Health & Social Care in an EHCP

We usually focus on the education part of Education, Health and Care Plans, but in this blog we are turning our attention to health and social care. 

The Health and Social Care Sections in an EHCP are:  

C – Health Needs 

D – Social Care Needs 

G – Health Provision 

H – Social Care Provision 

Health sections must be agreed by the responsible commissioning body (usually the integrated care board) not the Local Authority. Once health care provision is agreed and specified in Section G of the EHC plan, it is the legal duty of the responsible commissioning health body to arrange it. This is set out in section 42(3) of the Children and Families Act 2014.

Social care needs and provision will be identified via a social care assessment and provision set out inSection H1 and H2 must be provided by your local authority.

Does Health and Social Care Ever go in Sections B and F (the education sections)? 

The short answer is yes! Health and social care needs and provision can sometimes be treated as educational provision. When this is the case, the needs are detailed in Section B (rather than C or D) and the provision is detailed in Section F (rather than G or H). 

Health and social care needs are treated as a special educational need when they relate to education or training for the child or young person (Section 21(5), Children and Families Act 2014). 

Health and social care provision is treated as special educational provision when it provides education or training for the child or young person (SEND Code of Practice 2015, paragraphs 9.73–9.74). 

Common examples of this include Speech and Language Therapy and Occupational Therapy needs and provision. These are considered educational needs and provision, and must be included in Sections B and F of an EHCP. Key case law is X & Anor v Caerphilly County Borough Council & Anor [2004] EWHC 2140 (Admin) at [19], which states that “Speech and Language Therapy should normally be regarded as educational provision unless there are exceptional reasons for not doing so”. 

What Can I Do if I Am Not Happy with Health or Social Care in an EHCP? 

Health and social care needs and provision in an Education, Health and Care Plan can be appealed at the First-tier Tribunal in conjunction with an educational element of the EHCP (Section B, F and/or I). 

However, the Tribunal can only make non-binding recommendations for health and social care rather than legally binding orders. When Tribunals make recommendations, local authorities and health commissioners rarely ignore them, as this would be likely to result in a successful Judicial Review. 

If the health or social care needs or provision educate or train and have been omitted from Sections B and F, they can be directly appealed to the First-tier Tribunal as an educational element. 

Understanding whether health and social care provision belongs in the education sections of an EHCP (B and F), the health sections (C and G), or the social care sections (D and H) is complicated, and you are likely to need professional support to understand this. 

For more information on appealing the contents of an EHCP, please see this blog. 

For more details on the key health and social care sections of the EHCP see below: 

Section C – Health Care Needs - This section is for the identification of health care needs that relate to a child’s SEND (see SEND Regs 2014 (12)). The Integrated Care Board (ICB) may also choose to specify other health care needs that are not related to the child or young person’s SEN (for example, a long-term condition that might need management in a special educational setting), but this is not legally required. 

Section D – Social Care Needs - This section is for the identification of social care needs that relate to a child’s SEND (see SEND Regs 2014 (12)). The local authority may also choose to specify other social care needs that are not linked to the child or young person’s SEND, but this is not legally required. 

Section G – Health Care Provision - Section 37 of the Children and Families Act 2014 states that Section G must specify any health care provision reasonably required by the learning difficulties or disabilities that result in the child or young person having SEN. 

Health care needs, such as routine dental check-ups, are unlikely to be reasonably required (paragraph 9.69 of the Code of Practice). 

Provision must be detailed and specific and should normally be quantified, for example, in terms of the type of support and who will provide it.   

The LA and ICB may also choose to specify other health care provision reasonably required by the child or young person that is not linked to their learning difficulties or disabilities, but which should be co-ordinated with other services in the plan. 

The health care providers must agree to the provision and fund it (Section 42(3), Children and Families Act 2014). 

Section 42 of the Act and paragraph 9.141 of the Code set out the duties on the health service to maintain the health care provision in the EHC plan. 

Section H1 – Social Care Provision - Section 37 of the Children and Families Act states that Section H1 must specify any social care provision required from social services under the Chronically Sick and Disabled Persons Act 1970, and/or reasonably required by the learning difficulties or disabilities that result in the child or young person having SEN. 

Section H2 – Social Care Provision - Section H2 must include only services that are not provided under Section 2 of the Chronically Sick and Disabled Persons Act 1970. 

This is likely to include provision identified through: 

• early help 

• children in need assessments 

• safeguarding assessments for children 

The local authority may also choose to specify in Section H2 other social care provision reasonably required by the child or young person that is not linked to their learning difficulties or disabilities, such as: 

• child in need plans 

• child protection plans 

• provision meeting eligible needs set out in an adult care plan, where it is unrelated to the SEN but appropriate to include in the EHC plan. 

For further detail on EHCPs please see this blog. 

If you require additional support, find out how Empowering Families of Children with SEND can help you here. 

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For more information about how Empowering Families can help you, email admin@empoweringSENDfamilies.co.uk  

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