The NICE Quality Standard for Children and Young
People who are looked after: Care Leavers
Dr Linda Sheppard, National Institute for Health and Care Excellence
Tuesday 4th March 2014
Presentation
• Background NICE guidelines and quality standards
• NICE’s role in social care
• Quality Standard and Care Leavers
• Engaging with the social care sector
• Recent developments
• NICE digital pathways
Background
1997 Government wanted to focus on:
• Faster uptake of effective and cost effective medical
treatments and interventions
• More equitable access to treatments of proven
clinical and cost effectiveness
• Reduce variation in clinical practice
• Overall – make better use of available resources
Background
• Different organisations were producing a range of
different guidelines about medicines, clinical
treatments and interventions
• Organisations funded by government, private and
voluntary sector
• Organisations specialised by discipline, condition or
those producing a particular pharmaceutical product
Background
Guidelines were of variable quality and:
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Produced or updated at different times
Developed using different methods
Written differently
No consistent cost impact evaluation
No consistent comparison with standard care
Not consistently impartial
Background: How to Improve?
• Establish a single national guidance
producing centre
• Funded by government, but independent of
government and private enterprise, impartial
and evidence based
• The National Institute for Clinical Excellence
established in 1999 (NHS special health
authority)
Background
• NICE remit expands in 2005 to
include public health
• Social Care - 2012
• The National Institute for Health and
Care Excellence (NICE)
• The independent organisation
responsible for providing national
guidelines and quality standards to
improve health and social care
NICE’s role in social care
Evidence Based Quality Standards
‘The relevant commissioner may direct NICE
to prepare statements of standards in relation
to the provision of:
– NHS services
– Public health services
– Social care
• NICE must keep a quality standard under
review and may revise it as it considers
appropriate
• In discharging its duty, the
Board/Secretary of State ‘must have regard
to the quality standards prepared by NICE’
Background: NICE’s role in Social Care Guidelines
• Quality standards have to be evidence based
• Existing accredited guidelines in social care very
limited
• Topics for guideline development are referred to the
NICE Collaborating Centre for Social Care (NCCSC)
• Hosted by Social Care Institute for Excellence (SCIE) :
– Personal social services research unit (PSSRU)
– Evidence for policy and practice information and
coordination centre (EPPI-centre)
– Research in Practice (RIP)
– Research in Practice for adults (RIPfA)
The Programme:
NICE Quality Standards and guidelines for social care
Topic
Guideline
QS
Health and wellbeing of looked after children and young
people
Available
Available
Autism in children, young people and adults
Available
Available
Mental wellbeing of older people in care homes
Available
Available
Supporting people to live well with dementia
Available
Available
Managing medicines in care homes
March 2014
2015/16
Older people with multiple long-term conditions
Sept 2015
2016/17
Children’s attachment
Oct 2015
2016/17
Transition between health and social care
Nov 2015
2016/17
Challenging behaviour in people with learning disability
May 2015
TBC
Transition from children’s to adults’ services
Mar 2016
2017/18
Child abuse and neglect
July 2016
2017/18
Mental health problems in people with learning disability Oct 2016
TBC
The Quality Standard and Care Leavers
• Quality standards for health and social care aim to drive up
quality of care and also allows people to hold their local
commissioners to account
• It is envisaged that the quality statements for children and young
people who are looked after will apply to all CYP in all settings
wherever possible, including care leavers
• 8 quality statements for CYP are about the care they experience,
collaborative professional working, stability, access to mental
health services, transition between services and moving across
local authority boundaries and supporting children and young
people to fulfil their potential
• High quality core training
The Quality Standard and Care Leavers
• Each statement has a rationale, quality measure, outcomes, what
the statement means for each audience, source guidance and
data sources
• Statutory Guidelines
• Statement 8 directly addresses Young People who are leaving
care
• Quality statement 8: support the move to independence
‘Care Leavers move to independence at their own pace’
QS Statement 8 for Care Leavers: Quality measure Structure &
Outcome
Structure, evidence of local arrangements to ensure:
– A) Pathway planning is responsive to the needs of young people preparing to
leave care and equips them with the skills they need to live independently
– B) Care leavers are given the option to remain in a stable foster home or
residential home beyond the age of 18, and to return to the care of the local
authority, including their previous placement (if possible), if they experience
difficulty in moving to live independently
– C) Evidence that a range of accommodation and support is available
Outcome:
– A) Feedback from care leavers that they felt supported to move to live
independently at their own pace
– B) Care leaver satisfaction with their accommodation*
– C) Accommodation status of young people leaving care
Outcome:
– A & B Local data collection. National: The Children’s Rights Director for
England Children’s Care monitor collects and reports info from CYP in
England about their experience of care
– C data collected through Children looked after return (SSDA903)
*Children Act 1989 regulations vol. 3
QS Statement 8 Care Leavers: Quality measure Structure & Outcome
Example
• Data Sources for Structure A, B & C
Data collected through:
The Children looked after return (SSDA903)
Reported in the DfE Statistical first release: outcomes by local authorities for
children looked after by local authorities in England
• Data Sources for Outcomes:
A & B Local data collection.
