This article sheds light on how chronic health conditions impact upon concepts of inclusion in children's early childhood education and care in England; it draws upon findings from a small-scale research project which highlights the need to consider health, in particular, the impact of chronic health conditions on early childhood education and care. The study was conducted in two stages: Stage 1 involved a postal questionnaire to 60 early childhood settings and Stage 2 included interviews with 6 practitioners in 4 settings, interviews with parents and observations of a child (called DJ) in his setting over the course of a year. The findings from this study indicate that in an attempt to be inclusive, practitioners may be unintentionally exclusive in their practice. The data suggest that this may be as a consequence of practitioners having different understandings and definitions of what is meant by the term inclusion, leading to confusion about the aims of inclusion. The findings indicate that there is a need to identify what effective pedagogy is for children with chronic health conditions, as well as a need to redefine inclusion in relation to their needs.