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Children with special educational needs and disability in Doncaster health contribution (SEND) policy

Contents

  1. Policy summary
  2. Introduction
  3. Purpose
  4. Scope
  5. Procedure and implementation
  6. Training implication
  7. Equality impact assessment screening
  8. Associated documents
  9. References
  10. Appendices

1 Policy summary

A child or young person has special educational needs and disabilities if they have a learning difficulty or a disability that means they need special health and education support, we shorten this to SEND (NHS, England).

Rotherham, Doncaster and South Humber NHS Trust (RDaSH) see many children who have a learning difficulty or disability that will impact on their education. We are therefore well placed to work with colleagues from across the health sector and education to ensure these children are well supported in accessing the appropriate pre-school and school provision. This policy supports health practitioners to understand their statutory obligations and support them to contribute to the statutory requests for information to support assessment.

2 Introduction

The Children and Families Act 2014 introduced several new duties for local Boards. The South Yorkshire Integrated Care Board (ICB) has in place a SEND strategic lead as of August 2022 who will support, facilitate and coordinate health provider SEND provision and link across the health and education system to ensure that the ICB is fulfilling its statutory duties under the SEND code of practice.

The designated clinical officer (strategic lead), the designated medical officer and the designated clinical officer (operational lead) will work together to ensure health is fulfilling its statutory duties under the SEND code of practice.

Having SEND as a boroughwide strategic priority supports all agencies in their SEND processes. Doncaster has a SEND local offer, special educational needs, disabilities (SEND), homepage, Doncaster Council (opens in new window)

2.1 The SEND

Code of Practice 2015 defines SEND as: ‘A child or young person has SEN if they have a learning difficulty or disability which calls for special educational provision to be made for them’.

The SEND code of practice provides statutory guidance to many organisations, including health providers, who support children and young people with special educational needs and disabilities.

The following fundamental principles underpin the guidance in the SEN code of Practice 2015: a child with SEN should have his or her needs met, the SEN of children will normally be met in mainstream schools or early education settings, the views of the child should be sought and taken into account, parents have a vital role to play in supporting their child’s education, children with SEN should be offered full access to a broad balanced and relevant education, including an appropriate curriculum for the foundation stage and the national curriculum.

3 Purpose

The purpose of this policy is to clearly set out the statutory requirements and the responsibilities of those involved in the care of children and young people (0 to 25 years) with special educational needs.

4 Scope

This policy applies to:

  • staff working within the trust who work with children and young people (0 to 25) with SEND, including learning disability, intellectual disability children and adult services, children’s care group

For further information about responsibilities, accountabilities and duties of all employees, please see appendix A.

5 Procedure and implementation

Many children and young people who have Special Education Needs (SEN) may have a disability. Disability is described under the Equality Act 2010 as a physical or mental impairment which has a substantial and long-term adverse effect on a person’s ability to carry out normal day-to-day activities.

Special educational needs can result from:

  • a long term condition or life-limiting condition, such as Duchenne muscular dystrophy
  • a congenital condition, such as cerebral palsy
  • a learning disability
  • autistic spectrum disorder
  • attention deficit hyperactivity disorder (ADHD)
  • serious illness or injury, such as acquired brain injury
  • a sensory impairment
  • behavioural issues

The benefits of early identification of SEND are widely recognised: identifying need at the earliest opportunity, and then making effective provision, improves long term outcomes for children. RDaSH staff have an important role to play in early identification for all patients at the point a disability is recognised.

See appendix E for children’s care group chart to support entry into local authority SEND pathway.

It is important that the health system works closely with the education system. All maintained nursery schools, mainstream schools, free schools and academies have a special educational needs co-ordinator (SENCo) who will be a key point of liaison for health professionals. Within special schools they tend not to have a SENCO’s but pastoral leads.

A child or young person’s educational attainment can be affected by school absences due to hospitalisation, frequent appointments or lack of support to promote attendance. RDaSH mainstream school nursing staff can work with schools to support children during periods of ill health when they cannot access school, by providing appropriate education during inpatient stays, based on effective communication with the child’s school. The special school nursing team will support or signpost if a child and young person is absent from school due to health and work closely with education.

