meeting of WHSSC there'll be further progress on the south Wales position. So, again, when we share information about the end-of-year figures, we'll be able to give you more information about the progress with the actual creation of a mother and baby unit in south Wales. So, there'll be a case made for revenue, but also, potentially, capital that may need to be spent. My expectation is that within the service, with the additional moneys we've invested into the health service generally, the revenue will be there, but we may well have a business case asking for some more capital, but I can't properly anticipate that, because of course I'm not the person, and nor should I be the person, who's actually writing the business case and actually creating and designing the unit.
Yes, just a point of reassurance as much as anything. Of course, not all women live in north and south Wales, and there will be women in mid Wales for whom England actually is nearer. Presumably, they would still—. They wouldn't be blocked from access to English facilities as a result of this—.
Can I just come back to what you were saying about the north Wales—provision for women in north Wales? I know that would extend a lot into mid and west Wales as well. It sounds like the English NHS have adopted a little bit of a silo mentality. Would that be a fair comment?
I wouldn't quite describe it as that. I mean, NHS England are planning for the population that they directly serve. We've had a conversation with them, because it is a regular part of healthcare that people transfer geographically, and in north Wales more so than most other parts of the country. People are used to going for hospital-based treatment, in particular, into north-west England. But, actually, their own planning assumptions have changed because they'd invested in perinatal community mental health services across England after we'd started, but they've seen an impact, and I think it's fair to say they themselves don't understand the reduction in demand for mother and baby units because they expanded the number they had, but the demand's reduced. Now, I can't speak for them about why that is. We're interested in having a conversation about that because, obviously, we'd want to understand that not just for cross-border purposes, but it might help to inform our own work here in Wales as well.
What's the next stage of that conversation? Because, obviously, I'm assuming that you're not going to let it drop, that it is a good idea for the north-west of England and midlands, even, to share provision with Wales and for us to co-operate, regardless of the fact of the border or devolution issues. So, where do you think that conversation's going to go next? What kind of timeline are we looking at to provide for women in north and mid Wales and, as well, provide this MBU in south Wales?
Well, the current position is that women from north Wales, if they need a mother and baby unit, are—. The more regular provision is in Birmingham and Manchester, and that's a long way from any part of north Wales.
So, we would want to see a different position. The conversation is not completed, and it is still an option to block purchase beds. We need to think practically about what block purchasing means in terms of whether the access would be easier and nearer. Because, of course, you really are taking a woman away from all of her local support if you're taking her to Birmingham or Manchester. That may still be the appropriate thing to do, but we'd rather have something that was closer to home. So, that conversation isn't completed, and we need go back to WHSSC about when that is likely to be, but one of the things that I've mentioned to the Chair is that I think that we should provide the committee with a six monthly update on our general progress on what's happening, because we could provide some answers to this on a regular basis, which would answer some of the questions that we may not be able to give you in all of the detail you'd want today, the figures that we'll acquire, but, also, to give some reassurance that progress is being made and not to say, 'We'll get through today, and then maybe in a year to 18 months' time we'll have to come again', but, actually to give information on a more regular basis because it is something that I want to return to regularly to have assurance that progress is being made, and if there are things that we need to do within the Government, that we're able to do them, and I think that would be a helpful message for the service to know that they'll need to come back to me on a regular basis and that I'm expecting to report to the committee, and that correspondence, would, of course, be made public as well.
Okay, thank you. I mean, I appreciate you're working on the MBU issue. In the meantime, we've got women who are being sent out of area for in-patient services. I know there are some women who would prefer to be sent out of area for various reasons, but what support's being provided to patients who are being sent out of area? And those who are refusing the option of being sent out of area—what's happening to them and what support are they getting?
This goes back to the community teams having a very strong step-up, step-down type of model. So, the community teams would be involved from the beginning. They would be involved through the lady's stay in whichever unit she was at, and then be ready to receive and bed her back into her community and her home. So, it's a strong thread there that is followed.
It is about the link between the specialist service, in-patient service, wherever that is, and the community team, and, to be fair, I think, in the original report by the committee, that was one of the points that you made about wanting the reassurance that the investment in community services won't be somehow distinct and completely alien to a specialist service as well, and that is absolutely the position that we're in now in each part of Wales, following the investment that we've made in community perinatal mental health teams.
