Education, health and care plans - Section G, the responsible commissioner
In Section G of a child or young person’s Education, Health and Care plan, the “responsible commissioner” refers to a Clinical Commissioning Group (CCG).
Clinical Commissioning Groups or CCGs as they are known, became responsible for planning and organising many NHS funded health services for children and adults across England from 1 April 2013.
They are made up of local GPs and other experienced health professionals. The group pays (commissions) other organisations, often called “service providers” to provide the health services which are needed for the people living in the community they serve.
Examples of services provided for children and young people with SEND are speech and language therapists or specialist consultants.
In Norfolk and Waveney, there are 5 CCGs:
Guidelines for finding your responsible CCG can be found at the end of this page.
Some health services are commissioned from and are the responsibility of NHS England. These include some of the most highly specialist services required to support children with disabilities and complex needs. These services are best delivered through a small number of centres of excellence, ensuring health professionals maintain their skills and expertise.
The Local Authority (Norfolk County Council) must involve health professionals in making an assessment of need for an education, health and care plan.
The specific advice required will be different for every child and will usually be given by a health professional (clinician) who works for one of the service providers commissioned by the Clinical Commissioning Group (CCG), for example, a speech and language therapist or specialist consultant. Commissioned health service providers and clinicians must provide health information and advice to support the education, health and care plan needs assessment when asked.
Health clinicians who are asked for advice will write a report about the child or young person. In the report they will specify the health needs or provision which must be included in the education, health and care plan. The education, health and care plan coordinator will write this into Section G of the plan which is called “Health Provision”.
If a health need educates or trains a child or young person, for example, speech and language therapy or occupational therapy, it must be written in Section F, which is called “Special Educational Provision”, of an education, health and care plan.
For most children and young people with SEND the needs or provision stated relating to their health needs can be met by services already in place. A decision about the health provision in the education, health and care plan is then requested from the clinicians working for the health service provider.
If what is needed to meet the health needs of the child or young person is outside the core commissioned services (what is usually provided) the relevant CCG must agree to this provision being made.
There will be times when a child or young person with SEND requires additional health provision (more provision than is normally provided).
The assessments and recommendations for this are usually made by clinicians from commissioned services. These clinicians have the appropriate skills, knowledge and competency to assess and identify the health provision needed to help the child or young person.
Requests for specific provision must be in line with what is called “sound evidence”. Sound evidence could be, for example, guidance from The National Institute for Health and Care Excellence (NICE) which provides advice to improve health and social care across England. This means that what is being asked for is something a health professional from an NHS service agrees is appropriate.
When there is a need for additional health provision, the responsible Clinical Commissioning Group (CCG) must look at all the information and then make a decision. The responsible CCG needs to agree to the additional provision in order for it to be given and show this by “signing off” the education, health and care plan.
The responsible CCG must also justify why a decision to give additional health provision has been made or refused before the final plan is issued. See attached Flow Chart.
Once the responsible CCG has agreed to this additional health provision, they have a duty to arrange and commission the required services and it will be shown in Section G of the child or young person’s education, health and care plan.
- Where a child or young person is registered on the list of NHS patients of a GP practice, the responsible commissioner will be the Clinical Commissioning Group (CCG) of which the GP practice is a member. These can be found on the GP and CCG websites.
- Where a patient is not registered with a GP practice, the responsible commissioner will be the CCG of the area where the child or young person usually lives (“is usually resident”). This can apply to unaccompanied asylum seekers.
- The responsible CCG for a child or young person (aged 0-18 years) who is accommodated by the Local Authority (Norfolk County Council) and known as a ‘looked after child’ will be determined by the membership of the GP practice where the child or young person was registered just before or at the time of being accommodated.
- Should a baby be accommodated at birth and not registered with a GP, the responsible CCG is determined by the GP practice where the mother is registered on a list of NHS patients. The responsible commissioner will usually be the CCG where the GP practice is a member.