Background

The number of looked-after children in England continues to increase. In 2009, around 60 000 children and young people in England were looked-after1 and this has risen to just over 80 000 in 2021.2 The National Society for the Prevention of Cruelty to Children estimates there were approximately 102 000 looked-after children in the UK as a whole in 2018–2019.3 As a comparison, France with a similar size population to the UK had just over 158 000 children in alternative care in 2017.4

The majority of children in England are in foster placements (72%) with the remainder between residential care, connected care or a smaller percentage placed with their birth parents.2 This is a significantly disadvantaged group—many children entering care will have experienced neglect or abuse. In fact, this is the most common reason for entering care (65%). Children may have been witness to domestic violence or alcohol or drug misuse. All will have experienced trauma in some way.2

‘Adverse childhood events’ such as abuse and neglect are strongly linked to poorer physical and mental health. Compared with their peers, looked-after children and young people experience a higher rate of mental health issues. Forty-five per cent of children between 5 and 15 years of age will experience mental health problems compared with around 10% in the general population. This increases further to 72% for those in residential care.2

Information about the current guideline

‘Looked-after children and young people’ (NG205) was published by the National Institute for Health and Care Excellence (NICE) in October 2021. Its aim is to show those that work with looked-after children and young people across education, health and social care how to work together to provide high-quality care so that these children and young people may ‘reach their full potential and have …