Thursday, 17 September 2015

Schools, roads and automobiles

We need to talk about escorts…

No, not that kind of escort (though I sense this post may get some ‘interesting’ Google traffic).

I’m talking about transport escorts.  SEN transport escorts to be specific. Which means that right now, depending on who you are, you are either saying, ‘Who the what now?’, or, ‘Oh, I love our escort’, or banging your head repeatedly off the table whilst slowly chanting the phone number of the local authority transport team (which are now the only words you are capable of saying after desperately trying to organise transport for the last two weeks.)

You see, it’s the start of the school term after six long weeks of summer <prosecco corks pop across the land>.  And for those of us with children of the more unique variety, that doesn’t just mean dusting off the school bag and frantically scribbling names onto clothing labels: it also means figuring out how on earth they will get there. 

Yes, it's a bear riding a cement mixer. 
No, we don't have a toy bus.
Because children who attend special needs schools often travel long distances to reach them.  In some cases an hour each way.  Which would mean four hours of a parent driving.  A parent who may have a job to hold down, or siblings at completely different schools. Thankfully, when writing policy, some sensible governmenty person recognised that this was not viable and ensured that many special needs children are entitled to transport.

In theory….

And this is where it all gets a bit sticky.  Let me start by saying this post is NOT a criticism of transport escorts.  They are pretty fabulous.  It’s about the process in the background which does little to protect them, is hugely variable across the UK and within which the combined words ‘risk’ and ‘assessment’ are about as likely as ‘Prime Minister’ and ‘Bobby Davro’ (Big Brother aside)………(look, we had limited TV channels for a while…I judge myself more than you judge me).

Now I do accept that my opinion is a little skewed, as I only have our experiences in two boroughs.  But if I was to tell you that in borough 1, my little boy was transported on specialist medical transport marked ‘ambulance’, on his own, with an escort in a paramedics uniform, with no clear assessment process behind that decision; and that in borough 2, they were initially considering putting him on transport with five other children and one escort with no training… can see why the adjective ‘variable’ seems appropriate.  For the record, we are not in favour of either option (and not because I’m just that objectionable and annoying).  Both transport companies are great – the objection is nothing to do with them.  But I don’t think it is appropriate to spend public money putting a child on specialist transport when all that is needed is a 15 min training course, nor do I think it is safe to have a child who needs constant supervision and has 20 neurological attacks per day on a busy bus with other potentially vulnerable children in need of support. 

And at the heart of this problem is one key issue…..accountability.  Because what is happening in most local authorities is a stark avoidance of accountability.  Transport contracts are outsourced.  Which is fair enough, as long as responsibility and accountability aren’t outsourced with them.

Escorts are generally not employed by the local authority.  They are employed, interviewed and supported by whoever has the contract – in some cases a transport company.  And in others a local taxi firm.  These companies are often not given the information they need, or any training.  Responsibility for making escorts aware of the vital information that they need is often handed to parents.  This has been the case for us in both our boroughs.  In our current borough, the transport provider was given no information about our son’s condition whatsoever before taking the contract.  All information has come from us at a later stage.  We have been told by the local authority that escorts ‘cannot’ intervene with basic actions like keeping our son’s head upright to ensure he doesn’t choke in a prolonged paralysis attack.  Nor are they supposed to perform basic CPR should the worst happen.  They have not been given this basic training.  They can just pull over and call and ambulance – on remote roads.  In the middle of nowhere.

And this is where I get a little bit antsy.  Not because I have a ‘special’ child with ‘specialist’ needs.  Not because I’m a foot stamping, unreasonable parent with no understanding of the pressure on local authority budgets.  But because it makes no sense.  Lets’ park the fact my son is medically complex.  Let’s completely forget that he is high risk.  Let’s just focus on one thing……he’s pre school age.  The highest risk age.  The age where there is a current, completely justifiable push for all mainstream nursery staff to be trained in CPR.  A push that is quite rightly about to become law.

Yet, for some unfathomable reason.  Pre-school children, without their parents, on remote roads, with a history of medical emergencies are not protected by any law to ensure that escorts are given this basic training.  And neither are the escorts.  I said at the beginning this is not a criticism of escorts, or the companies who employ them – they deserve this training for their own wellbeing.  The duty of care is not theirs.  It is the local authority who contracts them.

And so, in our experience, what often happens is parents and transport companies work together.  They develop a trust and a bond.  There are no guarantees, no legal guidelines, but we work together to reach a point of trust.  A ‘don’t worry, Dave the driver used to be a paramedic’ reassurance.  A little wink to the escort (...that’s just doubled the questionable Google traffic). 

Does it work…for the most part.  Is it right…I’ll let you make your own decision. 

In asking around on this issue I’ve heard lots of different stories from different areas.  Those with escorts trained to perfection by Community Nurses … tales of taxi companies with bald tyres and no child locks showing up to transport a vulnerable, mobile, pre-school child.   It really depends on where you live.

There’s no question that funding is a root issue here.  Local Authority budgets are bending so hard that the impending snap is almost audible.  There are lots of core challenges around accountability, appropriate assessment and consistency.  But there is also one around rhetoric and response.  Stating ‘well many parents choose to transport their children themselves’ is not a viable response to any challenge.  Firstly, that doesn’t really inspire confidence.  And secondly, I can’t.  Me driving alone, monitoring neurological episodes for 45 mins each way is not a preferable option.  Secondly, I work.  I have no plans for that to change.  I’m not going to bang the working carers drum again, but… know (hashtag parliamentary inquiry – nuff said.) 

But all of that aside...this issue is so complex I can only boil down it to one request.  To me, it is very simple.  Transport escorts should be given the basic 15 minute training that they need to save a child’s life.  This should be mandatory if that child is in the high risk pre-school age category.  For their confidence and support, for safety’s sake….it just makes sense.  I’m not saying it resolves everything, I’m not saying that it’s a perfect solution….but knowing that when I put my baby onto a bus, there is someone there with the confidence and knowledge to breathe life back into his lungs on the side of the road is a pretty major reassurance in the context of our lives.

We have waited an hour for an ambulance in an emergency before.  Thankfully it wasn’t a respiratory emergency.  But every day, it gives me immense confidence to know that I do have this training.  I have it, because I had to.

I have it because we weren’t allowed to leave hospital without it - twice.  It was deemed so important, that we were given it twice.   

It took 15 minutes.  15 minutes to learn chest compression depths, learn the vital breath:compression ratio.  To have the tough talk.  The one where you know this training really matters, because no one sugar coats it.  15 minutes to learn how to save a life.

That’s all.

Just 15 minutes.