The Children and Families Act 2014 introduced several new duties for Clinical Commissioning Groups (now known as the South Yorkshire Integrated Care Board (ICB)) to:

  • commission services jointly for children and young people (up to age 25) with SEND, including those with Education Health and Care (EHC) plans
  • work with the local authorities’ (LA) to contribute to the Local Offer of services available
  • ensure that health providers inform parents and the appropriate LA where they think that a young child under compulsory school age has, or probably has, SEN or a disability
  • have mechanisms in place to ensure practitioners and clinicians will support the integrated EHC needs assessment process
  • agree personal budgets, where they are provided for those with EHC plans

The Act strengthens the statutory responsibilities of local systems to:

  • take a person-centred approach to planning for support needs, with the voice of children, young people and their families at the centre
  • focus on children and young people achieving life outcomes that are meaningful, rather than focus on inputs only
  • strengthen the engagement and allow children, young people and their families to influence all aspects of SEND support, including being involved in co-design and co-production
  • focus on the future and prepare children and young people for adulthood and independence from early on, including transitions and moving to employment

The ICB must work with the LA to develop a local offer co-produced with children and young people with SEND and their parents, covering support available for those with SEND, both with and without EHC plans.

The SEND code of practice came into force in 2014 providing statutory guidance on duties, policies and procedures relating to part 3 of the Children and Families Act 2014 and associated regulations and applies to England. It relates to children and young people with special educational needs (SEN) and disabled children and young people. A ‘young person’ in this context is a person over compulsory school age and under 25.

Doncaster’s 6 priorities are:

  • to ensure that the graduated response to meeting special educational and disability needs is delivered coherently and consistently
  • ensuring that there is a clear and partnership wide response to young people’s mental health needs. This includes a commitment to making sure that children and young people (CYP) with SEND with social emotional and mental health (SEMH) needs have their needs identified and met effectively in a timely manner so they can engage and make good progress, particularly in mainstream settings
  • ensuring that children and young people on the autism, attention deficit disorder and other neurodevelopmental pathways have their needs identified and met in a consistently timely manner and post diagnosis support is a focus for the future
  • ensuring that Doncaster’s secondary schools provide curricula and teaching that effectively meet the needs of students who have SEND so that they make good progress and are well prepared for their next stage in education and future employment
  • improve positive transitions for young people with SEND so transitions are planned, young people are prepared for adulthood, and they are able to independently access suitable sustainable employment or supported employment
  • improving the use of information to inform strategic planning and joint commissioning

5.1 Quick guide to the EHCP process

5.1.1 EHCP

  • An education, health and care (EHC) plan is for children and young people aged up to 25 years who need more specific long term support in order to make progress.

5.1.2 Who can ask for one

  • Parent’s and carers, the young person themselves if aged 16 to 25 social workers, school SENCO following multi-agency discussion including parents or carers and professionals involved.

5.1.3 What happens first

  • Local authority are provided with information. About what will she or he be able to do that they cannot do currently the interventions and strategies in place and an evaluation of the impact of these on improving outcomes for the child and the resources or special arrangements that they already made available.

5.1.4 EHCP assessment

  • Is coordinated by the LA and they require information to be returned to them within 6 weeks using the Doncaster EHCP health advice template in SystmOne.
  • This is a statutory requirement.

5.1.5 What health do next

  • Formal advice is requested from relevant health professionals involved.
  • Health provision should be detailed and specific and should normally be quantified where appropriate, for example, in terms of the type of support and who will provide it.

5.2 Education, health and care plans (EHCPs)

Many Children and Young people (CYP) may need ‘special educational provision’ that is different from or additional to that normally available to pupils or students of the same age. This can be delivered locally by the school using their devolved SEN budget and is overseen by the SENCO at the school.

An education, health and care (EHC) plan is for children and young people aged up to 25 years who need more specific long term support in order to make progress, it identifies the key outcomes that the CYP needs to achieve, and the resulting educational, health and social care provision that is required to meet those needs in each area.

Requests for EHCPs can be made by.

  • school SENCOs following multi-agency discussion including parents, carers and professionals involved
  • parents and carers who think they need the additional support that an EHCP provides
  • a young person can request an assessment themselves if they are aged 16 to 25 years
  • social workers working with the family

Parental consent or person over 16 years of age consent is given at this stage to allow the local authority to seek information across agencies to inform decision making.

