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OT Assessment for EHCP: What Evidence You Need
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OT Assessment for EHCP: What Evidence You Need and Why It Matters

If you are navigating the Education, Health and Care (EHC) needs assessment process, you may have heard that occupational therapy (OT) evidence is important. But what exactly do local authorities (LAs) look for in an …

For familiesPublished 28 April 202629 min read· Written by the Sensphere OT team

In this guide

  1. Where OT Sits in the EHCP Framework
  2. The Four EHCP Sections Relevant to OT
  3. The Difference Between Needs and Provision
  4. Why the Wording of OT Recommendations Matters
  5. What Local Authorities Look for in an OT Report
  6. Functional Assessment
  7. Sensory Processing Profile and Its Impact
  8. Fine Motor and Handwriting Assessment
  9. Recommendations Framed as Provision
  10. EHCP-Ready Report Formatting
  11. NHS OT Evidence vs Independent OT Evidence
  12. What to Do If an LA Dismisses Independent Evidence

If you are navigating the Education, Health and Care (EHC) needs assessment process, you may have heard that occupational therapy (OT) evidence is important. But what exactly do local authorities (LAs) look for in an OT report? How does independent evidence differ from NHS assessment? And what happens if your child's EHCP plan doesn't include OT provision, even though you know they need it?

This guide is for parents who already understand the EHCP framework and need to know specifically how OT fits into it, what evidence carries weight, and how to ensure OT recommendations become enforceable provision in your child's plan.

Where OT Sits in the EHCP Framework

An EHC plan has eight numbered sections, each serving a specific purpose. Occupational therapy evidence informs four of these sections, and understanding the difference between each is crucial to getting the right outcome.

The Four EHCP Sections Relevant to OT

Section B: The child's special educational needs

Section B describes what the child needs educationally to access the curriculum and participate in school life. This is where OT assessment typically sits. An OT report on handwriting stamina, fine motor coordination, sensory processing, self-care skills (dressing, toileting, managing belongings), and independence in everyday school tasks all feed into Section B.[1]

For example: "Child struggles with the physical act of writing, holding a pencil for more than five minutes before hand fatigue prevents further work. This is compounded by difficulty with hand-eye coordination and finger isolation, affecting copying from the whiteboard and note-taking."

This is a need, it describes what the child cannot do and why.

Section C: The child's health needs

Section C covers health needs identified through assessment by health professionals. An NHS occupational therapist, or an independent OT working within a holistic health context, might contribute here. The distinction is subtle: Section B focuses on learning and curriculum access; Section C focuses on health and wellbeing more broadly.

For example: "Child has sensory processing disorder affecting proprioceptive input, resulting in poor body awareness, coordination difficulties, and reduced ability to regulate arousal levels in busy environments."

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Requesting the LA Commission an OT Assessment
  • Timing the OT Assessment
  • Proactive: Before Making the EHC Request
  • During the 20-Week Assessment Window
  • Before Annual Review
  • Before SEND Tribunal
  • Statutory Deadlines and Timing Risk
  • Working with the School
  • What a SENCO Can Contribute
  • School-Commissioned OT vs Parent-Commissioned OT
  • Should the OT Conduct a School Observation?
  • OT Recommendations in Section F: Vague vs Specific
  • If Things Go Wrong
  • LA Refuses to Commission an OT Assessment
  • Draft Plan Does Not Include OT Provision
  • OT Evidence Disputed by LA-Appointed Assessor
  • SEND Tribunal: Role of Independent OT Evidence
  • Mediation as Mandatory Step Before Tribunal
  • After the Plan: Ensuring Provision Is Delivered
  • Named Provision in Section H: Who Commissions?
  • If Named Provision Is Not Delivered
  • Annual Review: Using Updated OT Evidence to Amend the Plan
  • Key Takeaways for Parents
  • References
  • Related reading
  • Ready to take the next step?
  • Section F: The child's special educational provision

    This is the most important section for parents to understand because it is legally binding. Section F sets out what the school must provide to meet the needs described in Section B.[2] Here, OT recommendations must be translated into specific, quantified, time-bound provision.

