Education Health And

CONFIDENTIAL [OFFICIAL-SENSITIVE]

Education Health and Care Plan Name:

Pupil Name: SEND14_EHCP_Template_v7.18 Page 1 of 15 CONFIDENTIAL [OFFICIAL-SENSITIVE] Firstname’s Surrey Education, Health and Care Plan

Version: Draft or Final: Draft Date Original EHCP: Amendment 1: Amendment 2: Amendment 3:

Section A IMPORTANT INFORMATION page x

EDUCATION HEALTH CARE

NEEDS Section B Section C Section D page x page x page x

OUTCOME Section E Section E Section E S page x page x page x

PROVISION Section F Section G Sections H1, H2 page x page x page x

Section E MONITORING page x

Section I PLACEMENT page x

Section J PERSONAL BUDGET page x

Section K ADVICE AND INFORMATION

Pupil Name: SEND14_EHCP_Template_v7.18 Page 2 of 15 CONFIDENTIAL [OFFICIAL-SENSITIVE] page x

Who has been included in writing Firstname’s plan

Firstname’s Key Information

Family Name: First Name: Known as: Date of birth: Gender: NHS/NI/ICS/other registration numbers: Parent/carer names:

Who has parental

responsibility?: LAC status: Siblings: Contact address for child or young person: Contact addresses for parent/carers: Telephone: Mobile: E-mail: SEND Case Worker Name and Email Year group: Placed out of year: Ethnicity: First language: Language used at Religion: home: Main communication method: Language interpretation support needed: GP Name and contact details: Current consultant(s) details: Other practitioners who are/have been involved (Name, email, telephone): Times that are difficult for me or family to attend appointments: Barriers that might make it more difficult for me or family to attend Pupil Name: SEND14_EHCP_Template_v7.18 Page 3 of 15 CONFIDENTIAL [OFFICIAL-SENSITIVE] appointments: Other relevant plans: Other useful information:

Pupil Name: SEND14_EHCP_Template_v7.18 Page 4 of 15 CONFIDENTIAL [OFFICIAL-SENSITIVE] One Page Profile

Date Completed Completed by

Pupil Name: SEND14_EHCP_Template_v7.18 Page 5 of 15 CONFIDENTIAL [OFFICIAL-SENSITIVE]

Firstname’s story – play, health, schooling, independence, friends and relationships, further education, future plans.

Firstname’s family’s story

More information on how to support Firstname and his/her family

Firstname’s aspirations

Firstname’s family’s aspirations for him/her

How Firstname’s and his/her family have taken part in this plan

Pupil Name: SEND14_EHCP_Template_v7.18 Page 6 of 15 CONFIDENTIAL [OFFICIAL-SENSITIVE] Special educational needs

Summary of main special educational needs

More detailed information:

Communication and Interaction

Strengths and achievements 

Special Educational Needs 

Cognition and Learning:

Social, Emotional and Mental Health:

Sensory and Physical:

Pupil Name: SEND14_EHCP_Template_v7.18 Page 7 of 15 Educational Outcomes

Educational Provision

Educational Outcomes sought for the child Educational Provision required to achieve or young person (Section E) Outcome (Section F) Communication and Interaction

Cognition and Learning

Social, Emotional and Mental Health

Sensory and Physical

Curriculum

Provision Health needs

Health needs which relate to the child or young person’s special educational needs

Non-educational health needs

Health Outcomes

Health Provision (Including support, therapies, equipment, specialist services)

Health Outcomes sought for the child or young Specific Health Provision (Section G) person (Section E) Social care needs

Social care needs which relate to the child or young person’s special educational needs, or social care needs which require provision for Children and Young People under 18 under Section 2 of the Chronically Sick and Disabled Person Act (CSDPA)1970

Needs related to child or young person’s special educational needs

Needs in relation to the CSDPA1970

Social care needs (with consent if appropriate) which do not relate to child or young person’s SEND CONFIDENTIAL [OFFICIAL-SENSITIVE]

Social Care Outcomes

Social Care Provision

Outcomes for social care needs which relate to Social Care Provision (Section H1) Firstname’s special educational needs or disability (Section E)

Additional Social Care Provision not provided under Section 2 of the CSDPA

Outcomes for social care needs which do not Social Care Provision (Section H2) relate to Firstname’s special educational needs or disability (Section E) CONFIDENTIAL [OFFICIAL-SENSITIVE]

What are the arrangements for monitoring and reviewing Firstname’s progress towards achieving his/her outcomes?

A planning meeting should be arranged with CYP and his/her parents/carers in order to set shorter term targets and agree monitoring and review arrangements. These targets should be reviewed regularly to ensure that CYP remains on track to achieve the outcomes specified in their plan in line with their aspirations.

EHC plans must be reviewed as a minimum every 12 months. The first review must be held within 12 months of the date when the EHC plan was issued, and then within 12 months of any previous review. At the review meeting outcomes must be reviewed in line with Firstname’s aspirations. Consideration should be given to reviewing an EHC plan for a child under 5 at least every 3 to 6 months to ensure that the provision continues to be appropriate.

Firstname’s plan will be maintained until such time that he/she no longer requires the special educational provision specified in the EHC plan

Education placement (only to be completed in final EHCP)

Name and type of school Name: Address:

Contact number:

CONFIDENTIAL [OFFICIAL-SENSITIVE]

Firstname’s personal budget (if requested)

Has a personal budget been agreed for any Yes/No educational, Health and Care needs in this plan?

This section should provide, where requested, detailed information on any personal budget that will be used to secure provision in the EHC Plan.

It should set out the arrangements in relation to direct payments as required by Education, Health and Social Care Regulations

The Special Educational Needs and Outcomes that are to be met by any direct payment must be specified.

What need What What will Funding is being outcome is be By Cost Arrangements addressed? being provided? Whom? (£) (see Key) addressed?

Education

Health

Key: DP – Direct Payment NB – Notional Budget TPA – Third Party Arrangements CONFIDENTIAL [OFFICIAL-SENSITIVE]

Advice

The following advice and information was collected during the EHC Needs Assessment

Statutory Advice Author Date Received CONFIDENTIAL [OFFICIAL-SENSITIVE]

Who can Firstname’s plan be shared with?

This plan must not be disclosed without the consent of the child’s parent or, where the young person is over 16, the young person, except for statutory purposes or in the interests of the child or young person. Full list of statutory purposes is included in the SEN Code of Practice and should be shared with parent/pupil at the point of referral.

Sign off Name: Role/organisation Signature Date

North-West South-West North-East South-East SEN team SEN team SEN team SEN team Quadrant Court Quadrant Court Esher Local Office Consort House 35 Guildford Road 35 Guildford Road Elmbridge Civic Centre 5-7 Queensway Woking Woking High Street Redhill GU22 7QQ GU22 7QQ Esher RH1 1YB

KT10 9SD

Reigate and Woking, Surrey Epsom and Ewell, Guildford, Waverley Banstead, Tandridge, Heath, Runnymede Elmbridge, Spelthorne Mole Valley Post - 16 SEN Team All Areas Quadrant Court 35 Guildford Road Woking GU22 7QQ