SEND pathfinder programme evaluation: education health and care planning pathway
Special Educational Needs and Disability Pathfinder Programme Evaluation
Thematic Report: The Education, Health and Care (EHC) Planning Pathway for families that are new to the SEN system
Research report
January 2014
Rhian Spivack, Meera Craston, Graham Thom & Christopher Carr – Sqw
Contents
List of figures 3
List of tables 3
Key findings 4
1. Introduction 5
Evaluation of the SEND Pathfinder Programme 5
Rationale for the research 5
Research focus 5
Our approach 6
Intended audience 6
2. The EHC planning pathway 7
The common EHC planning pathway 8
Variations between the pathways across the areas 10
Differences between the EHC planning and SEN Statementing pathways 11
3. Key enablers and challenges 14
Key challenges and enabling factors 14
Contribution to the achievement of the programme objectives 17
Annex A: Glossary of terms 19
Annex B: Research methods 20
Fieldwork 20
Analysis and reporting 20
List of figures
Figure 1 The EHC planning pathway 9
Figure 2 Differences between the EHC planning and SEN Statementing pathways 12
List of tables
Table 1 Main differences between the EHC planning pathways across the thematic areas 10
Table 2 Key challenges and enabling factors 14
Key findings
This report was produced as part of Sqw’s evaluation of the SEND Pathfinder Programme for the Department for Education. It focuses on the ‘planning pathways’ developed in five pathfinder areas, leading to a single, coordinated Education, Health and Care plan (EHC plan). The key learning points, useful to other areas preparing for the SEND reforms were that:
Areas appear to be retaining their previous approaches to eligibility. So those
who were eligible for an SEN Statement are expected to be eligible for an EHC plan
The largest change in eligibility is around 19-25 year olds. As covered in the
legislation, young people in this age band may now be eligible for support
The five pathfinder areas that contributed to the report had developed similar
EHC planning pathways which included common elements and sequencing. The pathways included five stages: referral; considering if an assessment is required; co-ordinated assessment; planning; and sign-off
There are differing approaches to some key elements of the pathway in terms
of: the amount of information that is gathered at the referral stage; the extent of choice a family has over who will be their EHC plan co-ordinator; whether the plan is written by a multi-disciplinary team established on a case-by-case basis (the Team Around the Child (Tac) approach) or drafted by the co-ordinator based on the assessment; how plans are signed-off and approved; and the step down process used for children and young people that were not felt to require an EHC plan, which in some cases meant using the EHC planning template on a non- statutory basis as a means of extending the new way of working to all families
The EHC planning pathway is different to the SEN Statementing process.
There are three main points of difference: there is more emphasis on gathering information from across services at the point of referral; the family is much more involved through the co-ordinated assessment and planning stages; and it produces a plan which is more outcome focussed and family centred, having involved the family much more
There remain a number of challenges in implementing the EHC planning
pathway. Overcoming these challenges will be important to delivering the change envisaged, and pathfinders are identifying possible solutions. They focus around proper co-ordination/co-operation between agencies, and ensuring that the EHC plan co-ordinator has sufficient time to deliver a meaningful plan for each family
The (new) family-centred way of working can lead to better quality plans as it
enables professionals to develop a more comprehensive understanding of the child or young person.
1. Introduction
Evaluation of the SEND Pathfinder Programme
Sqw was commissioned by the Department for Education to lead a consortium of organisations to undertake the evaluation of the SEND Pathfinder Programme. A series of reports from the study are available on the government publications website1. During the course of the research, a number of key issues were identified as requiring more in- depth thematic review. This report focuses on one of these issues – the EHC plan pathway for families that are new to the SEN system.
Rationale for the research
Pathfinder areas developed and trialled early versions of their EHC planning pathways during the first 18 months of the programme. Evaluation of the first phase illustrated that most of the focus had been on families and young people that were already in receipt of SEN services. Areas have since reflected on their experiences and the Draft Revised SEN Code of Practice to refine their pathways to enable them to roll out the approach to families that are new to the SEN system from September 2013. This research aimed to gather some of these experiences and so inform the work of others.
