School absence was a highly sensitive topic with this group, given all members had health needs which necessitated school absence. The group highlighted a frequent lack of support and understanding with their respective schools.

What we learnt about school absences:

• There are many reasons for absences: Hospital appointments, feeling unwell, religious holidays, family commitments and mental health.

• Mental health is often linked to school absences. There is a frustration when having to miss school. 

What we learnt about reducing school absences:

• There are avoidable absences that something should be done to reduce (e.g., making schools safer/supportive to reduce absences due to mental health/bullying). 

• There are unavoidable absences that something should be done to support (e.g., virtual classes when ill/recovering from an operation). 

• There are absences that seems unavoidable on the surface, but may actually be avoidable if healthcare is changed (e.g., absences due to medical appointments could be reduced if appointments were outside of school hours or delivered in schools).   

• The focus in schools on good attendance and presenteeism can be demoralising for young people with health conditions.

• Pupils who are ill should be encouraged to stay at home, to recover fully and not expose others to viruses and illness.

• Pupils can better engage with their learning if fully recovered.

What we learnt about how schools and hospitals could help?

• There is a conflict between being encouraging to look after your mental health and taking time off, as this can result in falling behind with education, which in turn negatively impacts mental health.

• There are feelings of being ‘singled out’ due to absence.

• Technology, in terms of virtual classes, would help improve attendance if being at school in person is not possible.

What we learnt about school absences:

• Parents described variable experiences with schools and their child’s health-related school absences.

• Some schools were supportive and used interventions to help students (e.g. virtual lessons)

• Some schools left parents feeling “victimised for absence”, even if the absence was unavoidable because of hospital appointments.

• There can be tension between overloading a student and also making sure a child does not fall behind.

What we learnt about how schools and hospitals could help?

• A helpful model may be online lessons, blended with in-person lessons.

• Government backing, and free WIFI in hospitals could help.

• Better communication between schools and healthcare could help, perhaps including a coordinator/liaison function. 

What we learnt about school absences:

• There are many reasons for absences: Poor mental health, too much workload, pressure from teachers, bullying, family responsibilities, health issues and appointments, a perception of insufficient support upon return and worries about exposure to Covid-19.

• Reducing school absences is important, but it is also important to look at different ways to provide schooling if absent.  This should avoid pressures to complete a large amount of work.

• School absence is something that should be considered on a case-by-case basis.  Every pupil has a different situation and requires individual support.

• The focus should be on improving the support system at school rather than reducing absences.

What we learnt about how schools and hospitals could help?

• Better communication about long-term conditions.

• Better informed teachers able to understand and provide support.

• Reduce pressure to attend school if unwell, especially as this can increase contagion. 

• A liaison member of staff, either based in hospitals or in schools, could help coordinate the schoolwork missed.

• More trust from teachers when returning to school and reporting reasons for absence.

• Free WIFI in hospitals to support schoolwork being completed when in hospital.

This event brought together a range of stakeholders from government departments, the third sector and children’s services with expertise in health, education and social care. The purpose of the event was to provide an opportunity for stakeholders to ask questions about and share their views on the ECHILD Database and its use in future research for the public benefit. A more detailed report describing discussions at the stakeholder event can be found here.

What we learnt about stakeholders’ views on the ECHILD Database and its use for research

• The key strengths of the ECHILD Database were seen to be its coverage of the whole population and the ability to cut across areas the interrelated areas of health, education and social care.

• Stakeholders raised the importance of data security in research using linked administrative data. ECHILD project partners explained that data security has been a central consideration when creating the ECHILD Database and will continue to be crucial when making the data available for wider use by accredited researchers.

• Stakeholders questioned whether commercial organisations would be able to use the ECHILD Database. ECHILD project partners highlighted that all future research using the ECHILD Database - whether proposed by accredited researchers from academic, third sector or commercial organisations - will need to demonstrate a public benefit by promoting children’s education and wellbeing, or the provision of health and social care services.

• Stakeholders emphasised the importance of continuing to embed children and young people’s voices in the way the ECHILD Database is made available and used by researchers.

• Stakeholders also discussed the importance of engaging with intended users of the research (such as school leaders and teachers) to ensure that research findings are useful to them and they can understand and apply them to the immediate benefit of children and young people. 

• Stakeholders expressed an interest in expanding the range of datasets included in the ECHILD Database to broaden the types of research questions it could address. 

In this session, we explored the relationship between children’s health and education using two examples: preterm babies and children who have Special Educational Needs and Disabilities (SEND). 

What we learnt about how being born preterm can affect children’s education

• Early intervention to support preterm babies’ development is key and should be offered to all babies as soon as possible following birth, rather than waiting for problems to emerge later on.

