What makes a good outcome in an Education, Health and Care Plan?

What makes a good outcome on an Education, Health and Care Plan?One of the changes within the SEND reforms is that the support in the statutory Education, Health, and Care Plan must contain outcomes instead of objectives. So what is an outcome?

The SEND code of practice states:

9.61   EHC plans must specify the outcomes sought for the child or young person. Outcomes in EHC plans should be SMART (specific, measurable, achievable, realistic, time-bound).

9.66     An outcome can be defined as the benefit or difference made to an individual as a result of an intervention. It should be personal and not expressed from a service perspective; it should be something that those involved have control and influence over, and while it does not always have to be formal or accredited, it should be SMART.

Developing an Outcome

When developing outcomes there should be a ‘Golden Thread’ directly through the aspirations, needs, outcomes and provisions. Please refer to the examples below:

Aspirations

(Section A)

Needs

(Section B, C, D)

Outcomes

(Section E)

Provisions

(Sections F, G, H1, H2)

Mohammed wants to have friends. Mohammed has difficulty with his social skills. Long Term: By the end of Key Stage 4 Mohammed will be able to maintain and make appropriate friendships.

Short Term: Mohammed will have 2 friends, who he will socialise with at breaks and lunch times at least twice a week.

Mohammed will participate in a daily 15 minute group (up to 3 students) session focusing on social skills and role play activities, which will be led by the teaching assistant.

Creativity and forward thinking

In my opinion, section E allows for creativity and forward thinking, which enables the child or young person to work towards their aspirations.

Therefore, outcomes should:

  • Be holistic
  • Support aspirations and set high expectations
  • SMART
  • Support cultural change and be age appropriate
  • Set out what needs to be achieved by the end of a phase or key stage. These may be 2 or 3 years.
  • At year 9 onwards, they need to be preparing the young person for adulthood (employment, independent living, community inclusion and health)
  • Outcomes MUST be person-centred.

The Council for Disabled Children have produced a detailed guidance on EHCPs, which includes an Outcomes Pyramid, which you may find useful, which you can obtain it here. 

Defining an Outcome

Outcomes can be short, medium or long term. Every local authority has their individual way of defining the time scale on an outcome. Some local authorities use long and short, others use all three. I prefer to write the long and short outcomes and allow the schools to create their own medium outcomes.

There are two types of outcomes:

  • Intrinsic - valued by and relate primarily to individuals, such as happiness, self-esteem, confidence etc.
  • Extrinsic - can be measured and valued by other people, including educational achievement, literacy, and numeracy or good health etc.

Intrinsic and extrinsic outcomes are often written together.

Please see the table below containing a range of long and short-term outcomes:

Long Term Short term
By the end of Key stage 1, Mustafa will be able to independently use cutlery to feed himself throughout a meal with no adult prompts. Within the next 12 months, Mustafa will be able to use a knife and fork together to cut up soft foods consistently with one adult prompt 3 times a week.
By the end of Key stage 2, Safa will be able to socialise with her peers without adult supervision. Within the next 12 months, Safa will be able to play in an age appropriate way with at least one child of her own age throughout 4 designated break times.
By the end of Key stage 3, Joseph will be able to improve his legibility of his handwriting or recording written work. Within the next 12 months, Joseph will be able to formulate his letters and increase in accuracy, more consistent in size and positioned correctly in line, in all his English lessons.
By the end of Key Stage 4, Ricky will be able to become more independent from his parents by learning essential life skills such as shopping for food and travelling on his own. Within the next 12 months Ricky will be able to:

  • travel daily by bus to school.
  • write a weekly shopping list and go shopping (or online shopping) with support buying healthy options.
By the end of Further Education, Sally will have had 4 meaningful work experiences in a range of community-based settings so that she has an understanding of different type of job roles. Within the next 12 months Sally will be able to:

  • Be aware of 4 types of paid work environments and roles.
  • Develop work skills such as telling the time, punctuality, solve problems, make decisions, using the phone.
After Post-19 Tom will have decided who he wants to live with and where he would like to live. Within the next 12 months, Tom will have visited four types of housing so he knows how they differ.