Research focus
This thematic report provides further insight into:
1 https://www.gov.uk/government/collections/send-pathfinders#evaluation-of-the-send-pathfinders
•How have areas defined eligibility for the EHC plan process? And how are the relevant families referred into the EHC plan pathway? Eligibility
• What are the key stages and sequencing of the EHC plan pathway for families that are new to the SEN system? How is this different to the traditional SEN pathway? Key stages
• Which agencies and individuals are responsible for the delivery of each of the stages, how are they involved and why? Professional
involvement
• To what extent are families (parent-carers and children/young people) involved at each stage and why? Family involvement
• How has/will the new pathway contributed/contribute to the achievement of the objectives of the pathfinder programme? Contribution to Pathfinder
objectives
Our approach
Evidence was gathered from five pathfinder areas – Darlington, Greenwich, Southampton, West Sussex and Wigan – via a set of in-depth, face to face interviews. These were held with key individuals involved across SEN, health and social care in developing and delivering both the EHC plan and SEN Statement processes (see Annex B for more detail on research methods). Sqw would like to thank staff and stakeholders in the participating areas for their contribution to the research.
Intended audience
The report is intended to support those charged with the responsibility of developing and rolling out the EHC planning process across SEN, health and social care by September 2014.
2. The EHC planning pathway
The Draft Special Educational Needs (SEN) Code of Practice2 sets out a definition of eligibility for statutory assessment and the EHC plan. It places emphasis on taking children and young people whose needs cannot be reasonably met through their normally resourced local mainstream provision through the EHC planning process. Eligibility for the new process therefore remained largely similar to the existing SEN Statementing process, with one significant difference. This related to an expansion in the age-range covered (now 0-25 years).
Evidence gathered from across the five thematic pathfinder areas confirmed that all had retained their existing eligibility criteria, partly to avoid confusing families and partly to meet perceived Government expectations. They therefore anticipated that all children and young people that would have been previously eligible for an SEN Statement or S139a Assessment would remain eligible for an EHC plan over the short-term.
Looking forwards, a number of the areas intended to use the SEN reforms as an opportunity to significantly improve their non-statutory provision, which it was hoped would reduce the number of families requiring a statutory EHC plan. Improvements were to include wider workforce development to strengthen family-centred and multi-agency working across the children’s workforce.
The recently introduced School Funding reforms3 were also reported to have had an impact on existing eligibility thresholds for SEN statutory services (and therefore
2 Department for Education & Department of Health, 2013, Draft Special Educational Needs (SEN) Code of Practice: for 0 to 25 years: Statutory guidance for organisations who work with and support children and young people with SEN 3 http://www.education.gov.uk/aboutdfe/executiveagencies/efa/fundingallocations/a00215225/school- funding-reform
“A local authority must conduct an assessment of education, health and care needs and prepare an Education Health and Care plan when it considers that it may be necessary for special educational provision to be made for the child or young person through an EHC plan. This is likely to be where the special educational provision required to meet the child or young person’s needs cannot reasonably be provided from within the resources normally available to mainstream early years providers, schools and post 16 institutions.” Draft SEN Code of Practice (October 2013)
“We’re planning on keeping eligibility criteria the same and to just change the process, to ensure it is easy for parent who are anxious about the changes at the moment…” Senior Manager
thresholds associated with the new process). The reforms stipulated the minimum level of SEN-related funding and associated responsibilities that should be delegated to schools, and introduced the ‘high needs block’ of funding that could be used at the local authority’s discretion for needs beyond schools’ resources. Impacts of this change varied by local area depending on their previous funding arrangements. That is, areas that previously delegated a large proportion of funding to their schools had not experienced much change, whereas areas that had only delegated a small proportion of SEN funding to schools witnessed a larger change.
