Education, Health and Care (EHC) Plan
Transfer Review/Annual Review
DateofStatement/EHCPlan/lastannualreviewDateofcurrentreviewmeeting
Primaryareaofneed(asperStatement/EHCPlan)
(SpLD/SLCN/ASD/SEMH/PD/PMLD/MLD/SLD/HI/VI/MSI)
Background Information
My DetailsSurname / Forename
Date of Birth / Year Group / Gender / M/F
Home Address
Telephone Number / Email
Nationality / Ethnicity
Religion / Language Spoken
Name of parent/carer(s)/person responsible
Address of parent/carer(s)/person responsible
Any other friends, family, community support networks
Is the child/young person subject to a Care Order (where the Local Authority shares parental responsibility?)
Is the child/young person accommodated under Section 20 of the Children Act 1989?
Safeguarding Plan in place / Care Leaver
Subject to Mental Health Act / Any legal considerations inc. court proceedings
GP Contact Details:
Are these details different from those on the Statement / EHC Plan?
My School
Name of current placement
Date of admission
Attendance to date / Actual / Possible / Percentage
Is the child/young person dual registered? / Yes/No / If yes, where?
Has an Early Help Assessment or My Self- Assessment been completed? / Yes/NoPleaseattachacopyifwithinthe last12months
Lead Professional
List of names invited to, and indicate if present at the Transfer Review/Annual Review
Name / Designation (including, telephone number and e-mail) / Indicate if
present at meeting / Written contribution provided?
Prior to the meeting / At the meeting
Documentation provided in support of the Transfer/Annual Review
(circulated at least two weeks prior to the meeting)
Title of information / Date of report/document / Author / Date of circulated
Strengths, Skills and Difficulties – Add new or state any changes
What do people like and admire about me?What do I need to stay safe and healthy?
What is important to me now?
What do I find difficult?
What is currently working well in my placement? What am I proud of?
What is currently working well outside of my placement?
What is currently not working well in my placement?
What is not working well outside my placement?
What is important to me in the future?
What will be important for me in the future?
Attainment and Progress
ProgressSubject/Area / Last Year’s Levels (as recorded at last AR) / Current Levels
Assessment Tool Used
Special Educational Needs & SMART Outcomes
Communication & InteractionStrengths
Special Educational Needs
Long Term Outcome
(3 Years or End of Key Stage)
Medium Term Outcome
(By the next AR i.e. within 12 Months)
Special Educational Provision / Who is responsible / Frequency/Duration
Review from Previous AR / Comments
State if Long Term Outcome has been:
Fully Achieved / Partially Achieved / Not Met Yet
Review from Previous AR
State if Medium Term Outcome has been:
Fully Achieved / Partially Achieved / Not Met Yet / Comments
Cognition & Learning
Strengths
Special Educational Needs
Long Term Outcome
(3 Years or End of Key Stage)
Medium Term Outcome
(By the next AR i.e. within 12 Months)
Special Educational Provision / Who is responsible / Frequency/Duration
Review from Previous AR / Comments
State if Long Term Outcome has been:
Fully Achieved / Partially Achieved / Not Met Yet
Review from Previous AR
State if Medium Term Outcome has been:
Fully Achieved / Partially Achieved / Not Met Yet / Comments
Social, Emotional and Mental Health
Strengths
Special Educational Needs
Long Term Outcome
(3 Years or End of Key Stage)
Medium Term Outcome
(By the next AR i.e. within 12 Months)
Special Educational Provision / Who is responsible / Frequency/Duration
Review from Previous AR / Comments
State if Long Term Outcome has been:
Fully Achieved / Partially Achieved / Not Met Yet
Review from Previous AR
State if Medium Term Outcome has been:
Fully Achieved / Partially Achieved / Not Met Yet / Comments
Sensory and/or Physical
Strengths
Special Educational Needs
Long Term Outcome
(3 Years or End of Key Stage)
Medium Term Outcome
(By the next AR i.e. within 12 Months)
Special Educational Provision / Who is responsible / Frequency/Duration
Review from Previous AR / Comments
State if Long Term Outcome has been:
Fully Achieved / Partially Achieved / Not Met Yet
Review from Previous AR
State if Medium Term Outcome has been:
Fully Achieved / Partially Achieved / Not Met Yet / Comments
Independence & Preparation for the Future
Strengths
Special Educational Needs
Long Term Outcome
(3 Years or End of Key Stage)
Medium Term Outcome
(By the next AR i.e. within 12 Months)
Special Educational Provision / Who is responsible / Frequency/Duration
Review from Previous AR / Comments
State if Long Term Outcome has been:
Fully Achieved / Partially Achieved / Not Met Yet
Review from Previous AR
State if Medium Term Outcome has been:
Fully Achieved / Partially Achieved / Not Met Yet / Comments
Health and Social Care Needs
My HealthAny diagnosed medical condition / Diagnosed by / Date of diagnosis
Health Needs
Does the young person have a medical condition that affects their wellbeing and prevents them caring for themselves?
SocialCare Needs
Please identify the young person’s social care needs in the following areas?
1.Personal Care
2.Eating and Drinking
3.Making decisions
4.Run/maintain my home
5.Being part of my community
6.Being safe community/home
7.Managing behaviours
Summary
Summary of DiscussionAny Additional Actions
Person / Action / By When
Personal Budget
In receipt of a Personal Budget / Yes/No
Any changes to the Personal Budget recommended / Yes / No / Not Applicable / If Yes, state details and any supporting evidence:
Recommendation / Please Tick One
Maintain the EHC Plan without any amendments
Amend the EHC Plan
Cease the EHC Plan
Transfer from Statement to an EHC Plan
(Note only where the LA has confirmed this is a Transfer Review)
Authorisation
Authorisation (Headteacher / Principal) / Name: / Designation:Signature: / Date:
Date Submitted to the LA
Please return this report within 2 weeks of this meetingas a Microsoft Word document, together with any written advice not previously circulated, to:
16-25 Vulnerable Learners Service, Derby City Council, Peoples Service, The Council House, Corporation Street, Derby DE1 2FS or Secure Email: