Research and analysis

Beyond the classroom: the experiences of children with SEND who are not in school

Published 11 December 2025

Applies to England

Summary of findings

Every child should be able to have their education, health and social care needs met while remaining in education. This includes children with special educational needs and/or disabilities (SEND) having these needs met in mainstream schools, when this environment is in their best interests. When we refer to ‘children not in school’ throughout this report, we are specifically referring to children with SEND. As highlighted in this report, we know that many children with SEND are leaving the school system because their needs are not being met sufficiently well.

When children are not in school, we found that their access to services is inconsistent. Parents and carers told us that they feel that they have to fight to get their child’s needs met while they navigate a complex system. School leaders told us that they lack the resources to meet the needs of many children with SEND.

Despite the challenges, this report highlights multiple examples of services and professionals working well together to help children with SEND remain in school or to support children with SEND who are not in school. We found that many children who leave a school roll are still able to receive strong support from education, health and social care providers.

The government is already working to resolve some of the issues highlighted in this report. For example, it is legislating to help local areas maintain better oversight of all children not in school, via the Children’s Wellbeing and Schools Bill. This includes local authorities maintaining compulsory registers of children not in school and a requirement for parents to obtain local authority consent to home educate their child where there are existing safeguarding concerns or the child attends a special school. The government has also committed to tackling wider issues in the SEND system so that more children with SEND can have their needs met well in mainstream education. This includes the Department for Education’s (DfE) forthcoming schools white paper.

However, this report highlights several other issues that should be addressed by national government or sector bodies. For example, we consistently found that there are missed opportunities to identify children’s additional needs early enough and to put in place the right support for them to remain in full-time education. We heard that this was due to settings not having enough capacity, resource or expertise.

Once needs are identified, we heard that children often cannot access relevant health services before their needs escalate. As a result, too many children with SEND leave the school system when this could be avoided.

Recommendations

Recommendation

The DfE should prioritise working with local area partnerships to ensure that children’s emerging needs are consistently identified early and accurately so that more children with SEND can remain in school. In its forthcoming white paper, the DfE should set a clear expectation that all schools and education settings support children with SEND to remain in school full time, when this is in their best interests.

Recommendation

NHS England and the DfE should provide local area partnerships with access to the necessary resources and training so that they can support schools to take a needs-led approach to supporting children with SEND. This should ensure that more children with SEND, including those without a formal diagnosis or education, health and care (EHC) plan, can have their individual needs met while remaining in mainstream education, if this is in their best interests.

When we explored the oversight of different arrangements for children not in school, we found variation. This was in terms of parents’, carers’ and professionals’ understanding of their responsibilities. This was particularly the case where education otherwise than at school (EOTAS) arrangements were used.

Recommendation

The DfE should lead on developing guidance for the appropriate use of EOTAS arrangements. The guidance should set minimum expectations and provide examples of best practice for different types of EOTAS arrangements. This should include how local area partners work with parents and carers to ensure that children’s educational, health and social care needs are met.

It is vital that local area partnerships have robust information-sharing arrangements once a child is at risk of leaving or has left a school roll. For children in care who have SEND, information-sharing is particularly important when they move because of changes in placement or if they achieve permanence, such as through kinship care or adoption. Key transition points also include when a child moves into a new phase of their education, for example when they start secondary school. These transitions can put children at greater risk of leaving education if poorly planned. However, too often we found that key information, such as attendance data or information about the child’s health needs, is not always shared with all relevant partners.

Furthermore, we heard that some partners, particularly health services, are often not involved in these processes. This can result in children with SEND being less likely to access key services when they are out of school or at risk of leaving.

Recommendation

Local area partnerships should prioritise establishing clear and robust processes for sharing information about children with SEND not in school or at risk of leaving school. Health services, including primary care, universal services and urgent care, should always be an important and involved partner in these arrangements.

Throughout our visits, we found that children with SEND who receive statutory social care services generally benefit from stronger multi-agency support. This is because they often have a lead professional who coordinates their support and remains a single point of contact. However, children with SEND who are not entitled to statutory services do not have the same coordinated multidisciplinary oversight.

Recommendation

Local area partnerships should ensure that all children with SEND who are not in school receive coordinated support to meet their education, health and social care needs. This should, where possible, involve appointing a lead professional from health, social care or education who knows the child and their family well. They should hold key responsibilities for the coordination of services.

We found many positive examples of local area partnerships working together to help children with SEND return to and remain in full-time education. However, we consistently heard that once a child is no longer in school it can be very difficult to help them to return to school. This is particularly challenging during the school year and outside the normal admissions cycle. Indeed, this is an issue that has been raised by the Office of the Schools Adjudicator in its recent annual report^{[footnote 1]}. One local area partnership has managed to overcome this barrier by agreeing that the local authority will coordinate all in-year admissions, despite it not having the powers to compel academies to admit children. This allows more children with SEND who are waiting for a school place to return to school more quickly.

Recommendation

The DfE should resolve the lack of consistency in how in-year admissions are coordinated across the country. The DfE should identify and share examples of best practice of local authorities successfully coordinating these admissions. This should contribute to the development of guidance, so that all local area partnerships can better understand expectations and replicate effective models of in-year admissions.