The common EHC planning pathway
Each pathfinder had developed its own EHC planning pathway. Figure 1 presents a common pathway, describing the general approach across the five areas (each area has slight differences, but is delivering within this broad model). It consists of five, usually discrete stages: with ‘referral’ leading to ‘consideration of whether assessment was necessary’, and then to ‘co-ordinated assessment’, ‘planning’ and ‘sign off’.
Figure 1 The EHC planning pathway
Source: Sqw
Request for assessment from young person,
parent, educational setting or other
professional working with family
Existing information/evidence collated
Multi-agency panel or designated LA professional decide whether to conduct
statutory assessment
LA writes to parent/young
people to inform them of
decision
EHC plan co- ordinator gathers professional inputs
to inform assessment
EHC plan co- ordinator undertakes
face-to-face structured discussion
with family
EHC plan co-ordinator collates information into a summary assessment
Multi-agency panel or designated LA
professional decide whether EHC
plan required
EHC plan co-ordinator drafts EHC
Plan signed off at EHC panel or by designated LA professional and issued to parent/carer young person and
Plan sent to professionals to review in advance
of panel
Plan sent to parents/young person
to comment on and
request an educational institution
LA consults governing
body, principal or
proprietor of the educational institution
LA writes to parent/young
person to inform them of
decision (and right to
appeal)
Pathfinders have ‘step down’ process to ensure
needs met without statutory provision
EHC plan co-ordinator writes to parent/young
person to inform them of decision (and right to
appeal)
Pathfinders have ‘step
down’ process to ensure needs met
without statutory
provision
Yes
No
No
Yes
Referral
Consider whether
assessment necessary
Co-ordinated assessment
Planning
Sign off
EHC plan co-ordinator
Variations between the pathways across the areas
Within the common model, a number of tasks were done differently or at different times, as explained in Table 1.
Table 1 Main differences between the EHC planning pathways across the thematic areas
Main differences Description The gathering of information that takes place at the referral stage
As a minimum, the referrer (or the education setting where families self-referred) was required to make a case for an EHC plan
To reduce the need to acquire information at the co-ordinated assessment stage, and so make it more feasible to meet the 20 week deadline, some areas had:
Aligned their early years and school paper work so that it could feed in to the EHC planning process
Insisted on a Team Around the Child (Tac) meeting before referral to gather information to inform the process
Allocation of an EHC plan co- ordinator
Some areas allocated the co-ordinator, while in others it was left to the family to nominate someone
Two approaches to planning - writing the plan
The plan is usually written:
Using a Tac approach
By the EHC plan co-ordinator building on the assessment information, and then discussed with the family
In some areas both approaches were used, with the former reserved for more complex cases. It is too early to say if the different approaches produce plans of differing quality
How plans were signed off
All areas had panels to sign off plans. However, in some areas these were only used for complex cases, with most plans signed off by a designated professional from the local authority
The step down process for children or young people that are not felt to require an EHC plan
All areas offered the equivalent of a ‘Note in Lieu’, which acted as a non-statutory alternative to the EHC plan and set out the reasons why the local authority decided that it was not necessary to undertake an EHC assessment or issue an EHC plan
The ‘Note in Lieu’ acted as a follow on from either the referral stage or the EHC assessment and was issued in the partially completed EHC planning template. This enabled the local authority and the family to continue to develop a non-statutory outcomes-based action plan, which would inform the workings of the relevant education setting and wider services. These notes were expected to be enhanced by the development of the local offer, which would describe services appropriate to those below the EHC planning threshold
Source: Sqw
Consideration of the resource associated with an EHC plan to date tended to focus on SEN (as opposed to SEN, social care and specialist health), and took place at different stages and via different decision making processes across the areas:
Resourcing was considered either before or after the ‘planning’ stage, with
the former resulting in an indicative budget to inform planning, and the latter simply costing the plan following its development
SEN funding allocations were either developed using an existing banded
funding matrix linked to varying levels of need (generally associated with resourcing prior to planning) or via a costing of individual elements in a plan (associated with costing after the plan has been developed)
Sign off of resourcing was considered by a multi-agency panel, at a Team
Around the Child meeting or by a designated senior member of the local authority (for example, an SEN Team Manager)
Where relevant, personal budgets were generally considered separately from
or at the end of the planning pathway. They were mainly sourced from social care and in a small number of cases from SEN, implying that more work needed to be undertaken to broaden the offer (to include social care, SEN and specialist health) and that integration of this form of resources into the wider EHC planning pathway remained in its infancy.
