Local authority variation in school-recorded special educational needs and disability provision in Year 1 among children born in England, 2003-13

Eur J Public Health. 2025 Feb 7:ckaf116. doi: 10.1093/eurpub/ckaf116. Online ahead of print.

Abstract

Evidence of disparities in special educational needs and disability (SEND) provision at local authority (LA) level in England is needed to guide policies for equitable provision. We described LA-level variation in recorded SEND provision using linked health-education records. We used linked hospital-primary school records (ECHILD - Education and Child Health Insights from Linked Data) to create a cohort of 3 729 265 children born in England between 2003/04-2012/13. LA of pupil's residential address and SEND provision [SEND support or Educational Health and Care Plan (EHCP)] were defined at Year 1 (5/6 years old). We compared single-level and multilevel logistic models, adjusting for individual-level sociodemographic, health indicators, and school governance, and stratifying by gestational age. In further multilevel models, we added LA characteristics. After accounting for individual-level characteristics, there was between 2.0% (SEND support compared with no SEND provision) and 5.8% (EHCPs compared with SEND support) residual unexplained variation between LAs across gestational age groups. Adding LA-level income deprivation reduced the between-LA variance for EHCPs by 14%-24% across gestational age groups; less so for other LA characteristics. Under 6% of the differences in school-recorded SEND provision in Year 1 between 2009/10 and 2018/19 was associated with the LA context. We need to carefully disentangle structural factors at the school and individual level to understand inequities in recorded SEND provision.