Introduction

This report sets out the findings from thematic visits to 6 local areas in 2025. The visits were carried out by Ofsted and Care Quality Commission (CQC) inspectors as part of our area SEND inspection framework. The purpose of the visits was to explore the arrangements that local area partnerships have in place for children with SEND who are not in school. Further information on the visits can be found in the published guidance.^{[footnote 2]}

For the purposes of this report, we define ‘children not in school’ as children with SEND, of compulsory school age, who are:

• not registered pupils at a registered independent school or any type of state-funded school
• on a school roll but are absent for some or all of the time when they would normally be expected to attend

‘Children with SEND who are not in school’ therefore covers a wide range of children and includes children who are:

• electively home educated (EHE)
• children missing education (CME)
• flexi-schooled
• on a part-time timetable
• in receipt of EOTAS
• severely absent (missing 50% or more sessions)
• attending unregistered alternative provision (AP)^{[footnote 3]}

This definition broadly aligns with the definition of ‘children not in school’ set out in the Children’s Wellbeing and Schools Bill.^{[footnote 4]}

We surveyed children with SEND who are not in school, parents and carers, and practitioners from education, health and social care, in each local area we visited. We received a total of 701 completed survey responses. We have also included some real-life stories of children in this report. To protect their anonymity, we have changed all names and some of the details in their stories. Ofsted and CQC would like to thank all parents, carers, professionals, and children and young people who contributed to the visits.

This report outlines some of the reasons why children with SEND are not in school. It also explores the support that is available for children with SEND who are not in school and how well local area partnerships maintain oversight of these children. Finally, it looks at how local area partnerships have been able to support children with SEND to remain in or return to school.

Context

The number of children known to be not in school in England has risen significantly over the past decade. It has increased more dramatically year on year since the COVID-19 pandemic. DfE data shows that between the 2021/22 and 2023/24 academic years, the number of children who were EHE increased by nearly a third to 153,300, and children who were CME by more than half, to 149,900.^{[footnote 5]}

Although the data does not include a breakdown of the number of children with SEND, research from the Office of the Children’s Commissioner found that children with SEND were disproportionately likely to become CME.^{[footnote 6]} We also know that looked-after children are more likely to have special educational needs (SEN).^{[footnote 7]} At the same time, research from the Education Policy Institute and the Children’s Commissioner found that care-experienced children are at a higher risk of missing education.^{[footnote 8]}

The true number of children not in school is likely to be much higher than official statistics suggest. This is in part due to the fluid nature of this cohort, as some children will move in and out of the education system, sometimes several times in the same year. Furthermore, we know there are children who have never been on a school roll and are therefore unknown to local services. For example, the Education Policy Institute estimated that the true number of children missing education during the 2022/23 academic year was approximately 2.5 times higher than the DfE figure of 117,100.^{[footnote 9]}

We know that some of these children will be receiving a suitable education, with plans in place to reintegrate them into school when it is in their best interests. However, we also often hear from parents and carers during area SEND inspections that they had no choice but to educate their child at home because schools could not meet their child’s needs. A recent survey from the charity Parentkind found that 1 in 3 parents or carers has asked a school to assess their child for SEN.^{[footnote 10]} The same survey found that 1 in 4 parents or carers is waiting for a SEN assessment for their child and has been waiting for more than a year.

During area SEND and other inspections, we often see the excellent work of dedicated leaders and practitioners in schools, local authorities and health services, who do their best to support children with SEND. We also hear that they are operating in a challenging context of a rising number of children requiring additional support from services that are already overstretched. Indeed, the Children’s Commissioner recently published the findings of a survey of all schools and colleges. They found that schools report that they are often unable to make reasonable adjustments that necessitate additional resource or staff capacity.^{[footnote 11]} At the same time, the Education Select Committee’s recent inquiry into ‘solving the SEND crisis’ found that there is no standardisation in both ordinarily available and SEN provision in schools.^{[footnote 12]} This has therefore resulted in inequity of provision available for children with SEND.

We know of the potential safeguarding risks associated with children not being in school. The Child Safeguarding Practice Review Panel reported that, where there is a risk of abuse and neglect, children who are not in school are not therefore able to benefit from the protective care that schools can provide.^{[footnote 13]} Furthermore, in 2024, Ofsted, CQC, His Majesty’s Inspectorate of Constabulary and Fire & Rescue Services (HMICFRS) and His Majesty’s Inspectorate of Probation (HMIP) carried out a series of joint targeted area inspections to look at how local partnerships and services respond to children and their families when children are affected by serious youth violence. We found that children with SEND and children who are not in full-time education are at a disproportionate risk of harm from serious youth violence.^{[footnote 14]}

The reasons why children with SEND are not in school

We explored the reasons why children with SEND have low attendance or do not attend school full time. We listened to the views of children, parents and carers, practitioners and leaders across local area partnerships. We found that when children’s needs are not identified early enough it can lead to their needs escalating, therefore making engaging in education more challenging over time.

What we heard from children, parents and carers

Children’s views and experiences

Over half the children who responded to our survey reported that they do not get the support they need from practitioners to help them to attend school. Furthermore, over a third of children said they do not get the help they need from health services.

Children reported having negative feelings and experiences, such as finding school scary and noisy, feeling upset, worried or stressed about school, and having experienced bullying as reasons for not attending school. Mental health, in particular anxiety, and medical needs or illness were also given as reasons.

Responses to the surveys indicated that there has been a breakdown in the relationship between some children and their school. They said that they feel that their school does not care about them, want them or understand their needs, and some expressed that they do not want to return. Others indicated that they would return to school if the right support was in place or said that they want to return because they liked their friends and teachers or want to get qualifications for the future.

“I need to know that I will be properly supported at school before I can return. I… don’t want to be a child at home with nothing to do. It’s boring and lonely.”

(Child aged 11 to 16 years and registered at a school but not attending full time)

Parents’ views and experiences

We consistently heard from parents and carers that there is a feeling of having to work tirelessly to access support for their child, and that there are many barriers and hurdles to navigate in a complex SEND system. They reported that home education is not usually a choice; it is something they feel forced to do due to schools’ inability to meet the needs of their child.

We heard that the ability of parents to advocate for their child is a key strength and driver in accessing appropriate support. This was highlighted by both parents and carers and practitioners. Indeed, practitioners reported inequities such that some parents and carers do not have the resources or knowledge to be able to access support. Furthermore, some parents and carers have their own mental health needs, SEND or language barriers. They reported that the fight to get suitable support for their child has led to them feeling exhausted and has impacted on their family and personal lives, such as maintaining employment.