Differences between the EHC planning and SEN Statementing pathways
The new pathways appeared to differ from the previous SEN Statementing process in three main areas, as shown in Figure 2. This included the introduction of more family- centred and holistic elements, which resulted in the development of an outcome-focused and co-produced EHC plan.
Figure 2 Differences between the EHC planning and SEN Statementing pathways
Source: Sqw
Other commonly cited differences between the new and traditional processes included the introduction of:
A single pathway for 0-25 years within SEN – which drew together the previous
SEN Statement and S139a Learning Difficulty Assessments into a single process and set of paperwork and included a new focus on preparing for adulthood
A more efficient process, achieved via…
…Improved communication and information sharing at the outset of the
process - while the SEN Statement process required areas to request new assessments at the outset of the statutory process (often requiring professionals to repeat assessments), the EHC planning process sought to draw on existing information, enabling professionals to rely on recent assessments where relevant
…Reduced duplication for families - EHC co-ordinators often circulated the
family profile (developed at the outset of the process) to professionals undertaking assessments to avoid them asking the same questions
…Reduced bureaucracy - One area had streamlined its process by
bypassing the designated medical officer who had acted as an intermediary for all previous SEN Statement requests4
A more holistic process – the EHC planning
process enabled wider aspects of the child and family’s life to be built in to the assessment and plan, while SEN Statements had been generally confined to the child’s time within the school premises and school day
Increased multi-agency working –some of the
barriers to integrated working had been addressed via the introduction of refreshed multi-agency panels, Team Around the Child meetings and multi-agency training to provide the opportunity for professionals to learn and talk collectively about how best needs can be met and to make joint decisions about resourcing.
4 In this instance the designated medical officer had been based within a different Health Authority to the professionals who needed to undertake the assessments, requiring them to send on the request and then act as a middle-man to receive and pass on the completed assessment. Through the EHC planning pathway, the requests and assessments were now passed directly between the Local Authority and relevant health contacts.
“The EHC planning process provides more room for joined up decision making than the very SEN focused SEN Statementing process” EHC Co-ordinator
3. Key enablers and challenges
Key challenges and enabling factors
Participant areas continued to grapple with a number of challenges, which are detailed below, along with mechanisms being tested to overcome them. In several cases these issues are fundamental to the new process and so it is important that they are considered and addressed in each area.