    This is where vague wording becomes a major problem. A plan that says "access to fine motor activities" or "OT support as needed" is not enforceable because it does not specify what, when, how much, or who delivers it. A plan that says "30 minutes of individual fine motor intervention per week, delivered by a teaching assistant trained in Neurodevelopmental Task Training (NTT), with progress reviewed by a qualified occupational therapist each half-term" is enforceable because the school and LA are held accountable to it.[3]

    Section H: The child's health provision

    Section H describes provision commissioned by the NHS Integrated Care Board (ICB) to meet health needs. If OT provision is health-related rather than education-related, it is named here. Unlike Section F (which is the school's responsibility), Section H can name a specific provider and frequency, and the ICB is legally responsible for commissioning it.[4]

    For example: "Child will receive 16 sessions of occupational therapy over 12 weeks, focused on sensory integration and regulation strategies, delivered by an NHS-commissioned occupational therapist."

    The Difference Between Needs and Provision

    This distinction is critical. Parents often conflate the two and then become frustrated when the plan acknowledges a need but provides vague or minimal provision.

    A need is what the assessment identifies: "Child has poor pencil grip and hand fatigue that prevents sustained writing." This goes in Section B.

    Provision is what the plan commits to doing about it: "Child will receive 20 minutes of fine motor exercises twice per week, delivered by a teaching assistant following an OT-designed protocol, with progress monitored by the school's SENCO monthly." This goes in Section F.

    If an EHCP plan describes a clear need in Section B but does not translate it into concrete provision in Section F, the need is acknowledged but not addressed. You then have grounds to challenge the plan and request that provision be added.

    Why the Wording of OT Recommendations Matters

    When an OT provides recommendations, they often sound like clinical guidance: "Child would benefit from sensory diet strategies," "Fine motor strengthening programme recommended," "Occupational therapy for handwriting remediation advised."

    To a trained LA officer or school SENCO, this is useful. But it is not provision. Provision must be:

    • Specific: Not "OT support" but "individual OT-led sessions" or "small group fine motor intervention"
    • Quantified: Not "regular support" but "45 minutes per week"
    • Named in method or tool: Not "fine motor activities" but "activities based on the Colorado Assessment of Everyday Fine Motor Skills (CAEFS), targeting pencil grip and hand strength"
    • Named in who delivers: Not "supervised by OT" but "delivered by a trained TA under quarterly OT review"
    • Reviewable: "Progress reviewed by the OT at the end of each half-term term with adjustments made as needed"

    When you commission an independent OT report with the EHCP process in mind, ask the OT to frame recommendations as provision, not just guidance. This significantly increases the likelihood they will end up in Section F of the plan.[5]

    Does this sound familiar? Many of the families we work with describe exactly this situation. If you'd like to talk it through, book a free 15-minute call, no pressure, just a conversation.

    What Local Authorities Look for in an OT Report

    Local authorities employ educational psychologists, SEN officers, and specialist teachers to review evidence submitted during the EHC needs assessment. They are looking for specific things in an OT report.

    Functional Assessment

    LAs want to understand how the child's OT-related difficulties affect real school life. This is not the same as standardized test scores (though these are relevant too). It is the functional impact.

    Examples of functional assessment:

    • "Child cannot fasten own coat buttons or zip jacket, requiring adult help at the start and end of every break and lunch. This reduces independent play time and places additional demand on supervising adults."
    • "Child's handwriting speed is 15 words per minute, approximately 40% below age-expected. In timed exams, child completes only 30% of written answers despite demonstrating knowledge verbally."
    • "Child avoids the dining hall at lunch due to noise and visual stimulation, eating lunch alone in a quiet room. This has led to social isolation and missed peer interaction during the school day."
    • "Child requires 10-minute transitions between activities, with significant distress if the routine changes. This delays access to curriculum time and disrupts timetabling for whole-class teaching."