We heard from parents, carers and practitioners that families find it difficult to navigate the SEND system, sometimes not understanding what services are available, how to access these and what they offer. While information is available via the local offer, and families are signposted to this, they are not always supported to understand it. Some health practitioners reported the even greater challenges for children with complex health needs who are new to the country and whose families do not understand the health services available to them. In one area, it was reported that families having a trusted and accessible professional to help navigate the system supports children’s improved attendance at school.

In our survey, some parents and carers reported that they rely on informal parent networks on social media as a source of peer support. This helps them to share information and navigate the system, sometimes more effectively than through official channels. Some leaders noted that the rise in requests for EOTAS packages is linked to parents sharing information with each other about provision, often using online forums and seeing what works for other children, including the use of specialist provision. We heard that these requests are not always appropriate, and headteachers reported that sometimes needs could have been met appropriately in mainstream schools.

Leaders in one area reported that recent changing parental and societal attitudes towards attendance can prevent the most vulnerable children from regularly attending school. They reported that this is a result of the COVID-19 pandemic, and has led to difficulties in gaining buy-in from parents to efforts to improve attendance. However, parents and carers highlighted that they feel that schools’ focus is on securing positive attendance rather than understanding and meeting their child’s needs, and that this approach is seen as punitive rather than supportive.

“I feel I’m responsible for getting the support my child needs. The system is hard to navigate, and it’s hard to know who to speak to, as a lot of services don’t want you to call them and it has to be done via email.”

(Parent or carer of child with SEND who is not in school)

Missed opportunities to identify and meet needs early

Missed opportunities to identify needs early and put support in place was a theme that consistently emerged across the local areas that we visited.

We heard that delays in accessing some health services lead to missed opportunities to understand children’s needs earlier. We heard from parents, carers and practitioners that there are long waiting lists to access neurodevelopmental assessments, such as for autism and/or attention deficit hyperactivity disorder (ADHD). There are also delays in accessing mental health services and therapies, including occupational and speech and language therapies. Almost three quarters of parents and carers who responded, and half the practitioners, told us in our survey that they disagree that children with SEND who are not in school are able to access health services that meet their needs. This typically leads to children not getting the right support early enough and their needs escalating while they are waiting for support to be put in place. For some, it results in them leaving school. Indeed, we found that there are a significant number of children with known or emerging neurodevelopmental needs who are not in school.

We heard that a lack of early identification and corresponding support to meet needs leads to some children having poor rates of attendance or leaving school altogether. This is exacerbated by transitions between phases of education. We heard how, in the early years, unidentified and unmet needs result in some children not being ‘school ready’. For example, they may have underdeveloped social, communication or self-care skills. Leaders in one area noted that this issue is sometimes classified as ‘SEND’ but is rather due to gaps in children’s learning that could be managed with appropriate school support. Parents, professionals and leaders reported that, for some children, not being ‘school ready’ results in a delay attending primary school. When children are moving to secondary education, unidentified and unmet needs in primary schools lead to wider challenges emerging or escalating. This is linked to the difference between secondary schools and primary schools, such as the size of the school, the structure, curriculum and behavioural demands.

In several local areas, it was suggested by school leaders that a lack of sufficient identification and support is linked to limited services or funding available for families in the early years. For example, we heard from school leaders that the reduction in the number of Sure Start centres that provide early help services to children and families has meant that children are less likely to have their needs identified quickly and accurately.

Schools’ capacity and resources to meet children’s needs

We found that not all schools are equipped to meet the needs of all their pupils. This is particularly the case where children require a significant degree of support, for example in medical interventions, help with self-care or managing behaviours that challenge. We heard that not all staff have the right training to support needs effectively or confidently. There is a particular lack of understanding of neurodevelopmental needs and the impact of trauma and poor mental health on children’s learning and/or wellbeing. This results in children’s needs escalating and leading to reduced attendance or to them leaving school.

School leaders consistently told us that there is also a lack of capacity or resources to meet needs. For example, in one area we heard from practitioners that limited staffing leads to teachers not being able to monitor the movement of children who need to leave the classroom to take breaks in a calm environment. The physical environment of schools was described by children, professionals, and parents and carers as not always being suitable for children’s needs, particularly sensory needs. They highlighted issues such as large and crowded buildings, large class sizes and a lack of quiet areas. Although we heard of some schools that work to ensure that their environment is more suitable for their pupils’ needs, other schools do not implement reasonable adjustments as well as they should. This leads to children’s needs escalating and occasionally to them leaving school. We also heard how some schools are unable to adapt buildings sufficiently well due to funding and structural constraints.

Often, in parallel to reports of schools being unable to meet needs, we heard from all groups that there are not enough special school places and AP. Practitioners’ responses to our survey highlighted that children remaining in an inappropriate school setting results in their needs not being met and them not being able to access education fully. Similarly, parent and carer survey responses identified a need for more specialist provision, including special school places that can meet different types of need. They also identified a need for more AP, access to EOTAS packages and online learning.

We heard from headteachers and practitioners that delays in securing dedicated transport for children with SEND result in them being out of school for long periods. There are different criteria for children to qualify for free transportation between home and school provided by their local authority. One criterion is them being unable to walk to school because of their SEND. The free transport can take different forms, such as a pass for free public transport or a dedicated taxi or school bus.^{[footnote 15]}

Furthermore, we found that when transport has been arranged, it is not always suitable to meet the needs of the child. For example, in one area, schools have to support some transport staff in using communication and autism-friendly strategies to help children access transport effectively. In the same area, practitioners reported that, if specialist medical assistance is not available to support children during medical emergencies, children cannot access the transport. This impacts on their learning and on their families. Other issues, such as changes in staffing, delays, long journey times and sudden changes to transport arrangements, were reported to further exacerbate difficulties in children accessing transport. This impacts negatively on their rates of attendance.