Table 2 Key challenges and enabling factors
Implication of not overcoming the challenge
Potential solutions
Challenge 1: Ensuring sufficiency and consistency of multi-agency working
The absence of sufficient multi-agency working is likely to limit:
The extent to which cultural change across SEN, specialist health and social care can take place
The ability of EHC co-ordinators to create holistic EHC plans
Any efficiencies that may be delivered across SEN, specialist health and social care, through for example reduced duplication of paperwork
The ability to complete EHC plans within the 20 week timeframe, due to delays caused by insufficient engagement
In addition, the absence of consistent multi- agency working may lead to:
Some families experiencing a more joined up service than others
Variations in the quality and comprehensiveness of EHC plans
Increased levels of strategic and operational commitment to contribute to the new process
Provision of clear guidance to all professionals detailing expectations of how, when and why they should be involved
Creation of ‘champions’ or ‘spearheads’ for individual agencies (and services within these) to act as the point of contact for the EHC planning process
Introduction of proportionate approaches to multi-agency working e.g. use of multi-media to enable capacity constrained professionals to input to meetings
Implication of not overcoming the challenge
Potential solutions
Challenge 2: Resourcing the delivery of a more family-centred process
Insufficient or inappropriate resourcing of the EHC planning process is likely to reduce its effectiveness by:
Limiting the extent to which effective face to
face contact can be made with families
Increasing the dependencies and burden
placed on the workforce
Creation of dedicated EHC co-ordinators
that have sufficient time to undertake the required family-facing elements of the process, which in turn will mean limiting their caseload
Adoption of proportionate approaches to
key working and family engagement based on the complexity of the child or young person’s needs
Challenge 3: Meeting the reduced 20 week statutory timeframe
Failure to meet the 20 week statutory timeframe is likely to result in:
Increased levels of family dissatisfaction
and stress
Increased requests for tribunals
Alignment of early years and school paper
work to enable efficient translation of pre- referral information in to the EHC planning process
Creating efficiencies between agencies
through sharing of assessments and reports
Introduction of proportionate approaches to
multi-agency working, e.g. use of multi- media to enable capacity constrained professionals to input to meetings
Development of integrated resourcing and
funding mechanisms
Challenge 4: Sharing of information between agencies and with families
Inadequate information sharing is likely to limit:
The extent to which different agencies can
work together efficiently
The ability to hold a single ‘live’ version of
the plan
Having the family as the holder of all
information and paperwork and relying on them to give permission and transfer it from place to place
Development of an integrated It system
that enables all relevant professionals and families to access the ‘live’ EHC plan and grants differing levels of permissions for distinct parties to edit the plan
Implication of not overcoming the challenge
Potential solutions
Challenge 5: Increased paperwork i.e. the co-ordinated or summary assessment
The production of a summary assessment, requires:
Additional time to complete
Knowledge to understand how to
summarise the range of assessments in a way all can understand
Providing EHC plan co-ordinators with
sufficient time to draft the summary assessment
Training for EHC plan co-ordinators in
interpreting assessments and drafting in plain English
Challenge 6: Providing a comprehensive and integrated personal budget offer
Failure to offer a comprehensive personal budget offer may limit:
The degree of choice and control that is
offered to families
In addition, failure to integrate the personal budget offer into the EHC planning pathway is likely to:
Increase the complexity of the resourcing
stage of the pathway
Increase the time taken to undertake the
resourcing stage of the pathway
Limit the extent to which multi-agency
planning can take place
Lead to duplication of resourcing across
services
Support and Inspiration – Introducing
Personal Budgets5 sets out an approach to planning the implementation and integration of personal budgets
A fuller exploration of the development and integration of the personal budget offer (into the EHC planning pathway) will be undertaken by Sqw as part of a separate thematic study from April 2014 onwards. Additional mechanisms used to address this challenge will therefore be revisited at a later date
5 http://www.sqw.co.uk/insights-and-publications/support-and-aspiration-introducing-personal-budgets/
Implication of not overcoming the challenge
Potential solutions
Challenge 7: Ensuring all families have the capacity to engage
The EHC plan process can involve significant time and emotional input from families. This can be challenging where:
Families have other priorities and so struggle
to be available in the timeframe expected
Families may struggle to articulate their
issues and so require more time in discussion to draw out what is important
Both issues can impact on the 20 week timetable of the pathway
Again, time needs to be allocated to EHC
plan co-ordinators to allow them to be flexible to family needs
EHC plan co-ordinators also need training in
communicating expectations and flexibilities to families, and in negotiating time with them
Providing independent advice and support
for families
Challenge 8: Negotiating between family members when conflicts arise
The greater degree of family involvement can highlight tensions and difference of opinions between family members. This was reported to be most likely where the plan is for an older young person, as their views can often differ from their parent-carers
Clarity in the Code of Practice about whose
views take precedence when there is a difference of opinion between young people and their parents
Key workers, independent supporters and
EHC plan co-ordinators need to be sure to identify any differences at an early stage, perhaps through taking separate soundings from each member of the family
They also need to have good negotiation
and mediation skills to enable them to conclude an agreed plan
Source: Sqw
Contribution to the achievement of the programme objectives
The new pathway is fundamental to the delivery of a number of the pathfinder objectives. It is providing better opportunities than previously for the process to be rationalised and integrated, both within and across services. These changes can be seen in the new paperwork that is being introduced and in the greater number of points in the pathway when different services come together / input to the plan. This greater involvement of services should lead to more holistic assessment and planning.
