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

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