Suchergebnisse

There are concerns that the performance indicators for children's services may not be adequately interpreted and used to improve service delivery for individual children. Data from a longitudinal study of 249 looked after children demonstrate that one target—improving the stability of placements—is more likely to be met if agencies can identify which children move frequently and why. While age, behavioural difficulties and the absence of mental health support may have contributed to placement breakdowns, the majority of moves were planned transitions from one temporary placement to another, suggesting that the system may ignore the needs of those children who cannot swiftly return home. Copyright © 2001 John Wiley & Sons, Ltd.

There is much evidence of instability in the care system and poor developmental outcomes for looked after children, but looked after children are far from being a homogenous group. Their lives, needs and experiences vary immensely. Harriet Ward, Tricia Skuse and Emily R Munro present the findings from a recent study of children's views of the care system in England (Skuse and Ward, 2003). They explore what children and young people did and did not like about being looked after, why some found it a beneficial experience while others did not, and discuss the reasons for their largely positive responses. Ordinary features of everyday life that peers would usually take for granted, such as having someone to talk to or doing ordinary family things like going to the cinema, were identified as benefits of the care system. These views and the expectations of looked after children need to be considered in the context of their past life experiences.

There is substantial evidence that looked after children have extensive health needs and disabilities, that they have often missed out on routine health surveillance and health promotion before entry to care or accommodation, but that at present they receive little compensatory care. Harriet Ward, Helen Jones, Margaret Lynch and Tricia Skuse discuss these issues. They look at how frequent changes of placement and poor inter-agency communication exacerbate difficulties in gaining access to adequate health care, especially when children lack an advocate who takes proactive action on their behalf. The Department of Health has responded by issuing new Guidance that sets clear standards for service delivery, encourages children's participation, and ensures that health assessments recognise inequalities and take a holistic view of healthcare needs. The implementation of the Integrated Children's System should improve the quality and accuracy of health information concerning all children in need. New Regulations and Standards for foster care, a National Healthy Care Standard and, on a broader policy front, the National Service Framework for Children should all ensure better access to health care for this population. However, as the authors conclude, such measures will only be successful if inter-agency working can be improved through multi-disciplinary training and better co-ordinated structures for service delivery.