Families and children and young people are much more engaged in the process. This changed ethos of the EHC planning process relative to the SEN Statementing process was cited by several of the professionals consulted during the research. They added that the new family- centred way of working had enabled them to develop a more comprehensive understanding of the child or young person and as a result had led to better quality plans.
“Most of the families I have worked with have liked the fact that they can see their child in their EHC plan, which has made them feel less anxious” EHC Co-ordinator
“It was mind blowing to hear how explicit the 13 year old that I was working with was about what he’d like to achieve in the future…” EHC Co-ordinator
“The real child or young person really jumps out of the EHC plan in the new world…so you really get a feel for them in their own context, which would never have been the case previously” Senior Manager, SEN
Annex A: Glossary of terms
EHC plan – Education Health and Care plan
LA – Local Authority
SEN – Special Educational Needs
SEND – Special Educational Needs and Disabilities
Tac – Team Around the Child
Annex B: Research methods
Research was undertaken in five pathfinder areas, selected in discussion with the DfE and Pathfinder Support Team. The basis for selection of the areas included: areas that were working with newcomers to the SEN system; a mix from across the regions; a mixture of rural/urban and large/small areas; at least one pathfinder champion; and areas that were able to contribute to the comparative costs of delivery work6. A call for evidence was also issued to obtain refined EHC planning pathways from across the pathfinder areas, to provide an overview of developments across the programme. Fifteen of the 31 pathfinder areas provided their pathways as part of this call for evidence, which were used to inform the development of the common EHC planning pathway (see Figure 1).
Once the five areas had agreed to participate in the fieldwork, a scoping consultation was held with the pathfinder lead in each area to discuss the research focus and objectives, gain a better overview of the SEN Statementing and EHC planning pathways locally, and identify staff to participate in fieldwork.
Fieldwork
Fieldwork was conducted between October and December 2013, and consisted of area- based consultations with the pathfinder lead and manager, operational managers of professionals from SEN, health and social care, and the professionals delivering the SEN Statementing and EHC planning proceses. Typically, interviews with the pathfinder lead and manager and operational managers were conducted on a one-to-one basis, while professionals delivering the two processes were consulted through group interviews. Between nine and thirteen participants were involved in each case study visit
The interviews followed a topic guide designed by the research team, which covered the five broad research questions outlined on page 6 of the report. Participants were asked to set aside approximately 1-2 hours for the consultations, and interviews were recorded.
Analysis and reporting
The analysis took place in two stages. Firstly, each area ‘case study’ was written up in alignment with the five research questions. Secondly, the research team looked across the five write-ups to explore commonalities and differences in responses across areas and the themes covered by the research questions.
The report was drafted based on these findings, with an emphasis placed on developing a ‘readable’ and pragmatic report, which drew on a range of experiences and would be useful to areas considering how to develop and refine their EHC planning pathway going forwards.
6 Given the interdependencies between the EHCP pathway and comparative cost thematics, we selected one group of five pathfinder areas to take part in both pieces of work.
© Sqw [2014]
Reference: DFE- RR326B
Isbn: 978-1-78105-292-1
The views expressed in this report are the authors’ and do not necessarily reflect those of the Department for Education.
Any enquiries regarding this publication should be sent to us at: angela.overington@education.gsi.gov.uk or www.education.gov.uk/contactus
This document is available for download at www.gov.uk/government/publications
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