Linking health and education data for research to improve outcomes for children in England
Lead Research Organisation:
University College London
Department Name: Institute of Child Health
Abstract
Education and health are deeply connected in childhood and adolescence. These links are particularly important for vulnerable or disadvantaged children, for whom challenges in one domain often occur alongside or cause difficulties in the other. Whilst Scotland, Wales and the Nordic countries are increasingly using linked data to improve health and education for children with chronic conditions, use in England is patchy. This project will bridge this gap in knowledge by linking education and health data for all children in England. Our aim is to create a research-ready dataset, the All Years Dataset, which can be used in future research to improve outcomes for children in England.
Firstly, we will carry out strategic research based on an existing linked education-health dataset of a subset of 2 million children. Evidence on the accuracy of linkage between health and education data will be used to improve the All Years Dataset. We will produce research to show how the data can be used to inform policy and produce a manual, or metadata, to help future researchers to understand and use the dataset. We will involve the public in developing priorities for future studies using the All Years Dataset. The All Years Dataset will link children across two datasets. The National Pupil Database, which contains education records for all children in England from 2002 onwards and Hospital Episode Statistics, which contains information on hospital care from 1997 onwards. The linked dataset will be anonymised, meaning that it does not contain any personal information that could directly identify someone. The data will be analysed in secure environments, hosted by the Office of National Statistics and by NHS Digital. Access to these environments will be strictly controlled. No record level data will be able to be taken out of these environments and summary data will be checked before being released. The project will facilitate future research across a range of health and social science disciplines and will support research to improve policymaking for children's health, education and wellbeing.
Firstly, we will carry out strategic research based on an existing linked education-health dataset of a subset of 2 million children. Evidence on the accuracy of linkage between health and education data will be used to improve the All Years Dataset. We will produce research to show how the data can be used to inform policy and produce a manual, or metadata, to help future researchers to understand and use the dataset. We will involve the public in developing priorities for future studies using the All Years Dataset. The All Years Dataset will link children across two datasets. The National Pupil Database, which contains education records for all children in England from 2002 onwards and Hospital Episode Statistics, which contains information on hospital care from 1997 onwards. The linked dataset will be anonymised, meaning that it does not contain any personal information that could directly identify someone. The data will be analysed in secure environments, hosted by the Office of National Statistics and by NHS Digital. Access to these environments will be strictly controlled. No record level data will be able to be taken out of these environments and summary data will be checked before being released. The project will facilitate future research across a range of health and social science disciplines and will support research to improve policymaking for children's health, education and wellbeing.
Planned Impact
Education and health are deeply connected in childhood and adolescence. These links are particularly important for vulnerable or disadvantaged children, for whom challenges in one domain often occur alongside or cause difficulties in the other. For example, children with chronic health conditions tend to be heavy users of both hospital and educational support services and have high rates of school absence and poor school performance.
The creation of a large linked health-education dataset will enable researchers and government analysts to delve into these complex issues and produce reliable and policy-relevant research. Two exemplar studies will be conducted as part of our strategic research to demonstrate the dataset's value for policy in two specific areas: predicting academic performance based on measures of early social disadvantage and health, and evaluating school absences and performance among children with chronic health conditions.
The creation of a large linked health-education dataset will enable researchers and government analysts to delve into these complex issues and produce reliable and policy-relevant research. Two exemplar studies will be conducted as part of our strategic research to demonstrate the dataset's value for policy in two specific areas: predicting academic performance based on measures of early social disadvantage and health, and evaluating school absences and performance among children with chronic health conditions.
Organisations
- University College London (Lead Research Organisation)
- OFFICE FOR NATIONAL STATISTICS (Collaboration)
- University of Manchester (Collaboration)
- University College London (Collaboration)
- Institute for Fiscal Studies (Collaboration)
- UNIVERSITY OF CAMBRIDGE (Collaboration)
- DEPARTMENT FOR EDUCATION (Collaboration)
- Bradford Institute for Health Research (BIHR) (Collaboration)
- UNIVERSITY OF OXFORD (Collaboration)
- NHS DIGITAL (Collaboration)
- London School of Hygiene and Tropical Medicine (LSHTM) (Collaboration)
- Anna Freud Centre (Collaboration)
- University of Bristol (Collaboration)
Publications
Blackburn RM
(2022)
COVID-19-related school closures and patterns of hospital admissions with stress-related presentations in secondary school-aged adolescents: weekly time series.