Special educational needs and disability information, advice and support(SENDIAS), helps parents who want to request an EHCP, advice given and support.

5.2.1 What happens before the decision to assess?

A statutory assessment will consider special educational needs together with health and social care needs. When a request is made, the child will have demonstrated ‘significant cause for concern’ despite all relevant and purposeful action being taken. The education setting, or other practitioner, such as a portage worker, health visitor or social worker, may bring a child to the attention.

They should provide the local authority with a range of information including: evidence of how the child and family have been involved, the child’s strengths, special educational needs and any health and care needs relating to their SEN, the outcomes for the child, for example, what will she or he be able to do that they cannot do currently, the interventions and strategies in place and an evaluation of the impact of these on improving outcomes for the child, the resources or special arrangements that they have already made available the specialist advice they have acted upon over time.

A panel of education, health and care professionals makes this decision as to whether the child requires an EHCP, this decision is based on how complex the child’s needs are, the level of support the child has already received and whether the child can be given support in their current setting.

5.2.2 What happens if the local authority decide not to proceed with the EHC needs assessment?

The local authority may decide that the evidence does not support a statutory needs assessment and that the child’s needs should be met through school based SEN support. In these situations, the local authority will explain the reasons to the parent and to the education setting and set out what they should do next to continue to meet the child’s needs.

The local authority will also set out the rights of appeal.

If parents, and young people over the age of 16 (if they are able to make their own decision), disagree with this decision, they first have to consider mediation and have a right of appeal through The special educational needs and disability (SEND) tribunal.

5.2.3 What happens during the EHC needs assessment?

If the local authority feels that it should assess the child formally, it must seek statutory advice from all the services and settings involved and ask the child and family for their views, wishes and feelings. The SEN service and the lead practitioner will provide further information and support to the family. Everyone has six week timescale from the date of request to return their advice and reports.

5.2.4 Health have a statutory responsibility to provide advice within the 6 week timescale using the Doncaster EHCP health advice template in SystmOne (Appendix D).

The statutory assessment will provide information on the following:

  • the child’s strengths
  • the child and family’s view
  • wishes and feelings
  • the special education
  • health and care needs
  • how the needs can best be met
  • special resources, equipment or input, curriculum

what outcomes are desired: what will the child be able to do that they cannot do now? What happens after the EHC needs assessment?

See appendix H ‘What good health advice includes’

5.2.5 If the local authority (LA) decides an EHCP is needed

If, following the EHC needs assessment, the LA decides that a child requires support above what must be provided by the setting, an education, health and care plan (EHCP) will be issued. This will be drafted in consultation with the family. It will not state at this stage where the child will go to school.

The family has 15 calendar days to give their views on the content in the EHCP. They can express a preference for a named setting and confirm if, and how, they would like to take up the offer of a personal budget.

Health professionals need to be prepared to work with all settings, specialist and mainstream, to ensure that children’s health needs are met appropriately.

If a child’s parent or a young person makes a request for a particular nursery, school or post-16 institution in these groups the LA must comply with that preference and name the school or college in the EHCP unless, it would be unsuitable for the age, ability, aptitude or SEN of the child or young person, or if the attendance of the child or young person there would be incompatible with the efficient education of others, or the efficient use of resources.

A final EHCP must be issued within 20 weeks of the initial request being received and it will name an education setting although there are some exceptions allowed. Parents and young people have a right of appeal at this stage through the SEND tribunal. It important that the EHCP is specific and identifies all the child’s needs and that it matches detailed provision to meet these needs and the identified outcomes.

5.2.6 If the LA decided an EHCP is not needed

Sometimes the LA’s view is that the statutory assessment advice suggests that an EHCP is not needed. If this is the case, the authority will explain in writing and also say how the education setting should continue to meet the child’s needs. The local authority will also set out the rights of appeal.

If parents, and young people over the age of 16 (if they are able to make their own decision), disagree with this decision, they first have to consider mediation and have a right of appeal through the special educational needs and disability (SEND) tribunal.

The EHCP timeline (opens in new window).