Finally, policies and approaches in schools sometimes do not support these children well enough. There were reports of schools, particularly secondary schools, that did not take a flexible approach to their behaviour policies and curriculum expectations or did not implement reasonable adjustments as well as they should. It was reported that behaviour policies do not always account for or recognise children’s SEND and are not sufficiently flexible. For example, we heard that behaviour models can be too punitive or that there is inconsistency in behaviour management and the understanding of children’s needs.

Responses from parents, carers and practitioners to our survey often reflected these issues. Parents and carers reported a lack of support to help their children attend, such as schools not enabling access to learning or not following health practitioners’ advice. Although some did speak about schools working to try to meet needs using the resources they have, this is not always enough. Practitioners’ responses also highlighted schools’ lack of resource, capacity and expertise, and a lack of flexibility towards supporting needs and learning.

Case study: Daniel’s story

We spoke to Daniel, a primary-age child who is EHE, and his mum. Daniel had been waiting for a neurodevelopmental assessment for over 2 years when his mum decided to home educate him. Although some of his needs had been identified early, he had not received the support he needed while waiting for a formal diagnosis.

Daniel told us that he could not fit in at school. He said he struggled to learn in a classroom environment where there are a lot of children, noise and distractions. As he got older, Daniel’s sensory needs affected his behaviour. As a result, he became more isolated and attended school less often. Daniel was initially supported by a teacher who recognised his needs and implemented strategies to support them well. This included allowing him to take sensory breaks and checking in with him regularly. Daniel and his mum told us that this time was the happiest he had been at school. But this support did not continue as Daniel moved through school because he did not have a formal diagnosis or a plan to meet his needs. This led to gaps in his learning that made it difficult for him to keep up with his peers.

It was by chance, at a health visitor appointment for his younger sibling, that Daniel’s parents were helped to recognise his neurodiversity. They were told how to self-refer to relevant services and where to find further support. However, health professionals did not share key information about Daniel’s needs with other relevant services, such as the local authority school attendance team.

Daniel’s mum eventually made the difficult decision to home educate him. It was at this point that the school and local authority offered support, but Daniel’s family felt it was too late. They described to us how they had reached ‘crisis point’. The local authority told our inspectors they had not been made aware of Daniel’s escalating needs by the school or health services. Daniel’s parents did not receive any information about services available for home-educating families and told us that they had had to navigate the system alone.

Despite the commitment from dedicated practitioners, Daniel’s needs could not be met in school because earlier opportunities to support him had been missed. We found that this was because some staff did not understand Daniel’s emerging needs, and, at times, there were not enough staff with the right expertise available to provide the support he required.

Local area partnerships’ oversight of children with SEND who are not in school

For many children, being in school is a protective factor. It helps to keep them safe, whether they are at risk of harm within or outside the home. Once a child is out of the school system, local area partnerships need sufficient oversight to ensure that the child is still having their education, health and care needs met. We explored how local area partnerships support children with SEND when they are not in school, including the information-sharing arrangements. We also looked at the oversight of different types of provision for children not in school and how local areas provide access to services.

Information-sharing across education, health and social care

It is clear that, while schools and local authorities generally have strong information-sharing processes regarding children not in school, health partners are often absent from these arrangements. A common barrier is information management systems not sharing information with each other. For example, we heard that individual local authority teams or health providers are often using separate information management systems. This can result in some partners not being alerted when a child is no longer in school. As a consequence, children’s needs are at greater risk of being unmet. Although we were told by leaders that efforts are under way to join up these systems, they are often in their infancy or face significant challenges.

Health leaders told us that, when information is shared with them in a timely manner, they are able to take more flexible approaches, so that children not in school can still access health services that meet their needs. For example, if all relevant historical information about a child is shared with health partners once that child is not in school, the right support can be put in place without the need for a diagnosis. However, we also heard that this is not always happening.

We found that communication between the local area partnership and the school nursing team (where this service is available for children not in school) is often lacking. We typically found that when a child with SEND moves into the local area there is effective information-sharing with the school nursing team. Yet, all too often, this team is not alerted when a child leaves the school roll. Across many areas, we heard that the school nursing team often discovers that a child is not in school, such as being EHE, by chance. For example, we heard of health visitors visiting the family home with reference to one particular child and noticing that a sibling is being EHE. The health visitor will then pass this information on to the school nursing team. However, because there is often no clear process of notifying the school nursing team, many of these children do not receive the same support from the school nursing service, and onwards referrals as required, as their peers in school.

“Children who are not in school tend to have unidentified needs because they have not been able to see an educational psychologist, speech and language therapist or other health professionals. Therefore, vital information about the child is not shared with all relevant professionals.”

(A practitioner working with children and young people in education)

Oversight of different types of provision or destination

We found that the quality of oversight of children not in school by local area partnerships varies considerably. This is because of different levels of understanding of roles and responsibilities and the capacity of local area partners to maintain oversight once a child is no longer in school. Local area partners are generally more likely to have a good understanding of their responsibilities for children who are EHE than of their responsibilities for children who were flexi-schooled, on part-time timetables, placed in unregistered AP or receiving an EOTAS package.

Children who are electively home educated or flexi-schooled, and children missing education

We found that, despite the challenges of maintaining oversight of a growing population of children not in school, local area partners have clear processes in place to monitor and provide support for children who are EHE or CME and their families. We found some positive examples of innovative approaches to providing better oversight and support. In one local area, we heard that the local authority provides support for children who are EHE and their families by suggesting curriculums, educational resources and online activities that are suited to the child’s needs. They maintain regular visits and put in place support to help the child return to school full time. The partnership works with those families to agree the right school to attend where this is in the child’s best interests. Once the child’s place at that school is confirmed, a representative from the school visits the child in their home and helps them gradually start attending on a regular basis. This helps to bridge the gap between being EHE and attending school.

