Children with learning disabilities in schools in England: 2023 update

 

The Department for Education has released its latest annual statistics concerning children and young people identified within the English education system as children/young people with learning disabilities, recorded in an annual census of schools that takes place in January each year.

 

In the Special Educational Needs (SEN) statistics there are a number of mutually exclusive categories of SEN, three of which concern children with learning disabilities – Moderate Learning Difficulties (MLD), Severe Learning Difficulties (SLD) and Profound & Multiple Learning Difficulties (PMLD). There are a number of other SEN categories recorded within these statistics (Specific Learning Difficulties; Speech, language and communication needs; Social, emotional and mental health; Autistic spectrum disorder; Visual impairment; Hearing impairment; Multisensory impairment; Physical disability).

Within the annual census, a child can be classified as having a ‘primary need’ in one of these categories, and optionally classified as having an additional, ‘secondary need’ in another category. Most importantly in terms of how children are supported, children may have a special educational need that has been judged to require specific support in the form of an SEN statement (historically) or now an Education, Health and Care (EHC) plan. Beyond that, DfE statistics now only report an additional much larger number of children at a level of ‘SEN support’, which has no requirements to specifically support a child.

This blogpost simply updates a post I did last year on Department for Education (DfE) statistics, and goes through what some of these statistics say about the education of children and young people with learning disabilities, as identified within the education system. For a brilliant analysis of what these statistics say and what they mean for children with SEND generally, I highly recommend the Special Needs Jungle analysis, and I would urge you to read it.

The first question is simply – how many children and young people with learning disabilities are recorded in DfE statistics?

The first graph below shows the number of children with a statement/EHC plan with a ‘primary SEN need’ of MLD, SLD and PMLD, from 2010 to 2023 (apologies for the acronyms).

The graph shows that in 2023, over 74,000 children in England had a statement/EHC plan and were identified as children with learning disabilities. For children with MLD this was 32,898 children in 2023, with a large decrease of 31% from 2010 to 2018 but an increase of 16% from 2018 to 2023.

In 2023, there were 31,322 children with a statement/EHC plan and identified with a primary need of SLD, an increase in numbers of 24% from 2010 to 2021 but no increase from 2021 to 2023. Finally, in 2023 there were 10,120 children with a statement/EHC plan and identified with a primary need of PMLD, an increase of 16% from 2010 to 2018 but with fluctuating numbers since.

 

The second graph below shows the number of children with a ‘primary SEN need’ of MLD, SLD and PMLD at the level of SEN Support, from 2015 to 2023 (the reporting of statistics changed in 2015).

The graph shows that in 2023, over 190,000 children in England were identified as children with learning disabilities at the level of SEN Support. For children with MLD this was 189,375 children in 2023, with a large increase from 2015 to 2016 and a decrease from 2016 onwards.

In 2023, there were 2,277 children with a primary need of SLD at the level of SEN Support, with numbers fairly steady until 2020 but decreasing after then. Finally, in 2023 there were 824 children at the level of SEN Support with a primary need of PMLD, again with a recent decrease.

How many children with learning disabilities are being educated in mainstream schools or special schools? The graph below shows the number of children with a statement/EHC plan and primary needs of MLD, SLD and PMLD being educated in mainstream schools and special schools in England, from 2010 through to 2023. These figures don’t include potentially substantial but often not really known numbers of children not in school (including those being educated at home), or in places like residential special schools or specialist inpatient units.

The graph has quite a lot of stuff in it, so let’s take it bit by bit. The lilac lines are for children with MLD in mainstream schools (diamonds) and special schools (circles). As we know from earlier on the number of children with statements/EHC plans associated with MLD decreased from 2010 to 2018 but increased from 2018 to 2023. This graph shows that the number of children with a statement/EHC plan and a primary need of MLD in special schools declined steadily from 2010 to 2023; the number of children in mainstream schools declined rapidly from 2010 to 2017 but has been rapidly increasing since then.

For children with statements/EHC plans associated with SLD (the blue lines), the number of children with SLD in mainstream schools slightly decreased, with fluctuations, from 2010 to 2023, while the number of children with SLD in special schools rapidly increased up to 2022 but decreased slightly in 2023.

