Welcome to the HOPE Study

The HOPE Study (Health Outcomes of young People throughout Education) investigated factors that affect variation in additional help for special educational needs and disabilities (SEND) in English primary schools. We also assessed the impact of additional help for SEND on children’s health and education. It used national linked data from the ECHILD database, which brings together education and hospital records for all children in England, to explore differences in SEND provision and how these differences influence children’s outcomes.

What has the HOPE Study researched?

We focused on four main research questions, which have been informed by young people, parent carers and professionals throughout the project. 
The questions were:

1. Which health conditions are linked with outcomes that might improve when children receive SEND support?
2. What factors affect which children are given SEND support, and when and where this happens?
3. What impact does SEND support have on children’s health and education?
4. What do people’s experiences and current policies tell us about how the SEND system works in practice?”

The HOPE  is led by University College London (UCL) in collaboration with the University of Cambridge and the University of Exeter, funded by the National Institute for Health Research Programme for Applied Health Research. 

Why is this research needed?

Parents and young people have raised concerns that support for special educational needs and disabilities (SEND) isn’t fair or good enough. We wanted to understand why support varies across England. To do this, we looked at whether differences in SEND provision could be explained by children’s needs as recorded in the ECHILD database, which links health and education records. We also examined whether SEND support leads to better health or learning outcomes.

What we did

We carried out 14 studies using the ECHILD database, which allowed us to follow millions of children in England from birth to age 11 through their anonymised health and education records. We explored how children’s health conditions, assessment results, and factors linked to their school and local area affected who received SEND support. We also used statistical methods to estimate how much receiving SEND support in Year 1 helped groups of children with certain health conditions, such as cerebral palsy.

Alongside this, we ran 10 additional studies using interviews, surveys, and document analysis. We spoke with hundreds of parents, children and practitioners about their experiences of the SEND system and the difference it made. Parents, young people and practitioners also helped shape parts of the research and interpret the findings.

What we found

By age 11, 30% of children had some form of recorded SEND support. Health conditions made it more likely that a child would receive SEND provision, but so did other factors such as social disadvantage, early development and school characteristics. Boys, children living in disadvantaged areas, those with lower test scores, children in community schools and those who started in state nursery were all more likely to receive SEND support. When comparing children with similar characteristics, voluntary aided schools and sponsor led academies gave out fewer Education, Health and Care Plans (EHCPs) than community schools.

We found only limited evidence that SEND support reduced unauthorised school absences, and no evidence that it improved hospital admission rates or test scores. However, interviews and surveys showed that parents, young people and practitioners often felt SEND support had a positive impact when it was given early and tailored to the child’s needs. Families also described negative effects when support was delayed or insufficient, and many said that strong parental advocacy was crucial for securing an EHCP.

What we learned

Current education data does not fully capture which children need SEND support, even when it is linked with information about their health. It also does not clearly record what support children receive, when they receive it or for how long. Parents, young people and practitioners can see clear benefits when SEND support is timely, flexible and high quality, but these improvements—such as feeling happier, taking part in lessons and developing new skills—are not measured by the standard tests used by government.

To understand what types of support work best for which children, and to guide future SEND policy, we need better measures linked to ECHILD data and more use of robust evaluation methods such as randomised comparisons.

To view all HOPE outputs and research summaries, visit the HOPE study outputs webpage: https://www.ucl.ac.uk/population-health-sciences/child-health/hope-study-outputs. 

You can also read more about the study in the HOPE programme summary paper: Preprint: https://www.medrxiv.org/content/10.1101/2025.08.31.25334778v1 (DOI: https://doi.org/10.1101/2025.08.31.25334778). September 2025

How was the research carried out?

The HOPE Study uses diverse methodologies and involve young people, parents and practitioners.  Our research methods use the fact that SEND provision has not been evenly distributed across local authorities and the amount of provision has varied over time. This makes it possible to compare outcomes in children who received support with similar children who did not receive support for SEND. Different methods have been used to analyse how certain we can be that SEND provision causes a change in health outcomes. Four interlinked research questions within the HOPE Study have iteratively investigated and informed each other’s findings throughout the programme.

You can also read more about the HOPE study in the research protocol here:
Evaluation of variation in special educational needs provision and its impact on health and education using administrative records for England: umbrella protocol for a mixed-methods research programme: https://bmjopen.bmj.com/content/13/11/e072531 (DOI: http://dx.doi.org/10.1136/bmjopen-2023-072531). November 2023.

NIHR programme grant for applied research, read more here.

Privacy Policy

To find out more about the ECHILD database used in this study’s research, how we collect, manage and use data and what to do if you (or your child) do not want to be part of the study:

Read ECHILD Privacy Notice