    An OT report that contains pages of standardized test results but does not clearly link them to what the child actually struggles with during the school day will be less persuasive to an LA than one that does both.

    Sensory Processing Profile and Its Impact

    Many children with SEND profiles (autism, ADHD, dyspraxia, and others) have underlying sensory processing differences. An OT can assess whether the child has:

    • Hyper-sensitivity (overly sensitive) to sensory input
    • Hypo-sensitivity (under-responsive) to sensory input
    • Sensory-seeking behaviour
    • Difficulty filtering background noise or visual clutter
    • Poor proprioceptive awareness (sense of where their body is in space)
    • Vestibular difficulties (balance, movement-induced nausea or dizziness)

    The LA is not just interested in whether the child has these differences, but how they manifest in school and how they affect attention, engagement, and learning. For example:

    "Child is auditorily hypersensitive and experiences significant distress in unstructured, noisy environments such as the dining hall, playground, and assembly. Auditory overstimulation leads to shutdown behaviour (non-responsiveness, withdrawal) and emotional dysregulation (crying, aggression) 15-20 minutes after exposure. This reduces access to social opportunities and unstructured learning time."

    This is a link between sensory profile and functional outcome that an LA must address in the plan.

    Fine Motor and Handwriting Assessment

    For primary and secondary pupils, handwriting and fine motor function are often central to accessing the curriculum. An OT report should include:

    • Pencil grip quality (tripod, quadrupod, whole-hand, etc.)
    • Hand strength and endurance (how long before fatigue)
    • In-hand manipulation skills (ability to adjust objects within the hand: critical for scissor use, pen control, turning pages)
    • Handwriting speed and accuracy (compared to age norms if available)
    • Letter formation and sizing
    • Functional impact: can the child write fast enough to take notes, complete classwork, sit for exams?

    Standardized tools might include the Movement Assessment Battery for Children 2 (MABC-2), the Beery VMI (Visual-Motor Integration), or the Colorado Assessment of Everyday Fine Motor Skills (CAEFS). The report should name the tool, include raw scores and percentiles, and explain what this means functionally.

    Recommendations Framed as Provision

    As discussed above, an EHCP-ready OT report frames recommendations not as clinical suggestions but as specific, quantified, named provision. An LA reviewing the report should be able to copy recommendations almost directly into Section F of the plan.

    Vague recommendation: "Occupational therapy to address fine motor skills and handwriting."

    Specific provision: "Individual fine motor intervention, 30 minutes twice per week, delivered by a teaching assistant trained in fine motor strengthening protocols from [named approach]. Sessions to include hand strength activities, tripod grip re-education, and controlled writing practice. Progress to be reviewed by a qualified occupational therapist each term."

    EHCP-Ready Report Formatting

    An EHCP-ready OT report should include:

    • Cover page with the OT's name, title, HCPC registration number, and the date of assessment
    • Clear sections: referral reason, assessment method, results, functional impact, recommendations
    • Dated assessment session(s) and any observation in school
    • Standardized assessment tools named with results presented as raw scores, percentiles, or age equivalents
    • Photographs or videos of functional tasks (with parental consent) can be powerful
    • Clear links between assessment findings and functional classroom impact
    • Recommendations with specific detail on frequency, duration, method, and review process
    • HCPC registration number included (clients and LAs expect this as evidence the OT is regulated)
    • Signature, date, and contact information for the OT

    Reports that lack this formatting, even if clinically sound, may be set aside by busy LA officers as "not in the right format" for the EHC process.[6]

    NHS OT Evidence vs Independent OT Evidence

    A common question from parents is: does the LA have to consider a private OT report, or does it only accept NHS evidence?

    The answer is yes, the LA must consider independent evidence. The Children and Families Act 2014, Section 36, explicitly requires LAs to consider evidence from a range of sources, including evidence provided by parents.[7] The SEND Code of Practice 2015 reinforces this: "Local authorities must consider evidence from a range of sources, not solely from statutory services."[8]

    However, there is a critical difference between "must consider" and "will accept and act on." In practice, many LAs dismiss independent OT evidence, offering reasons such as:

    • "We do not commission independent assessments; we rely on NHS evidence."
    • "The child is not open to NHS OT, so there is no need for OT provision."
    • "The private report does not follow our format."
    • "We have an NHS occupational therapist who disagrees with the independent assessment."

