Choose an item.

’s

Education, Health and Care Plan (version 4)

I like to be known as:

Forenames / Surname
DOB / Student ID
Click here to enter a date.
Date of Summary

1

Document Control v1.2

Personal information

Surname
Other names
Likes to be known as
Gender
First Language
Date of Birth / Click here to enter a date.
Home address
Parents / Carers
Home address
Home number / Mobile number
Email address
Name(s) of Person(s) with Parental Responsibility
Emergency Contact
GP (Name and Address)
NHS Number
Primary SEN / Secondary SEN

SECTION A

My One Page Profile

SECTION A:

Parents/Carers Views

What is important to your child

What is important for your child

What are your concernsabout your child at the moment

What are your hopes for your child in the future

SECTION B

My Special Educational Needs

Background Information

Communication and Interaction
Strengths
.
.
Special Educational Needs
.
.
Cognition and Learning
Strengths
.
.
Special Educational Needs
.
.
Social, Emotional and Mental Health Needs
Strengths
.
.
Special Educational Needs
.
.
Sensory and/or Physical Needs
Strengths
.
.
Special Educational Needs
.
.

SECTION C

My Health Needs related

Summary of Needs
.
.
.
.
.
.
.
.

SECTION D

My Social Care Needs

Summary of Needs
.
.
.
.
.
.
.
.

SECTIONS E AND F

My Support Plan

My Outcomes and Special Educational Provision

Communication and Interaction
Outcomes
Provision required to achieve the outcome / Provided by who and by when
.
.
.
.
Cognition and Learning
Outcomes
Provision required to achieve the outcome / Provided by who and by when
.
.
.
.
Social, Emotional and Mental Health
Outcomes
Provision required to achieve the outcome / Provided by who and by when
.
.
.
.
Sensory and/or Physical
Outcomes
Provision required to achieve the outcome / Provided by who and by when
.
.
.
.
Provision / Support
Monitoring Arrangements
Arrangements for the review of this plan will be co-ordinated by ’s educational establishment (school/setting).
Reviews must be undertaken in partnership with and hisher parent(s), and must take account of their views, wishes and feelings, including their right to request a Personal Budget. It is expected that is prepared for, and involved in, the review in an appropriate way suited to hisher needs. may wish to bring examples of how heshe has progressed towards the outcomes.
The first review will take place within a year (6 months if under 5) of the issue of this EHC Plan. If under 5 reviews will continue to take place every 6 months until the child reaches 5 years of age when they will become annual.
The review will:
  • focus on ’s progress towards achieving the outcomes specified in Section E
  • gather and assess information so that it can be used by ’s educational establishment to support hisher progress and access to teaching and learning
  • review the special educational provision made for and its effectiveness in ensuring access to teaching and learning and good progress
  • review the health and social care provision made for and its effectiveness in ensuring progress towards outcomes
  • consider the continuing appropriateness of the EHC plan in the light of ’s progress during the previous year or changed circumstances and whether changes are required, including any changes to outcomes, enhanced provision, change of educational establishment or whether the EHC Plan should be discontinued
  • set new interim targets for the coming year and, where appropriate, agree new outcomes
  • review any interim targets set by the early years provider, school or college or other education provider
The following professionals should be invited to the review; SENCo or representative from ’s educational establishment, SEND Key Worker, Educational Psychologist, (Specialist Teacher for the VI / HI / AOT, Speech Language Therapist, Occupational Therapist, Physiotherapist) Paediatric Consultant, Social Worker or a representative(s) and any other professionals ’s parents would like to be invited or who are deemed appropriate to enhance planning and provision.
The review of the EHC Plan should include the review of any existing Personal Budget arrangements, including the statutory requirement to review any arrangements for direct payments.
All reviews taking place from Year 9 at the latest and onwards must include a focus on preparing for adulthood, including employment, independent living and participation in society.

SECTION G

My Health Care Provision

Health Care Provision
Outcomes
Provision required to achieve the outcomes / Provided by who and by when
.
.
.
.

SECTION H1

My Social Care Provision

Section H1 of the EHC plan must specify all services assessed as being needed for a disabled

child or young person under 18, under section 2 of the CSDPA

Social Care Provision
Outcomes
Provision required to achieve the outcomes / Provided by who and by when
.
.
.
.

SECTION H2

Any Other Social Care Provision

Section H2 must only include services which are not provided under Section 2 of the CSDPA.

Social Care Provision
Outcomes
Provision required to achieve the outcomes / Provided by who and by when
.
.
.
.

SECTION I

Education Placement

Name of Setting:

Type of Setting:

SECTION J

Personal Budget Details

Personal Budget Amount
Direct Payment Amount
Virtual Budget Amount
Signed By

SECTION K

Plan Advice and Information

Date of previous plan/statement / SEND Key Worker

Advice and Information Gathered

These are the people who have been involved in my Plan

Advice / Title / Name / Role / Date
A - Individual’s views
Parental views / Click here to enter a date.
Click here to enter a date.
B - Educational advice / Click here to enter a date.
Click here to enter a date.
C - Medical advice / Click here to enter a date.
Click here to enter a date.
D - Educational Psychology advice / Click here to enter a date.
E - Social Care advice / Click here to enter a date.
F - Other advice / Click here to enter a date.
G - Advice obtained since the last assessment / Click here to enter a date.

SECTION L

Agreeing the Plan

This EHC Plan was completed onClick here to enter a date.

Name / Signature / Date
Duly Authorised Officer / Click here to enter a date.
Name / Signature / Date
Child/Young Person or their representative / Click here to enter a date.
Parent/Carer / Click here to enter a date.

Note: The lack of signature from a parent or child/young person does not invalidate the EHCP or mean that it does not have legal standing. The only person who is required to sign the EHCP is the Local Authority Officer responsible for signing off the Final Plan.

In accordance with Section 37 of the Children and Families Act 2014 and Regulations 11 and 12 of the SEND Regulations 2014 this EHC Plan is made by Staffordshire County Council in respect of the child, whose name and other particulars are set out above.

1

C/YP’s name and DOB