Children and Young People with Special Educational Needs and Disabilities (SEND) are a population group that experience poor outcomes. The NHS has a duty to reduce inequalities in outcomes for disadvantaged groups.

People with learning disabilities have poorer health than the general population. This may be because people in this group are more likely to have difficulty saying or explaining how they feel and seeing a doctor or nurse when they need to. Research shows that regular health checks for people with LD can often uncover treatable health conditions. More serious illnesses, such as cancer, can also be found at an earlier stage when they can be more easily treated.

Evidence tells us:

  • up to 2.5% of the UK population has a Learning Disability
  • 40% of this group will experience significant psychiatric disorder
  • 75% of Young People under 25 years with SEND are male
  • The commonest SEND primary need identified in EHCP’s is Autistic Spectrum Disorder (ASD)
  • Up to 70% of Children Looked After (CLA) are identified with SEND
  • Around 25% of Children and Young People in custody have a Learning Disability

Health services are critically important for many disabled children and young people, historically, the health needs of children in general, and disabled children in particular, were not prioritised. In 2013 following reorganisation of the NHS there was a mandate from government to the NHS Commissioning Board asking NHSE to pursue as part of its objectives the support of children with disabilities, ensuring access to services. Improving care for people with Learning Disabilities is one of NHSE’s top 4 priorities.

Key contacts

Dr Jess Turnbull, Consultant Paediatrician and Designated Medical Officer for SEND

Bridget Nichola,  Designated Clinical Officer for SEND

For further information please visit

The Children and Families Act 2014

The government has made changes to the support system for disabled children and young people and those with SEND with The Children and Families Act 2014. The SEND Reforms, introduced under part 3 of the Children and Families Act 2014, includes key requirements relating to health. The key principles of The Act were to create an integrated and streamlined approach to supporting children and young people with SEND from birth to 25 years. There is a focus on two key areas: a) greater cooperation between education, health and social care and b) a greater focus on outcomes. SEND code of practice can be found in documents below.

Main changes:

  • Education, Health and Care Plans (EHCPs) replace Statements of Special Educational Needs
  • Covers all children and young people with Special Educational Needs and Disabilities from 0-25 years of age
  • Focus on Preparation for Adulthood
  • EHCPs focussed on outcomes rather than service provision
  • Shortened timeframe of 20 weeks from request for needs assessment to delivery of EHC Plan
  • Joint commissioning of services between Health and LA
  • Focus on co-production with CYP/family  based on aspirations of child and family
  • Development of Local Offer website with all relevant info on local area resources
  • Specific health duty to assess some disabled children’s health needs as part of an Education Health and Care needs assessment and to specify provision to meet those needs in a Plan (EHCP)

Education Health and Care Plan (EHCP)

In Southwark these health assessments and subsequent provision of the required health information are provided by our Community Paediatricians for those under 18 years of age. Where health information is required for an EHC assessment for a young person 18-25 years old it is expected that this will be provided by the young person’s GP. Our Community Paediatricians have put together a very useful template to populate with the required information and can be found in documents below.

EHCP support split into following areas:

  • Physical health and sensory problems
  • Communication and Interaction
  • Cognition and Learning
  • Social, Emotional and Mental wellbeing
  • Independence and Community Involvement

How can Primary Care support this group of vulnerable children and young people?

  • By providing health information for EHC assessments in a timely manner when requested
  • By identifying your patients (aged 14+) with Learning Disability and ensuring they are on the practice LD register
  • Inviting those on the LD register for an annual health check
  • Understanding co-morbidities between SEND, those who are Children Looked After, Youth Offenders and those with Long Term Conditions
  • Making reasonable adjustments for those with SEND, this may be as simple as offering appointments at the start or end of practice sessions with aims of reducing waiting times and busy, noisy waiting rooms which may be particularly problematic for those with autism and or LD
  • Understanding other national initiatives in place to improve outcomes for this vulnerable group (Transforming Care, Integrated Personal Commissioning, Continuing Health Care, Local Transformation Plans, Mental Health crisis care, LeDer programme)
  • Know about the Local Offer as a resource and to signpost families of children and young people with SEND.
South East London Integrated Care System

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