    These are pushback tactics, not legal barriers. You have rights.

    What to Do If an LA Dismisses Independent Evidence

    If an LA refuses to consider or act on a private OT report:

    1.Request in writing that the LA explain in detail why they have rejected the evidence. Ask them to address specific points from the report and state which statutory guidance permits them to ignore parental evidence.
    2.Reference the legislation in your response. Write: "The Children and Families Act 2014, Section 36, requires you to consider evidence from a range of sources, including parental evidence. Under the SEND Code of Practice 2015, paragraph 9.51, independent evidence must be considered."
    3.Ask the LA to commission its own OT assessment if they do not accept the private evidence. This is your right during the EHC needs assessment window. If they refuse, they must explain why in writing. Refusal to assess, without clear justification, is a ground for appeal.
    4.If the plan is issued without OT provision despite your independent evidence, you can appeal to SEND tribunal. You then have the right to present the private OT evidence to the tribunal and, if you choose, to have the OT present as an expert witness.[9]

    Important: You do not have to accept the LA's decision that independent evidence is not relevant. Parent-commissioned evidence is legally admissible at tribunal, and tribunals frequently make decisions in favour of parents based on independent professional evidence.[10]

    Requesting the LA Commission an OT Assessment

    If the child is not open to NHS OT services (a common situation, particularly in areas with long waiting lists), you can formally request that the LA commission an OT assessment as part of the EHC needs assessment.

    How to do this:

    • In your initial EHC request letter (before the 20-week assessment window opens), state: "I request that the local authority commission an occupational therapy assessment to evaluate my child's fine motor skills, sensory processing, and functional independence in school settings."
    • If the LA agrees, they will instruct an NHS OT or a commissioned independent OT to assess your child. The cost comes from the LA, not from you.
    • If the LA refuses without justification, they are in breach of their statutory duty to carry out an adequate EHC needs assessment. This refusal is itself a ground for challenging the decision.

    Timing the OT Assessment

    When you commission a private OT assessment (or request the LA commission one) depends on your circumstances and strategy.

    Proactive: Before Making the EHC Request

    This is the strongest position. If you commission an OT assessment before requesting an EHC needs assessment, you arrive at the first meeting with the LA already holding professional evidence of need. The assessment is not reactive to a LA decision (which might lead them to discount it) but proactive evidence of an existing difficulty.

    Advantage: The LA cannot claim "we have no evidence of OT need" because you have provided it.

    Disadvantage: You incur the cost of private assessment upfront (typically GBP 800-1,500 for a comprehensive assessment including school observation) before you know if the child will be assessed for an EHCP.

    During the 20-Week Assessment Window

    The EHC needs assessment process takes a maximum of 20 weeks from request to the issue of the plan (or notice that the LA will not issue a plan).[11] If you have not commissioned an OT assessment beforehand, you can commission one during this window.

    Advantage: You know the LA is assessing, so the assessment is directly relevant.

    Disadvantage: You have limited time. A private OT assessment typically takes 4-8 weeks to complete (appointment to report), and you need the report submitted to the LA well before the 20-week deadline (ideally by week 10) for it to be considered before the plan is drafted.

    Before Annual Review

    If an EHCP plan has been issued but does not include OT provision, or the provision is inadequate, you can commission an updated OT assessment before the annual review meeting (held within 12 months of plan issuance). This gives you new evidence to support a request to amend the plan.