5.3 The health role in developing EHC plans

The NHS Standard Contract states that where a local authority requests the cooperation of the provider in securing an education, health and care needs assessment, the provider must use all reasonable endeavours to comply with that request within 6 weeks of the date of receipt.

RDaSH therefore have a statutory requirement to support all EHC plan requests from local authorities, responding within the timescale of 6 weeks.

Health professionals will need to contribute to section G of the plan: ‘Any health provision reasonably required by the learning difficulties or disabilities which result in the child or young person having SEN.’ However, not all health advice is made in section G if the support of the health professional has a direct impact on education. For example, speech and language therapy contribution has been deemed to be relevant as educational advice by the high courts.

Information should be included as follows:

  • health 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 the outcomes, including the health needs to be met and the outcomes to be achieved through provision secured through a personal (health) budget
  • clarity as to how advice and information gathered has informed the provision specified
  • health care provision reasonably required may include universal services, specialist support and therapies, a range of nursing support, specialist equipment, wheelchairs and continence supplies. It could include highly specialist services needed by only a small number of children which are commissioned centrally by NHS England (for example therapeutic provision for young offenders in the secure estate)
  • the LA and ICB may choose to specify other health provision reasonably required by the child or young person, which is not linked to their learning difficulties or disabilities, but which should sensibly be co-ordinated with other services in the plan
  • how the health needs impact on the child and young person’s special educational needs

5.4 Process for responding to requests for formal advice for EHC needs assessments

All requests for information to support EHC plans should come via the RDaSH SEND inbox: rdash.cypf-dco-ehcprequests@nhs.net.

Requests for health advice are set at 3 levels; low, medium and high. The operational DCO coordinates low and medium level advice and high-level advice is completed by a paediatrician at Doncaster and Bassetlaw Teaching Hospital NHS Foundation Trust (DBTH).

Appendices E and F show the process for low, medium and high health advice.

Child health request advice from our therapy services; physiotherapy, occupational therapy and speech and language therapy services, via tasking them on SystmOne.

The operational DCO reviews the SystmOne records for health services involved, these services are contacted for advice either by SystmOne tasks or by email, advising them of the request and the six weeks return date.

The operational DCO will contact the family to review if there is any health services involvement, if there is no current health services involvement, the operational DCO will send the universal health statement as the response to the health needs request.

5.4.1 The universal health statement

’X’s health needs have been screened and contact made with their family. X does not have any health needs over and above those normally met by universally available health services. There are no special educational needs arising from health needs.’

The DCO operational health lead support LA requests for health information by signposting to the most appropriate health provider who will hold the most relevant information about the child. Where possible, health professionals should work in co-production with the family of the child or young person.

It is very important that Health professionals must restrict their advice to their area of expertise and must not make recommendations about specific educational placements.

5.5 Requests for advice for a child known to Doncaster health professionals

Where a child or young person is already known to a Doncaster health professional or team, it is expected that the most appropriate person completes the following:

  • provides an opinion, based on the young person’s history, health records, and the professional’s experience

5.6 Requests for advice for a child not known to Doncaster health services

All these requests for ECHP’s go through the DCO and the DCO makes the decision whether the paediatrician’s expertise is required. The paediatrician (at Doncaster and Bassetlaw Teaching Hospital Foundation Trust) will review the child’s records, contact the parents or carers and provide a report (this paediatrician works with the designated medical officer (DMO) also at Doncaster and Bassetlaw Health Trust)

Professionals will need to decide how to respond to such requests, satisfying themselves that advice is being sought from other appropriate professionals, and that the child or young person does not require their attention. They should seek advice and further information from the DCO regarding the request, so that an informed decision can be made.

Where a child is completely unknown to a service or professional, it may not be appropriate for an assessment to be undertaken, or for advice to be provided, beyond written notice to the LA that it is not possible to comply. This would be reasonable where the request appears to have been made of the wrong service, or where there is no evidence that the child or young person is suitable for referral.

It might be appropriate for some services to retain slots for providing short notice assessments. Where there are significant waits for an assessment, it may be reasonable to provide some initial advice, with the fuller assessment ideally taking place within 12 to 14 weeks, so that the EHC plan is completed within the statutory timescale.

