Transcript Slide 1

Education, Health and Care plans for children
and young people with
Special Educational Needs and disability
(SEND)
A guide to the new process
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Introduction
The Children and Families Act introduces a new approach to
securing the care needed by children and young people with special
educational needs.
This guide to the process is intended for any professional who
supports children or young people, taking them through the steps in
the EHC plan process, with links to important resources and
information.
The legislative framework
1. Special
educational
needs
2. Joint
commissioning
3. Education,
health and
care planning
4. The EHC
plan
The legislative framework - 1.
Part 3 of the Children and Families Act 2014
introduces new arrangements for children and young people with SEN.
A local authority in England and its partner commissioning bodies must make
joint commissioning arrangements for the education, health and care provision
to be secured for:
• children and young people for whom the authority is responsible who have
special educational needs, and;
• children and young people in the authority’s area who have a disability.
The partner commissioning body is the responsible commissioner of health
services for the child (usually a clinical commissioning group, although NHS
England will have commissioning responsibility for some children under section
3B of the National Health Service Act 2006).
1. Special
educational
needs
2. Joint
commissioning
3. Education,
health and
care planning
4. The EHC
plan
The legislative framework - 2.
Joint commissioning arrangements must include arrangements for considering
and agreeing the education, health and care provision reasonably required by
children with SEN, including:
-
-
what education, health and care provision is to be secured and by whom;
what advice and information is to be provided about education, health
and care provision, and how;
how complaints about education, health and care provision may be made
and are to be dealt with;
procedures for ensuring that disputes between the parties to the joint
commissioning arrangements are resolved quickly.
The arrangements must in particular include arrangements for— .
- securing EHC needs assessments;
- securing the education, health and care provision specified in EHC plans;
- agreeing personal budgets.
1. Special
educational
needs
2. Joint
commissioning
3. Education,
health and
care planning
4. The EHC
plan
1. Special
educational
needs
2. Joint
commissioning
3. Education,
health and
care planning
4. The EHC
plan
1. SEND
SEN and disability
A child or young person has SEND if he or she has a learning difficulty or disability
which calls for special educational provision to be made for him or her.
A child of compulsory school age or a young person has a learning difficulty or
disability if he or she —
- has a significantly greater difficulty in learning than the majority of others of the
same age, or
- has a disability which prevents or hinders him or her from making use of facilities
of a kind generally provided for others of the same age in mainstream schools or
mainstream post-16 institutions.
A child under compulsory school age has a learning difficulty or disability if he or
she is likely to be within the above categories (or would be likely to be if no special
educational provision were made).
2. Joint
commissioning
3. EHC planning
4. The EHC plan
1. SEND
Prevalence of SEN and disability
It is estimated that in 2010/11, around 6 per cent of children aged 0-15 were
disabled - this is around 600,000 children in England. (Source: Family Resources
Survey, DWP)
In January 2012, around 66,200 children in all schools (around 1%) were identified
as having a Special Educational Need due to Autistic Spectrum Disorder. (Source:
Children with special educational needs: an analysis - 2012, DfE)
Other estimates agree that the estimated prevalence of autism spectrum
conditions are between 1-2% of the child population, which includes previously
undiagnosed cases. (Source: Prevalence of autism-spectrum conditions: UK
school-based population study – Baron-Cohen, Scott, Allison et al., 2009
2. Joint
commissioning
3. EHC planning
4. The EHC plan
1. SEND
Prevalence of SEN and disability – local information
The Child and Maternal Health Intelligence Network – part of Public Health
England - provides tools to help understand local needs.
http://www.chimat.org.uk/disability
Service Snapshot - Disability provides a summary of demand, provision and
outcomes for services in a particular area. It combines data from ChiMat and the
Children’s Services Mapping programme.
Needs Assessment Report - Children and young people with disabilities
provides evidence-based information on prevalence, incidence and risk factors
affecting children’s health and the provision of healthcare services, for:
- Child and adolescent mental health (CAMHS) for local authorities and CCGs
updated
- Children and young people with disabilities for local authorities
- Speech and language impairment for local authorities
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commissioning
3. EHC planning
4. The EHC plan
1. SEND
Why is reform needed?
• Parents have struggled to find the services that should be helping them.
