18. An EHCP is a legal document that sets out a child or young person's special educational, health and social care needs and how those needs should be met.
19. The Children and Families Act explains that an EHCP is a plan specifying the child's or young person's special educational need, the outcomes sought, the special educational provision required, any health care provision reasonably required, and any social care provision reasonably required. The Act states that it is the Local Authority’s responsibility to prepare the EHCP, agree this with all parties, and review and maintain the plan, including making any changes.
20. Child A’s EHCP explains in section F that he needs ‘access to appropriate support to meet his medical needs of epilepsy as detailed in section G’. It then explains in section G that ‘Child A needs help with the management of his epilepsy (cluster focal and Tonic Clonic seizures), Child A has a protocol in school for administrating buccal midazolam (5mg) in emergency’.
21. It continues that ‘he needs staff trained in epilepsy recognition and treatment to observe and time every seizure (essential for giving treatment) and to maintain a seizure log – what happened, how long was it, what treatment was given.’
22. Mrs P explained that Child A’s school have implemented this training on a voluntary basis and that there is no staff member who is always in Child A’s classroom or allocated to manage or observe Child A specifically.
23. Mrs P told us that she feels that as Child A’s EHCP says that he ‘needs’ staff trained in the management of his seizures the provision should not be provided on a voluntary basis. She feels that it is not appropriate for the ICB to agree that staff trained on a voluntary basis is enough.
24. Mrs P told us that this is stressful for her, as she worries what will happen if the member of staff is not on site or if no one volunteers to fulfil this position in the future.
25. In its complaint response on 29 September 2023, the ICB explained that it was satisfied that the children’s community nursing team have offered appropriate training to staff at Child A’s school as per the wording of section G of the EHCP. It confirmed that there are two members of staff trained in the management of Child A’s seizures at the school.
26. The SEND code of practice outlines how health and local authority organisations must work alongside each other to ensure that the provisions outlined in EHCP’Ss are being upheld. It says that ‘for health care provision specified in the EHC plan, the CCG (or where relevant NHS England) must ensure that it is made available to the child or young person.’
27. It continues that ‘as health service commissioners, CCG’s (now known as ICB’s) have a duty under Section 3 of the NHS act 2006 to arrange health care provision for the people for whom they are responsible to meet their reasonable health needs.’
28. The Children and Families Act also says that ‘if the plan specifies health care provision, the responsible commissioning body must arrange the specified health care provision for the child or young person’.
29. Our adviser explained that in line with the Children and Families Act and the SEND code of practice it is the responsibility of the ICB to ensure any health care provisions outlined in an EHCP are fulfilled.
30. Child A’s ECHP does not explain how many staff should be trained, what the training of the staff should look like, or if it should be on a voluntary basis or not. The ECHP explains that Child A must have staff trained in the management of his seizures. The ICB have confirmed with Child A’s school that there are two members of staff trained in the management of his seizures.
31. The EHCP outlines what should happen if Child A has a seizure at school and a trained member of staff is available. It does not outline what should happen if there are no trained members of staff available.
32. Mrs P explained to us that she asked the ICB what would happen in this situation, and it explained to her that the school confirmed that it would call an ambulance for Child A. Mrs P told us that this is not a suitable plan for this situation, as if Child A has a long seizure, and is not given his medication promptly, it could cause him brain damage.
33. Our adviser explained that the ICB could have gone back to the local authority who wrote the EHCP and asked for a plan for if this situation arises to be written into the EHCP. It did not do so.
34. However, as specified above, the Children and Families Act states it is the Local Authority’s responsibility to review and maintain the plan. The ICB does not have any legal obligation to ask the Local Authority for further information than what is already written in the EHCP. It would be the responsibility of the Local Authority to write any further information on Child A’s needs into the EHCP.
35. We therefore consider that the ICB have upheld its duties by ensuring that there are staff trained in the management of Child A’s seizures at school. Although we understand Mrs P’S concerns about what would happen if Child A had a seizure at school and no staff were available to support him, it is not the responsibility of the ICB to ask the local authority for further information than what is written in the EHCP.
36. We recognise that this decision may be disappointing for Mrs P to read, and we understand that is it worrying for her to be without a clear plan in Child A’s EHCP to accommodate for if the trained staff members are not available.
37. The ICB have upheld its responsibilities by confirming that there are staff members trained in the management of Child A’s seizures at school.
38. We would like to thank Mrs P for taking the time to bring her complaint to us and for her continued patience throughout this process. We wish her all the best with any ongoing support she may seek for Child A at school.