I hear what the noble Baroness says, and she speaks from a great deal of experience. That is the kind of challenge that has led to us trying
to move forward across the board on SEN to ensure that what is provided for children is more uniform and more joined up. If need be, I will write with more detail in response to her but, as I said, what the pathfinders were saying was encouraging. They said that they would link up with those who came after to try to spread best practice. As noble Lords have said, it is often what happens in practice on the ground that may be wanting.
That links up with an issue raised by the noble Baroness, Lady Jones, about how families might hold their local authority and CCGs to account for having arrangements for joint commissioning in place. Ultimately, families could take out a judicial review, but we believe that there are other, more effective ways to hold local bodies to account through local complaints procedures and through NHS England, which will review how CCGs are fulfilling their duties under the NHS mandate. I remind noble Lords that the NHS mandate refers specifically to children and young people with SEN. Therefore, there are those novel routes. That is a new lever.
As the services that result from joint commissioning arrangements will be reflected in the local offer through direct involvement in developing and reviewing it, we hope that that will bring about the opportunity to improve things in the way that both noble Baronesses seek.
Returning to my script, as opposed to my thoughts, Clause 26 requires local authorities and CCGs to keep the arrangements under review, so that service provision will evolve over time and continue to meet the needs of the community that it serves. I have spoken about the pluses and minuses of putting duties in the Bill.
I also note that service providers must take responsibility themselves for how they best use their resources to provide services for children and young people with SEN. I was struck by what the pathfinders said about how often that meant finding a cost-effective way to do that. It was not necessarily the case that working together was more costly. That was interesting to hear.
The final paragraph in Amendment 86 highlights the importance of key workers, which is something that we support and have specifically included in the code of practice. Chapter 3 makes clear that the kind of support that local authorities should offer children, their parents and young people should include key work and support, such as individual casework and informal advocacy, support in attending meetings or contributing to assessment and reviews, and participating in decisions about outcomes.
There was reference to how the NHS provides services and how that might mesh. The fundamental principle of the NHS is that provision should meet reasonably required needs. We have to be careful. There is a wide understanding, certainly among noble Lords, as to why that is the case and why, for example, the previous Government set up NICE to assess treatments and to work out what was effective. An NHS that was free at point of need, universal and comprehensive had to make sure that what it was providing to the population made sense and that clinicians would agree as to what was an effective treatment and so on. All of
that is built into the way the NHS has always operated. We therefore have to be careful that we do not inadvertently seek to change that fundamental principle of provision to meet the reasonably required need.
The CCG has a statutory duty to provide services to meet the reasonable needs of those for whom it is responsible. We have a good understanding of that. We may challenge it around the edges, but we do have an understanding of it. It must act consistently with the NHS mandate—