• They have to battle to get the help their children need, and have to tell
their stories time and again to different people across health, education,
social care.
• Moving from children’s to adults’ services can be very difficult.
• English local authorities spend over £5 billion a year on SEND provision,
and yet those with special needs are far more likely to achieve poorly at
GCSE, Not be in Education, Employment or Training, or be unemployed.
• The 2011 Green Paper Support and aspiration: a new approach to
special educational needs and disability proposed a new approach to
joint commissioning for children with SEND in 2011.
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commissioning
3. EHC planning
4. The EHC plan
1. SEND
The aim of the reforms
We want children and young people with special needs and disabilities to
achieve well in their early years, at school and in college; find employment;
lead happy and fulfilled lives; and have choice and control over their support.
The special needs reforms will implement a new approach which seeks to join up
help across education, health and care, from birth to 25. Help will be offered at the
earliest possible point, with children and young people with SEND and their parents
or carers fully involved in decisions about their support and what they want to
achieve. This will help lead to better outcomes and more efficient ways of working.
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commissioning
3. EHC planning
4. The EHC plan
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The new approach
• New requirement for LAs, health and care services to commission
services jointly for SEN and disability;
• LAs to publish a clear, transparent ‘local offer’ of services;
• More streamlined assessment process, co-ordinated across
education, health and care;
• New 0-25 Education, Health and Care Plans for those with more
complex needs;
• New statutory protections for young people aged 16-25 in FE
• A new duty on health commissioners to deliver the agreed health
elements of EHC plans;
• The option of a personal budget for families and young people with
an EHC plan.
• A phased transition for those already with Statements and
Learning Difficulty Assessments, taking place over time.
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commissioning
3. EHC planning
4. The EHC plan
1. SEND
SEND Pathfinders
Groups of local authorities (‘Pathfinders’) have been piloting new
approaches to joint commissioning for SEN for several years,
generating a considerable body of learning for all local authorities on
the workforce development and the cultural and organisational
change needed to implement the reforms of the Children and
Families Act.
In 2014, a number of current Pathfinders applied to be SEND
Pathfinder Champions, for both regional and national roles).
An implementation pack outlines the vision for the reforms and
contains useful information for strategic leaders. Further information
and case studies, together with details of the Pathfinder Champions
available in every region, can be found at www.sendpathfinder.co.uk
If you want to contact your regional champion please email Mott
MacDonald on: [email protected] or call 020 7651 0308.
2. Joint
commissioning
3. EHC planning
4. The EHC plan
1. Special
educational
needs
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commissioning
3. Education,
health and
care planning
4. The EHC
plan
2. Joint
commissioning
Joint commissioning: the key to improving outcomes
Children with complex conditions or disability commonly have to
access different agencies, across different sectors, including education
and social care, and poor communication and record sharing and
disjointed services.
This results in parents having to repeat their story to many different
professionals, considerable duplication of effort, and the risk of children
failing to access all of the services they need.
Find a path through such a fragmented system places a severe strain
on the resources of the severely ill-child and their family.
Section 26 of the Children and Families Act 2014 requires local
authorities and partner commissioning bodies to commission
services jointly for children and young people with SEN and
disabilities, including those without Education Health and Care
Plans.
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4. The EHC plan
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commissioning
From September 2014 CCGs must work with LAs to:
• commission services jointly for 0-25 year old children and young
people with disabilities and SEN, including those with Education
Health and Care(EHC) plans;
• ensure that procedures are in place to agree a plan of action to
secure provision which meets a child or young person’s reasonable
health need in every case;
• work with the local authority to contribute to the local offer;
• ensure that mechanisms are in place to ensure practitioners and
clinicians will support the integrated Education Health and Care
Assessment within a 20 week maximum;
• agree personal budgets under section 49 of the Children and
Families Act.
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3. EHC planning
4. The EHC plan
2. Joint
commissioning
Working together
While local authorities will lead the local SEN arrangements, their CCGs
are key partners. CCGs will need to ensure they have a strong
relationship with their local authorities which can provide a basis for joint
working to secure SEN services.
The CCG and local authority may will wish to consider formal joint
arrangements, and appropriate governance, including accountability to
the CCG governing body and executive.
