G485(P)\u2005Quality of medical advice for education health care plans (ehcp)

Abstract

Introduction Regulations supporting Children and Families Act 2014 place duty on local Authorities when carrying out EHC needs assessment to obtain medical advice. Following the area SEND inspection in January 2017, quality of medical advice was found by inspectors to be variable. Medical Advice report is provided where children are already known to Community Paediatric services and is not known to other health teams. A weekly published traffic light tool is used to support timescale compliance. Aims The aim of this audit was to establish the quality of the reports and recommend ways to embed requirements for EHC advice into all neurodisability medical reports. This reduces duplication of medical reports produced without compromising the quality. Methods Twenty reports for children seen over a period of 5 months were randomly selected by SEND administrator. The quality of the reports was assessed using Quality Assurance tool designed in-house. Results Medical advice was provided within 6\u2009week statutory timeframe in 18/20 children (90%). In all children the agreed Medical Advice proforma was used. Reports were jargon free in 18 children (90%). Health needs impacting on Education were identified in 7 out of 20 children (35%). Two out of 20 children were not known to Neurodevelopment. One had already been referred to CAMHS by school for ADHD assessment and the other did not have identified health needs. Despite using a specific Medical Advice proforma, outcomes were SMART in 2 out of 7 cases with identified health needs. Evidence of child’s and young person’s voice was in 3 out of 20 cases (15%). Evidence of coproduction with parents was found in 20 cases (100%). Conclusion Providing Medical Advice for EHC in addition to neurodevelopmental/neurodisability reports puts strain on doctors’ time, did not improve the quality and resulted in duplications. Following the audit, proforma with examples of wording was established to ensure consistency of recommendations within the team. Care Plan format (Care Plans given to parents following neurodisability MDT clinics) was changed so it is compatible with EHC Medical Advice to support doctors in integrating the Advice in neurodisability reports while reducing duplications without compromising quality.