Some children who are educated at home most of the time are also registered at school and attend school for part of the week. This is often known as ‘flexi-schooling’. We heard from leaders across different partnerships that there is limited understanding about what flexi-schooling is, how often it is being used and how arrangements for it should be applied. We heard that parents or carers sometimes request flexi-schooling for their child but that what the school can offer does not meet their expectation. Furthermore, when flexi-schooling is agreed between a school and a parent or carer, this information is not always shared.

We found examples of local areas having robust oversight of CME so that provision is identified quickly. Here, provision for children’s next steps is often planned at the earliest stage. CME panels also enable local area partnerships to collaborate with other services to track children with SEND who are missing education and to put the right support in place. However, we regularly heard that health partners are not involved in these processes. We heard that this can lead to delays in putting in place the right support to meet children’s health needs and thereby helping them return to full-time education, where appropriate.

Education otherwise than at school

EOTAS under section 61 of the Children and Families Act 2014 is a form of education for children with SEND, typically with an EHC plan, when it would be inappropriate for the provision to be made in a school, college or other educational institution. We heard from local area leaders that more parents and carers are requesting EOTAS packages for their children. Some professionals also linked this rise to a reduction in specialist provision available. Through our visits, we found wide variation in the ways that EOTAS packages are used, the quality of these packages and the quality of oversight applied by local area partnerships.

We found that, where EOTAS arrangements work well, the partnership is able to provide support and activities that are responsive to the child’s needs. For example, for children with SEND who cannot attend school due to physical or mental health needs, EOTAS packages typically include tutoring to ensure that the child continues to receive a suitable education. In one local area, leaders have restructured the teams working with children on EOTAS packages so that the virtual school maintains oversight of these children. While this is not a statutory requirement of the virtual school, we found that this approach enables better access to wrap-around services. For example, we saw that children who receive EOTAS packages can access relevant health services and other appropriately planned activities, such as horse riding, community gardening or singing therapy, to support their mental health needs. The virtual school quality assures these activities for all children.

We heard of examples of EOTAS packages funded via personal budgets provided for parents and carers of children with an EHC plan. This allows the local area to maintain engagement with the family and meet the specific needs outlined in the child’s EHC plan. Furthermore, we heard that this helps the partnership to work closely with parents and carers, in monitoring their spending of the personal budget, and thereby understanding whether it is leading to better positive outcomes for the child. These reviews provide opportunities to engage with the family more frequently. However, we found that the use of personal budgets can also lead to differences of opinion between parents and carers and local area leaders about whether provision is suitable and who should have oversight and decision-making powers.

We found a wide array of activities commissioned as part of EOTAS packages, with typically little understanding of how they contribute to children’s educational outcomes. More often than not, we found that professionals responsible for different elements of EOTAS provision work in isolation and do not routinely meet to review children’s progress or the ongoing suitability of the packages. In some cases, these children have not had an annual review of their EHC plan. We found other examples where there was no quality assurance process to ensure that the EOTAS package reflects the aspirations of the child or will result in them receiving an effective education. In one local area, leaders from across the partnership told us that there is no agreed understanding of the minimum requirements of an EOTAS package or what should be in its scope. Indeed, we heard that some schools believe that they can still support some or all of a child’s needs effectively without the need for an EOTAS package but, despite this, an EOTAS package is still put in place.

Part-time timetables

We found that part-time timetables for children with SEND are used inconsistently, with varying levels of oversight. Where oversight is effective, we found that the local area partnership works with schools to understand and challenge how part-time timetables are being used to improve children’s experiences and outcomes. For example, we visited a local area where the partnership closely monitors the use of part-time timetables and offers targeted support to schools that use them more frequently. This includes the use of attendance support officers from the local authority, who work with schools to help children increase their attendance over time.

We also heard from local area leaders of an ‘accountability gap’ between the duty on a school to report the use of part-time timetables and the levers available to partnerships to provide support or challenge. We were told that they do not have the levers, or the capacity, to ensure that a part-time timetable is only in place for the shortest time necessary, according to statutory guidance.

The experiences of children not in school in need of help and protection

We found that children with SEND who are not in school and are known to statutory children’s services, such as when they are looked after or a child in need, receive a more effective multi-agency response. These children are therefore more likely to benefit from wrap-around support to help them to remain in or return to full-time education.

We consistently heard of the positive impact of the virtual school for looked-after children and those with a social worker. Virtual school staff typically act as a central point of contact to bring together relevant professionals in a joined-up way. For example, they work with social workers, health professionals and schools to support helping children return to school or to improve their attendance. We heard that virtual school staff play a key role when a child in care moves to a new area to make sure they are attending school. They bridge gaps by working with local agencies in the new area to ensure that relevant information is passed on.

Social workers and alternatively qualified workers, such as family support workers, also played a critical role in supporting children not in school. They understand the impact of trauma and adverse childhood experiences and gather children’s wishes and aspirations. We heard that they are able to help other professionals to understand the impact of these factors on children when meeting their education needs. This helps to inform planning to support children to return to full-time education.

We were told by leaders in one local area that social workers often visit the homes of children who are not on a school roll to gather their views as part of the EHC plan needs-assessment process. This helps to ensure that these views are included and maintains suitable oversight of the child’s education and care. However, some EHC plans do not include this information that could help to strengthen other professionals’ understanding of the child’s needs.

Children’s access to health services

Many children who are not in school experience long delays in accessing health support and assessments. Although we found examples of good practice, where health services provide targeted support for children not in school, this was variable across the areas we visited. Many of the services that children with SEND rely on when they attend school regularly, such as mental health support teams, occupational therapy or speech and language therapy, are no longer available once they leave the school roll.