The examples below are NOT outcomes - they are provision:

  • Trey will receive 15 minutes, each week of targeted support with his teaching assistant.
  • Jestina needs a weekly visual timetable.
  • Parent and mentor to encourage and support Malika to develop cooking skills.
  • Imran to continue to access speech and language, one day per week for 45 minutes.

Challenging the Outcomes

There is currently no clear way in which a parent or young person can challenge the contents of Sections A or E. Parents or young people might be able to go to Judicial Review. (Judicial Reviews are a challenge to the way in which a decision has been made, rather than the rights and wrongs of the conclusion reached).

In relation to Section E (outcomes), Section 19 (d) of the Act requires the local authority to have regard to:

(d) the need to support the child and his or her parent, or the young person, in order to facilitate the development of the child or young person and to help him or her achieve the best possible educational and other outcomes.

Parents and young people should read this section carefully, and there should be an outcome relating to each of the identified needs. As well as, a provision designed to work towards each outcome.

It is important to remember setting outcomes is based on making assumptions about your son or daughter. Therefore, it is important to ensure that progress towards outcomes is evaluated regularly, not just at the annual review. This will give you and the professionals the opportunity to identify whether interventions are working and whether the outcomes are still relevant.  You have the right to request a review or a reassessment of the EHCP, and the local authority must ensure this happens unless it is less than 6 months since the assessment was conducted.

[Relevant legislation: Section 37 of the Children and Families Act 2014 and Regulations 11 and 12 of the SEND Regulations 2014]

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Marguerite Haye
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Marguerite Haye

SEND Advocate at Haye Independent Services
Marguerite Haye joined us as a columnist toward the end of 2015. Marguerite is knowledgeable in the SEND legislation she embraces its ethos at the heart of everything she does, by adopting a child-centred approach to ensure every child receives the right provision.
As a SEND teacher, Faculty Leader and Assistant Head Teacher in the education sector for over 15 years. Marguerite can recognise individual learning abilities and uses her initiative to tailor learning programs to meet individual need.
Marguerite continues working with other agencies, schools and local authorities to promote and support their understanding and implementation of EHCP’s and SEND reforms efficiently. Through effective leadership, Marguerite promotes an appropriate culture, empowers staff and demonstrates high standards.
Marguerite has built a connection with parents, young people and professionals alike in her career and this a huge asset to her current role as SEND advocate.
Marguerite Haye
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  • @bjpren

    I initially had a problems with my interpretation of this, but the golden answer was right at the start:

    9.66 An outcome can be defined as the benefit or difference [……] as a result of an intervention.
    It is the intervention – i.e. the provision – that leads the outcome, not the other way around! This is often misunderstood, since we are used to working in alphabetical order. The needs (B) must first be established, which come from the reports (K), then the provision (F) from those reports, then the outcomes (E), again, set out in the reports. Essentially the order is K-> B-> F-> E. How counter-intuitive!!!
    It shows how essential it is to gain reports that are fit for purpose, as outcomes should not be a guessing game but the result of clearly specified & quantified provision, based on individual identified need.

  • Rebecca Donnellan

    As a mother of a child with SEND and having engaged in this tiresome battle to secure provision, this article is a welcoming piece as it offers a different perspective. There is a way that professionals have viewed children by their presenting needs and what provision can be applied to support them. That being said I have also in the past viewed the process as looking at my child’s needs (Section B, C, D); then considering the Outcomes (Section E) and matching that with Provision (Sections F, G, H1, H2) in order for my daughter to achieve her Aspirations (Section A). By doing this I forgot to see my daughter in light of what she could aspire to be. The approach in this article promotes a more positive outlook at how people with SEND should be viewed. Utilising the social model of disability encourages us to consider developing outcomes in the sequence highlighted in the article , that is Aspirations (Section A), Needs (Section B, C, D), Outcomes (Section E) and finally Provision (Sections F, G, H1, H2).