in The British journal of psychiatry : the journal of mental science
Elizabeth Waind
(2021)
ECHILD Stakeholder Event Report
Etoori D
(2022)
Reductions in hospital care among clinically vulnerable children aged 0-4 years during the COVID-19 pandemic.
in Archives of disease in childhood
Feng Q
(2024)
Data Resource Profile: A national linked mother-baby cohort of health, education and social care data in England (ECHILD-MB).
in International journal of epidemiology
Grath-Lone LM
(2021)
Ethnic bias in data linkage.
in The Lancet. Digital health
Jay MA
(2022)
Evaluation of pushing out of children from all English state schools: Administrative data cohort study of children receiving social care and their peers.
in Child abuse & neglect
Libuy N
(2021)
Linking education and hospital data in England: linkage process and quality.
in International journal of population data science
Libuy N
(2023)
Gestational age at birth, chronic conditions and school outcomes: a population-based data linkage study of children born in England.
in International journal of epidemiology
Mc Grath-Lone L
(2022)
Data Resource Profile: The Education and Child Health Insights from Linked Data (ECHILD) Database.
in International journal of epidemiology
Mc Grath-Lone L
(2022)
What makes administrative data research-ready? A systematic review and thematic analysis of published literature
in International Journal of Population Data Science
Description | ECHILD stands for Education and Child Health Insights from Linked Data. ECHILD aims to link administrative data for all children in England from education, social care and hospital services. Our first objective was to validate the linkage accuracy and assess potential biases. We applied multi-step rule-based linkage algorithms to 4 one-year cohorts of children born 1 September-31 August in 1990/1, 1996/7, 1999/00 and 2004/5. In stage 1, full names, date of birth, and postcode histories from education data in the National Pupil Database were linked to the NHS Personal Demographic Service. In stage 2, NHS number, postcode, date of birth and sex were linked to hospital records in Hospital Episode Statistics. Since June 2021, we have been able to access linked education and hospital data for all children in England born from 1995. The data has been used to produce reports for DHSC, and has been presented at seminars for ADRUK, HDRUK, Institute for Government, DfE and DHSC. The objective of making ECHILD available to external researchers has not yet been achieved, but options are being productively pursued. Funding is being extended to enable the UCL team to support wider use under licence, if granted by NHS DIgital |
Exploitation Route | The purpose of this award is to enable wider use of linked administrative data for research across government and academia. Future research could provide important evidence to inform decisions by children and families about their expected needs and outcomes, and by service providers and policy makers about resource needs, equitable provision of services, which groups are most likely to benefit from targeted services, how education, social care and health can support children and families more effectively across the child life course, and the effectiveness of specific interventions (eg SEND provision). Future research could enhance this resource by adding data (eg by linking families, adding more accurate measures of house income deprivation, linking to primary care data), by improving connectivity with cohorts, surveys and trials, and enhancing interoperability with similar resources in other UK countries. |
Sectors | Communities and Social Services/Policy Education Healthcare Government Democracy and Justice |
URL | https://www.ucl.ac.uk/child-health/research/population-policy-and-practice-research-and-teaching-department/cenb-clinical-20 |
Description | Our findings on the feasibility and accuracy of linkage between education and hospital data for children in England has been used by ADR UK and NHS Digital, DHSC, Dept for Education to plan further linkages and use of the ECHILD database. We have also published findings of a study, comissioned by DHSC through the NIHR Policy Research Programme, on the impact of the COVID pandemic on vulnerable children. These findings have been shared with the Chief Scientific Advisory, Lucy Chappell, and the NHS England Clinical Director, Simon Kenny. See list of publications |
First Year Of Impact | 2021 |
Sector | Communities and Social Services/Policy,Education,Healthcare,Government, Democracy and Justice |
Impact Types | Societal Policy & public services |
Description | "The SPECIAL study" - SPecial Educational needs provision to Improve Child heALth |
Amount | £1,445,777 (GBP) |
Funding ID | 202025 |
Organisation | National Institute for Health Research |
Sector | Public |
Country | United Kingdom |
Start | 07/2021 |
End | 07/2024 |
Description | COVID ECHILD study: impact of the pandemic on vulnerable children |
Amount | £64,000 (GBP) |
Organisation | National Institute for Health Research |
Sector | Public |
Country | United Kingdom |
Start | 05/2020 |
End | 06/2021 |
Description | Enhancement of ECHILD with a mother-child and Unique Property Reference number link |
Amount | £268,461 (GBP) |
