1. Improving Education, Health and Care Plans: Quality Assurance Feedback
Sheena Byron, SEND Manager
Mike Barker, Education Inclusion Lead Teacher, SEND
Tara Harness, Children’s Continuing Care Nurse/Designated Clinical Officer for SEND, NHS North Lincolnshire CCG
May 7th 2019

2. Our Quality Assurance Framework
Background
Our Quality Assurance Framework

3. Advice
Use the invite the Disability Service to each annual review for all your pupils with an EHCP (the Disability Service may not always attend the review but they will write and submit reports where appropriate).
Several weeks before the annual review date make sure you have a conversation/discussion with parents and carers about which professionals are currently involved and will need to be invited to the review.

4. The Annual Review process
Step 1 – Well in advance of meeting, obtain information and advice from parent/YP, head teacher, SEN officer, social care and health
Step 2 – at least two weeks before date of meeting, send invites to all of the above along with copies of all information and advice obtained
Step 3 – Hold meeting
Step 4 – Within two weeks of meeting, provide annual review report
Step 5 – Within four weeks of meeting, LA makes a decision and notifies parent/YP – decision itself completes ‘the annual review’ – not the meeting.
Whole process must be completed within 12 months of plan being issued or the last AR

5. A quick look at our local area guidance.
Annual Review Guidance

6. Single route of Redress – National Trial
Two year trial from March 2018 expanding the powers of the First-tier Tribunal SEND to make non-binding recommendations about the health and social care aspects of LA decisions concerning EHC Plans as part of an education appeal.

7. Section C: Health Needs relating to SEN
A direct contribution by health should be evident or it should be stated that there are no health needs
Needs must be recorded as such, not as provision
Key needs should be identified rather than conditions
Implications for the educational setting should be included
Each need must link to Provision (G) and should be reflected in Outcomes (E)
The CCG may also specify non- SEN health care needs

8. Section G: Health provision
This section should be as detailed as Section F (SEN Provision)
Speech and Language Therapy is usually included in Section F
If health needs are identified in Section C, there should usually be provision to match
LA and CCG may include other health care provision not linked to learning difficulties or disabilities for co-ordination purposes.
Should be clear how any health provision secured through a personal health budget will support achievement of the outcome

9. Section D: Social Care needs relating to SEN
It should be clearly stated if there are no social care needs
Key social care needs identified through the EHC needs assessment should be clearly set out
Each need must link to Provision (H1 or H2) and should be reflected in Outcomes (E)
The LA may also choose to specify non-SEN social care needs

10. Sections G, H1 and H2: Health and Social Care provision
Health and social care provision must be:
Made for each health and/ or social care need that appears in Sections C and D of the plan
Specific – say exactly what the provision is
Quantified – how much of it, who will deliver it
Detailed – but not to teaching strategy level
Linked to Outcomes (E)

11. Future Areas of Focus: Longer Term Outcomes
Section F: Special Educational Provision

12. Longer Term Outcomes
Outcomes underpin and inform the details of the EHC Plan, and detail what needs to be achieved by the end of a phase or stage of education in order to enable the child/young person to progress successfully to the next phase or stage.

13. Defining and Outcome
An outcome can be defined as the benefit or difference made to an individual as a result of an intervention.
It should be personal and not expressed from a service perspective; it should be something that those involved have control and influence over. It should be specific, measurable, achievable, realistic/relevant and time bound (SMART).
It will describe what the expected benefit will be to the individual as a result of the educational or training intervention provided.
From Y9 onwards, outcomes should also prepare young people for the transition to adulthood.
Outcomes are not a description of the service being provided.
Outcomes should be identified for each area of need.
(Code of Practice, 2015, 9.66)

14. Aspiration/Hope/Dream
I want to be able go to the shops by myself.
Long-term outcome (in 2-3 years time/end of key stage)
By June 2021 Sam will safely cross familiar roads on his own.
Medium-term outcome (by this time next year)
By April 2020 Sam will know three rules about crossing the road.
Short-term target (by the next review in 6-8 weeks time)
By July 2019 Sam will cross a pretend ‘road’ in the playground with adult support by saying ‘stop, look and listen’ on three separate occasions.

15. Other Examples: By April 2019 I/Sam will count up to 20 without help
Other Examples: By April 2019 I/Sam will count up to 20 without help. By July 2019 I/Amy will use the first 30 high frequency words on a daily basis. By September 2019 I/Ali will add and subtract numbers up to 20. By March 2020 I/Shay will join in activities I enjoy, such as swimming.

16. Section F: Special Educational Provision
Provision must be:
Specific – say exactly what the provision is.
Quantified – how much of it, who will deliver it.
Details given for each SEN (Section B)
Linked to outcomes (Section E)
Can be helpful to show the outcomes and provision in one table- must label clearly which is Section E (outcomes) and which is Section F (provision)

17. Specificity and Quantification
Activity 1 – in groups of 2 or 3
Jenny will receive upto approximately 90mins of speech and language therapy delivered by a qualified speech and language therapist as appropriate, subject to termly review.
Social care services provided as detailed in Maisie’s Family Service Plan for short breaks.
On a scale of 0-10, how (a) specific and (b) quantified are these extracts from an EHC Plan?
How could each be improved?

18. Examples of good specification and quantification
Greg (10 years old) will have short and frequent touch typing sessions. He will receive 3 x 10 minute sessions at school per week. A Rehabilitation Worker for Visually Impaired Children will attend the school to support Greg and his teacher in the use of the software for an initial two hour session in the first week of term, followed by a one hour visit every month. Greg’s teacher will deliver the sessions in class, and will review the programme and Greg’s progress with the Rehabilitation Worker on a termly basis.
Ryan’s LSA will work with him in college for 5 hours per week to develop problem solving skills and to practice transferring skills between different environments e.g. college and the community.
Amy will receive a 30 minute session twice per week focussed on developing social language to help her communicate better with her friends. The sessions will be delivered by a trained teacher with support from Amy’s Speech and Language Therapist (SLT). Amy’s SLT will review progress on a termly basis.

19. Examples of good specification and quantification
Katya will work with a higher level teaching assistant (HLTA) for 15 minutes every morning to support her in choosing between 2 simple options presented through the ‘Choices’ card system.
Joe will receive a 30 minute session twice a week focussing on developing his social use of language. The sessions will be delivered by a teaching assistant (TA) with one other child. The programme will be developed by a Speech and Language Therapist who will train the TA in delivering the sessions and review his progress on a termly basis.
Termly visits in school from a physiotherapist to review Maisie’s postural care needs.

20. Specificity and Quantification
Activity 2: Another go – in groups of 2 or 3
Jenny will receive up to approximately 90mins of speech and language therapy delivered by a qualified speech and language therapist as appropriate, subject to termly review.
Social care services provided as detailed in Maisie’s Family Service Plan for short breaks.
Now you’ve seen the examples, can your first attempts
from Activity 1 be improved?

21. QUESTIONS