What the DCO is
The Designated Clinical Officer (DCO) is a senior health professional who helps the Integrated Care Board meet its SEND duties for ages 0-25 and is the health point of contact for councils, schools and colleges. The role is recommended in the SEND Code of Practice (paragraphs 3.45-3.48), and its three core functions are usually described as oversight of health needs and provision, coordination across health providers and partners, and a strategic role in joint commissioning of health support for children and young people with SEN or disabilities.
DCO or DMO – the same role, two titles
DCO and Designated Medical Officer (DMO) describe the same function under different titles. When the post is held by a doctor – usually a paediatrician – it is a DMO; when it is held by a suitably qualified nurse or other registered health professional, it is a DCO. Some health systems use both, with a DMO providing medical leadership and a DCO carrying the day-to-day coordination. Either way, you are dealing with the health system’s designated SEND lead, not a separate tier of decision-maker.
A non-statutory post supporting statutory duties
The post itself is a non-statutory role: the Code says partners should ensure a DMO or DCO is in place, not that they must. What is statutory are the duties the role exists to support – the ICB’s obligations under Part 3 of the Children and Families Act 2014, including co-operating on EHC needs assessments and securing the agreed health care provision named in a plan (s.42). So if a DCO post is vacant, the ICB’s legal duties do not pause; they still sit with the Board.
What the DCO does not do
The load-bearing point for a council officer is this: the DCO is not a caseworker. They are not routinely involved in individual EHC needs assessments or in care planning for a named child. Their job is to make sure the system delivers – that assessment, planning and health input happen and are compliant with the Code – not to write the health advice for a specific plan themselves. Use the DCO for the things only they can do:
- strategic advice on how health input into EHC plans should work across the area;
- unblocking systemic problems – for example repeated late or missing health advice into assessments;
- joint-commissioning and governance questions about health provision for 0-25s.
One currency check worth making: the DCO now supports the Integrated Care Board, not the Clinical Commissioning Group. CCGs were abolished in July 2022, so any local page or contact list that still says ‘CCG’ is out of date. The revised national DMO/DCO Handbook (August 2025) reflects the ICB framing.
For the wider picture, see how councils work with health partners on EHC plans and what joint commissioning for SEND involves.
Where the law comes from
Related
This page is general information, not clinical or legal advice.