I'd just like to say I welcome the commitment to six-monthly updates, really, because it is important for north Wales, and, rightly mentioned, mid Wales, as well, for the women there to get a service. If England aren't playing ball, if you like, we do need to continue the conversation about what we could do within north Wales for, certainly, my constituents and many across the room. That's my comment. Thank you.
I'm sure you can understand the committee's frustration that, over a year ago, we were told WHSSC would be making a decision in two weeks. That was in summer 2017, and here we are, well over a year later and, you know, we still have no mother and baby unit.
And that's a sense of frustration that is well understood and, to a large extent, shared on this side of the table as well. I'm not going to try and say that this is something we just need to have a bit of understanding about. Actually, I think that's part of the point about wanting to have the regular updates—we need to see a bit more progress, and I understand that very well, Chair.
In terms of south Wales, you've got a health board now that want to do this. Are you able to give us a timeline of how you think that's likely to look in terms of when will we have those mother and baby unit beds in south Wales?
I'm not sure that I can give a specific now, but I do think I want to be able to come back with something more detailed, because the WHSSC meeting in March will take place and we'll have more detail about the plans. Because they've agreed on which health board, and, to have definite confirmation of the site within that health board, I'd want that certainly by that point as well, and then the level of work that is then required to actually compete and deliver that unit. So, I don't want to give a hostage to fortune now; I want to be able to come back to you with some more certainty, and recognising that, actually, we are behind where we want to be and there's a need to demonstrate some urgency with some more detail so that the committee but, more more than that, broadly the public can see that progress is going to be made and there is a timescale to meet.
And in terms of north Wales, if it's not possible to reach agreement with NHS England, is it an option to simply commission a unit in Wales for north Wales use?
It's always an option, but the challenge comes back to the reason why the previous unit in south Wales didn't continue, about the ability to maintain skills and quality. And it depends on the demand as well. At this point, the demand isn't there to sustain a single unit on its own in north Wales. But we have got to have an answer for how we improve the service, where that service is needed. And that still goes back to linking to the community team, and if the beds that we are going to make use of are in England, we still have to make sure that the current beds that exist are continued between the north Wales community team and wherever that specialist unit is, whether it's in Wales or whether it continues to be that the regular port of call is in England.
Jest i ddilyn fyny’r pwynt ynglŷn â’r gwasanaethau ar gyfer menywod yn y gogledd, rydw i'n deall y pwynt ynglŷn â lefel y boblogaeth ac efallai nad yw lefel yr angen ddim yna'r un peth, ond hyd yn oed wedyn, mae chwech o ferched wedi cael eu derbyn i unedau cleifion mewnol seiciatrig acíwt yn y gogledd heb eu babanod. Yn amlwg, nid ydy hynny’n sefyllfa gynaliadwy ac nid ydy’n sefyllfa deg, ac, felly, byddwn i’n awgrymu eich bod chi’n dilyn y llwybr o gynnal trafodaethau yn fewnol yng Nghymru, ac mae’n ymddangos i fi nad ydym ni'n yn mynd i unlle efo NHS Lloegr. Ydy hyn yn bryder ichi—hynny yw, bod yna wahaniaethau sylfaenol sydd yn creu anghydraddoldeb daearyddol yng Nghymru ar hyn o bryd?
Just to follow up on the point regarding services for women in north Wales, I understand the point regarding the population level and perhaps the need isn't the same, but, even so, six women have been admitted to an in-patient acute psychiatric unit in north Wales without their babies. Clearly, that's not a sustainable service and it's not an equitable service, so, I would suggest that you do follow the route of holding internal discussions in Wales because it seems we're going nowhere with NHS England. Is this a concern of yours, that there are significant differences that create geographic inequalities in Wales at the moment?