There is inconsistent access to therapies and assessments of need for children not in school. We found that this is often due to commissioning arrangements. Leaders in one local area told us that their neurodevelopmental assessment pathway prioritises children who are not in school. We heard that this helps children not in school to access support more quickly. However, in other local areas, some of these services are only available for children in school. Furthermore, some services, such as occupational therapy, educational psychology and neurodevelopmental pathways, require supporting information from a practitioner working with the child, such as a teacher, to complete the referral to the service. This is a barrier for some children who have not been in school for a long time, or have never attended school, because of a lack of first-hand professional evidence of their needs.

Some parents, carers and practitioners reported other barriers to accessing health appointments for children not in school. For example, families whose first language is not English sometimes require an interpreter, but this service is not always provided. Furthermore, we heard that children having multiple appointments to attend is difficult to balance with a full-time education and results in poorer rates of attendance. 

We found some positive examples of local areas commissioning targeted health services for children not in school. These include extending the school nursing offer to support children who are EHE or receive EOTAS. However, all too often we found that these services are not consistently available and not always easy to access. Instead, children’s positive experiences are more often the result of individual practitioners than a clear process for children not in school to access services. We heard that parents and carers have to be the main driver in organising the right health provision for their child. We heard of the significant strain that this places on them, sometimes impacting negatively on their own health and wellbeing.

Case study: Nina’s story

We spoke to Nina, who is of secondary school age and receives an EOTAS package. Nina has autism and has 2 siblings who also have additional needs. She has been unable to attend school due to ill health but has been receiving educational support from an unregistered AP setting. She has an EHC plan and is subject to a child in need plan.

Nina’s parents told us of their frustration at having to wait a long time to get the right support in place. They told us that Nina’s school took too long to identify her needs, which delayed her getting an EHC plan. They also felt that professionals initially put Nina’s challenges down to issues with their parenting, rather than recognising her needs. They told us that Nina stopped attending school and that only when she started receiving support from child and adolescent mental health services (CAMHS) did her wider needs become recognised and more support was put in place.

Nina eventually received an EOTAS package as part of her EHC plan. This included support from the medical needs service and attending an unregistered AP for 15 hours a week. There she studied English and mathematics. The local authority provided regular visits to ensure that the setting was safe and suitable while maintaining oversight of Nina’s progress. Nina’s parents, and professionals working with her, believe that she could be supported well in a mainstream school. However, the local authority is struggling to identify a school that can support her needs.

Because Nina is subject to a child in need plan, she has a lead professional to coordinate her support and ensure that services are joined up. Regular child in need meetings bring key professionals together to share and gather up-to-date information about Nina and her family. Nina has also benefited from accessing short breaks, such as swimming or bowling trips. A social worker who works with the whole family sees Nina on a regular basis. This helps other professionals who work with Nina to understand the wider challenges within her family and the impact they may have on her, for example when she presents behaviours that challenge.

We heard that Nina has been starting to make improvements since receiving support from dedicated professionals who understand her education, health and social care needs. We heard from professionals that she is growing in confidence and has better relationships with those around her.

How local area partnerships support children with SEND to remain in or return to school

When a child with SEND leaves formal education, it can be a significant challenge to help them to return to school. From the moment they are no longer in school, it is critical that all relevant partners are informed and that a clear plan is put in place to help them to return. We looked at the enabling factors that help children with SEND to remain in full-time education. We also explored how local area partnerships support children with SEND back into full-time education, where appropriate.

Use of alternative provision to aid transitions back into full-time mainstream education

We found that, where AP is used appropriately, it can support children with SEND back into mainstream education. This includes both registered and unregistered AP that is well matched to children’s needs and ambitions. However, leaders told us of the challenging context for the sector: the number of children being placed in AP is rising but there is not enough appropriate provision available.

We visited local areas that make effective use of the 3-tiered model of AP (targeted support in mainstream school, time-limited placements and transitional placements).^{[footnote 16]} This helps to support children back into school or to support children with SEND to remain in school. For example, we visited a local area that uses unregistered AP settings as time-limited placements. We heard that these placements are being used to supplement the schools’ offer by allowing children to focus on learning new skills while helping them to reset relationships. It also allows children to continue studying a curriculum similar to that of their home schooling. The local authority quality assures all unregistered settings commissioned by schools, most of which are on the local authority’s list of approved providers.

We consistently heard of the positive impact of AP schools to support moves back into mainstream education. We spoke with leaders from a large provider that has multiple sites across the local area that caters for a wide range of needs. The variety of provision allows children waiting for a place at a special school to receive an education in an appropriate setting. They engage well with all local partners by sharing timely information about children, including when they are moving to another school. The provider also works closely with local schools to provide outreach services to support children with SEND by enhancing staff’s expertise. This helps them to remain in or reintegrate into mainstream education.

We visited a local area where pupil referral units work collaboratively, alongside special schools, to share facilities and commission therapies. We heard from professionals that this has a hugely positive impact on supporting children with the most complex learning and social needs and provides staff with extra support. The focus on joint working allows the local area partnership to target resources so that children with SEND can access the right provision more easily.

We heard of the positive impact of hospital schools for children with some of the most complex medical needs. Families and practitioners told us of the strengths of outreach services, such as home tutoring, for children who are physically unable to attend an education setting. At the same time, professionals from hospital schools work closely with education settings to put plans in place to help children transition back into mainstream education, where appropriate. This helps children with SEND to return to school more quickly.

In the 6 local areas we visited, we came across a small number of schools that are creating their own provision to support children with SEND on their roll to remain in school. This is sometimes referred to as ‘internal AP’, a ‘pupil support unit’ or ‘in-school provision’. We found that this is often used effectively as a short-term intervention. For example, schools use this provision to offer enhanced support to meet children’s academic, personal and social needs. Schools also adapt children’s curriculums as necessary. However, it was clear from our visits that settings would benefit from national standards that set out what high-quality in-school provision looks like. We also heard of the unintended consequences of using this provision. Leaders told us that as a child approaches the next stage in their education, such as when moving from secondary school to post-16 settings, there is often no equivalent provision in place at their next destination. This is because not all schools have the resources to create similar provision. This is particularly the case for smaller schools or trusts. We heard that parents and carers consequently feel that their child’s needs cannot be met without such provision. We heard that they are therefore more likely to request an EHC plan or decide to home educate their child to provide dedicated support where this provision is not going to be available.

