Government’s SEND Reforms Promise Better Support, But Health Services Face Uncertain Role

The government’s long-awaited Special Educational Needs and Disabilities (SEND) reform, unveiled in February 2026, represents the most significant overhaul of the system in decades. However, leading health experts are raising questions about whether healthcare services will receive sufficient focus and resources to make the new model work effectively.

The British Medical Journal has highlighted a critical gap in the proposals: whilst the reforms comprehensively address educational provision through new layers of support and increased school accountability, the role of health professionals—particularly paediatricians and medical specialists—remains unclear. This concern matters significantly for children and young people whose SEND has both educational and medical dimensions.

The Scale of the Current Crisis

The SEND system has reached breaking point. Since 2018, the proportion of pupils receiving an Education, Health and Care Plan (EHCP)—the most intensive form of support—has doubled from under 3% to over 5% of the school population. Over the same period, high-needs funding has increased by more than £4 billion. Approximately 1.7 million children in England currently have identified special educational needs, with annual SEND provision costs projected to reach £15 billion.

Parents frequently describe the experience of accessing SEND support as a battle, eroding trust between families and educational institutions. High levels of absence, exclusions, and informal removals from school—particularly among children with chronic health conditions—suggest that mainstream schools are struggling to support or retain SEND students effectively.

What the Government’s Reforms Propose

The government is investing £7 billion over four years to create a fundamentally different system. Rather than focusing on whether a child receives an EHCP, the new approach will assess specific areas of development, such as executive function, speech and language, or social and emotional wellbeing.

The reforms introduce three new layers of support, all available in mainstream settings:

Universal support will be provided to all children as standard within schools. Targeted support includes structured interventions like small-group speech and language therapy or help managing sensory needs. Targeted Plus support brings specialist professionals—including Speech and Language Therapists and Educational Psychologists—directly into schools through a new “Experts at Hand” offer funded with £1.8 billion over three years.

Only children with the most significant needs will receive the new specialist support, with a digital Individual Support Plan replacing traditional EHCPs for many. The transition begins in September 2029, though existing EHCPs and protections remain until at least September 2030.

The Health Question

Whilst the reforms strengthen school accountability and introduce new duties on settings to use evidence-based interventions, the integration of healthcare services remains ambiguous. The £1 billion allocated for commissioning “experts at hand” to work in schools explicitly mentions speech, language and communication specialists and physiotherapists, but does not specifically reference medical specialists such as paediatricians or other doctors.

Ruth Gilbert, child health expert at UCL Great Ormond Street Institute of Child Health, noted in the British Medical Journal that this represents a significant oversight. Children and young people with complex SEND often require coordinated support across education and health services. Without clear healthcare roles and adequate resourcing for medical input, the reforms risk creating a system that addresses educational needs whilst leaving health-related barriers to learning unresolved.

Accountability and Oversight

The government has strengthened accountability measures. Ofsted’s new inspection framework will assess all settings for inclusion, and school performance measures will be updated to recognise mainstream schools effectively supporting pupils facing the greatest barriers to learning. Integrated Care Boards—the NHS organisations responsible for health planning at local level—will have new statutory responsibilities alongside local authorities for SEND provision.

Mediation and school complaints processes will be improved, with the Tribunal reserved as a genuine last resort. A new remit for the Children’s Commissioner will provide independent oversight of SEND reform implementation.

The Timeline

This is deliberately a decade-long reform programme, reflecting the complexity of transforming a system affecting nearly 2 million children. Assessments for the new system begin in September 2029, with no changes to existing EHCP support before September 2030. As pupils reach the end of a school phase—primary, secondary, or post-16—they will transition to either the new specialist EHCP or the flexible layers of support through digital Individual Support Plans.

What This Means for Kent Residents

For families in Kent and Medway, these reforms will gradually reshape how SEND support is delivered. NHS Kent and Medway Integrated Care Board will have expanded responsibilities for commissioning specialist professionals to work in mainstream schools, working alongside local authorities and schools.

Parents should expect to see more speech, language and communication specialists and educational psychologists in school settings, potentially reducing waiting times for assessment and intervention. However, families whose children require ongoing medical management alongside educational support should ensure their GPs and paediatricians remain closely involved during the transition. The Kent and Medway ICB’s local implementation plans, when published, will clarify how healthcare services will integrate with the new educational support structure. Parents with concerns should contact their local authority SEND team or their child’s GP for guidance on how these changes will affect their individual circumstances.

Key Takeaways

• The government is investing £7 billion over four years to transform how SEND support is delivered in schools
• A new three-tier system aims to get earlier support to children in mainstream settings without lengthy battles for EHCPs
• Health experts question whether healthcare services, particularly medical specialists, have a sufficiently defined role in the new system
• The transition begins in September 2029, with existing EHCP protections remaining until at least September 2030