Keeping the Promise - health and wellbeing of care experienced children and young people: longitudinal quantitative evidence review

Data gaps and under-explored outcomes

Under-explored health outcomes

Some outcomes central to The Promise remain under-explored. To improve policy relevance future research should prioritise:

• mental health service access and timeliness, including community-based care and preventive services;
• early intervention and preventive healthcare, such as immunisations;
• sexual and reproductive health service use and outcomes;
• subjective wellbeing, including self-reported happiness and sense of belonging;
• experiences of stigma or discrimination; and
• identity and connection, including continuity of trusted relationships.

Additionally, a wider limitation is the restricted range of outcomes captured in quantitative administrative data. Quantitative data can provide rich information on service use and ‘hard’ outcomes, such as hospital admissions and mortality. However, many of the outcomes central to The Promise are not well represented. Measures of subjective wellbeing, children’s own views, experiences of relationships, stigma, and sense of belonging are rarely included in administrative datasets. Any quantitative analysis should be complemented by qualitative evidence.

Placement type and transition analyses

Findings from this review show potential variation in outcomes by placement type and during transitions out of care, but these analyses remain limited. To help identify high-risk groups and inform targeted interventions future studies should:

• examine outcomes by placement type (kinship care, foster care, residential care, supervision at home; Annex 2);
• analyse the effects of placement stability, including number and timing of moves; and
• track post-care trajectories, including timing of exit, preparation for leaving care, and follow-up support.

Preschool linkage

Current gaps include analysis of children who experience care before school entry. Existing linkage approaches exclude this group because SCNs, used for linkage, are not assigned until school age. This limits understanding of early health and developmental outcomes for some of the most vulnerable children. Work is underway to address this gap: CLAS collections from 2023/24 onwards will include additional data, which may enable linkage and improve coverage.

Intersectional analysis

Future research should analyse differences by sex, disability, ethnicity, and socioeconomic status. It would also benefit from exploring how multiple disadvantages combine to influence health and wellbeing.