1. 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 4 th March 2014

2. 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

3. 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

4. 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

5. Background Guidelines were of variable quality and: –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

6. 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)

7. 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

8. 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’

9. 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)

10. TopicGuidelineQS Health and wellbeing of looked after children and young people Autism in children, young people and adults Available Mental wellbeing of older people in care homes Supporting people to live well with dementia Available Managing medicines in care homesMarch 20142015/16 Older people with multiple long-term conditionsSept 20152016/17 Children’s attachmentOct 20152016/17 Transition between health and social careNov 20152016/17 Challenging behaviour in people with learning disabilityMay 2015TBC Transition from children’s to adults’ servicesMar 20162017/18 Child abuse and neglectJuly 20162017/18 Mental health problems in people with learning disabilityOct 2016TBC The Programme: NICE Quality Standards and guidelines for social care

11. 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

12. 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’

13. 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

14. 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

15. 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

16. 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

17. 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: –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

18. 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

19. Recent Developments Making links with regulators –Ofsted –Department for Education –Care Quality Commission

20. NICE Pathways A quick route into recommendations and resources

21. 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 NICE Digital Strategy: ‘NICE Pathways’

26. 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.

27. All guidelines, standards, and resources are available free of charge www.nice.org.uk www.scie.org.uk www.info4carekids.org.uk www.nice.org.uk www.scie.org.uk www.info4carekids.org.uk

28. Thank You