Well, of course it's a concern of ours to make sure that we do have appropriate provision as close to home as possible. When you have a really specialist service like this, there's an acceptance that that may involve travel, and that is sometimes difficult. If you go back to where we were in 2017, for some people, 30 miles away is actually a very long distance when you take them away from their community support mechanisms as well. So, we recognise that travel is an issue with specialist units. What we've tried to do in investing in our perinatal mental health teams on a community level is to make sure that we do provide that greater equality of access across the country, because investing in community facilities is something where we do expect there to be easier and more local support, and often that support isn't about taking women out of their home; it is actually about supporting them in their home and their home community, and that's the point about having that additional expertise. That's why we invested £1.5 million in 2015-16. It's also why, within this calendar year, we've invested another £0.5 million within our perinatal community mental health teams across the country, and I expect to be in a position within coming weeks to confirm an additional investment for the year ahead. So, this is an area where, yes, it is an obvious concern of the Government that we have equity of access and provision in different communities across Wales, and that's why we continue to make perinatal mental health community teams a priority for investment and support.
Felly, mae mwy o arian yn dod i'r gwasanaethau iechyd meddwl amenedigol yng Nghymru ar draws. A oes gennych unrhyw syniad o faint yn ychwanegol o arian a fydd yn dod?
So, more money will be coming to perinatal mental health services in Wales across the board. Do you know how much, specifically, will be coming?
I'll confirm that announcement when I make it in the coming weeks. You'll have to give me a few more weeks, but I will then confirm it and make that clear in public.
Iawn, ac a fydd hi'n bosib i ni wybod faint mae pob bwrdd iechyd yn cael allan o'r pot arian yna, a beth fydd eich trefniadau chi wedyn i fonitro bod yr arian yn cael ei wario yn effeithiol?
Okay, and will it be possible for us to find out how much each health board will receive from that pot of money, and what will your arrangements be then to monitor that the money is spent effectively?
Yes. As you know, when we made the initial announcement, we allocated to health boards on the basis of birth rate. That seemed to be the most sensible way to allocate money between the different health boards. I'm happy to confirm how I expect that money to be split when it is announced, but also to give an update on the purpose, and then, of course, as we report back to this committee, as per the undertaking that I've given today, every six months, to be clear about the evidence that we're seeing of the impact of that upon services. And I also think it would be helpful, given that we have got the managed clinical network taking place and we have a clinical lead that is in place from the start of this year, that you won't just have a voice from Government; you'll also have the opportunity to have a conversation on information provided by that clinical network with the clinical lead on the work that they're doing in developing and improving the service.
Jest i droi at ansawdd y gwasanaethau yma, dim ond dau fwrdd iechyd sydd wedi cytuno i gydymffurfio â safonau ansawdd Coleg Brenhinol y Seiciatryddion ar gyfer y maes yma. Sut ydych chi'n mynd i wneud yn siŵr rŵan fod pob bwrdd iechyd, gan gynnwys bwrdd iechyd Betsi Cadwaladr, yn cytuno i gydymffurfio â'r safonau yma, i ganiatáu i'w gwasanaethau nhw gael eu hadolygu a'u hachredu?
Just to turn to the issue of quality of these services, only two health boards have signed up to the Royal College of Psychiatrists' quality standards for perinatal mental health services. How will you ensure now that all health boards, including Betsi Cadwaladr health board, sign up to these standards in order to enable the review and accreditation of their services?
Every health board has committed to working towards the standards from the Royal College of Psychiatrists, and the managed clinical network will have an obvious role in promoting not just the benefits of those, but also in being clear about how close health boards are to meeting those standards as well. So, I do expect there to be consistent work towards meeting those standards by every health board in the country, not just Betsi Cadwaladr.
Okay. So, two have actually agreed and the rest are working towards it. When would you expect them to actually agree the process outlined by the Royal College of Psychiatrists? What timeline are you giving them?
Well, given they've all committed to working towards them, the point about having the network is for it to give us a better idea of how we're actually going to be able to meet those standards in the future. I think if I give a commitment today without having had a conversation with the clinical lead, without having looked at the work of the network, that might be great for an answer in the committee, but I don't know if it would be very practical and achievable. I'm more than happy to come back about our expectations on timelines for achievement in the regular updates that I've committed to providing to the committee.
And, of course, it was a recommendation from the committee that you accepted last year.
Okay, thank you very much. The next questions are on psychological therapies, from Janet Finch-Saunders.
Okay. I know we've talked about data collection, and it's problematic in many aspects of health, but can you confirm what data is currently available in relation to access to psychological therapies for perinatal mental health patients?