5.7 Safeguarding and SEND

Adults who work with children and young people with SEND should be aware of the additional needs children may have that could mean they are more vulnerable to abuse and less able to speak out if something isn’t right. Some children may be vulnerable because; they have additional communication needs, they do not understand that what is happening to them is abuse, need intimate care, are isolated from others, are dependent on adults for care.

Disabled children at greatest risk of abuse are those with behaviour or conduct disorders. Other high-risk groups include; children with learning difficulties or disabilities, children with speech and language difficulties, children with health-related conditions and deaf children.

Reference:

6 Training implications

SEND training is not mandated for any staff groups however it is recommended for staff who regularly receive requests for EHC plan information.

6.1 The Council for Disabled Children have recently launched a SEND training course

6.1.1 Training or course name

The Council for Disabled Children have recently launched a SEND training course, covering:

  • aspirations
  • outcomes from CYP and family perspectives
  • outcomes from professional perspectives, including writing SMART outcomes
  • legal considerations
  • annual reviews
  • specific e-learning for CAMHS practitioners

6.2 Staff who regularly receive requests for EHC plan information.

  • How often should this be undertaken: Once, prior to doing level 1, 2 or 3.
  • Length of training: 2.5 hours.
  • Delivery method: E-learning modules.
  • Training delivered by whom: Council for Disabled Children.
  • Where are the records of attendance held: ESR or Personal file

6.3 E-learning: Health Advice for EHCP’s

6.3.1 Employee group require training

Health professional completing EHCP’s

Level 1 is for Health colleagues who:

  • are new to the world of SENDs
  • may occasionally give advice for EHCPs

Level 2 is intended for Health colleagues who:

  • regularly give advice for EHCPs
  • already have a clear understanding of the purpose of an EHCP, from the child or young person’s perspective
  • already have a clear understanding of the difference between aspirations, outcomes sought and SMART outcomes
  • already have a clear understanding of the holistic nature of outcomes

Level 3 is intended for Health colleagues who:

  • have a strategic role in the EHCP process
  • have a role in quality assurance
  • already have a good understanding of aspirations as the golden thread through the plan

6.3.2 training

  • How often should this be undertaken: Once, repeat as required
  • Length of training: 60 minutes for each level
  • Delivery method: E-learning
  • Training delivered by whom: The Council for Disabled Children have also produced helpful guidance in the form of e learning, to support health professionals when providing health advice for EHCP’s. The course will help you to understand the role of good advice in the plan, what good advice looks like, and the features of an effective advice giving process. There are three levels and each one is for different audiences.
  • Where are the records of attendance held: ESR or personal file

7 Equality impact assessment screening

To access the equality impact assessment for this policy, please email rdash.equalityanddiversity@nhs.net to request the document.

7.1 Privacy, dignity and respect

The NHS Constitution states that all patients should feel that their privacy and dignity are respected while they are in hospital. High Quality Care for All (2008), Lord Darzi’s review of the NHS, identifies the need to organise care around the individual, ‘not just clinically but in terms of dignity and respect’.

Consequently, the trust is required to articulate its intent to deliver care with privacy and dignity that treats all service users with respect. Therefore, all procedural documents will be considered, if relevant, to reflect the requirement to treat everyone with privacy, dignity, and respect, (when appropriate this should also include how same sex accommodation is provided).

7.1.1 Indicate how this will be met

All employees, contractors and partner organisations working on behalf of the trust must follow the requirements of this policy and other related policies, particularly those relating to information governance. All health employees must also meet their own professional codes of conduct in relation to confidentiality.

7.2 Mental capacity act

Central to any aspect of care delivered to adults and young people aged 16 years or over will be the consideration of the individual’s capacity to participate in the decision-making process. Consequently, no intervention should be carried out without either the individual’s informed consent, or the powers included in a legal framework, or by order of the court.

Therefore, the trust is required to make sure that all colleagues working with individuals who use our service are familiar with the provisions within the Mental Capacity Act (2005). For this reason, all procedural documents will be considered, if relevant to reflect the provisions of the Mental Capacity Act (2005)to ensure that the rights of individual are protected, and they are supported to make their own decisions where possible and that any decisions made on their behalf when they lack capacity are made in their best interests and least restrictive of their rights and freedoms.

