Study 1

Study lead: Dr Sarah Wadd

Inclusion Health Groups are groups of people who experience very high levels of social exclusion and health inequalities. This study is about ‘Street Inclusion Health Groups’, that is, people who engage in street activities – ‘begging’, street drinking, public injecting, street sex work, and rough sleeping. There is a considerable intersection between these groups as well as common life experiences and risk factors including addictions, extreme poverty, complex trauma, violence, mental health conditions, criminal justice involvement, chaotic lifestyles, and risky behaviours. This study aims to conduct in-depth interviews and focus groups with different stakeholders across BLMK with an emphasis on the voice of Street Inclusion Health Groups.

Study 2

Study lead: Prof. Emily Munro, Amy Lynch, Seana Friel

Care leavers experience widespread and long-lasting inequalities including in relation to poverty, homelessness, unemployment and health, fulfilling the criteria for an ‘Inclusion Health Group’, a key focus of ‘Core20PLUS5’ and a priority for ICS evaluation and development. Rates of mental ill-health are high amongst looked after children and care leavers and they report lower emotional wellbeing than their non-care experienced peers, but services typically reduce and change as they negotiate the transition from care, and from CAHMS to AMHS (if thresholds are met). Disengagement with services is common despite continuing need and COVID-19 is likely to exacerbate this and further widen the ‘care-gap’. There are gaps in understanding surrounding the models and approaches that local health and social care sector providers (public and voluntary) adopt to meet the heterogeneous needs of young people leaving care and in understanding of the barriers and enablers to access and effective service delivery. The need to address the knowledge gap and improve integrated care for children in care and care leavers has been recognised at a national policy level.

Study 3

Study lead: Mrs. Alice Yeo

Research shows that children and young people at risk of or experiencing exploitation or extrafamilial harm, and their parents / carers, do not feel that their voices are heard in the service responses they receive (Cossar et al, 2016; Diaz et al, 2019; Hill & Warrington, 2022). This is particularly problematic with this group, for several reasons, including the replication of the lack of control associated with these forms of harm.

The Tackling Child Exploitation (TCE) Support Programme, funded by the Department for Education, was commissioned to develop a set of evidence-informed Practice Principles to guide and inform multi-agency responses to child exploitation and extra-familial harm. Non-statutory guidance, the Practice Principles are underpinned by research evidence (Yeo et al, 2023) and were developed through extensive consultation with professionals, young people, parents and carers and endorsed cross-Government.

The aim of this project is to implement and evaluate the three Practice Principles that relate to voice. These are:

• Putting children and young people first
• Respecting the voice, experience and expertise of children and young people
• Approaching parents and carers as partners, wherever possible

There are three stages of the research:

1. Deep dive into pan-Beds response to child exploitation and extra-familial harm in order to:
   1. map the system response to child exploitation and extra-familial harm and
   2. understand practice across different parts of the system. A survey of children, young people, parents, carers and professionals will be administered pan-Beds. This will contextualise experiences of practice, and serve as the ‘before’ data for a pre-/post-evaluation.
2. Design and implementation: a workshop with service providers, parents, carers, children and young people to inform the design of a response to child exploitation and extra-familial harm that includes the voices of parents, carers, children and young people. A test site will be identified and the approach implemented for six months.
3. Evaluation: the approach will be evaluated to identify evidence of impact.