    Before SEND Tribunal

    If you are pursuing a tribunal appeal against the decision not to issue an EHCP, or against the content of the plan, you may want an updated OT assessment to submit as evidence to the tribunal. Assessments submitted directly to the tribunal (rather than to the LA) can be particularly persuasive because they are seen as genuinely independent and current.[12]

    Statutory Deadlines and Timing Risk

    The key timeline:

    • Week 0: You request an EHC needs assessment.
    • Week 2: The LA should notify you that it is proceeding with assessment and invite you to submit evidence.
    • Week 10: Evidence should be submitted to the LA so there is time for the educational psychologist and other professionals to review it.
    • Week 14-18: The LA drafts the plan.
    • Week 20: The plan is issued (or the LA notifies you it will not issue a plan).

    If you commission a private OT assessment starting at Week 4, you have approximately 6 weeks for the assessment to be completed and the report returned to you. If the OT takes the full 8 weeks, the report arrives at Week 12, leaving only 2 weeks for you to submit it to the LA before the plan is drafted. While not impossible, this is tight and leaves little room for questions or delays.

    Risk: Commissioning too late means your OT evidence may not be properly reviewed or integrated into the draft plan, even though the LA is legally required to consider it. You then face the burden of challenging the plan through appeal or tribunal.

    The safest approach is to commission the assessment as early as possible: ideally before the EHC request (if you are confident an assessment will be needed) or within the first two weeks of the request.

    Working with the School

    The school, and specifically the Special Educational Needs Coordinator (SENCO), will have observations and records about the child's functioning that can support an OT assessment.

    What a SENCO Can Contribute

    A SENCO can provide:

    • Observational data: how the child manages in the classroom, dining hall, playground, and during transitions
    • Examples of the child's work: photocopies of handwriting samples, photographs of fine motor tasks completed
    • Feedback from class teachers on the child's fine motor difficulties, handwriting speed, behaviour in response to sensory environments
    • Records of interventions already tried and their outcomes
    • Baseline data and progress records if fine motor or sensory support has already been attempted

    An OT who is assessing for EHCP purposes should request this information from the school and, ideally, conduct at least one school-based observation to see the child in context.

    School-Commissioned OT vs Parent-Commissioned OT

    If you commission a private OT assessment, the OT's client is you (the parent), and you own the report. You can choose to share it with the school and LA, or not.

    If the school commissions an OT (for instance, from their SEN budget, or from an NHS service to which the school has referral access), the OT's client is the school, and the report belongs to the school. The school will decide whether and how to share it with you and the LA.

    Important: This matters because of confidentiality and autonomy. If you commission an independent OT report, you control its timing and content. If the school commissions, you have less control. However, school-commissioned evidence may be viewed more favourably by the LA (rightly or wrongly) because it comes from an institution rather than a parent.

    In practice, many schools are cash-strapped and rely on parents to commission private assessments. If the school offers to fund an OT assessment, you are in a fortunate position; the SENCO should be a partner in explaining the findings to the LA.

    Should the OT Conduct a School Observation?

    Yes. An EHCP-focused OT assessment should include at least one school visit where the OT observes the child in genuine school contexts: in the classroom during a writing task, in the dining hall or unstructured time, during PE or handcraft lessons if there are fine motor demands. This is not a formal assessment but observation, and it provides crucial context for understanding the child's functional difficulties in the environment where they matter most.

    OT Recommendations in Section F: Vague vs Specific

    The school's SENCO, the LA's SEN officer, and you (the parent) will work together (ideally) to translate OT recommendations into Section F provision. Here are worked examples of how this translation should happen:

    Vague provision (unenforceable):

    "Access to fine motor activities. OT support as needed."

    Why this is weak: It does not specify what the activities are, who delivers them, when, how often, or how progress is measured. A school can claim compliance by offering "access" without actually providing structured intervention.

    Specific provision (enforceable):

    "Child will receive fine motor intervention, 30 minutes twice per week, in a small group or individually. Sessions will use the Colorado Assessment of Everyday Fine Motor Skills (CAEFS) protocol and focus on pencil grip, hand strength, and finger isolation exercises. A teaching assistant trained in the protocol will deliver sessions. Progress will be reviewed by the school's SENCO monthly, with a formal progress report from the qualified occupational therapist each term."

