Education, Health and Care Plan Nightmare!

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Helen Woodley

Helen Woodley is a primary trained SENDCo currently working in a large KS1-4 Pupil Referral Unit in the North East of England. She spent 3 years studying Theology in Durham; Helen has worked in a wide variety of special school settings, including all age schools....
Read more about Helen Woodley

Is an ECHP (Education, Health and Care Plan) just an Education Plan?

Last week I decided to tidy my office. It wasn’t untidy by my own standards yet it has been noted that it was looking a little unruly. As I shifted files into their new cupboard, it struck me how much paperwork I had accumulated.

Making an Education, Health and Care Plan (EHCP) request has become a paperwork nightmare and it’s only getting worse.

When I started as a Special Educational Needs Coordinator (SENCo) under the old statement system, making a request was straightforward: educational advice, educational psychologist report, Individual Education Plan (IEP) and anything from anybody else you could think of thrown into the mix for good measure. A request might amount to 20 pages at the most. Once the paperwork was in, I generally got a phone call just to chat about the pupil. I felt that my opinion and professional knowledge stood for something and Special Educational Needs (SEN) then went away and asked other professionals for their knowledge.

Fast Forward, Step Backwards

Jump forward in time and I have become less of a professional and more of a circus animal jumping through an ever increasing range of hoops.

Image: Shutterstock

The 2014 changes started okay in this respect and the system just seemed a bit more formal, with the importance of Health and Care being noticed. Then, almost silently, the word spread that only Education had a statutory role: in reality the EHC had dropped to ‘E’ alone.

Over the last year the hoops have come out in force. Now an EHCP request could stretch to 60+ pages!

Instead of handing reports over that I have in my possession, I appear to be responsible for hounding the NHS and Social Services knowing that I run the risk of a request being turned down for lack of evidence if other professionals do not share their reports. I cannot force them to give me paperwork.

Example Student:

I knew I needed a Child and Adolescent Mental Health Services (CAMHS) report so I called the office and left a message.

Then I called again…

And again…

Then I emailed…

Then called…

When I eventually spoke to someone, they asked me to fax a request to them!

Fax: the MySpace of communication methods.

It took me over 2 months of hassling to get an updated report and all that time I sat watching a young man rapidly deteriorate and had staff feeling frustrated that they felt nothing was progressing. The young man himself was barely holding on and his father was falling apart with the stress of waiting.

So, for the next request, I learnt. I bombarded professionals at every opportunity from TAFs (Team Around the Family) to chance meetings. I was ready and, in order to preempt any hoops being added, I sent into SEN a paperwork heavy request with the full works attached. But it still got turned down and this time for a new reason and added hoop: no TAF notes.

In a rebellious mood, I copied everything that came from the TAF over a year period: illegible handwritten notes and all; 70 pages of them. When I eventually sent the email, the request was over 100 pages long.

Low and behold it was accepted; I doubt anyone read a single extra page I sent. What annoyed me the most was that none of the other professionals in the TAF (and I had named them all) were asked to contribute or chased for their reports.

Schools are the only ones pulling these requests together and the weight of the request is on the SENCo. I totally understand the pressure that CAMHS and others are under; I don’t think for one moment that they like the way things are now. But the simple fact is that SENCos are picking up the pieces; it’s all on the shoulders of schools and that means the EHC plan is a myth: it should be called an E plan.

What To Do

So how would I do it differently? Firstly, I would reinstate the professional judgement of SENCos; I would take their advice seriously and treat their opinions with respect.

Secondly, I would love to see a time when I was called to discuss a case with the SEN panel; some kids are just too complicated to fully express on paper, no matter how many reports you have talking about them, having space for people to ask questions might speed up the process of making a decision.

Finally, I wouldn’t expect schools to do all the leg work chasing other professionals; surely there can be support and additional clout coming from a local authority level?

Sending off an EHC plan request is a logistical nightmare that is too time consuming and paper heavy. Getting one shot at building a case is virtually impossible when you are alone in doing it. The idea of a joint plan was so positive and had so much potential.

In an ideal world I would go for broke: either keep it as an EHC plan and encourage full multi-agency working, or be honest and change the title!

2 thoughts on “Education, Health and Care Plan Nightmare!

  1. All over the country, the nightmare scenarios as exemplified here arise. With my school nurse, we attended an NHS local road show in the Town Hall late last month, in which the local NHS hierarchy presented to a wide audience of education, health and care professionals their take on Multi Agency Sector working. 8 or so presentations dating from the 2015 kick-start were offered as if it was the first time such collaborations had been identified on the to – do list. At the close, I offered our specific anecdote involving a Y11 exclusion (October 2016) giving rise to a CAMHS referral recommended by the local MASH team (early November), and asked why in late March we still did not have an appointment date. The answer was almost kafkaesque – the delay in appointing an NHS professional to lead was entirely our fault, as we should have abandoned the multi agency approach and secured the NHS engagement before anyone else. As if we have a route into that appointment making in the first place. I pressed my case; I was wrong, delays are not happening, and perhaps I’d like to consider listening better and asking fewer questions. The School nurse and I left after the 2 hour conference frankly deeply saddened by our witness of one third of the EHC triumvirate being so far behind the process actually on the ground. Still no date offered that fits everyone’s schedule; I and the parents were happy with an Easter holiday break date, but other interested professionals could not make that date. In my schools submission to the Green paper last autumn, I reported this failure of local MASH working, and we have many more examples to report. Simply, there are insufficient humans and money around to make the multi agency approach to work.

  2. Ultimately the decisions lie in the hands of those who administer and oversee the system who coincidentally are directly linked to the LA purse strings. This often leads to the unofficial whispers between professionals (yes, often SENCos and Heads) about whether or not the process is deliberately sluggish in order to save money. Surely not – well that was most good folks experience going back to before the start of the larger scale education cuts. Indeed, those experiences themselves led to the rise of organisations such as IPSEA striving to support and inform parents/carers about the minefield that was the statement now the EHCP.

    Interestingly, when I started teaching in 1982, I was pushed into a course on what was then referred to as a multi-disciplinary approach to SEN. So, no not a new idea by any analysis. I’ve been involved at various levels with varying responsibilities ever since and the financial argument (i.e. the process is/was deliberately onerous so as to save ever shrinking budgets or staffing) has steadily developed into a strong case well addressed by supporting legal guidance on Tribunals.

    The system is inept. Simple. Despite the current legal framework, with explicit procedures detailed for LAs, the child is not at the centre. There are too many potential opportunities to avoid acting on behalf of the child. Indeed I know of LAs where the EPs have sustained the pressures for too long and have cracked and left to work independently in frustration at their perceived collusion with the administration.

    Look at the rise in Tribunals, the expert legal guidance, external EP reports (which were initially rejected for not being LA EPs), involvement of solicitors, etc. Now, more than ever, the whole thing has become antagonist and is often characterised by waiting for other agencies to contribute or by further pressures on schools to send reports to legal teams to take to Tribunals or Appeals.

    When a system is not working it should be fixed by ALL of the agencies charged with its duty of care. Especially when one considers the values-based approach so proudly affirmed by the NHS, the MASH initiatives and learning from recent CSC reports. Tie this to the ridiculously high number of children excluded who (just happen?) to have SENs and we, quite frankly, don’t have a system.

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