The Children’s Rights Director for England Children’s Care monitor collects and
reports information for looked after children and young people in England about
their experience of care.
C data collected through Children looked after return (SSDA903) The Children
looked after return (SSDA903) Reported in the DfE Statistical first release:
outcomes by local authorities for children looked after by local authorities in
England
Children and Young People: Implementation Work
Quality Standard
– Tailored resource for corporate parents and commissioners, with
key messages to enable the decision makers and budget holders to
implement changes
– Info4carekids website – website aimed at children and young
people incorporating the quality standard, with video clips and
statements from young people demonstrating the relevance of the
standard
– Guide to resources – updated guide for people using the standard,
signposting to relevant websites, training, support tools, resources
and information
– Practice examples – examples of where the standard has been
used and adopted and the impact it has made
Examples of implementation work
• Looked after children and young people QS:
– An 8-10 minute film targeted at children and young people,
featuring real people with real stories, based around the quality
statements and delivered in a ‘social media’ themed format
How we are engaging with the sector
• The social care sector is massive:
– over 22,000 organisations delivering social care
– 152 local authorities commissioning social care
– approx 211 Clinical Commissioning Groups who can commission social
care
– over 800,000 voluntary organisations who work on social care
• NICE teams involved in engaging with the sector:
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Social care team
Communications team
Implementation team
Field team
Public involvement programme
The NCCSC has a Stakeholder Engagement and Dissemination Manager
whose role is to work with the sector and promote the NICE products and
work on Implementation products
How we are engaging with the sector
• What we have done so far:
– Set up a Social Care External Network with 40 key partners
– Met with key national partners on an individual and ongoing
basis and used their networks
– Met with 80% of local authorities, including directors of adults’
and children’s services
– Run focussed media briefings and placed articles in key
publications and briefings
– Spoken at a range of national social care conferences
• Further work underway to develop a strategic
stakeholder engagement plan during 2014-2015
• Local government briefings to include social care
Recent Developments
• Making links with regulators
– Ofsted
– Department for Education
– Care Quality Commission
NICE Pathways
A quick route into
recommendations and
resources
NICE Digital Strategy: ‘NICE Pathways’
An online tool that brings together all
related NICE guidelines, quality
standards & associated products.
Represented as a set of interactive
topic-based diagrams allowing fast
access to evidence based
information.
Further information available on the
NICE website
Developments
NICE – Digital Strategy: Phone Apps
• The NICE British National Formulary
(BNF) app has been developed to provide
easy access to the latest up-to-date
prescribing information from the BNF - the
most widely-used medicines information
resource within the NHS.
• NICE Guidance App: If you use an
Android or iPhone smartphone you can
download the free app, which will give you
offline access to all of NICE's guidance
products, organised by clinical or public
health topic.
Available to download for free
by health and social care
professionals who work for or
who are contracted by NHS
England.
All guidelines, standards, and resources
are available free of charge
www.nice.org.uk
www.scie.org.uk
www.info4carekids.org.uk
Thank You