    Why this is strong: It names the frequency (twice per week, 30 minutes), the method (CAEFS protocol), who delivers it (trained TA), and how progress is measured (monthly by SENCO, formal review termly by OT). The school can be held accountable to this.

    Another example, for sensory needs:

    Vague:

    "Sensory support as required. The school will make reasonable adjustments to the sensory environment."

    Specific:

    "Child will have access to a quiet work space for fine motor and writing tasks, available on request, with a visual schedule showing when the space is available. The school will provide movement breaks between seated work, approximately every 30 minutes, using proprioceptive activities (resistance exercises) designed by the occupational therapist. Noise-dampening headphones will be available during unstructured times (lunch, transitions). The SENCO will review these arrangements each half-term with the occupational therapist."

    The second version is specific enough that the school's provision can be monitored and you have grounds to challenge if it is not being delivered.


    Thinking about an assessment? Sensphere offers private paediatric OT assessments from £450, with no GP referral needed. Payment is via Stripe (card payment). Book a free call or view our full pricing.


    If Things Go Wrong

    Despite your best efforts, the LA may refuse to commission an OT assessment, may dismiss your independent evidence, or may issue a plan that does not include adequate OT provision. Here is what you can do.

    LA Refuses to Commission an OT Assessment

    If you have made a written request for the LA to commission an OT assessment during the EHC needs assessment process, and the LA refuses without adequate explanation, this is a breach of their duty to carry out a comprehensive assessment.

    How to challenge:

    1.Write to the LA (keeping a copy) asking them to explain in detail why they refuse to commission an OT assessment. Ask them to cite the statutory guidance that permits them to omit a health-related assessment.[13]
    2.If they respond with a weak explanation ("We do not routinely commission OT assessments" or "The child is not on an NHS OT waiting list"), this is not a valid justification. Respond stating that the refusal appears to breach the SEND Code of Practice 2015, which requires comprehensive assessment of all identified needs.
    3.If the LA issues a plan without an OT assessment despite your request, this is a ground for appeal. You can appeal the decision within two months of the plan being issued.
    4.Alternatively, you can request LA-funded or SEN tribunal mediation (which is free and now mandatory before tribunal in many cases, though there are exemptions).[14]

    Draft Plan Does Not Include OT Provision

    When the LA issues a draft plan, you have 15 calendar days to submit representations (objections and new evidence) before the final plan is issued. If the draft plan lacks OT provision, this is the time to act.

    Submit in writing:

    • Your independent OT report (if you have not already)
    • A clear statement of what provision you are requesting (e.g., "30 minutes of fine motor intervention twice per week, delivered by a trained TA under OT supervision")
    • Evidence that the need is academically or developmentally significant (e.g., handwriting speed is preventing exam completion; sensory needs are preventing social participation)
    • If relevant, evidence that the school cannot meet this need without LA-commissioned provision

    The LA must then respond. They may agree and amend the plan, or they may issue the plan as drafted (with your objection noted). If they refuse to include OT provision, they must explain why, in writing. This explanation becomes part of the appeal record and can be challenged at tribunal if necessary.

    OT Evidence Disputed by LA-Appointed Assessor

    Sometimes the LA commissions its own OT assessment and the NHS OT's findings conflict with your independent OT's findings. This is not unusual; different assessors may reach different conclusions, or one may assess the child at a different developmental stage.

    The key question at tribunal is: which evidence is more persuasive? Tribunals are experienced in weighing conflicting professional evidence. They will consider:

    • The qualifications and experience of each OT
    • The comprehensiveness of each assessment (did each OT conduct a school observation? Use the same standardized tools? Consider functional impact?)
    • The consistency of findings with other evidence (e.g., teacher observations, educational psychology report, medical history)
    • Whether the recommendations are supported by the assessment findings

    An independent OT who has conducted a thorough, recent assessment, including school observation and standardized testing, and whose findings align with teacher reports and other evidence, will often be viewed as persuasive at tribunal, even if an NHS OT disagrees.[15]

    SEND Tribunal: Role of Independent OT Evidence

    If you appeal to SEND Tribunal (the Special Educational Needs and Disability Tribunal, or SENDIST), you can submit the independent OT evidence as part of your case. You can also invite the OT to attend the tribunal as an expert witness if you believe a tribunal panel would benefit from hearing directly from the OT about the assessment, the child's functional needs, and the recommended provision.