Section 75 of The National Health Service Act 2006 supports joint
working between local authorities and health bodies. The arrangements
cover lead commissioning, joint management of provision and pooled
budgets.
Any partnership arrangement needs to be covered by a signed
agreement between the partners, and partners must undertake
consultation with people that would be affected by such arrangements
when developing a section 75 agreement.
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3. EHC planning
4. The EHC plan
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commissioning
CCG role
CCGs must have:
-
a designated health officer or officers, who can ensure the CCG
exercises its statutory responsibilities in relation to SEN;
-
designated capacity to participate in the development the local
offer, and EHC plan process, and in particular, supporting delivery
of EHC assessment processes within the 20 week maxima (which
may be drawn from commissioning support);
-
clear oversight of the participation of their contracted providers in
contributing to EHC assessments, and a mechanism for
considering commissioning requests for high-cost, interventions;
-
a mechanism for addressing complaints, including patient liaison,
and appropriate integration.
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3. EHC planning
4. The EHC plan
2. Joint
commissioning
Designated medical / clinical officer
Each CCG should have a designated medical / clinical officer (usually
a community paediatrician, although there is flexibility for the role to be
undertaken by nurse or other clinician).
The DMO /CO supports the CCG in meeting its statutory
responsibilities in relation to SEN.
The DMO / CO provides the main point of contact for local authorities,
schools and colleges seeking health advice on children and young
people who may have SEN, and contact for CCGs or healthcare
providers to make appropriate notification to the local authority of
children believed to have SEN.
Several CCGs may share a DMO / CO.
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3. EHC planning
4. The EHC plan
2. Joint
commissioning
The local offer
The local offer is the name given to the range of services which are
locally available for a child with special educational needs or disability.
It captures the key services which are commissioned across health,
social care and education.
Each local authority will publish clear, comprehensive and accessible
information about these services, including information on how they
are accessed, eligibility criteria etc.
The local offer is more than just a list or directory of services, as the
local authority and its partners, including CCGs, should involve
children and young people with SEND, parent carers, and service
providers in its development and review.
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3. EHC planning
4. The EHC plan
2. Joint
commissioning
The local offer
The JSNA / JHWBS informs the local offer; individual EHC plans
draw on the services in the offer.
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4. The EHC plan
2. Joint
commissioning
The local offer
North Yorkshire County Council has produced an interactive map of
the services which comprise the local offer. Click on the image
below to explore.
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4. The EHC plan
2. Joint
commissioning
Parent Carer Forums
In each local authority there is a parent carer forum, whose
membership is made up of parents of children with a range of
disabilities and complex conditions, working in partnership with
strategic leads, service providers and commissioners to improve the
services across health, education and social care that their children
access.
Parent carer forums can also work with commissioners and providers
to reach disabled children and young people to make sure their views
are heard, and make sure services meet their children’s needs and
help commissioners monitor how well these services are being
provided.
For resources on parent participation and contact details for every local
parent carer forum, see www.cafamily.org.uk/parentcarerparticipation
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3. EHC planning
4. The EHC plan
2. Joint
commissioning
Code of Practice
The Code of Practice is the
statutory guide to the EHC
process and covers all the legal
requirements and important good
practice.
Click on the title page to link to
the full Code
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3. EHC planning
4. The EHC plan
1. Special
educational
needs
2. Joint
commissioning
3. Education,
health and
care planning
4. The EHC
plan
3. EHC
planning
The CCG role in EHC planning
Relevant local clinicians, such as community paediatricians, will
participate in the development of the child’s or young person’s EHC plan,
advising on the child’s needs and the provision appropriate to meet
them.
CCGs must ensure that commissioned services are mobilised to
participate in the development of EHC plans. The CCG as commissioner
will often have a limited involvement in the process (as this will be led by
clinicians from the services they commission) but they must ensure that
there is sufficient oversight to provide assurance that the needs of
children with SEN are being met in line with their statutory responsibility.
The CCG will have a more direct role in considering the commissioning
of a service that does not appear in the Local Offer to meet the complex
needs of a specific individual, or in agreeing a Personal Budget.