For children with a statement/EHC plan associated with PMLD (the purple lines), the numbers of children with PMLD in both mainstream and special schools has very gradually increased from 2010 to 2018 but has fluctuated since.

Another way of looking at this is to look at the percentage of children in mainstream vs special schools. The graph below shows this from 2010 to 2023 for children with a statement/EHC plan. As the graph shows, the percentage of children with a primary need of MLD and a statement/EHC plan in mainstream school dipped from just over 50% in 2010 to 43% in 2017, with the percentage returning to above 50% from 2021 onwards. For children with a statement/EHC plan and a primary need of SLD, the percentage of children in mainstream schools decreased from 17% in 2010 to less than 12% from 2018 onwards. For children with a statement/EHC plan and a primary need of PMLD, the percentage of children in mainstream school has remained fairly consistent around 14%-16%.

For children identified at the level of SEN Support (I haven’t included a graph on this), in 2023 almost all the children with a primary need of MLD (99.97%) and the vast majority of children with a primary need of SLD (92.3%) or PMLD (85.3%) were in mainstream schools.

Although it’s not an ideal marker of the financial circumstances of families, eligibility for free school meals is collected within DfE statistics. The graph below shows the proportion of children with statements/EHCPs associated with MLD, SLD and PMLD eligible for free school meals compared to the proportion of all children eligible for free school meals in 2023. For all children on the school roll, 23.8% of children in 2023 were eligible for free school meals. For children with a PMLD label the proportion of children eligible for free school meals is higher (36.2% for children with a statement/EHC plan), then higher again for children with an SLD label (43.5% for children with a statement/EHC plan), and highest for children with an MLD label (46.9% for children with a statement/EHC plan). It is worth mentioning that the proportion of children in all groups eligible for free school meals has increased in recent years.

A brief summary of the main points:

•  While the number of children identified as having special educational needs associated with severe learning difficulties or profound and multiple learning difficulties and needing statements or EHC plans have changed gradually over time, the number of children identified as having a special educational need associated with moderate learning difficulties has been plummeting but for the last five years has increased rapidly.
• There are slightly different trends for different groups of children with learning disabilities in terms of the proportion of children in mainstream vs special schools, but some earlier trends towards special education seem to be starting to reverse for children with MLD in the last few years. Less than 20% of children with an EHCP/statement and a label of SLD or PMLD are being educated in mainstream schools.
• Children with learning disabilities are much more likely to be eligible for free school meals than children generally.

Vanishing point: When will targets about the number of people with learning disabilities and autistic people in inpatient units be met?

 "Happiness is the target one only has to aim at in order to miss" John Cooper Clarke

There are myriad ways to bring to light the abject failure of governments and services to make good on their promises after the Panorama programme on Winterbourne View, over 12 years ago in 2011. The most important are direct accounts of people's experiences in these places, and how life can be so different with decent support. A small way to add to the picture is to examine, on the government's own terms, whether they are achieving what they say they've set out to do, most obviously in terms of the number of people still in inpatient units.

To keep this blogpost relatively short I won't go over again what has happened, and more especially what has failed to happen, since the Winterbourne View programme first aired. I will just focus on a set of targets that the government has set about the maximum number of children and adults there should be in inpatient units, by the end of March 2024. With less than a year to go until this deadline, how close is the government to meeting the targets they've set? 

The Building the Right Support for People with a Learning Disability and Autistic People Action Plan (2022) restates the NHS Long Term Plan target that “by March 2024 mental health inpatient provision for people with a learning disability and autistic people will reduce to less than half of 2015 levels (on a like for like basis and taking into account population growth). This means that for every 1 million adults, no more than 30 people with a learning disability and autistic people will be cared for in an inpatient unit. For children and young people, no more than 12 to 15 autistic children and young people and children and young people with a learning disability per 1 million children, will be cared for in an inpatient unit.” 

So, these targets (themselves a watering down of targets set in the original Building the Right Support in 2015, and puny in comparison to the aims of the government immediately after Winterbourne View) are expressed in a relatively straightforward way. What's actually happening?

