This Is Important Information About Me

Statutory Education, Health and Care Plan forName: This plan started on: Plan number: This plan will be next reviewed on: Date of last review: This is important information about meThis plan should not be discussed or copied without asking the child/young person or family first. The format of this EHC Plan is under development and will continue to be updated based on learning from implementation, and formally reviewed at least annually. Page 1 My Personal Details Surname Name Preferred Name Home Address Date of Birth Gender Religion Ethnicity Preferred Language NHS Number CareFirst Number Impulse Number UPN NI Number My Parent(s)/ Carer(s)Surname Name Home Address Telephone Number Relationship to Parental Child/Young Person Responsibility Mobile Number (Please ) Yes No Email Surname Name Home Address Telephone Number Relationship to Parental Child/Young Person Responsibility Mobile Number (Please ) Yes No Email Any others with parental responsibility (Please ) Yes No Name Contact details SECTION A: What you need to know about SECTION A: and Parents Views, Interests, Hopes and Aspirations My StoryThis plan should not be discussed or copied without asking the child/young person or family first. The format of this EHC Plan is under development and will continue to be updated based on learning from implementation, and formally reviewed at least annually. Page 2 What people like about me and what I can do well What’s important to me now and in the future How best to support and communicate with me What my parents/carers think is important to me now and in the future SECTIONS B, C, D: My AssessmentSECTION B: Strengths and Special Educational Needs Communication and interaction Strengths and SkillsSpecial Educational Needs Cognition and learning Strengths and SkillsSpecial Educational NeedsSocial, emotional and mental health difficulties Strengths and SkillsSpecial Educational NeedsSensory and/or physical needs Strengths and SkillsSpecial Educational NeedsThis plan should not be discussed or copied without asking the child/young person or family first. The format of this EHC Plan is under development and will continue to be updated based on learning from implementation, and formally reviewed at least annually. Page 3 SECTION C: Strengths and Health Needs Strengths Health Needs SECTION D: Strengths and Social Care Needs StrengthsSocial Care NeedsSECTION E: Outcomes Communication and interaction Long term OutcomeShort term Outcome(s)Cognition and learning Long term OutcomeShort term Outcome(s)Social, emotional and mental health difficulties Long term OutcomeShort term Outcome(s)Sensory and/or physical needs Long term OutcomeShort term Outcome(s)This plan should not be discussed or copied without asking the child/young person or family first. The format of this EHC Plan is under development and will continue to be updated based on learning from implementation, and formally reviewed at least annually. Page 4 SECTION F: Special Educational ProvisionThe Special Educational Provision By Whom (and funding source, where appropriate)SECTION G: Health provision reasonably required by the child or young person as a result of their Special Educational Needs The Health Provision By Whom (and funding source, where appropriate)SECTION H1: Any Social Care provision that must be made for a child under 18 under Section 2 of the Chronically Sick and Disabled Person’s Act 1970 This plan should not be discussed or copied without asking the child/young person or family first. The format of this EHC Plan is under development and will continue to be updated based on learning from implementation, and formally reviewed at least annually. Page 5 The Social Care Provision By Whom (and funding source, where appropriate)SECTION H2: Social Care provision reasonably required as a result of the child or young person having Special Educational Needs The Social Care Provision By Whom (and funding source, where appropriate)SECTION I: Education PlacementSECTION J: Resources Provision in this plan that is eligible to be provided through a personal budget are: Provision Personal Budget Value Direct Payment (Please )This plan should not be discussed or copied without asking the child/young person or family first. The format of this EHC Plan is under development and will continue to be updated based on learning from implementation, and formally reviewed at least annually. Page 6 Yes No Yes No Yes No Yes No Total Personal Budget SECTION K: AppendicesInformation used Who wrote it Date of information Appendix 1 Appendix 2 Appendix 3 Appendix 4 Appendix 5 Appendix 6 Appendix 7 Appendix 8 Appendix 9 Appendix 10 Arrangements for reviewing EHC Plan This must happen at least annually Date of next review: Does the EHC Plan need to be reviewed in conjunction with/informed by another plan? Yes No This plan should not be discussed or copied without asking the child/young person or family first. The format of this EHC Plan is under development and will continue to be updated based on learning from implementation, and formally reviewed at least annually. Page 7 e.g. Care Plan (LAC), Continuing Care Plan (Health) or Adult Care Plan If yes, type of plan: Professionals required at next review: The lead professional responsible for reviewing this plan: Contact details: Plan Coordinator (A duly authorised Officer of the Authority) Name Position Contact details Signature Date This plan should not be discussed or copied without asking the child/young person or family first. The format of this EHC Plan is under development and will continue to be updated based on learning from implementation, and formally reviewed at least annually. Page 8

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