“Schools offer the best packages they can to support reintegration back into school. However, there often needs to be a bridge between the home and school that further supports reintegration, making the transition for the pupil easier.”

(A practitioner working with children and young people in education)

Transitions between different stages of education

When children with SEND move through different stages of their education, such as from primary to secondary school, it is vital that local area partners work well together to put in place the right support so that children have their education, health and social care needs met. We found that, where these transition points are planned well, children are more likely to settle quickly and remain in education.

We found some positive examples of local area partners working together to share information about a child’s needs before they move to the next stage of their education. We heard from leaders that this relies on strong collaborative relationships between schools, local authorities and health partners. We heard that the transition from Year 6 to Year 7 is often a point at which children with SEND are at greater risk of no longer attending school or facing permanent exclusion. One local area partnership uses data, such as attendance data, to identify the children who are most at risk of falling out of education and assigns them adult mentors in Year 6 to help improve their attendance. This has led to a significant reduction in the number of children leaving education in Year 7 across the local area.

As explored earlier in this report, leaders told us of emerging challenges with children entering primary school not being ‘school ready’. At the same time, we heard of a rise in primary-age pupils leaving education. To tackle this issue, one local area partnership works closely with private, voluntary or independent nursery settings in areas with the highest levels of need. The local area partnership has put in place additional support for children with emerging SEND, particularly those with speech, language and communication needs. This includes colleagues from the local authority and health services training nursery staff in evidence-informed approaches to support children’s speech and language development. We heard that this has prepared children with SEND better for primary school.

We consistently heard from leaders, practitioners, and parents and carers of the challenges in finding a school place, outside of the normal admissions round, for children not on a school roll. Local authorities do not have the power to direct schools that are their own admissions authority, such as academies, to admit a child without an EHC plan in year. However, we found some positive work to help resolve this problem. We visited a local area where all in-year admissions are handled centrally by the local authority, rather than by individual schools. We heard that this enables leaders and staff across the partnership to maintain effective oversight of all children with SEND who do not have a school place and to help them reintegrate into school, when appropriate. This process relies on strong relationships and joined-up processes across the partnership.

Multi-agency working

Maintaining positive relationships between individuals and partner agencies is key in supporting children with SEND to remain in or transition back into full-time education. We found that multi-agency working is most effective when services are coordinated early, once a child’s needs are identified.

We found some positive examples of health services working well with local schools to support children with SEND to remain in school. One local area partnership has jointly funded a nurse educator role to provide training to education and school transport staff. This includes supporting staff to care appropriately for children who require enteral feeding such as via a nasogastric tube. They also help signpost schools to appropriate specialist health services when necessary. We heard that this helps professionals feel more confident to support children with health needs. Similarly, in a different local area, the occupational therapy service works with schools to help them better support children with neurodevelopmental needs. This includes offering schools a ‘learning walk’, when an occupational therapist spends a day in a school identifying any environmental issues within the school site that may impact on children with neurodevelopmental needs. Leaders in another local area told us that the more inclusive schools provide visual timetables or planned breaktimes to avoid children facing overcrowded environments. These small adaptions help children with SEND to feel at ease and improve their engagement with school.

“CAMHS are good. After initial delays, they try hard to provide significant support to my child and work with the local authority. They repeatedly try to be involved in all decision-making.”

(Parent or carer of child with SEND who is not in school)

Schools that have access to mental health support teams are able to use this resource effectively to support children with SEND to remain in school. Headteachers in one local area told us that they hold termly meetings with the mental health support team to discuss children who are at risk of not attending school. We heard that this allows the partnership to identify children’s needs early and put in place the right support.

The most effective examples of multi-agency working allow local area partnerships to better identify children’s needs and put in place the right support quickly. Using youth workers in schools is one such example of a local area partnership identifying children at risk of disengaging with education, and putting in targeted support. We visited a local area that implements this model effectively by joining up with other local services across social care and health. We heard that this strategy has led to children having sustained positive outcomes when they are no longer being supported by a youth worker.

Family hubs also enable children with SEND to receive support earlier by bringing together staff from a range of services in one setting. We visited a local area that has put significant resource into their family hubs, particularly in neighbourhoods where there is the greatest need. We heard that they have teams of staff who have been trained to support families in a wide range of areas across education, health and social care, by, for example, supporting children with SEND who are not in school or providing parents and carers with strategies to improve their child’s attendance. We heard that the hubs are well attended by local communities and therefore allow the local area partnership to reach more children with SEND who are not in school.

Similarly, we visited a local area that has recently established a multidisciplinary specialist team focused on supporting children with SEND to remain in education. Practitioners, including therapists, mental health practitioners, youth offending officers and educational psychologists, work together to support children with complex learning, social, emotional and/or health needs to reintegrate into school, whenever appropriate. We heard that this improves information-sharing between agencies and allows the right support to be put in place quickly when concerns are raised about a child.

Case study: Noah’s story

We spoke to Noah who is of primary school age and has complex health needs. Noah and his family settled in the UK from another country 2 years ago and, until recently, he was attending a hospital school. Noah has an EHC plan and receives an EOTAS package.

Shortly after Noah and his family arrived in the country, his health started to deteriorate, and he was supported in a hospital. It was at this point that a referral was made by the hospital to other relevant health services, such as the children’s complex care team, as well as the local authority children’s social care team. Noah was soon receiving support from a social worker and local health services. We heard that a social worker supported Noah and his family to access wider support to meet his needs. This included services that were available through the local offer, such as short breaks. The local offer was translated for Noah’s parents and saved onto their phone so that they were aware of all local services available. The social worker then referred Noah to the local authority SEND team so that an assessment could take place for him to receive an EHC plan. An educational psychologist completed an assessment of Noah’s needs, and the SEND team gathered all other relevant information about his education, health and care needs. His EHC plan has now been finalised.