We can't break the data down. We do know how long people wait for specific therapies. So, we are introducing a target of 26 weeks for the most complex therapies, but we're also aware that there are lower intensity therapies that can be delivered within 28 days. But we're unable at this point to disaggregate the perinatal therapies from the generic psychological therapies.
Okay. So, taking the last 12 months, has access to psychological therapies for perinatal mental health patients improved over the past year?
Well, as I say, we're unable to disaggregate—
Well, the honest truth about not being able to disaggregate means that I couldn't honestly tell you that I could give you a statistical figure for improvement. What we can say, and what you'll see when we share the figures with you is the significant numbers of women who are now able to access the perinatal mental health service. I think that, in a four-month period from April to July last year, across Wales, there were 1,500 referrals. So, actually there's significant activity taking place. So, actually, that's what we've been able to deliver with our investment in the community service to actually make access easier. What we can't do, though, and this is being completely honest, is tell you that there is a statistical figure, because we can't disaggregate that from the data set that we have at present. In the future, though, as we move forward with the mental health core data set, we will be able to have a better understanding just within the perinatal mental health field, because, on the earlier questions, we'll have much more detail on that. So, being completely honest—
So, on that note, though, you've really no idea how long people are waiting then, have you, and whether it's improving or—? As a committee, when we are taking evidence, it's key that we're able to ascertain that you're on top of your brief and that you know whether something as important as this is getting better or whether it's in decline.
We can be confident that we've improved access, because you'll see from the additional investment we've made in the community teams that there are women who are able to access services in a way they weren't in the past, and you'll be able to have that assurance, not just from me but from the managed clinical network about the work they do. The problem is that that is not at the level of official statistics, so I can't give you that assurance, but I think we can have confidence that we've improved the service and we've improved access but also improved quality for women as well. That directly comes from the investment that we've made.
It is a fact—and it's a bit worrying—that just throwing money at something and saying, 'We've spent this amount of money'—you know, without the accountability and any sort of actual evidence base, I don't see really—. It's very vague evidence, and I'm not getting my questions answered as I'd—. I'd like you to be really more on top of this.
Liz, can you expand on the points that you made? You said that you have got some data in relation to people waiting for more serious therapy. Can you just say what you mean by that and what data's available?
The sort of people who need the most complex levels of therapy—so, very often, trauma-informed-type of therapies. So, for example, eye movement desensitization and reprocessing—some of those therapies. But there are the lower intensity therapies, which are more around counselling or the behavioural activation-type of therapies that can be delivered within 28 days by the community mental health team and by the various members within that perinatal community mental health team. And, also, the core data set will be capturing these numbers. The standards have been drawn up. They haven't yet been put into place, but they're there ready to go when the core data set floats, which is alongside the Welsh community care informatics service.
But you do recognise that, obviously, we know how many people are waiting for hip operations and we know how many people are waiting for heart surgery, and if we're going to have parity with mental health we need urgently to get to grips with the numbers of people who are waiting for mental health treatments. Is that something you'd accept, Minister?
Yes, and we've created not just waiting time standards but the information we publish on the time people wait. What we're trying to do in this particular field and perinatal mental health is to make sure that we have that additional information, which will come from the mental health core data set. So, we'll have much more specific information about not just mental health as one block but, within that, for this particular inquiry follow-up, perinatal mental health within that, and it will be much, much clearer and much more transparent.
But, as the Minister, you'll be aware that I've raised several concerns about the Betsi Cadwaladr health board and its general community health team, where we've had massive numbers of vacancies, where people have been failed in the system and people have been slipping through the net, in this, in particular. We're talking about a mum and baby in a lot of instances, so, I'm sorry, I don't share the confidence that you seem to allude as regards this. So, I do think that maybe some work needs to be done where you can come back to committee again with something a little more concrete. Because, if it was raised before I even became a member of this committee and concerns had been raised, if we're no nearer forward, that causes me a great deal of worry indeed.
We are further forward in the service and the number of people the service is seeing that we've invested in. And, as I said, you'll have full-year figures that we'll provide to the committee, but our challenge is whether we can say that we have figures that don't currently exist on the internal statistics within the perinatal mental health service, and I don't want to look you in the eye and say that we have that when we don't, on the basis that we will have in the future when we have the mental health core data set for the perinatal mental health parts of that available.
