National Institute for Health and Clinical Excellence (NICE)
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Looking after the looked-after: draft guidance aims to improve the quality of life for looked-after children and young people

New guidance being developed by the National Institute for Health and Clinical Excellence (NICE) and the Social Care Institute for Excellence (SCIE) aims to improve the quality of life for children in the care system. The joint guidance, which focuses on the physical and emotional health and wellbeing for looked-after children and young people, is now open for consultation. This document includes draft recommendations which have been issued at this stage for consultation only: guidance has not yet been issued to the NHS, local authorities and the wider public, private, voluntary and community sectors.

The draft guidance is available on the NICE website. Organisations wishing to submit comments are invited to do so via the NICE website between Monday 15 February and Wednesday 14 April 2010. Only stakeholders can comment formally on consultations, but organisations in England, Wales and Northern Ireland can register to be a stakeholder at anytime during the process.  Visit the NICE website for more information.

Around 60,000 children and young people are looked after by local authorities in England at any one time. A number have positive experiences in the care system and achieve good emotional and physical health, do well in their education and have good jobs and careers. However looked-after children and young people are more likely to experience emotional and mental health problems than other children or young people in the same age range. A high proportion also experience poor health, educational and social outcomes after leaving care. New NICE/SCIE draft guidance aims to address these inequalities and improve the outcomes for looked-after children and young people.

The Department for Health (DH) and Department for Children, Schools and Families (DCSF) asked NICE and SCIE to produce evidence-based guidance on promoting the physical and emotional health and wellbeing of looked-after children and young people. This draft guidance focuses on systems, strategies and services and final guidance is due to be published in September 2010. It will help professionals, commissioners and managers within the NHS, local authorities and the wider public, private, voluntary and community sectors to implement updated statutory guidance published by the DH and DCSF in November 2009. Although the SCIE/NICE final guidance is not statutory, local organisations are expected to follow it.

The content of the NICE and SCIE draft guidance has been developed using a wide range of evidence. NICE and SCIE have consulted with children and young people during the process to ensure their views and experiences are reflected. Draft recommendations in the NICE/SCIE guidance include:

  • the need for children’s trusts to develop robust joint plans with health, education and social care for services for looked-after children
  • implementing more training on looked-after children for professionals, primary carers and social workers
  • ensuring carers and their families receive high quality ongoing support
  • keeping accurate and up-to-date health information on looked-after children and ensuring health information follows the child or young person
  • allowing each child or young person to explore their own life story using a sensitive and child-centred approach
  • delivering high-quality care and placement stability to allow continuous access to key services that support healthy emotional development and educational achievement
  • providing targeted support before and during applications to further or higher education for looked-after children, and continuing to support students throughout their time at university or higher education colleges
  • helping promote child’s personal identity and providing a choice of culturally appropriate placements for children from black and ethnic minority backgrounds
  • ensuring there is an effective and responsive leaving care-service for those preparing to leave care

Professor Mike Kelly, Public Health Excellence Centre Director, NICE said:  “We know a high proportion of looked-after children and young people experience emotional and mental health problems. This guidance, when it is published later this year, will aim to help more looked-after children achieve good emotional and physical health, and do well in their education. With our draft recommendations now out for consultation, we welcome feedback to ensure the guidance will improve the existing care system and place the needs of looked-after children at the heart of decision-making.”

Amanda Edwards, Deputy Chief Executive, SCIE said: “The task of ‘corporate parent’ for looked-after children is one that all local authorities, working with health providers, take seriously. As the ‘corporate parent’, local authorities need to prioritise the children’s needs. Promoting good health and wellbeing is central and the joint SCIE/NICE work on this will be a ‘must read’ for councils and others who care for looked after children. The consultation is an essential part of developing the guidance so we welcome comments on it.”

Colin Thompson, care-experienced young adult and member of the Programme Development Group said: “Young people are often at a disadvantage and they want to be listened to. This is getting more difficult these days as young people are subject to so many changes in placements, schools etc so often there’s no continuity. Educational outcomes also are vital. So I’m passionate about this guidance after my own experiences in care, but even more passionate about it being implemented. Each looked-after child has a difficult journey to take and I sincerely believe that if most of this guidance is implemented it will make a difference to a lot of young people’s lives and to their long-term outcomes. Every child should be treated with compassion and be listened to. They need continuity of good quality care to ensure they achieve their potential and become healthy fulfilled stable adults.”

Department for Children, Schools and Families and Department for Business and Innovation, 2009

The Department of Health and Department for Children, Schools and Families published revised guidance on Promoting the health and wellbeing of looked-after children in November 2009

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