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2. Joint
commissioning
4. The EHC plan
3. EHC
planning
Co-ordinated assessment
The co-ordinated assessment and EHC planning process should:
• promote a “tell us once” approach to sharing information wherever
possible;
• put children, families and young people at the centre of the process;
• have effective co-ordination between education, health and care
services, with joint agreement on key outcomes;
• include consideration of a step down process for children/young
people who do not have plan following assessment or who do not
meet the criteria for an assessment;
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commissioning
4. The EHC plan
3. EHC
planning
A speedier process
The whole process, from initial request to issuing the final EHC plan,
should take no longer than 20 weeks. A more detailed diagram is on the
next slide.
16
wks
6
wks
20
wks
LA notification that plan
will
not
be
issued
following assessment
Initial
request for an
EHC needs
assessment
LA
response
to
request
Assessment and
planning
Contributors to planning must respond
within 6 weeks of request for
information
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commissioning
4. The EHC plan
Fina
l
plan
3. EHC
planning
6
wks
16
wks
Plan finalised
20 wks
3. EHC
planning
Who might contribute to the EHC plan ?
Parents and
family
Designated
staff for
looked-after
children
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2. Joint
commissioning
Community
paediatricians,
therapists,
nurses
Schools, or
early year
settings
The child or
young person
and family
Educational
psychologists
Social
workers, care
workers
4. The EHC plan
3. EHC
planning
Involving the child and their family
Children, young people and families should experience well coordinated assessment and planning leading to timely, well-informed
decisions.
Local authorities must consult the child and the child’s parent or the
young person throughout the process of assessment and production of
an EHC plan, and families should be closely involved in the process, by:
-
being provided with access to the relevant information in accessible
formats;
-
given time to prepare for discussions and meetings, and
-
being allowed dedicated time in discussions and meetings to hear
their views.
Some young people and their families will receive advocacy support.
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commissioning
4. The EHC plan
3. EHC
planning
Co-ordinating the EHC plan process
The process of EHC assessment and planning will be led by the local
authority. An effective, co-ordinated assessment will need a clear plan to
ensure everyone who needs to contribute can do so.
Logistical issues include:
• planning the process to meet the needs of children, parents and
young people;
• timing meetings to minimise family disruption, and to allow for
professional schedules;
• keeping the child’s parent or young person informed through a single
point of contact wherever possible and;
• ensuring relevant professionals have sufficient notice to be able to
contribute to the process .
Click here to link to Cornwall
County Council’s Pathway for
16-19 year olds .
1. SEND
2. Joint
commissioning
Click here to link to
Southampton City Council’s
EHC process.
4. The EHC plan
3. EHC
planning
Health professionals
There is potentially a wide range of professionals who may need to input
to the development of an EHC plan for children and young people with
SEN, ranging from community paediatricians, to physiotherapists and
nurses.
The local authority will need to work with their partners, to make sure
they have considered as part of their joint arrangements:
• the range of professionals across education, health and care who
need to be involved and their availability;
• flexibility for professionals to engage in a range of ways and to plan
their input as part of forward planning;
• providing opportunities for professionals to feed back on the process,
and its implementation, to support continuous improvement.
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commissioning
4. The EHC plan
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educational
needs
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commissioning
3. Education,
health and
care planning
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plan
4. The EHC
plan
The role of the EHC plan
At the heart of the new arrangements for children with SEN is the EHC
plan, which replaces the current Statement.
The plan captures:
• the child or young person’s special educational needs and any health
and social care needs;
• the services which the relevant commissioners intend to secure;
• the outcomes which they will aim to deliver, based on the child or young
person’s needs and aspirations.
Like a Statement, an EHC is a statutory document: a local authority must
secure the specified special educational provision for the child or young
person.
If the plan specifies health care provision, the responsible commissioning
body – usually a CCG - must arrange the specified health care provision for
the child or young person.
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commissioning
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4. The EHC
plan
What the EHC plan should
cover
EHC plans should be:
clear, concise, readable and
accessible to parents, children,
young people and practitioners
specific on special educational
The format of an EHC plan will
be agreed locally.
However the plan must contain
the sections listed here,
identified by their letter.
Click on a section to find out
more.
