Professor Mike Kelly, Director of Public Health at NICE, discusses the new guidance on the physical and emotional health and wellbeing of looked-after children and young people.
About two years ago, NICE along with the Social Care Institute for Excellence (SCIE) began a piece of work - which has just published - and this was to produce guidance and recommendations for the national health service and local government to improve the care and improve the health outcomes of looked-after children.
This is an important area because looked-after children, of whom there are about 60,000 slightly more than 60,000 in care at any one time, are one of the most vulnerable groups in our society.
They are disproportionally affected by mental health problems. About a third of them finish up getting involved with, or have been involved with, the criminal justice system.
And the risk factors associated with substance misuse, with drug misuse, with inappropriate relationships, really cluster in this group of people.
And so the purpose of this guidance is to try and improve the educational and health outcomes of these young men and women.
Q: What are some of the main recommendations in this piece of guidance?
There are several. The first is to place the child or the young person at the centre of the decision making process. That is to say the child needs to be not only considered as an individual but also their views are taken account of in the placement process.
Second, to try and develop continuity of placement. One of the big problems is where children and young people move from placement to placement, from foster care into residential placements and so on.
What we know from the evidence is that by fostering continuity of care, whether it is in the foster situation or elsewhere, means the child has not only a much better start in life and better continuity in life. What that means is their education isn't interrupted; it is possible for their health to be monitored over time, and all of these things are the bedrock on which the better health and outcomes of these young people can be built.
The third dimension relates to looking after the health records. If a child moves from one local authority to another and in and out of primary care system into another, then the possibility to be able to monitor that child's health is sometimes lost as records go missing and that sort of thing. So a third dimension of what we are talking about here is to improve that record keeping. Better record keeping means better monitoring means better health.
Q: Will these new recommendations require additional funding?
No they won't, in fact it's the very opposite. If a young person or child is spiralling into problems or difficulties then that means long-term costs to society. Whether those costs are incurred in the healthcare system, the mental health system, criminal justice system or in prison.
If we can catch young people early by providing better integrated care for them through the looked-after children system then we will actually be saving money, and our economic analysis actually demonstrates that very clearly.
28 October 2010
This page was last updated: 28 October 2010