And, sorry, again, what are the timescales related to that, then, please?
Sorry, there's a point I'd like to make first. The people waiting for perinatal mental health psychological support are not floating in a separate group out there uncounted. They are counted, but they're counted within the general mental health team support.
The Welsh Community Care Informatics Service should be completed by 2022, but we're very hopeful that we'll have this set of data this year, 2019.
Yes, specifically on this statistics point. Just to point out that, in your evidence, you've recognised that the demand for perinatal mental health services is currently exceeding capacity. So, there's an understanding that demand is outstripping supply. Yet you're saying also that the latest published data, which was only in June last year, shows that health boards are meeting the targets for assessment and interventions on an all-Wales, all-age basis in the local primary and mental health services, which I appreciate is disaggregated. Are you saying, then, that you are satisfied with the level of support and that demand is being met at primary level and that the issue of lack of capacity is at secondary and further levels? Because I don't think you are, so I'm curious to know what this published data is telling us.
The local primary mental health support services are about the lower intensity therapies.
We are. We are.
So, bearing in mind you're making a statement in a few weeks on this, will you be saying that no extra money needs to go into perinatal mental healthcare at local level?
Well, as I've indicated, we've invested money this year. We recognise from our community teams that they are seeing more demand and that's why, as I indicated earlier, I'm going to be making an announcement in the coming weeks about investing more money in the service. Because I recognise that we need to—
No, I recognise that, to meet the rising tide of demand that we're seeing, we'll need to invest more in the service and I'll be confirming the amount of that in coming weeks and what we expect that to deliver.
Okay, at which point we will need some evidence that the perinatal mental health local things that Janet's been talking about have been identified and are being targeted. You can see the difficulty we've got with this, because you've got a very impressive statistic and yet it seems to be disguising something that you want to put money into.
We'll be investing more money in perinatal community mental health services, because we're listening to what teams are telling us on a local level about both what they're delivering but also about the demand that they still see coming through that service.
Okay, so you are giving some—. It's a specific statistic that you're unable to provide; it's not that you have no information about the level of demand at local level.
Of the £4 million extra funding being given to improve access to psychological therapies, how much of that can you be assured will be given to treat perinatal mental health patients, given the impact that a patient's perinatal mental health problems can have on a child's health?
There isn't a particular portion within that money that is earmarked solely for perinatal mental health. That is to improve access to psychological therapeutic support, and, again, when I make further announcements on mental health spending, I'll be confirming what we're able to do to invest further in that area. There's a challenge about not wanting to conflate our broader investment in mental health, but then to be able to outline the specific areas of support we're providing to perinatal mental health services.
But we're taking evidence because of the concerns raised previously on perinatal. So, it's—.
It would probably not make clinical sense to cut groups up. So, people with eating disorders, people with psychotic illness—we can't necessarily say that we target this at those people.
So, the money isn't targeted, really. It's going into the bigger pot of mental health, community mental health, but it's not being targeted.
It's going into a particular area of mental health services, and it's about the extent to which we can subdivide and target that. That's an honest way for the service to use the money.
That in itself does not mean that need isn't being recognised. It's actually about: you expect the service to be able to deal with the need with the investment we provide for the general service as opposed to the Government directly trying to micromanage every aspect of it. I think that many people who rely on the health service would much rather that I don't try to micromanage all of those particular areas of activity.
Okay. Mind Cymru states in its written evidence that the waiting-time target for accessing psychological therapies in secondary care is 26 weeks from point of assessment and believes this to be too long. Do you consider that this target should be reduced?
Well, this comes back to the point about: what is appropriate for each service to do in meeting the clinical need of the person in front of them? So, the 26 weeks is an overall measure, but it isn't the target to hit in the sense of you need to get this at 26 weeks, because a number of people need that help much sooner. So, that's why in this committee, and in your partner committee, the Health and Social Care Committee, people already talk about crisis, where, actually, a 26-week target is not appropriate. So, it is about meeting the clinical need, and actually the community perinatal mental health teams that we have are about providing support at that point in time, and not saying, 'I'll come back to you in six months' time.'
