Insider Perspectives of Education, Health and Care Plans

Abstract

The introduction of Education, Health and Care (EHC) plans proposed in the Children and Families Act 2014 has aimed to give parents and children who are going through the assessment process greater control and choice in decisions, and enhance the multi-professional collaboration between education, health services and social care. This research seeks to evaluate to what extent parents’, children and young people’s, and professionals' experiences correspond to these values at an early stage of implementation. The methodology of this thesis is based on a realistic evaluation framework informed by the work of Pawson and Tilley (1997). Realistic evaluation aims to construct a programme theory which links three distinct broad aspects of a programme: its context, mechanisms and outcomes (C-M-Os). This research employs a programme theory of how an EHC assessment is conducted and has been developed from the current literature on person-centred theory. Person-centred theory has been chosen because of its corresponding value base to the SEND reforms and the recommendation of its use in a number of government policy documents including the SEND Code of Practice (DfE, 2014). The programme theory has been used to devise questionnaires that have sought to gain professionals' experiences of the assessment process, particularly in relation to multi-agency working, and their perceptions of the person-centred nature of the assessment. In addition, five case studies have explored these issues in more depth to ascertain whether the EHC assessment process in this authority is meeting the core aims of the Children and Families Act 2014. Semi structured interviews and card sorting tasks were devised using the programme theory and conducted with a total of one child, five families and five professionals from five individual EHC assessments. This analysis goes beyond a description of the facilitating factors and barriers to person-centred support and examines how person-centred outcomes arise from specific contexts and mechanisms. Findings suggest that experiences of face-to-face multi-professional collaboration were positive within the EHC assessment group. Nevertheless, professionals expressed frustration that in some cases colleagues were not able to attend meetings due to time constraints, capacity within their services and the commissioning arrangements of their services. Parental and professional experiences of the process appear to be positive. The research demonstrates one case study where a person centred planning approach was utilised very successfully from the perspective of all involved. However, there are significant concerns raised in both phases of this study as to the way in which children and young people are provided with opportunities of contributing to their EHC assessment. The findings are relevant to the development of the EHC assessment process in the local authority (LA) in which I am employed, and will contribute to the debate about the role of educational psychologists (EPs) in evaluating this national policy.