    Can a private OT attend tribunal as a witness? Yes, absolutely. This is a normal and accepted practice.[16] The OT would be cross-examined by the LA's representative and questioned by the tribunal panel, so they must be prepared to defend their assessment and recommendations in detail.

    The presence of an expert witness who can clearly link assessment findings to functional school impact, and who can explain why specific provision (not just support) is necessary, significantly strengthens an appeal.

    Cost: Inviting an expert witness incurs a fee. Most independent OTs charge for tribunal preparation and attendance (typically GBP 150-300 per hour). Some parents are able to claim this cost through a tribunal appeal; ask your tribunal adviser or SEND support organisation.

    Mediation as Mandatory Step Before Tribunal

    Before pursuing tribunal, you are required (in most cases) to attempt mediation with the LA. Mediation is a free, facilitated conversation with a neutral mediator present, aimed at resolving disagreement over the EHC plan.

    Mediation often works well when the LA's concern is cost or feasibility rather than whether the child has a need. If you have strong OT evidence, mediation can sometimes move the LA to agree to provision they initially resisted.

    Exemptions: You do not have to attend mediation if:

    • The child is already subject to a child protection plan or public law order (family court proceedings)
    • The LA has already provided you with the mediation information and you have already attended mediation in relation to this child and issue (and it did not result in agreement)
    • The LA has not provided the mandatory mediation information leaflet

    If you believe one of these exemptions applies, you can go straight to tribunal. Otherwise, you are required to attempt mediation first.[17]

    After the Plan: Ensuring Provision Is Delivered

    Issuing an EHCP plan is not the end. The plan must be implemented, reviewed, and adjusted.

    Named Provision in Section H: Who Commissions?

    If OT provision is named in Section H (health provision), the Integrated Care Board (ICB) is responsible for commissioning it. The plan will name the frequency and type of provision (e.g., "Child will receive 16 sessions of occupational therapy over 12 weeks, focused on sensory regulation and fine motor development").

    Who actually delivers it? This depends on the ICB's commissioning arrangements. It might be:

    • An NHS occupational therapist (via the child's local health service)
    • A private OT commissioned by the ICB
    • A specialist service (e.g., a sensory integration clinic)

    You are entitled to ask the ICB which provider will deliver the provision and when the child will be seen. Do not assume it will happen automatically; NHS waiting lists for OT are long in many areas, and if the ICB does not actively commission the service, it may not be provided.

    If Named Provision Is Not Delivered

    If the plan names OT provision in Section H and it is not delivered after a reasonable time (typically, the child should be seen within three months of the plan being issued), you have grounds to complain.

    Steps:

    1.Contact the ICB's patient advocacy service (or PALS: Patient Advice and Liaison Service) in writing, stating that the named provision has not been commissioned. Ask for an explanation and a timeframe for delivery.
    2.If the ICB does not respond adequately, you can lodge a complaint with the NHS complaints process. This is free and is handled by the ICB's complaints team.
    3.If the complaint is not resolved, you can escalate to the Health Service Ombudsman (now part of the Local Government and Social Care Ombudsman).[18]

    Separately, if the LA commissioned provision in Section F (educational provision) and it is not being delivered by the school, complain to the LA's complaints service and, if necessary, request that your local authority member or MP intervenes.

    Annual Review: Using Updated OT Evidence to Amend the Plan

    Within 12 months of the plan being issued, you are entitled to request an annual review. This is an opportunity to update all evidence, including OT assessment, and to amend the plan if the child's needs or circumstances have changed.