7.2.1 Indicate how this will be achieved

All individuals involved in the implementation of this policy should do so in accordance with the guiding principles of the Mental Capacity Act (2005).

9 References

Listed in the links above.

10 Appendices

10.1 Appendix A Responsibilities, accountabilities and duties

10.1.1 The trust

The trust has a ‘duty of care’ to ensure that all aspects of the SEND processes are properly managed. The trust must adhere to the legislative, statutory, and good practice guidance requirements detailed in this policy.

10.1.2 The chief executive

The chief executive has overall accountability and responsibility for the delivery of care within the trust. This function is delegated to the executive medical director and the executive director of nursing and allied health professionals, who are responsible for driving high quality standards around SEND.

10.1.3 The trust’s executive medical director

The trust’s executive medical director (and trust Caldicott guardian) plays a key role in ensuring that NHS and partner organisations comply with current national guidance and relevant legislation around the SEND legislation.

10.1.4 Care group directors

Are responsible for:

  • the implementation of the policy across the specified care groups
  • the ongoing review of the policy to keep it up to date with current best practice
  • promoting collaborative working between services, in order that the needs of the patient remain at the centre of the process
  • providing reports to the operational management group (OMG) on any issues associated with the implementation of the policy
  • facilitating effective joint working with internal and external partners and stakeholders

10.1.5 Team managers

Are responsible for:

  • making their staff aware of the contents of this policy
  • monitoring the compliance of their staff with the contents of this policy
  • facilitating multidisciplinary team (MDT) discussion to assist decision making and communication of concern or actions
  • reporting any breaches in relation to this policy

10.1.6 The designated clinical officer (DCO)

The designated clinical officer (DCO) is an operational health leads that sits within RDaSH.

The DCO role is to support health colleagues both at Rotherham, Doncaster and South Humber NHS Trust (RDaSH) and Doncaster and Bassetlaw teaching hospitals NHS Foundation Trust (DBTH), to ensure health services are meeting the needs of children and young people 0 to 25 with special educational needs and disabilities. To ensure children and young people with SEND have the right health support to achieve the best they possibly can.

The DCO role is a key element in supporting the health service in its implementation of the Children’s and Families Act 2014.

The DCO role is a varied role and includes:

  • supporting joint working between health services and local authorities
  • attending educational, health and care panels to discuss which children go forwards for assessment and then if required have a formal plan (EHCP)
  • act as an operational health lead for the education, health and care plan pathway
  • supporting health professionals with the information required within these assessments
  • supporting the SEN team at the Local Authority with questions and queries on information

10.1.7 The designated medical officer (DMO)

The designated medical officer (DMO) is a paediatric consultant that sits within Doncaster and Bassetlaw NHS Trust. The designated medical officer is a strategic role which supports the ICB to meet their statutory health responsibilities for children and young people with special educational needs and Disabilities (SEND).

The DMO alongside the DCO (operational lead) supports health practitioners to meet our statutory responsibilities regarding health advice for children and young people undergoing education, health and care plan (EHCP) statutory assessments ensuring health are meeting the six week timescales.

10.1.8 Designated clinical officer (strategic lead)

Designated clinical officer (strategic lead) is a new role within Doncaster and is in post in September 2022. The designated clinical officer (strategic lead) sits within the South Yorkshire Integrated Care Board (ICB) and is a strategic role.

10.1.9 Clinical staff

Clinical staff are responsible for:

  • following the appropriate steps in this policy and informing the team manager or leader where necessary of any issues that impact on the delivery of care as defined within this policy
  • reporting any breaches in relation to this policy

10.2 Monitoring arrangement

10.2.1 Area for Monitoring, Key performance indicator (KPI) of % of appropriate health information provided within 6 weeks of the request received, greater than 95%

  • How: SystmOne reporting.
  • Who by: Data warehouse.
  • Reported to: South Yorkshire Integrated Care Board (ICB).
  • Frequency: Monthly.

10.2.2 Area for Monitoring, KPI activity, number of requests broken down into; high, medium and low

  • How: SystmOne reporting.
  • Who by: Data warehouse.
  • Reported to: South Yorkshire Integrated Care Board (ICB).
  • Frequency: Monthly.