• Sure Start and Children’s Centres play an important role in supporting preterm babies’ early development. If they continue to be scaled back, outreach services will need to fill the gap.  

• The Early Years workforce requires more training to support preterm babies’ development. 

• The school system does not seem to account for children who were born preterm. For example, it does not account for a preterm child’s adjusted-age in terms of educational assessments or when they start school.  

What we learnt about how Special Educational Needs and disabilities (SEND) support can affect children’s health

• It can be difficult for parents to navigate complicated systems to get the level of SEND support their child needs. It may be even more difficult for parents who aren’t familiar with the system or don’t speak English as a first language. 

• It is not always clear where the responsibility for protecting and promoting the health of children with SEND lies: schools or hospitals? For example, if a child has a communication difficulty, speech and language therapy may help to improve both their health and educational outcomes, but there can be confusion as to whether schools or hospitals should be providing this support. 

• Staff in schools and healthcare settings (including GP surgeries) need more training about how they can best support children with SEND, including those with learning difficulties and autism. 

• SEND support can have unintentionally negative effects on children’s health. For example, being removed from lessons to get extra support may make children feel different from their peers leading to mental health issues.

In this session, the children and young people from the FLARE group offered valuable insights to the lived experiences of receiving Special Educational Needs and Disability (SEND) support in school and higher education.  The group were very positive about sharing their own experiences, as well as offering key points to consider in the research moving forward. Some of these included:

• Exploring post 16 support, the stages in school when most support is needed,

• The positives and negatives of receiving support, 

• The varying types of support offered to children and young people. 

What we learnt from FLARE:

• The use of correct terminology is paramount when working with children and young people with SEND. This has resulted in the language used in our research being revised.  FLARE will be engaged to help confirm new the new terminology that we aim to use.

• SEND support varies across the country and across the age ranges.

• Further investigation is required to explore the experiences of more children and young people who currently receive or have received SEND support in school.

In this session, the Young Research Advisors discussed their views on how the pandemic has affected their education and health services.  Advisors also gave their priorities for what ECHILD should focus on next.

What we learnt about how the pandemic has impacted Children and Young People:
Education:

• At the initial stages of the pandemic, there was little interaction with schools and colleges. 

• In most cases online teaching replaced in person teaching.  This was generally not considered frequent enough. 

Health:

• Appointments were cancelled during the pandemic and there were difficulties in getting new appointments. 

• In person health support was generally replaced with telephone appointments and advice services, such as 111.

What we learnt about the Young Research Advisors’ priorities for future research:

Research should consider focusing on:

• The impact of the pandemic on mental health and levels of stress and anxiety.

• The impact of missed planned healthcare.  E.g. emergencies created or alternative ways that young people used to self-manage their health conditions.

• What early interventions can be put in place to prevent or manage chronic conditions. 

• Different approaches (E.g. testing, social distancing, face masks) for keeping young people safe in school whilst minimising school closures and the impact on education.

The FLARE group gave their thoughts about how children and young people with SEND can be better engaged and involved in research.  The group also recommended how research information and findings can be made more accessible.

What we learnt about better engaging children and young people in research:

• The language traditionally used in research is often too complex, this makes it hard to understand what is involved.

• The designs of research materials can often be seen as 'boring'.  The use of coloured fonts and pictures make material much more engaging.

• When first contacting children and young people about research, use information flyers to grab attention with a brief and clear overview of the research. 

• Animations are highly recommended when explaining more details about research.

In this session, we discussed the linking of health and education data, support for students with additional needs and the impact of school absences on educational outcomes.  

What did we learn:

• Moving to a new school (e.g. starting school, moving from primary to secondary school) can be overwhelming. Additional support could help young people settle in a new environment.

• Exams and applying for the next stage of education are stressful. There is a need for extra support (practice sessions, worksheets/ practice exams, guidance for writing applications). 

• The group felt there was not enough support during COVID for online learning. Sometimes students felt overwhelmed by the volume of online homework. 

How can students be better supported?

• If teachers were more aware of different types of special educational needs (e.g. dyslexia, dyscalculia), they could better identify pupils who need support sooner. 

• Schools are often unaware of medical care students are receiving.  Young people have to advocate for themselves.  Having to continuously tell others what is happening is exhausting.

• Communication between health and education is needed, e.g. a letter from a GP or hospital to inform schools.

• Young people who miss school because of health needs found tailored timetables and personalised sessions helpful. They were able to go back at a pace that worked for them.

• Peer support is also very important. There is a need for empathy and understanding. A buddying up system could help with catch up after coming back following time off.

• The group felt it is important to have someone to talk to or a place to go when they feel overwhelmed in school. 

• The accessibility of schools can be improved (e.g. not enough lifts).