So, that's the challenge about having a measure, and what the measure tells us—that why the dataset I think will be much more useful, not just for committees and for scrutiny, but actually for the service and the Government as well, to understand are we meeting the needs that we recognise exist within a broader area of activity, and are we meeting the needs that exist for the clinical need of the people who are presenting, whether it's in perinatal mental health or more generally within mental health services as well. Again, the frustration that people feel about not having that information now is shared by both the third sector and the health service and the Government, but we will be in a better position. Again, you've heard from officials today that we expect within perinatal mental health to have some of that information and a core dataset available, or rather, more useful sets of data available, within this year.
Okay. A little bit of frustration, I must explain, comes on my part, because I am quite keen on putting in written Assembly questions and, over the time I've been an Assembly Member and more recently, I quite often ask for statistics on certain aspects of healthcare, and all I get back in my responses: 'We do not hold that information'. I think that's a massive issue, really.
It's about understanding the information the Government holds and doesn't hold and what's held within the health service, as opposed to expecting the Government to hold and collect every single piece of information centrally.
Thank you, Chair. You mention in your written update that a group chaired by the deputy chief medical officer is considering the options for providing information to parents on perinatal mental health conditions. Will those involved in perinatal mental health services and those with lived experience be consulted on this? And, if so, do you intend updating the Bump, Baby and Beyond book with more information?
Yes. The group that the deputy chief medical officer is leading on is about updating Bump, Baby and Beyond, so not just a physical publication, but an online information and resource available. Yes, absolutely—we expect not just practitioners, but people with real lived experience, to be involved in the consultation about what is useful. The point is that it's useful for those different people. You know, I have the Bump, Baby and Beyond book. At the time, we went through it and it was useful to a point—we looked through it—but, actually, if you don't listen to a parent's experience of actually going through that, then we could end up providing something that clinicians may say is great but a parent may, 'That means nothing to me; it's not very helpful.' So, it's important, to have something that is genuinely useful, to listen to them.
Chair, thank you. I just wanted to ask you about specialist visitors. You did reject some of the recommendations of the committee, but you did accept this one in principle, which was recommendation 18 to
'ensure every Health Board has a specialist perinatal mental health midwife in post'
and that was even though there are specialist midwives at the moment and, in fact, there's a specialist health visitor in one of the health boards. Because you didn't reject this on the basis that it was already covered—you did accept it in principle—that, to me, implies that you thought that there is something more that could be done here. Can you tell us what that is and what have you done on it?
Five health boards have a specialist perinatal mental health midwife in place. One has a specialist perinatal health visitor, and the other has a perinatal lead nurse. Now, one of the things that we'll want the managed clinical network to do is to work with health boards, not just to map and understand what's in different teams, but then to make some recommendations on what a core team should look like, because there is variation in the way that health boards have organised their services, and we'll want to understand is there a particular structure we say should be at the core of that, and that should obviously come from the network with the clinical lead as opposed to me deciding for the service, 'This is what you should have in terms of the make-up of your clinical teams'. But to understand how much and how far the difference in teams is actually about local need or not, because, of course—. And I think you recognise this in some of your other recommendations that you made, at least in one of them, about wanting to have something that is standard but provides flexibility for health boards to understand and meet the needs of their population. That is exactly what we're expecting to be taken forward by the clinical lead and the clinical network as part of their work.
Okay, and just—on this particular point, I know you won't be wanting to give spoilers, but will this particular issue make an appearance in your statement in a few weeks' time?
It's work that'll be taken forward by the clinical lead and the clinical network to understand not just the difference in the way that teams have organised, but to then say, 'Is there then an evidence base to make recommendations saying, 'This is what the core staff teams should look like within each health board area'? So, we'll actually have some evidence from the way that our teams have worked and what that's delivered, as well as a direct conversation with the different clinicians around the country about what they deliver and how they've done it. And so it's definitely about me not wanting to say, 'I require a particular group of staff to be delivered in a certain way', but, actually, to have someone who's in a better place to make some recommendations and give some guidance about that, which it may or may not be helpful for me to endorse.
Right, okay, thank you. The third sector—we mentioned this earlier on in the evidence session this morning—again, I'm sure you don't want to give any spoilers here before your statement in a few weeks' time, but the third sector are massive players in what we're all hoping you're going to be able to achieve here. Are they getting enough money, and are they getting enough freedom?
