Background The COVID-19 Pandemic has amplified the pre-existing health and social inequalities in our society. The impact of the pandemic, from both direct and indirect consequences, on children and young people (CYP) with special educational needs and disability (SEND) is likely to be huge.
Objectives In partnership with an inner-city London council we conducted a rapid health services equity assessment with the aim of understanding the impact of the COVID-19 pandemic and associated first lockdown (23/03–01/06/20) on CYP with SEND and their families attending our health services. We sought to understand how their mental and physical health, accessing services, education, social connectedness and household financial security had changed as a result of the pandemic. The findings would help us understand the broader social and health needs of this population and shape our future service.
Methods A questionnaire was designed and piloted with two parents. The sample was non-random/convenience sampling taken from a contact list of CYP with SEND who were shielding or considered vulnerable. Participants were informed this was part of a service evaluation and consented to be interviewed. A total of 75 telephone interviews were conducted. The council completed 46 questionnaires and in October 2020 the medical team attempted contact with a further 94 families. 46 families answered the telephone and 29 agreed to complete the questionnaire. Ethics was not sought as it was a health service evaluation.
Results The participants children were between 0–19 years with the majority (40%) between 5–9 years. 89% of the sample was BAME. 55% of the school-age children were eligible for a school place during lockdown however only 21% of these opted to attend school. Parents cited reasons for not attending school as shielding, fear of COVID-19 and lack of equipment.
The most common services accessed were primary care, specialist services (eg child development centre) and food banks. Of the 27 families describing worse employment situation, only 1 accessed the jobcentre. Of the 31 families with worse financial situation 15 accessed the food bank and 1 accessed the Citizens’ Advice Bureau.
Conclusions Further exploration is required with validated measures to understand the impact of the pandemic and of associated interventions (eg lockdown) on health and mental health in particular. Our survey shows that emotional and financial services were not widely used despite the difficulties many faced. Signposting families to these services is being prioritised in our clinical interactions and through development of a social prescribing model. More in-depth qualitative research is planned on this population exploring the interplay between social determinants and COVID in CYP with SEND and their families.
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