Health views

When the local authority receives a request for an Education, Health and Care (EHC) needs assessment, it may ask health services to provide existing information about health care provision made for the child or young person.

As part of the EHC needs assessment, we may ask health colleagues to give statutory advice about health care provision reasonably required by the learning difficulties or disabilities which result in the child or young person having special educational needs.

What happens when a health need is identified for a child or young person with SEND?

Health clinicians who are asked for advice will write a report about the child or young person. In the report they will specify the health needs or provision which must be included in the Education, Health and Care (EHC) plan. The EHC plan coordinator will write this into Sections C and G of the plan which is called "Health Needs and Health Provision".

If a health need educates or trains a child or young person for example - speech and language therapy or occupational therapy, it must be written in Section F, which is called "Special Educational Provision", of an EHC plan.

For the majority of children and young people with special educational needs and/or disabilities (SEND), the needs or provision stated which relates to their health needs can be met by services already in place and a decision about the health provision in the EHC plan is then requested from the clinicians working for the health service provider.

If what is needed to meet the health needs of the child or young person is outside of the core commissioned services, for example, what is usually provided, the relevant Integrated Care Board (ICB) must agree to this provision being made.

What if the health needs identified cannot be met by services which already exist?

There will be times when a child or young person with SEND requires additional health provision (more provision than is normally provided).

It would be expected that the assessments and recommendations for this are made by clinicians from commissioned services. These clinicians have the appropriate skills, knowledge and competency to assess and identify the health provision needed to help the child or young person.

Requests for specific provision must be in line with what is called "sound evidence". Sound evidence is, for example, guidance from The National Institute for Health and Care Excellence (NICE) which provides advice to improve health and social care across England. This means that what is being asked for is something which a health professional from an NHS service agrees is appropriate.

How is this additional health provision approved?

When there is a need for additional health provision, the responsible Integrated Care Board (ICB) must look at all the information and then make a decision. The responsible ICB needs to agree to the additional provision in order for it to be given and show this by "signing off" the EHC plan.

The responsible ICB must also justify why a decision to give additional health provision has been made or refused before the final plan is issued. View the Flow Chart (PDF) [57KB]

Once the responsible ICB has agreed to this additional health provision, they have a duty to arrange and commission the required services and it will be shown in Section G of the child or young person's EHC plan.

In most cases it will be Norfolk and Waveney Integrated Care Board who decides which services it will provide to meet the reasonable health needs of the children and young people with SEN or disabilities for whom it is responsible. 

If the child or young person is not registered with a GP, the responsible ICB will be the one where their local GP practice is a member.

In the case of looked after children, the responsible ICB will be determined by the GP practice where the child or young person (aged 0-18) was registered just before or at the time of being accommodated.

Some health services are commissioned from and are the responsibility of NHS England. These include some of the most highly specialist services required to support children with disabilities and complex needs. These services are best delivered through a small number of centres of excellence, ensuring health professionals maintain their skills and expertise.

Find out more about health services for children and young people with SEND in Norfolk.

Quality assurance of health advice

All health providers submitting advice to the local authority will be expected to use the Suffolk Norfolk Quality Checklist Tool (Word doc) [120KB] to audit a 20% sample twice a year and submit results to the Designated Clinical Officer for SEND.

LA request for existing information

Existing information helps the LA decide whether or not to carry out an EHC needs assessment.

When NHS commissioned health organisations and the practitioners who work for them in Norfolk receive a request for existing health information from us they should follow their own internal process for sending existing information back to the LA.

The existing information should be sent to our SEN Operational Support Team at csehcp@norfolk.gov.uk.

Instructions to return all types of information/advice will also be included in the letter requesting the information/advice. Please read carefully to ensure the information reaches the appropriate email address.

LA request for statutory health advice to inform an EHC needs assessment

When writing advice as part of the EHC needs assessment and plan development process about a child or young person's needs and the provision appropriate to meet them, health colleagues should be clear about:

• The health needs to be met and the outcomes to be achieved
• What type of health care provision is required, who will provide it and how often

Health colleagues can refer to the Norfolk Information for Evidence Writers (PDF) [234KB] for principles and practical advice about writing outcomes-focused advice for EHC needs assessments) and the Guidance for health practitioners inputting into education, health and care plans that relate to health needs, and health provision required to access education (PDF) [57KB] to see a diagram about the process.

We ask health colleagues to use the Norfolk Suffolk Health Advice Form (Word doc) [108KB] to give statutory advice as part of the EHC plan needs assessment process. The Norfolk Suffolk Health Advice form may not be accessible for some users. To request it in an alternative format, please email Nwicb.send@nhs.net.

Statutory health advice for an Education, Health and Care needs assessment should be returned to the SEN Operational Support Team at csehcp@norfolk.gov.uk.

Instructions to return all types of information/advice will also be included in the letter requesting the information/advice.