How do LAs work with health partners on EHCPs?

The mechanism, in one line

Local authorities must commission EHCP support jointly with their integrated care board (ICB); health partners must supply assessment advice within 6 weeks, and the ICB must arrange health provision named in the plan. That single sentence holds the three places where health is statutorily on the hook. The relationship is not goodwill partnership working. It is anchored by the joint commissioning duty in section 26 of the Children and Families Act 2014, and the duties below all sit underneath it.

The three touchpoints where health is engaged

1. Strategic joint commissioning. The council and the ICB must make joint arrangements to plan and commission the education, health and care provision children and young people with SEND need (s.26). The Health and Care Act 2022 made the ICB the partner commissioning body, replacing clinical commissioning groups from 1 July 2022. The arrangements must cover what is needed, who secures it, how plans are drawn up, personal budgets, and how disputes are handled.
2. The 6-week advice duty on assessment. When you request co-operation from a health body during an EHC needs assessment, that body must comply within 6 weeks of the request (regulation 8, SEND Regulations 2014). The exceptions are narrow: genuinely exceptional circumstances, the family absent from the area for four continuous weeks or more, or a missed appointment. Late advice is a breach, not a courtesy shortfall. See who you have to consult during an assessment.
3. The duty to arrange Section G. Where a plan specifies health care provision in Section G, the responsible commissioning body, in practice the ICB, must arrange it (s.42). This is the point most summaries miss. The Section G duty is absolute and non-delegable: the council cannot deliver or substitute health provision the way it can with the special educational provision it secures in Section F.

The operational link person

The day-to-day link is the Designated Clinical Officer (DCO), or Designated Medical Officer (DMO) where the post is held by a doctor. Employed by the ICB, this person is the strategic clinical contact who supports joint working, oversees health advice across the EHCP process, and leads the ICB response on SEND Tribunal appeals with a health element (SEND Code of Practice 2015, Chapter 3). When health advice is late or absent, the DCO or DMO is your first named lever, not a generic contact us inbox. See the role of the Designated Clinical Officer.

If health does not co-operate: the escalation route

Start with the DCO or DMO and the reg.8 deadline, which is enforceable. If that does not resolve it, use the dispute resolution route your joint commissioning arrangements must already set out. At appeal, the SEND Tribunal has held a power since the national extension in 2018 to make non-binding recommendations on the health and social care elements of a plan, and the ICB must respond to them. Beyond that, the Local Government and Social Care Ombudsman and a CQC and Ofsted area SEND inspection are the accountability backstops where joint working is failing systemically.

The Schools White Paper of 2026 signals possible longer-term reform of the EHCP framework and the SEND Code, but no changes take effect before September 2030 and the duties above are the law today. Commission and escalate against them now.

This page is general information, not clinical or legal advice.