Regional variations in care planning in Northern Ireland: An infringement of the children’s rights

International research and official statistics indicate that regional variations exist in relation to the type of long-term placement identified for children in care (i.e. return to birth parents, kinship care, foster care, adoption, Residence or guardianship Orders). In Northern Ireland, in the Care Pathways and Outcomes study (a longitudinal study following 374 children who were in care in Northern Ireland under 5 years old on 31/3/2000), we found that there was a significant relationship between the type of placement children ended up living in and the Health and Social Service (HSS) Board area (equivalent to Local Authorities in England and Wales) responsible for them. This finding became the drive for the Regional Variation Study, which explored the reasons behind this relationship.
As part of this study, between January 2015 and May 2016, we conducted focus groups with senior managers involved in care planning in each of the five Health and Social Care Trusts in Northern Ireland. Based on the study findings, an ecological model of decision-making in care planning was developed. In this model, decision-making regarding care planning in each of the Trusts is partly influenced by three different kinds of factors: 1) individual and team factors; 2) regional practice factors; and 3) global context factors. Differences among all of the HSC Trusts were found within the model’s three levels, despite all of them operating under the same broad policy framework for care planning. For instance, different mindsets were obvious, as participants in some of the Trusts clearly equated the notion that children should be provided with a permanent home with adoption, while in focus groups in other Trusts, that was not the case. In addition, the Trust structures and initiatives differed slightly, and there were differences in the global context factors influencing decision-making (e.g. Courts’ influence, and population characteristics of each area, such as poverty levels, minority ethnic population, and sectarian divide).
The existence of these differences is an important issue because all children entering the care system, irrespective of their background, should be treated equally and in a consistent way, with the identification of long-term placement based upon their particular needs, not local placement dynamics. Thus, on the basis of the UN Convention on the Rights of the Child (UNCRC), children should have the same opportunities, and any post-code lottery regarding children’s placements should be considered an infringement of these rights. We believe that regional practical guidance and policies should be developed collectively by the Trusts, so as to avoid the possibility of children facing a post-code lottery regarding the placements given to them.
This poster will endeavour: 1) to highlight the historical regional variations found in the Care Pathways and Outcomes study, and those shown in recent official statistics; 2) to briefly describe and explore the findings of the focus groups in the Regional Variations study; 3) to display the ecological model of decision-making; and 4) to discuss potential implications and suggestions for a more socially just practice in relation to care planning.