    If the current OT provision is not meeting the child's needs, commissioning an updated OT assessment (or asking the school to do so) before the annual review meeting gives you fresh evidence to support a request for amended provision. For instance, if the child received 20 minutes of fine motor intervention per week and has made good progress but still requires ongoing support, an updated assessment might recommend continuing or increasing the frequency. If the child has not progressed despite the intervention, an updated assessment can recommend a different approach or setting.

    Annual reviews are a natural point at which to evolve the plan in line with the child's development and changing needs.

    Key Takeaways for Parents

    An OT assessment can be powerful evidence within the EHCP process, but only if it is conducted with the EHCP framework in mind, framed as concrete provision, submitted promptly, and properly acted upon by the LA.

    Timing matters: Commission early, ideally before the EHC request or within the first two weeks of the request.

    Evidence matters: Functional, school-based observation and assessment is more persuasive than test scores alone. Link every finding to school impact.

    Wording matters: Ensure OT recommendations are specific and quantified, so they can be written directly into Section F as enforceable provision.

    You have rights: The LA must consider independent evidence. If it does not, you can challenge the decision. Your private OT can attend tribunal. You are not powerless.

    It is ongoing: Once a plan is issued, implementation, delivery, and annual review are ongoing responsibilities. Monitor whether provision is actually being delivered and amend if the child's needs change.


    References


    Related reading

    • What a full children's OT assessment involves
    • What an EHCP-ready OT report should contain
    • Private OT versus NHS for EHCP timelines
    • Cost of the formal evidence pathway
    • What SENCOs look for when using OT evidence

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    References

    1.Children and Families Act 2014, Sections 36-61. HM Government. https://www.legislation.gov.uk/ukpga/2014/6/contents
    2.SEND Code of Practice: 0 to 25 years (2015), paragraph 6.1. Department for Education & Department of Health. https://www.gov.uk/government/publications/send-code-of-practice-0-to-25-years
    3.Special Educational Needs and Disability Regulations 2014, Regulation 4 (duty to specify provision). HM Government. https://www.legislation.gov.uk/uksi/2014/1097/contents
    4.SEND Code of Practice (2015), paragraph 8.1 (health provision in EHC plans). Department for Education & Department of Health.
    5.Royal College of Occupational Therapists (2019). *Professional Standards for Occupational Therapy Practice, Conduct and Ethics*. RCOT. https://www.rcot.co.uk/
    6.Health and Care Professions Council (2013). *Standards of Proficiency: Occupational Therapists*. HCPC. https://www.hcpc-uk.org/standards/standards-of-proficiency/occupational-therapists/
    7.Children and Families Act 2014, Section 36(3). HM Government.
    8.SEND Code of Practice (2015), paragraph 9.51. Department for Education & Department of Health.
    9.SOS!SEN (2023). *Using Independent Evidence at SEND Tribunal*. https://www.sososen.org/
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    10.Tribunal case law: Independent evidence is admissible and frequently persuasive. See reported decisions of SEND Tribunal (SENDIST) via the Tribunal Decisions Database.
    11.SEND Code of Practice (2015), paragraph 9.14 (20-week statutory timeline). Department for Education & Department of Health.
    12.IPSEA (2023). *How to Challenge an EHC Needs Assessment Decision*. IPSEA. https://www.ipsea.org.uk/
    13.SEND Code of Practice (2015), chapters 6-8 (comprehensive assessment requirements). Department for Education & Department of Health.
    14.SEND Code of Practice (2015), paragraph 2.24 (mediation and dispute resolution). Department for Education & Department of Health.
    15.Tribunal case law: Tribunals assess the weight of expert evidence based on methodology, impartiality, consistency with other evidence, and qualifications. See *EH v Coventry City Council [2011] EWCA Civ 719* (and similar cases on expert evidence in education law).
    16.Special Educational Needs and Disability Regulations 2014, Regulation 35 (right to present evidence at tribunal). HM Government.
    17.SEND Code of Practice (2015), paragraph 2.23-2.24 (mediation and exemptions). Department for Education & Department of Health.
    18.Local Government and Social Care Ombudsman. Complaints about health provision in EHC plans. https://www.lgo.org.uk/