Funding ID | ES/X000427/1 |
Organisation | Economic and Social Research Council |
Sector | Public |
Country | United Kingdom |
Start | 08/2022 |
End | 08/2024 |
Description | Linking health and education data for research to improve outcomes for children in England - Supplement |
Amount | £383,497 (GBP) |
Funding ID | ES/X003663/1 |
Organisation | Economic and Social Research Council |
Sector | Public |
Country | United Kingdom |
Start | 08/2022 |
End | 08/2024 |
Title | Database containing family court data linked to hospital episode statistics data for all mothers giving birth in England |
Description | Family courts data for England (100k linked), nested within 8.2 million mothers in HES giving birth in England Currently available to users in UCL. Funding being sought to enable linkage to ECHILD |
Type Of Material | Database/Collection of data |
Year Produced | 2022 |
Provided To Others? | No |
Impact | Evidence on high rates of public law involvement among young mothers, a minority with high rates of subsequent births, and that one half of those with subsequent births return to court |
Title | ECHILD database: Education and Child Health Insights from Linked Data |
Description | Links education, social care and hospitalisation data for 14.7 million children in England born from 1995. Purpose is for re-use for research |
Type Of Material | Database/Collection of data |
Year Produced | 2021 |
Provided To Others? | Yes |
Impact | The data will be made available from later in 2022. |
URL | https://www.ucl.ac.uk/child-health/echild |
Title | Family Courts data linked to Mental Health Data in South London |
Description | Linkage of public law family court data for mothers to mental health data (Clinical Research Interactive System) at South London and the Maudsley Trust |
Type Of Material | Database/Collection of data |
Year Produced | 2020 |
Provided To Others? | Yes |
Impact | Insights into high rates of mental health disorder, mostly serious, in mothers present to public law court care proceedings regarding their child(ren). Publications from UCL and KCL. 3 different user projects to-date of this research database. |
Description | Cambridge University Department of Psychiatry |
Organisation | University of Cambridge |
Department | Department of Psychiatry |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | I am principal investigator for this NIHR programme award. |
Collaborator Contribution | Prof Tamsin Ford is leading a workpackage within the programme and her team bring clinical and schools expertise. |
Impact | none as yet |
Start Year | 2020 |
Description | Children and Families Policy Research Unit (CPRU) |
Organisation | Anna Freud Centre |
Country | United Kingdom |
Sector | Charity/Non Profit |
PI Contribution | The Children and Families Policy Research Unit (CPRU) is one of 15 National Institute of Health Research (NIHR) Policy Research Units that undertake research to inform decision-making by government and arms-length bodies. The units work closely with the Department of Health and Social Care to determine priorities and provide evidence directly to the Secretary of State for Health, government departments and arms-length bodies, such as NHS England and Public Health England. Collaboration on ECHILD strategic research on changes in hospital contacts during the COVID-19 pandemic among vulnerable children and young people. |
Collaborator Contribution | Collaboration on ECHILD strategic research on changes in hospital contacts during the COVID-19 pandemic among vulnerable children and young people. |
Impact | Policy Briefing Report: Changes in hospital contacts during the COVID-19 pandemic among vulnerable children and young people |
Start Year | 2020 |
Description | Children and Families Policy Research Unit (CPRU) |
Organisation | Institute for Fiscal Studies |
Country | United Kingdom |
Sector | Charity/Non Profit |
PI Contribution | The Children and Families Policy Research Unit (CPRU) is one of 15 National Institute of Health Research (NIHR) Policy Research Units that undertake research to inform decision-making by government and arms-length bodies. The units work closely with the Department of Health and Social Care to determine priorities and provide evidence directly to the Secretary of State for Health, government departments and arms-length bodies, such as NHS England and Public Health England. Collaboration on ECHILD strategic research on changes in hospital contacts during the COVID-19 pandemic among vulnerable children and young people. |
Collaborator Contribution | Collaboration on ECHILD strategic research on changes in hospital contacts during the COVID-19 pandemic among vulnerable children and young people. |
Impact | Policy Briefing Report: Changes in hospital contacts during the COVID-19 pandemic among vulnerable children and young people |
Start Year | 2020 |
Description | Children and Families Policy Research Unit (CPRU) |
Organisation | University College London |