 

Targets for children

The first graph below shows the number of children (aged less than 18 years) in inpatient units over time, from March 2015 to March 2023 for AT data, and from March 2018 to March 2022 for MHSDS data. 

Without going over this again at great length, AT stands for Assuring Transformation, a set of data collected by health service commissioners and reported every month, which tends to focus on people with learning disabilities and autistic people in 'specialist' inpatient units. MHSDS stands for the Mental Health Services DataSet, which is collected in real time by mental health service providers and reported monthly, which additionally to AT tends to include people with learning and autistic people in mainstream mental health inpatient units. Unfortunately, according to NHS Digital (now being absorbed into NHS England), many mental health service providers have been subjected to a 'recent' cyber attack, meaning that there has been no national MHSDS information since July 2022. You can find all this information here.

Number of children (aged less than 18 years) with learning disabilities and autistic children in inpatient services in England

 

The second graph below shows the rates per million population (aged less than 18 years) of children with learning disabilities and autistic children in inpatient services. ONS mid-year population estimates were used from 2015-2020 – more recent population estimates were calculated by applying the annual population growth rate from 2015 to 2020.

Rate per million children population of children with learning disabilities and autistic children in inpatient services – England

 

The first graph shows that according to the AT dataset, 170 children in March 2015 (when the BtRS Action Plan states that the number of children in inpatient services were undercounted) through to 240 children in March 2023 were in inpatient services. There is no clear trend over time, certainly not of reducing numbers of children in inpatient services. The second graph shows that in March 2023 the rate per million of children in inpatient services was 19.4, above the target for 2023/24 of 12-15. On current population figures, the number of children in inpatient services needs to reduce to around 185 children to be within the upper target band and under 150 children to be within the lower target band.

The MHSDS reports smaller numbers of children in inpatient services than AT, from 175 children in March 2018 to 180 children in March 2022. Given that MHSDS figures are usually higher than AT figures, this direction of discrepancy is unusual. It may be that children are less likely to have an already existing health system learning disability or autism flag, which would result in the MHSDS undercounting this group. Again there is no clear trend over time, with recent rates per million child population according to the MHSDS at the level of the upper target band.

 

Targets for adults

The third graph below shows the number of adults (aged 18+ years) in inpatient units over time, from March 2015 to March 2023 for AT data, and from March 2018 to March 2022 for MHSDS data.

Number of adults (aged 18+ years) with learning disabilities and autistic children in inpatient services in England

The fourth and final graph below shows the rates per million population (aged 18+ years) of adults with learning disabilities and autistic adults in inpatient services. 

Rate per million adult population of adults with learning disabilities and autistic adults in inpatient services – England

The third graph shows that, according to the AT dataset, 2,735 adults in March 2015 through to 1,890 adults in March 2023 were in inpatient services (although as the March 2023 data is relatively recent it is likely to be a slight underestimate). There is a downward trend over time, at an average compound rate of a 4.5% reduction per year. The fourth graph shows that in March 2023 the rate per million of adults in inpatient services was 41.7, above the target for 2023/24 of 30. On current population figures, the number of adults in inpatient services needs to reduce to 1,360 adults to be within the target band.

Applying the average reduction of 4.5% a year to the 1,890 adults in inpatient units in March 2023, it would take seven years (to March 2030) to reach the Building the Right Support target of 30 per million for March 2024. The downward trend has slowed over time: it was faster for 2015-19 (average compound rate -5.6% per year) than for 2019-2023 (average compound rate -3.6% per year). Applying the more recent -3.6% rate, it would take nine years (to March 2032) to reach the target for March 2024.  

The MHSDS reports higher numbers of adults in inpatient services than AT, with 3,395 adults with learning disabilities and autistic adults reported to be in inpatient services at the end of March 2022. There is no clear trend in numbers over time according to the MHSDS, with lower numbers in March 2020 and March 2021 likely to be related to the COVID-19 pandemic. The rate per million of adults in inpatient services according to the MHSDS was 75.4 in March 2022, very similar to the 75.6 reported in March 2018, compared to the Building the Right Support target of 30 per million. Because there is no existing downward trend over time, there is no future date at which the target rate would be met.

Even on the progressively less demanding terms that the government has set for itself, this is abject failure.