10.3 Appendix C Definitions and explanation of terms used

Definitions
Term Definition
CYP Children and young people
DCO Designated clinical officer
DMO Designated medical officer
EHCP Education and health care plan
Learning difficulties The term ‘learning disability’ has been established for a number of years and many services still use this term. However, the term ‘Intellectual Disability’ is currently gaining favour as the preferred term by health professionals, but it is not consistently used (the association for child and adolescent mental health)
ICB South Yorkshire Integrated Care Board (ICB)
MDT Multidisciplinary team
SEN Special educational need
SENCo Special educational needs coordinator
SEND Special educational need and disability
RDaSH Rotherham, Doncaster and South Humber

10.4 Appendix D SEN health assessment report in SystmOne

SEN health assessment report in SystmOne

10.5 Appendix E Process for low and medium health advice, designated clinical officer (DCO) input

  1. Following decision by the LA to proceed with an EHC statutory assessment, SEN department (DMBC) send an email to Child Health advising that the education and health care statutory assessment (EHCP) assessment is going ahead, attaching a health advice letter with all required information on. The email will state health level, deadline date and services information is to be requested from.
  2. Child health input the letter into the Child’s SystmOne Records and tasks child health (CH) clerk responsible for that area. Clerk responsible for that area requests advice using drop down box on tasks from SystmOne, then lets the operational DCO know. Child health only request advice from physiotherapy, occupational therapy (OT), speech and language (SALT).
  3. Operational DCO receives email and inputs into designated clinical officer template on SystmOne and adds to the waiting list with the deadline date.DCO advises CH clerk whether DCO or Designated medical officer (DMO) is dealing with request.
  4. Operational DCO reviews SystmOne records and contact families to establish which health services are currently involved. Op DCO documents on designated clinical officer template within SystmOne. Operational DCO tasks services involved requesting advice within 6-week timescale, sends out template and supports professionals with completion if required.If no health services are involved, Operational DCO needs a universal health statement as the response.’ X’s health needs have been screened and contact made with their family. X does not have any health needs over and above those normally met by universally available health services. There are no special educational needs arising from health needs.’
  5. By week 4 to 5 operational DCO contacts services involved if advice not received to advise of the upcoming deadline date.

10.6 Appendix F Process for High health advice- designated medical officer (DMO) input

  1. Following special educational needs (SEN) panel, SEN department send email to child health (CH) advising education and health care plan (EHCP) is proceeding, deadline date, health level and requests for advice from any particular services.
  2. Child health forward email to designated clinical officer (DCO) and task clerk responsible for that area. Child health attach letter to child’s SystmOne record. Clerk for child’s area-request health advice from physiotherapy, occupational therapy (OT), speech and language (SALT) Child health to inform DCO on System One which services have been requested.
  3. DCO completes designated clinical officer template on SystmOne. High health advice requests are sent to the paediatrician to complete health advice. DCO emails request to beverley.jones1@nhs.net, for attention of paediatricians. DCO informs Beverley Jones if any specific advice was requested by SEN department.
  4. DCO places child in Paediatrician’s completing advice waiting list. No further action needed by DCO until draft is issued.
  5. Paediatrician’s personal assistant (PA) prints off request and requests medical records or notes. Request is dictated by the Paediatrician via a telephone assessment and reviewing of records or notes.
  6. PA types up the report and emails to SEN department. If child health informs administration that any reports are ready they are also sent. The PA will send any late reports if child health inform that they are ready. The PA updates the spreadsheet with completed advice and attaches medical advice to child’s SystmOne records.