Department | Institute of Child Health |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | The Children and Families Policy Research Unit (CPRU) is one of 15 National Institute of Health Research (NIHR) Policy Research Units that undertake research to inform decision-making by government and arms-length bodies. The units work closely with the Department of Health and Social Care to determine priorities and provide evidence directly to the Secretary of State for Health, government departments and arms-length bodies, such as NHS England and Public Health England. Collaboration on ECHILD strategic research on changes in hospital contacts during the COVID-19 pandemic among vulnerable children and young people. |
Collaborator Contribution | Collaboration on ECHILD strategic research on changes in hospital contacts during the COVID-19 pandemic among vulnerable children and young people. |
Impact | Policy Briefing Report: Changes in hospital contacts during the COVID-19 pandemic among vulnerable children and young people |
Start Year | 2020 |
Description | Children and Families Policy Research Unit (CPRU) |
Organisation | University College London |
Department | Institute of Education (IOE) |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | The Children and Families Policy Research Unit (CPRU) is one of 15 National Institute of Health Research (NIHR) Policy Research Units that undertake research to inform decision-making by government and arms-length bodies. The units work closely with the Department of Health and Social Care to determine priorities and provide evidence directly to the Secretary of State for Health, government departments and arms-length bodies, such as NHS England and Public Health England. Collaboration on ECHILD strategic research on changes in hospital contacts during the COVID-19 pandemic among vulnerable children and young people. |
Collaborator Contribution | Collaboration on ECHILD strategic research on changes in hospital contacts during the COVID-19 pandemic among vulnerable children and young people. |
Impact | Policy Briefing Report: Changes in hospital contacts during the COVID-19 pandemic among vulnerable children and young people |
Start Year | 2020 |
Description | Children and Families Policy Research Unit (CPRU) |
Organisation | University of Bristol |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | The Children and Families Policy Research Unit (CPRU) is one of 15 National Institute of Health Research (NIHR) Policy Research Units that undertake research to inform decision-making by government and arms-length bodies. The units work closely with the Department of Health and Social Care to determine priorities and provide evidence directly to the Secretary of State for Health, government departments and arms-length bodies, such as NHS England and Public Health England. Collaboration on ECHILD strategic research on changes in hospital contacts during the COVID-19 pandemic among vulnerable children and young people. |
Collaborator Contribution | Collaboration on ECHILD strategic research on changes in hospital contacts during the COVID-19 pandemic among vulnerable children and young people. |
Impact | Policy Briefing Report: Changes in hospital contacts during the COVID-19 pandemic among vulnerable children and young people |
Start Year | 2020 |
Description | Children and Families Policy Research Unit (CPRU) |
Organisation | University of Cambridge |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | The Children and Families Policy Research Unit (CPRU) is one of 15 National Institute of Health Research (NIHR) Policy Research Units that undertake research to inform decision-making by government and arms-length bodies. The units work closely with the Department of Health and Social Care to determine priorities and provide evidence directly to the Secretary of State for Health, government departments and arms-length bodies, such as NHS England and Public Health England. Collaboration on ECHILD strategic research on changes in hospital contacts during the COVID-19 pandemic among vulnerable children and young people. |
Collaborator Contribution | Collaboration on ECHILD strategic research on changes in hospital contacts during the COVID-19 pandemic among vulnerable children and young people. |
Impact | Policy Briefing Report: Changes in hospital contacts during the COVID-19 pandemic among vulnerable children and young people |
Start Year | 2020 |
Description | Children and Families Policy Research Unit (CPRU) |
Organisation | University of Oxford |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | The Children and Families Policy Research Unit (CPRU) is one of 15 National Institute of Health Research (NIHR) Policy Research Units that undertake research to inform decision-making by government and arms-length bodies. The units work closely with the Department of Health and Social Care to determine priorities and provide evidence directly to the Secretary of State for Health, government departments and arms-length bodies, such as NHS England and Public Health England. Collaboration on ECHILD strategic research on changes in hospital contacts during the COVID-19 pandemic among vulnerable children and young people. |
Collaborator Contribution | Collaboration on ECHILD strategic research on changes in hospital contacts during the COVID-19 pandemic among vulnerable children and young people. |
Impact | Policy Briefing Report: Changes in hospital contacts during the COVID-19 pandemic among vulnerable children and young people |
Start Year | 2020 |
