The Children and Families Act requires CCGs and local authorities to work together to commission services for children and young people with disabilities and special educational needs. One of the key requirements is that by 1 September 2014 all local authorities publish a Local Offer setting out information about the provision expected to be available across education, health and social care, including those commissioned by CCGs. Therefore, each CCG must determine which services it will commission to meet the reasonable health needs of children and young people with SEN or disabilities for whom it is responsible and these services should be described in the Local Offer.

It is essential that CCGs have put in place the joint arrangements to underpin the joint commissioning arrangements between the CCG and local authority

Education, Health and Care Plan or EHC plan

The new Act replaces statements of special educational needs with a single Education, Health and Care Plan which will cover individuals up to age 25. Each EHC plan must set out the health care provision as agreed by the CCG and the CCG is under a duty to ensure that the relevant local health professionals participate in the development of EHC plans.

The CCG's duty to provide health services remains under S.3 of the NHS Act 2006. However, the new Act includes an additional duty that requires the CCG to put in place arrangements to secure the provision of the health services agreed in the health element of an EHC plan.

CCGs must ensure that there is sufficient oversight of the process to provide assurance that the needs of children are being met. Each CCG will need to establish a clear and robust assurance process and ensure that this process is implemented.

The CCGs and LA must have clear dispute resolution procedure where there is disagreement about what services should be included in the EHC plan.

Who is your Designated Medical Officer?

There is a requirement for a designated medical officer to be appointed to support the CCG in meeting its statutory responsibilities for children and young people with SEN and disabilities.

The DMO provides the point of contact for local authorities, schools and colleges seeking health advice on children and young people who may have SEN or disabilities, and provides a contact (or contacts) for CCGs or health providers so that appropriate notification can be given to the local authority of children under compulsory school age who they think may have SEN or disabilities.
The DMO would not routinely be involved in assessments or planning for individuals, except in the course of their usual clinical practice, but would be responsible for ensuring that assessment, planning and health support is carried out.
CCGs may delegate key decisions to the DMO (for example, agreeing the health services in an EHC plan).


The Code of Practice sets out the range of options available to individuals where they are not happy with the decision ranging from NHS complaints to contacting the Ombudsman. However, the CCG and local authority are also at risk of being challenged by way of Judicial Review in relation to the process or implementation of the statutory requirements. Possible challenges include:

  • Failure to comply with the duties under the new Act. E.g. failure to jointly commission services, failure to consult on and/or publish the Local Offer
  • Failure to take a lawful decision.

How we can help

We can work with you to ensure that there are the appropriate arrangements in place for joint working.

We can assist you in drafting a dispute resolution procedure in place for where the local authority and CCG disagree about the content of an EHC Plan.  

We can review your local arrangements and Local Offer to ensure that they are robust in order to reduce the risk of challenge.

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