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18.1 EHCP blank - Pre 16 (Last Update 28 October 2016)
Blank EHCP - Pre 16Name
Date of Birth
Address
Contact Number
Setting/School/College
NHS Number
Unique Pupil Number
Social Care Reference
Is this child/young person looked after?Full Care Order, Interim Care Order, Section 20 or other
Name of Parent/Carer who has parental responsibilityAddress
Contact Number
Date of Final Plan
Scheduled Review Date
Version Number
(A) Views, Interests and Aspirations
<Child/Young Person’s Name> story, his/her views, interests and aspirations:
<Child/Young Person’s Name> communicates by:
Family story, including their views, interests and aspirations:
Support Network (family and friends)
How has <Child/Young Person’s Name> and her family participated in the development of this plan?
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(B) Strengths and Special Educational Needs
Please describe the needs that have been identified in the EHC Assessment (in priority order for each section where possible) in the following areasCommunication and interaction
Strengths:
Special Educational Needs:
Cognition and learning Strengths:
Special Educational Needs:
Social, emotional and mental health
Strengths:
Special Educational Needs:
Sensory and/or physical needs
Strengths:
Special Educational Needs:
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(C) Health Needs which relate to Special Educational Needs
Please describe the needs that have been identified in the EHC Assessment (in priority order, where possible)
(D) Social Care Needs which relate to Special Educational Needs
Please describe the needs that have been identified in the EHC Assessment (in priority order, where possible)
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(E) Outcomes – Summary
Provision to be provided byRef Outcome
Think long term, ultimate aspirations from YP & Parents.Need to consider these main headings, but use and amend as appropriate.
NB the PFA outcomes listed below E1, E2, E3 and E4 MUST be included in all year 9 plan’s
Educationx
Healthx
Social Carex
E1 Employment: For (YP name) to access employment opportunities within their locality
E2 Independent living – To learn key life skills (e.g cooking, cleaning, self-care, money skills, travel skills) for supported or independent living
E3 Community inclusion – (YP name) to access/ continue accessing community inclusion through local visits, weekly supermarket shop, attending social groups/ clubs in his/her area.
E4 Health - e.g to take medication/ improve diet/ opportunities to exercise, reduce incident of self harm
E5
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(F) Special Educational Provision *Note: Health or social care provision which educates or trains a child or young person must be treated as special educational provision and included in Section F.
Communication and Interaction: Outcomes and ProvisionOutcome Ref Insert the Outcome from the Summary Table at (E)
Over the next 12 months
(F) Special Educational Provision By Whom
(G) Health Provision By Whom
(H) Social Care Provision By Whom
Cognition and Learning: Outcomes and ProvisionOutcome Ref Insert the Outcome from the Summary Table at (E)
Over the next 12 months
(F) Special Educational Provision By Whom
(G) Health Provision By Whom
(H) Social Care Provision By Whom
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Social, Emotional and Mental Health: Outcomes and ProvisionOutcome Ref Insert the Outcome from the Summary Table at (E)
Over the Next 12 months
(F) Special Educational Provision By Whom
(G) Health Provision By Whom
H) Social Care Provision By Whom
Sensory and/or Physical: Outcomes and ProvisionOutcome Ref Insert the Outcome from the Summary Table at (E)
Over the next 12 months
(F) Special Educational Provision By Whom
(G) Health Provision By Whom
(H) Social Care Provision By Whom
(G) Health Provision - Any Health Provision reasonably required by the learning difficulties or disabilities which result in <child/young person’s name> having Special Educational NeedsOutcome Ref Insert the Outcome from the Summary Table at (E)
(G) Health Provision By Whom
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(H1) Social Care Provision - Any Social Care Provision which must be made for a child/young person under 18 resulting from section 2 of the Chronically Sick & Disabled Persons Act 1970 Outcome Ref Insert the Outcome from the Summary Table at (E)
(H1) Social Care Provision By Whom
(H2) Social Care Provision - Any other Social Care Provision reasonably required by the learning difficulties and disabilities which result in <child/young person’s name> having special educational needsOutcome No: Insert the Outcome from the Summary Table at (E)
(H2) Social Care Provision By Whom
(I) Education Placement
Final EHC Plan onlyName of Placement Type of Placement
Arrangements for Review
Date/Frequency of Review
Name of Person Co-ordinating ReviewContact Details
Next Key Transition PointsEHCP 0-25 v1 September 2014 8
Key Transition Date
(J) Personal Budgets
Have the family/young person made a request for a Personal Budget? Yes / NoSource How will the
Personal Budget be used?
Which outcome will this support?
Amount £
Education
Health
Social Care
Total Amount £
(K) Advice & Information - Contributors to the EHC Assessment and Plan
Name Position Contact details (address/telephone/email)
Report Attached Y/N
(inc date)
Attendance at meeting
Y/N
Signature on behalf of local authority
Date
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Appendix A
Progress and Assessments – Early Years
Communication and Language
Personal, Social and Emotional Development
Physical Development
Literacy Mathematics
Understanding the World Expressive Arts and Design
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Progress and Assessments – School Age
National Curriculum AssessmentPlease complete fully (include previous year’s levels)
Y1 Y2 Y3 Y4 Y5 Y6 Evaluate progress
English
Speaking / Listening
Reading
Writing
Overall Subject level
Mathematics
Science
Standardised test results and/or Entry Assessment
Date of Test Name of Test/Assessment Results Administered by (name and role)
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National Curriculum Assessment
Please complete fully (include previous year’s levels)
Y7 Y8 Y9 Y10 Y11 Y12 Y13 Evaluate progress
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English
Speaking / Listening
Reading
Writing
Overall Subject level
Mathematics
Science
Standardised test results and/or Entry Assessment
Date of Test Name of Test/Assessment Results Administered by (name and role)
Progress and Assessments – Post 16
GCSE results or relevant accreditation
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Foundation or level 1/2 course
Other accreditation
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