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plan
What the EHC plan should cover
A. Views, interests and aspirations of the child or
young person, and their parents
• The child or young person’s aspirations
and goals for the future
• Play, health, schooling, independence,
friendships, further education and future
plans including employment (where
practical)
• How to communicate with the child or
young person and engage them in
decision-making
• The child or young person’s history
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plan
What the EHC plan should cover
B. The child or young person’s special
educational needs (SEN)
• All of the child or young person’s
identified special educational needs must
be specified
• SEN may include needs for health and
social care provision that are treated as
special educational provision because
they educate or train the child or young
person
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commissioning
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4. The EHC
plan
What the EHC plan should cover
C. The child or young person’s health needs
which relate to their SEN
• The EHC plan must specify any health
needs identified through the EHC needs
assessment which relate to the child or
young person’s SEN. Some health care
needs, such as routine dental health
needs, are unlikely to be related
• The CCG may also choose to specify
other health care needs which are not
related to the child or young person’s
SEN (for example, a long-term condition
which might need management in a
special educational setting).
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plan
What the EHC plan should cover
D. The child or young person’s social care needs
which relate to SEN
• The EHC plan must specify any social
care needs identified through the EHC
needs assessment which relate to the
child or young person’s SEN or which
require provision for a child or young
person under 18 under section 2 of the
Chronically Sick and Disabled Persons
Act 1970
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plan
What the EHC plan should cover
E. The outcomes sought for the child or young
person
• A range of outcomes over varying
timescales, covering education, health
and care as appropriate
• Steps towards meeting the outcomes,
arrangements for monitoring progress
• Forward plans for key changes in a child
or young person’s life, such as changing
schools, moving from children’s to adult
care and/or from paediatric services to
adult health, or moving on from further
education to adulthood
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commissioning
3. EHC planning
4. The EHC
plan
What the EHC plan should cover
F. The special educational provision required by
the child or young person
• Provision must be detailed, specific and
quantified, e.g. the type, hours and
frequency of support / level of expertise
• Provision must be specified for each and
every need specified in section B. It
should be clear how the provision will
support achievement of the outcomes
• Health or social care provision which
educates or trains a child or young person
must be treated as special educational
provision and included in Section F
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commissioning
3. EHC planning
4. The EHC
plan
What the EHC plan should cover
G. Any health provision required by the child or
young person
• Provision should be detailed and specific
and should normally be quantified, for
example, in terms of the type of support
and who will provide it
• It should be clear how the provision will
support achievement of the outcomes,
including the health needs to be met and
the outcomes to be achieved through
provision secured through a personal
(health) budget
• For more information on possible health
services to be included, click HERE
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commissioning
3. EHC planning
4. The EHC
plan
What the EHC plan should cover
H. Social care provision
• Section H1 of the EHC plan must specify
all social care services needed for a
disabled child or young person under
section 2 of the Chronically Sick and
Disabled Person’s Act 1970 , such as
practical assistance in the home and nonresidential short breaks
• Section H2 includes social care services
not covered by the CSDP, such as
residential short breaks
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commissioning
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4. The EHC
plan
What the EHC plan should cover
I. Placement
• The name and type of the school,
maintained nursery school, post-16
institution or other institution to be
attended by the child or young person and
the type of that institution (or, where the
name of a school or other institution is not
specified in the EHC plan, the type of
school or other institution to be attended
by the child or young person).
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commissioning
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4. The EHC
plan
What the EHC plan should cover
J. Personal budget (including arrangements for
direct payments)
• This section should provide detailed
information on any Personal Budget that
will be used to secure provision in the
EHC plan
• It should set out the arrangements in
relation to direct payments as required by
education, health and social care
regulations
• The special educational needs and
outcomes that are to be met by any direct
payment must be specified
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commissioning
3. EHC planning
4. The EHC
plan
What the EHC plan should cover
K. Advice and information
• The advice and information gathered
during the EHC needs assessment must
be set out in appendices to the EHC plan.
There should be a list of this advice and
information.
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commissioning
3. EHC planning
4. The EHC
plan
Health services in the EHC plan
Health care provision reasonably required may include:
•
•
•
•
•
•
speech and language therapy;
occupational therapy, physiotherapy, arts therapies;
wheelchair services and community equipment;
children’s community nursing;
continence services;
palliative and respite care and other provision for children with
complex health needs
• other services, such as emergency care provision and habilitation
support;
• provision for children and young people’s continuing care
arrangements;
• support for young people when moving from healthcare services
for children to healthcare services for adults.