I'm sure the third sector, just as everyone else, would tell us they could always make use of more money and deliver more with it. The challenge is about whether the budget priority we're providing in this area of activity and how we expect the health service to work with the third sector and to work with the citizen. I've made announcements on additional money in mental health generally, but also on grants going to third sector organisations. It will never be a completed conversation, and recognisng that it will never be one where the third sector are entirely satisfied, and nor should they be—it's not their role to say, 'We have enough money; don't give us any more, and we won't ask for any more.' I'd expect that, if they were in front of you, they would tell you that they could and should have more and they could do lots with it.
Okay. Well, I think what you say is true there—that they probably are likely to ask for more money. But you accepted a recommendation in this report—and it wasn't in principle; it was an outright recommendation—that the third sector would be properly funded. What do you think 'properly' looks like?
About helping to meet need—about meeting the need of people within the population, about the work that they can do together as part of the services that we provide. So, it would be fairly unusual for someone to say, 'I do not agree that the third sector should be properly funded'. The challenge is always about proper funding to meet the needs that we have and, obviously, within the finite resources that we're able to deploy within any of our public services.
So, having agreed that the third sector is likely always to ask for more money, then is it the case that they're not being properly funded, or they're asking for something to which you don't think they're entitled?
No, it's not about what people aren't entitled to. It's always about how we deploy our resources to try and meet the need. Even if not in front of a subject committee, then the third sector may acknowledge that we are investing together with them. They're part of the conversations we have about this and pretty much every other aspect of our health service. We don't always agree, but they're a regular part of the conversation, and, actually, we fund them to help deliver services alongside the NHS. We recognise that there's a direct role on a local level, regional and national level.
Okay. Just a very direct question then: this directory for third sector services—is that currently available, or is it likely to be available shortly?
It is available—[Inaudible.]—is the directory.
Just briefly, how is it updated? Is it like a rolling directory online or something like that, that just gets added to?
I'm sorry, I can't answer that, but I can come back to you properly.
I'm sure the committee would be keen to have information on the directory, given our interest in this area.
What role do the leads for maternity bereavement support in health boards have in relation to improving support for families of babies who die in neonatal settings?
The bereavement leads are key to us actually having the right support for both staff and affected families. And they're involved and are starting to develop information for women and families, as well as the care standards, and, of course, we're working with the Stillbirth and Neonatal Society to make sure that we have appropriate environments for care, as well as staff who are able to deliver the care in those particularly tragic circumstances.
Thank you. Bliss told the committee in written evidence that the Welsh Government had failed to outline within the required six months how the lack of psychological support in neonatal services will be addressed, and that no service improvements have yet been implemented to ensure compliance with standards. How do you respond to this, and can you confirm whether the lack of psychological support in neonatal services has been addressed now?
Karen may want to come in, but we are setting up a group to involve key services, including both Bliss and the Sands, to consider where we are, and to actually help us in a route forward to explain what we'll need to do to further improve the support for families.
So, we're currently setting that group up, in conjunction with the sector, so Sands, Wish Upon a Star, with Bliss themselves, and we've had those conversations to ensure that we map exactly what provision we have in Wales at the moment and what we need for families in the future to further extend that. So, that is work that's started.
Thank you. What support will be given to health boards to ensure compliance with the latest edition of the all-Wales neonatal standards?
Well, there are a couple of things. There's a point about the work that we're doing from a staff point of view around sharing practice and wanting to improve, but there's also the very practical points that we're making about meeting standards and the capital investment that we're making. This has been an area of significant activity within the last four years. I think by 2020, within a five-year period, we'll have invested £110 million in neonatal service development in capital terms. So, it's a significant area of activity. I've signed off business cases and I've visited facilities where they're making a significant difference in a physical layout to meet a range of those standards.
But it isn't just about the capital development and the environment. It is about investing in our staff, and that goes back to your first few questions about making sure that we have adequate provision in terms of staff, in terms of the environment, and making sure that we actually deal with some of the recognised inconsistencies we have in different parts of the country.
Okay, thank you. Suzy, do you want to ask the question on third sector—?
Okay. Sorry, just going back to the questions I was asking about the third sector and whether they're able to make direct application to the mental health transformation fund. If they are, is it a complex process? Do they need the health boards' or social services' endorsement, and if they can't, why not?
