MJ article: Unravelling the knot of education, health and care plans

This blog has been adapted from our article originally published in The MJ.

Barely a week goes by without another headline about the increase in demand for Education, Health and Care Plans (EHCPs) and the extraordinary pressure this is putting on local High Needs systems. (Use of the term ‘High Needs’ covers children with special educational needs and disabilities or SEND, children in alternative educational provision, and children who have been excluded from school.)

Some councils are facing cumulative deficits of over £80 million as a result. Perhaps what is even more extraordinary is that – despite the ever-increasing levels of demand and cost – many parents of children with SEND describe a constant battle to get the support they need, and are often deeply dissatisfied with the responses they receive across the High Needs system.

The 2014 SEND reforms are often cited as being behind the rise in demand and cost, as they changed the upper age limit for ECHPs from 18 to 25. Overnight, this increased the number of young people who could be subject to an EHCP, but without providing any additional funding.

But while the reforms clearly had an significant impact on EHCP numbers, they don’t tell the whole story.

1. Parents feel they have to battle for the support they need. This challenge was endemic across SEND before the 2014 reforms, was not addressed by them, and has intensified since.
2. The system is too often deficit-based rather than strength-based. Parents are often told to describe their ‘worst day’ with their child as part of the assessment process – setting an expectation that their child will be seen as a “challenge”, rather than grounding initial analysis around both a child’s needs and (more importantly) their strengths and longer-term aspirations. This can create a lack of confidence in the system and often results in an adversarial culture.
3. The move towards academisation has led to the fragmentation of the education system. In many areas the push towards academisation led to the belief, politically, that local authorities would no longer need to play a leadership role in education. But listen to sector experts – the local authority must play a key systems leadership role in developing a shared ambition for children with schools and other settings.
4. Where the link between local authorities and schools has been broken, some schools no longer automatically see themselves as part of a local strategic group. Many such schools are linked to national Multi-Academy Trusts with limited footprints in a local area. I am not implying that academisation is wrong or the sole cause of this situation – but there have been no clear governance proposals to fill this gap. The councils that have managed demand well are those that have continued to influence and work in partnership with their local schools, with shared value being clear on both sides.
5. The removal of the Early Intervention Grant meant that support could only be accessed (without payment) by gaining a statutory assessment. This was an unintended consequence of academisation, as this fund was used to provide early behaviour support and Educational Psychology input to reduce escalation of need. Removing it created the default of a EHCP plan resulting in more resources being available.
6. As spending gets more out of control, rationing inevitably begins to take place. This has often been the default response rather than it leading to a comprehensive analysis of how the system could (and should) be re-balanced in a sustainable way.
7. There is no strong framework for understanding need in a holistic way. As a result, it is extremely difficult to confidently match need with the right provision, at the right time and for the right length of time. EHCP’s are narrative-based, too focused on a diagnosis and miss an individual’s broader strengths. They also do not provide tangible analysis of the level of need and how to meet it.
8. Once support is finally achieved, reducing or changing it feels like a huge loss. Nationally, only 0.5% of EHCPs end because needs are met, which poses a question about what they are for. Support, provision and intervention should be focused on maximising independence at all levels and on tangibly reducing needs. The lack of a clear ambition in the system around this is a fundamental problem.

The crisis in High Needs is growing and will continue to grow unless there is change. It is crucial that the incoming SEND reforms are delivered and that they are delivered well.  Without action, more children and families in the High Needs system will be let down – and they deserve better.