The partnership ensured that home tuition was put in place for Noah. We were told that this will take place for 10 hours a week until an appropriate school that can best meet Noah’s needs is identified. However, because Noah is not in school, he cannot access support from the speech and language therapy team while he remains at home. Noah’s parents told us of their frustration with this barrier.

Noah has benefited from a group of practitioners across education, health and social care, who have a shared, holistic understanding of Noah’s and his family’s needs. Noah’s parents told us that they receive effective support from a range of practitioners and that Noah’s needs are well understood. They told us they look forward to Noah starting school and taking the next step in his educational journey.

Concluding remarks

This report highlights barriers that children with SEND face to remaining in school, the quality of oversight they receive when they are not in school full time, and how well partnerships help children reintegrate into school when they have left. While we are concerned about the national picture of children not in school, this report also showcases some good practice where local area partnerships have collaborated well to help children with SEND remain in or return to full-time education. It is clear from our findings that, while strong joint working at a local level can lead to improved outcomes, some of the challenges lie beyond the control of any one local area partnership. We have therefore made recommendations for both national government and the sector. We hope that these recommendations are acted upon and build on the government’s commitment to improving the SEND system.

Annex

List of recommendations

• The DfE should prioritise working with local area partnerships to ensure that children’s emerging needs are consistently identified early and accurately so that more children with SEND can remain in school. In its forthcoming white paper, the DfE should set a clear expectation that all schools and education settings should support children with SEND to remain in school full time, when this is in their best interests.
• NHS England and the DfE should provide local area partnerships with access to the necessary resources and training so that they can support schools to take a needs-led approach to supporting children with SEND. This should enable more children with SEND, including those without a formal diagnosis or EHC plan, to have their individual needs met while remaining in mainstream education, when this is in their best interests.
• The DfE should lead on developing guidance for the appropriate use of EOTAS arrangements. The guidance should set minimum expectations and provide examples of best practice of different types of EOTAS arrangements. This should include how local area partners work with parents and carers to ensure that children’s educational, health and social care needs are met.
• Local area partnerships should prioritise establishing clear and robust processes for sharing information about children with SEND not in school or at risk of leaving school. Health services, including primary care, universal services and urgent care, should always be an important and involved partner in these arrangements.
• Local area partnerships should ensure that all children with SEND who are not in school receive coordinated support to meet their education, health and social care needs. This should, where possible, involve appointing a lead professional from health, social care or education who knows the child and their family well. They should hold key responsibilities for the coordination of services.
• The DfE should resolve the lack of consistency in how in-year admissions are coordinated across the country. The DfE should identify and share examples of best practice of local authorities successfully coordinating in-year admissions. This should contribute to the development of guidance so that all local area partnerships can better understand expectations and replicate effective models of in-year admissions.

Methodology

Inspectors from Ofsted and CQC visited 6 local areas:

• Luton
• Manchester
• North Lincolnshire
• Somerset
• Southwark
• West Berkshire

We selected areas according to several factors, such as data, intelligence and contextual variety, and in line with with consideration of other inspection activity.

We did not make an evaluation about individual areas during these visits. Our intention was not to check compliance against statutory responsibilities. Rather, we explored the arrangements that local area partnerships have in place to oversee and support children with SEND who are not in school.

Each visit consisted of up to 4 days of off-site activity and up to 4 days of on-site activity. Inspectors held meetings with education, health and social care partners, as well as with children and young people and their families. We also gathered information through surveys, documents and visits to providers. For more detail, see the published guidance for the visits.

We had 83 completed responses to our survey from children and young people aged 11 to 16 years old who were in scope to be included in the survey analysis. We also received 382 completed responses from parents and carers of children with SEND aged 5 to 16 years old and 236 responses from practitioners and leaders across health, education and social care or who are responsible for arrangements for children with SEND not in school. Surveys have been used alongside findings on visits to illustrate the perspectives of these groups in this report. However, we cannot assume that these respondents constitute a representative sample of the general population.

1. ‘Office of the Schools Adjudicator annual report: 1 January 2024 to 31 December 2024’, Office of the Schools Adjudicator, July 2025. ↩

2. ‘Thematic reviews of children not in school in local areas’, Ofsted, January 2025. ↩

3. Also known as ‘non-school AP’. See the DfE’s voluntary national standards for non-school AP. ↩

4. ‘Children’s Wellbeing and Schools Bill’, section 436 B. ↩

5. ‘Elective home education’, Department for Education, December 2024.
   ‘Children missing education’, Department for Education, December 2024. ↩

6. ‘Lost in transition: The destinations of children who leave the state education system’, Children’s Commissioner, February 2024. ↩

7. ‘Outcomes for children in need, including children looked after by local authorities in England’, Department for Education, April 2025. ↩

8. ‘Children missing from education’, Education Policy Institute, December 2024.
   ‘Looked after children who are not in school’, Children’s Commissioner, May 2023. ↩

9. ‘Children missing from education’, Education Policy Institute, December 2024. ↩

10. ‘The national parent survey 2025’, Parentkind, September 2025. ↩

11. ‘The children’s plan: The Children’s Commissioner’s school census’, Children’s Commissioner, September 2025. ↩

12. ‘Solving the SEND crisis’, Education Committee, September 2025. ↩

13. ‘Safeguarding children in elective home education’, Child Safeguarding Practice Review Panel, May 2024. ↩

14. ‘Multi-agency responses to serious youth violence: working together to support and protect children’, Ofsted, CQC, HMICFRS, HMIP, November 2024. ↩

15. ‘Home-to-school travel’, Department for Education, July 2014. ↩

16. ‘SEND and alternative provision improvement plan’, Department for Education, March 2023. ↩