They need to work through their partnership boards, and they have seats on the partnership boards. I'd say it—I suppose I would, wouldn't I—but it seems a very straightforward process. It needs a bid that's outlined, supported by evidence, and with a specific request. We would receive those bids from the partnership boards as we would from anyone.
Okay, so that's the mechanism. Brilliant, thank you. Thank you, Chair.
Thank you, Chair. Minister, given the fact the Government's accepted the committee recommendation in November 2017 to undertake further work on the link between health inequalities and perinatal mental health, could you update the committee, please, on the progress that has been made in improving the understanding of the link of health inequalities and perinatal mental health and ensuring equity of access to the services, particularly in terms of early intervention?
All families would have an assessment of need in relation to any inequalities from both midwifery services and health visiting services. That would then give the ability to actually look at what families need in relation to care provision. In relation to adverse childhood experiences, the ACE hub have been doing a lot of work on training and early interventions, and those early interventions are known to the generic services and midwifery and health visiting to ensure that they put that early intervention work within the inequalities. We know that inequalities exist and we know that we need to be in there as soon as possible to ensure that we support families through that mechanism. Obviously, there's also the work of the early years programme board at the moment that's looking at ensuring that the systems link up together and join so that families don't have to traverse themselves through systems but that actually it's a very easy system for them to get through.
Thank you for that. I'm particularly pleased to hear you mention ACEs there, because we all accept ACEs are critically important. As the Minister, are you happy with the progress that's been made so far and the way we're going ahead?
I'd always want us to make faster progress, but I do think we'll see—. The appointment of the clinical lead I think will help to accelerate some of that work as well. It should always be the point of the health service to make sure that we have a service that recognises and addresses health inequalities within and around the country, because it definitely affects health outcomes.
Okay. The final set of questions are on our rejected recommendations, from Hefin David.
We haven't heard much more from the Government about recommendations 13, 22, 23 and 24. We've had specific concerns raised from stakeholders about recommendations 13, 22 and 24, but the Government hasn't made any further comments since November 2017. Therefore, can I invite the Minister to make some comments about progress with those rejected recommendations and what alternative action has been taken?
Recommendation 13 was centred around a public awareness campaign. And there's a broader point that I'll make, and that is that a number of committees make recommendations about public awareness-raising campaigns. And unless they have evidence that that public awareness-raising campaign is going to be specific and have a particular impact—it is regularly the case that the evidence isn't there that it will make the sort of impact that we would want to have.
There's a slightly different point about the broader awareness raising of mental health, because we still have a challenge on the stigma around any form of mental health discussion. So, on a particular campaign centring on perinatal mental health, the evidence wasn't there—which is why we rejected the recommendation—that this would have the impact that the committee understandably would want it to have.
There is a need, though, to carry on making sure, in the way that generic services are provided—so, the generic midwifery and health visiting service—that there is a clear understanding of this issue. I think, even before the inquiry, there was a fairly widespread understanding, and you can expect to see that improved as we carry on with the rest of the work.
So, you maintain there's a difference of opinion between you and what the committee felt.
And have you got plans then to do a general public awareness campaign on mental health? Because obviously the health committee has also made a recommendation around the suicide prevention inquiry. Have you got anything in the pipeline more general?
We continue to support the Time to Change Wales campaign, which is about wanting people to talk about mental health in the way that they do about physical health, for it be a more normalised part of conversation—the whole thing about, 'It's okay to say I'm not okay.' And that should be about mental health as much as physical health, and we know that we're not there. We've made progress—the assessment of the impact of Time to Change Wales shows that there is a rising awareness and a lessening of stigma, but it's certainly not where any of us in this room or outside would want it to be. So, it's an unfinished piece of work, but that is a campaign we continue to invest in and support.
And the perinatal mental health visitor role—you didn't accept the recommendation—there's been no movement on that either.
No, but in answer to other questions about whether there should be a specialist midwife, I've indicated that there will be work led by the new clinical lead, who herself is a health visitor, on the core team that should exist. So, we should come back with an idea about what that should look like once that work is completed.
Okay. And so there's an implicit recognition that further work would be done by the Government on that.