Introduction School absence is a major challenge, with one in five pupils persistently absent in 2022/2023. School attendance is an important predictor of long-term educational, health, economic and social outcomes in children and young people (CYP). Methods This article reviews recent trends, determinants, effects and proposed strategies relating to school absence. It provides practical guidance for paediatricians to address absence in consultations and draws out key themes for future research. While focusing mainly on the English context, common challenges and solutions in the USA and other countries are also discussed. Conclusions The importance of CYP–parent–school partnerships, special educational needs and disabilities and mental health provision, collaborative interagency support, flexible, individualised plans and curricula for absence and positive school cultures is raised. Despite current challenges, there may be opportunities for improvement by engaging further with integrated neighbourhood teams and mental health support teams in schools.
James et al. (2026) studied this question.