Does local authority care make a difference to the lives of vulnerable children? Longitudinal analyses of a retrospective electronic cohort

拟议的研究旨在检查，随着时间的推移，由地方当局（即照顾）照顾（CLA）的儿童的教育和医疗保健结果。仅使用一个时间点的现有研究表明，CLA的教育和健康结果比一般人群差。学前教育经历，如身体虐待，父母精神健康疾病和父母酗酒，是被照顾的常见原因。这些经历也预示着没有得到照顾的年轻人的健康、教育和社会成果较差。由于这些原因，很难理解CLA较差的健康和教育结果是因为学前教育经验的差异，还是护理本身。拟议的研究将首次将威尔士现有的教育和卫生数据集与定期收集的关于社会服务对年轻人的支持的数据联系起来。研究有三个目标。首先，它将解决英国缺乏大规模研究的问题，这些研究从统计学上研究了CLA状态在预测教育成果和医疗保健使用方面的作用。其次，它将减少CLA中不良结果的不确定性，因为预护理经验或护理经验。这将通过比较CLA和接受社会服务帮助但不属于CLA的儿童（需要帮助但得不到照顾的儿童）来实现。这两个群体之间可能存在差异，预测为什么一个群体成为CLA而另一个群体没有，但NLA可能比一般儿童群体更类似于CLA。为了考虑群体之间的进一步差异，我们将在分析中调整与接受社会服务帮助有关的一些共同经历。这些包括身体虐待、父母精神疾病、父母酗酒和家庭暴力。第三，虽然CLA状态通常是基于这样的假设，即将年轻人从逆境中移除将使他们走向更好的生活轨迹，但这项研究将是第一个研究随着时间的推移，护理在减少学前教育和医疗保健结果的影响方面的作用。这项研究将为当代社会的关键问题提供见解，社会护理预算面临越来越大的财政压力。它将以一种以前从未尝试过的方式评估社会服务帮助弱势青年的影响。

The proposed research aims to examine, over time, education and healthcare outcomes of children who are looked after (CLA) by the local authority (i.e. in care). Existing studies that use only one point in time have shown that CLA have poorer educational and health outcomes than the general population. Pre-care experiences, such as physical abuse, parental mental health illness and parental alcohol misuse, are common reasons for becoming looked after. These experiences also predict poorer health, education and social outcomes in young people who are not in care. For these reasons, it is difficult to understand whether poorer health and educational outcomes for CLA are because of differences in pre-care experiences, or of care itself. The proposed research will, for the first time link an existing Wales-wide dataset on education and health with routinely collected data on young people's support from social services. The research has three objectives. First, it will address the lack of large-scale studies in the UK that statistically examine the role of CLA status in predicting educational outcomes and health care usage over time. Second, it will reduce uncertainty over the extent to which poor outcomes among CLA are because of pre-care experiences, or experiences of being in care. This will be achieved through comparison between CLA, and children who receive help from social services but are not CLA (Children In Need, but Not Looked After - NLA). There are likely to be differences between these two groups that predict why one group becomes CLA and the other does not, but NLA are likely to be more similar to CLA than the general child population. To take account of some further differences between groups, we will adjust for a number of common experiences linked to receiving help from social services in our analysis. These include physical abuse, parental mental health illness, parental alcohol misuse and domestic violence. Third, whilst CLA status is often based on the assumption that removing young people from adversity will move them toward better life trajectories, this study will be the first to examine over time the role of care in reducing the effects of pre-care experiences on education and health care outcomes. The research will provide insights into critical issues for contemporary society, where social care budgets are under increasing financial pressure. It will estimate the impact of social services help for vulnerable young people in a way that has not been attempted before.