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commissioning
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plan
EHC plan outcomes
An outcome can be defined as the “benefit or difference made to
an individual as a result of an intervention”. An outcome is not a
description of the service being provided e.g. ‘three hours speech
and language therapy’ is not an outcome.
The EHC plan should capture not only the range of services which
the child or young person will be receiving, but also the specific
outcomes which the services will deliver. The plan is only truly
person-centred, if it describes what success looks like in terms of the
child’s experience and abilities.
The child’s aspirations, captured in section A of the plan might
provide a context for setting outcomes, but the plan actions should
be focused on more immediate deliverables.
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commissioning
3. EHC planning
4. The EHC
plan
Examples of EHC plan outcomes
Emma will achieve level
1c in reading, writing and
maths this year
Toby will be able to use
the toilet independently
by July 2016.
Jamie will be able to
demonstrate understanding
of basic feelings and
emotions (i.e. happy, sad,
angry, tired, excited,
anxious) through body
language, facial expression
and pictorial
representations.
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2. Joint
commissioning
3. EHC planning
Alice will complete
a course in
computer skills
4. The EHC
plan
Examples of EHC plans
Click on the documents below to explore examples of EHC
plans developed by Pathfinders Nottinghamshire and
Southampton.
1. SEND
2. Joint
commissioning
3. EHC planning
4. The EHC
plan
Nottinghamshire County Council EHC animation
The Nottingham Pathfinder has developed a short animation to
explain their EHC plan process.
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2. Joint
commissioning
3. EHC planning
4. The EHC
plan
Signing off the plan
The health care provision specified in section G of the EHC plan must
be agreed by the CCG (or where relevant, NHS England) and any
health care provision should be agreed in time to be included in the
draft EHC plan sent to the child’s parent or to the young person.
As part of the joint commissioning arrangements, partners must have
clear disagreement resolution procedures where there is disagreement
on the services to be included in an EHC plan.
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2. Joint
commissioning
3. EHC planning
4. The EHC
plan
Signing off the plan
The health care provision specified in section G of the EHC plan must
be agreed by the CCG (or where relevant, NHS England) and any
health care provision should be agreed in time to be included in the
draft EHC plan sent to the child’s parent or to the young person.
As part of the joint commissioning arrangements, partners must have
clear disagreement resolution procedures where there is disagreement
on the services to be included in an EHC plan.
1. SEND
2. Joint
commissioning
3. EHC planning
4. The EHC
plan
Reviewing plans
EHC plans should be used to actively monitor children and young
people’s progress towards their outcomes and longer term
aspirations, with reviews at least every 12 months. Reviews must
focus on the child or young person’s progress towards achieving the
outcomes specified in the EHC plan. The review must also consider
whether these outcomes and supporting targets remain appropriate.
Review should aim to:
- review the health and social care provision made for the child or
young person and its effectiveness in ensuring good progress
towards outcomes
- consider the continuing appropriateness of the EHC plan in the
light of the child or young person’s progress during the previous
year or changed circumstances and whether changes are
required
- set new interim targets for the coming year and where
appropriate, agree new outcomes
1. SEND
2. Joint
commissioning
3. EHC planning
4. The EHC
plan
Transfer of plans
Where the child or young person’s move between local authority
areas also results in a new CCG becoming responsible for the
child or young person, the old CCG must notify the new CCG on
the day of the move or, where it has not become aware of the
move at least 15 working days prior to that move, within 15
working days beginning on the day on which it did become aware.
Where for any other reason a new CCG becomes responsible for
the child or young person, for example on a change of GP or a
move within the local authority’s area, the old CCG must notify
the new CCG within 15 working days of becoming aware of the
move. Where it is not practicable for the new CCG to secure the
health provision specified in the EHC plan, the new CCG must,
within 15 working days of becoming aware of the change of CCG,
request the (new) local authority to make an EHC needs
assessment or review the EHC plan. The (new) local authority
must comply with any request.
1. SEND
2. Joint
commissioning
3. EHC planning