Plans to support the country’s most vulnerable children are often being drawn up without any input for health and social care providers, an investigation has found. Education, health and care plans (EHCPs) are supposed to be created in collaboration with health and social care professionals. But analysis of Ofsted area SEND inspections show this is not the case. Ofsted flags missing health partners An September inspection of Derbyshire’s SEND services found that some plans were 鈥渇inalised without contributions from health or social care professional鈥. In Milton Keynes, an inspection in March last year found 鈥渕ost EHC plans do not contain health and care outcomes, even when children and young people have demonstrable needs. 鈥淭his means that schools often lack the expert advice and support required to ensure the full ranges of a child鈥檚 needs are met.鈥 In Lancashire, contributions from health and social care in plans 鈥渃an be scant and, in a number, not evident鈥. 鈥淕eneral practitioners (GPs) are not routinely asked to inform the EHC plan process, even as primary record holders. For some, they are not aware when there is an EHC plan in existence for a child or young person under their care,鈥 the report added. In Hillingdon, west London, a report last year found 鈥渢oo often health and social care professionals were not invited, did not attend, or did not submit updated advice for annual reviews鈥. “Consequently, the plans focus too heavily on education.鈥 The report concluded that: 鈥淥verall, many EHC plans are not useful.鈥 Read the rest of our special, five-part investigation: Investigation: How EHCPs are failing our most vulnerable children Fidget spinners and learning styles: EHCPs鈥 interventions exposed Copy and paste: Poor quality EHCPs shortchange schools Feature: The case for a SEND evidence ‘custodian’ Comment: SEND provision is the last bastion of unevidenced practice A report by the children鈥檚 commissioner in 2022 analysed about 650 EHCPs from two councils, one in London and the other the Midlands. None of the EHCPs had a blank section F 鈥 which mandates education provision. But data was missing for 61 of the 152 (40 per cent) EHCPs for the “health” and “social care” provision sections. In one of the councils, the average word count to describe all aspects listed under “general” provision was 150. For health and social care provision, the word counts were 16 and 38 respectively. Reforms must look at health contribution Warren Carratt, the chief executive of the Nexus MAT of mostly special schools, warned of a 鈥渕yriad鈥 of interventions that were 鈥渃learly misplaced鈥 in the education section. Warren Carratt His trust has an EHCP which includes hydrotherapy’ 鈥渂undled鈥 into section F, for instance. This means 鈥渟chools have to provide it, and councils have to fund it鈥. 鈥淭o compound this issue, universal health services have been reduced over time.鈥 鈥淭here then isn鈥檛 the availability of health professionals for schools to commission, leaving more public money flowing to private providers.鈥 A Schools Week investigation in 2019 revealed how complex health needs of special schools pupils are delegated to school staff as the number of school nurses has dropped. Leaders say the situation has worsened. One trust recently wrote to an NHS board about nursing service cuts at some of its schools, warning it creates 鈥渟ignificant risk to the health and life of these children”. Councils have to 鈥渁bide by changes鈥 directed in SEND tribunals over section F issues. But tribunals can 鈥渙nly recommend changes, they have no power to direct鈥 over health and social care provision, Keer added. Robert Gasson, the chief executive of the Wave Trust, said: 鈥淗ealth advice is supposed to be a core part of these plans, yet delays, vague recommendations, and poor coordination mean many children miss out on the support they deserve.鈥 Former government adviser David Thomas added the often-missing health contribution was the 鈥渕ain catastrophe of EHCPs. The big challenge for SEND reforms now is how you ensure health provision when the NHS is so stretched.鈥 NHS Providers, the membership organisation for health organisations, did not want to comment. The Department for Health and Social Care did not respond to a request for comment.