10.7 Appendix G Children’s care group flowchart to support entry into the local authority SEND pathway

  1. Special educational need disability (SEND) suspected following a health assessment.
  2. Health practitioner to discuss findings with parents and carers and obtain consent to discuss with other agencies and refer for further assessment and support.
  3. Health practitioner can be lead professional on the ‘assess, plan, do and review’ process (engaging with family and other services involved to gather a full picture). Lead professional to complete two termly cycles of support plans.
  4. if another agency is the lead professional, they can contact SPOC on 03000218997, to request health information from health visitors and school nurses or special school nurses.
  5. Lead practitioner to collect all information together to request a general development assessment (GDA) and submit the request.
  6. Lead professionals:
    • early years’ service, for children aged 0 to 5 years
    • health visitor, if child is not in early year’s provision
    • school(SENCO), for 5 to 19 years or pastoral lead in special schools
    • school nurse and special school nurse, for home educated children and if school does not support referral
  7. Does the child need referral to other agencies?
    • early help or stronger families, 01302734110 or complete the form through the red button on the DSCP website “concern about a child”, parents can self refer
    • speech and language therapy and audiology: Complete the child health referral form in letters on SystmOne admin to task to child health
    • occupational therapy, complete the child health referral form on SystmOne as above, you can refer to occupational therapy prior a GDA assessment, for sensory profiling
    • children’s sleep charity, 01302751416, parents can self refer for support with sleep issues

10.8 Appendix H Good quality health advice

The purpose of a statutory assessment of special educational needs under the Children and Families Act 2014 is to gain a clear picture of the child as a whole person in terms of educational and social strengths as well as educational weaknesses and difficulties.

Good quality health advice is vital to developing EHC plans that support children and young people to achieve. Good quality health advice should be based on the child and young person’s aspirations, it should clearly state their needs and what provision is needed to achieve their outcomes.

10.8.1 Health Advice should be clear, accessible and specific

Good quality health advice structure

Health advice should:

  • provide advice about outcomes relevant for the child or young person’s age and phase of education, and strategies for their achievement. Indicate clearly, outcomes relevant for the child and young person’s age and phase of education and strategies of any future health care and provision which needs to be provided or specially. commissioned by the health authority
  • include the child’s and young person’s needs, strengths and have clear outcomes
  • be coproduced with the child’s parents and the young person
  • be limited to the professionals areas in which they have expertise
  • be provided within six weeks unless personal exceptional circumstances affect the child, young person or parents
  • not be influenced by consideration of the name of a school at which the child and young person might eventually be placed. Specific schools must not be suggested
  • be written in a manner which will be easily understandable to parents as well as to the other professionals involved in the assessments
  • clearly state if there are no medical factors that appear to be affecting a child’s performance at school
  • where possible use layman’s language or explain any specific medical terms which are used
  • where a child or young person is not known to health services and there is no evidence of a relevant specialist health need this should be clearly articulated with agreed reference to universal services
  • give detail of any medical diagnoses and a brief description on what the diagnosis means
  • if training is required, state who will provide the training and when it will be reviewed
  • detail the health care needs which relate to the child or young person’s special educational needs and be commented on. You may also specify health care needs not related to the child or young person’s special educational needs
  • include if appropriate, a parent’s submission of reports from non-NHS practitioners if they wish (independent health advice)
  • include new assessments-where it is agreed a new medical assessment is required this should be organised as soon as possible to ensure this is carried out within the timescale, supported by a mechanism to ensure this can happen
  • include shared advice, where a child has a number of health professionals involved in their care the EHC plan process should include a mechanism to make sure that the health needs are considered holistically, rather than in isolation
10.8.1.1 Outcomes
  • Must be personal and not expressed from a service perspective.
  • Must not be a description of the service being provided.
  • Should set out what needs to be achieved by the end of a stage or phase
  • Must be SMART:
    • specific, the outcome should be a clear and easily understood statement
    • measurable, it should be clear how the outcome will be achieved and measured
    • achievable, is it informed by CYP and families views, and professional views of evidence-based practice, and the resources available
    • realistic, it should clearly state how the outcome supports the CYP and family aspirations
    • time bound, it should clearly state when the outcome should be achieved, each outcome needs to say when it will be achieved by

10.9 Appendix I Doncaster special education needs and disability (SEND) strategy

Document control

  • Version: 1.2.
  • Unique reference number: 1014.
  • Approved by: Clinical policies review and approvals group.
  • Date approved: 20 February 2024.
  • Name of originator or author: Designated clinical officer and nurse consultant.
  • Name of responsible individual: Executive director of nursing and allied health professionals.
  • Date issued: 23 February 2024.
  • Review date: November 2024.
  • Target audience: Staff working within the trust who work with children and young people (0 to 25) with special educational needs (SEND).

Page last reviewed: April 30, 2024
Next review due: April 30, 2025

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