Description | ECHILD Strategic Research Collaboration |
Organisation | Institute for Fiscal Studies |
Country | United Kingdom |
Sector | Charity/Non Profit |
PI Contribution | Research collaboration to deliver strategic research exemplar studies using the ECHILD database. Research into the relative importance of early health, skills and disadvantage in predicting later educational attainment; the importance of health, skills and disadvantage changes over the lifecycle and whether early health continues to matter over and above later health and attainment. Research into the impact of the Covid-19 pandemic on the timing of repair surgery for children born with an oral cleft in England, and implications of delays for educational outcomes. |
Collaborator Contribution | Research collaboration to deliver strategic research exemplar studies using the ECHILD database. |
Impact | Preprint publications, with manuscripts currently being prepared. |
Start Year | 2020 |
Description | ECHILD Strategic Research Collaboration |
Organisation | London School of Hygiene and Tropical Medicine (LSHTM) |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Research collaboration to deliver strategic research exemplar studies using the ECHILD database. Research into the relative importance of early health, skills and disadvantage in predicting later educational attainment; the importance of health, skills and disadvantage changes over the lifecycle and whether early health continues to matter over and above later health and attainment. Research into the impact of the Covid-19 pandemic on the timing of repair surgery for children born with an oral cleft in England, and implications of delays for educational outcomes. |
Collaborator Contribution | Research collaboration to deliver strategic research exemplar studies using the ECHILD database. |
Impact | Preprint publications, with manuscripts currently being prepared. |
Start Year | 2020 |
Description | ECHILD partnership |
Organisation | Department for Education |
Country | United Kingdom |
Sector | Public |
PI Contribution | This is a four-way partnership and I lead the academic component. We also collaborate with LSHTM and Institute of Fiscal Studies |
Collaborator Contribution | As for NHS Digital partnership |
Impact | As for NHS Digital partnership |
Start Year | 2019 |
Description | ECHILD partnership |
Organisation | NHS Digital |
Country | United Kingdom |
Sector | Public |
PI Contribution | This is a four-way partnership and I lead the academic component. We also collaborate with LSHTM and Institute of Fiscal Studies |
Collaborator Contribution | As for NHS Digital partnership |
Impact | As for NHS Digital partnership |
Start Year | 2019 |
Description | ECHILD partnership |
Organisation | Office for National Statistics |
Country | United Kingdom |
Sector | Private |
PI Contribution | This is a four-way partnership and I lead the academic component. We also collaborate with LSHTM and Institute of Fiscal Studies |
Collaborator Contribution | As for NHS Digital partnership |
Impact | As for NHS Digital partnership |
Start Year | 2019 |
Description | NIHR CPRU 2024-28 |
Organisation | Bradford Institute for Health Research (BIHR) |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | I co-lead the programme |
Collaborator Contribution | Prof Matt Sutton and team contribute economic expertise to the NIHR CPRU programme |
Impact | Funding for NIHR CPRU programme 2024-28 |
Start Year | 2023 |
Description | NIHR CPRU 2024-28 |
Organisation | University of Manchester |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | I co-lead the programme |
Collaborator Contribution | Prof Matt Sutton and team contribute economic expertise to the NIHR CPRU programme |
Impact | Funding for NIHR CPRU programme 2024-28 |
Start Year | 2023 |
Description | ECHILD knowledge sharing and engagement sessions |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Seminars, Network Symposiums and user group engagements with researchers, analysts and policy makers regarding the ECHILD database and project research. 991 individuals engaged through 20 events over the duration of the project. |
Year(s) Of Engagement Activity | 2020,2021,2022 |
Description | ECHILD small group patient and public involvement and engagement sessions |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Patients, carers and/or patient groups |
Results and Impact | 11 small group engagements with children and young people and parents and carers, engaging 127 individuals to understand different views on the use of linked health, education and social care data for research and steer for ECHILD project research plans and results. |
Year(s) Of Engagement Activity | 2020,2021,2022 |
URL | https://www.ucl.ac.uk/child-health/research/population-policy-and-practice-research-and-teaching-dep... |
Description | Stakeholder meeting |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Other audiences |
Results and Impact | Organisations representing children's interests are invited to question the Government and Research partners of ECHILD. The aim is to give their perspectives on how the database should be used and to contribute suggestions for research priorities. |
Year(s) Of Engagement Activity | 2021 |