Preparing for adulthood staying healthy

As a young person with SEND, there are many changes to negotiate including how your health and care is managed when you move from children's to adult services. This includes looking at services that may no longer be available once you reach 18, and identifying and putting different healthcare in place.


Health pathways vary depending on the needs of the young person and which professionals from each community and hospital settings they will need, to ensure that appropriate support is in place.  

A key aim with transition for these young people is to ensure that a consistent and continuous package of support is provided for, both during the years before, and after, the move to adulthood. The nature of the package may change because the young person’s needs or circumstances change.  

If your main need is related to health a referral for an Adult Continuing Health Care Assessment should be made.  This should be done well before your 18th birthday to allow enough time for the assessment to be completed and for any discussions about the care you are entitled to.

Mental health services

There are specialist adult mental health (AMH) services in Bromley for people aged 18 and above.  Referrals can be made through the young person’s GP.  

If you are experiencing ongoing mental health issues and are already known to child and adolescent mental health services (CAMHS), then discussions between them and AMH should start when the you are no older than 17.5 years old so that correct adult provision can be identified and put in place in good time.  

AMH services should also be invited to your education, health and care (EHC) plan review.

Social care

If you have an allocated social worker/care manager and/or in receipt of support, for example being a looked after child – it is essential there is joint working across education and social care. 

It is important that the outcomes are discussed with you and your family during the Year 9 annual review, so that they can be worked on both at school and at home, and where appropriate, be supported via social care.  The allocated social worker/care manager should be involved in the EHCP annual review process, from the Year 9 annual review, in order to provide up to date information and advice.

When approaching 18 years old, you may have ongoing care and support needs and should be referred for an assessment under the Care Act 2014.  The assessment will focus on the your needs, how they impact on your wellbeing and the outcomes you want to achieve in your day-to-day life. It should:

•    Involve you and your family/carers in discussions and decisions about your care
•    Take into account your personal history and life story
•    Take a whole family approach, including the needs of your family/carers
•    Consider your housing status and where and who you want to live with
•    Be aimed at promoting your interests and independence and respectful of your dignity
•    Be transparent in terms of letting you and your family/carers know how, when and why decisions are made
•    Take into account the potential negative effect of social isolation on  your health and wellbeing.

The assessment should take place at a time that is of most benefit to you and uour family.

People over the age of 18 who have eligible care and support needs may have to contribute towards their care and support costs – this can include paying towards:

  • Home care (day and night)
  • Day activities and respite care
  • Supported living
  • Support from a Personal Assistant (PA)

Personal budgets and direct payments

A personal budget is an amount of money identified to deliver the outcomes in an EHC Plan/Support Plan

Personal budgets can be paid in different ways:

  • By direct payments – the money is paid directly to the young person
  • Notional – the LA or CCG commission services for you
  • Third party – such as a broker 
  • Combination – a mix of the above

Direct payments are available to those young people who are in receipt of social care support.  It can be spent on anything agreed in the EHC or social care support plan, such as:

  • Access to local community and groups
  • Access to a variety of short breaks
  • Personal care
  • Day trips/activities
  • Personal assistants 

Carer's assessments

The Care Act (2014) and the Children and Families Act (2014) gives local authorities a responsibility to assess your needs for support as a carer.  This assessment should consider:

  • The impact of caring on you
  • What you want from life
  • Are you able or willing to carry on caring
  • Do you work or want to work
  • Do you want to study or do more socially

Further information

Download our PfA pathways guide