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As Children’s Commissioner, I am proud to run an advice and support service for children who are in care or have a social worker, children accommodated by the state in another way (such as in hospital or custody) and care leavers. This service – Help at Hand – is for children at their most acute moments of need, and often after they have been failed by services meant to protect, support, love, care for, and educate them. This is why this service is so important to me. Not only do my team and I endeavour to get the best possible outcomes for each of these children, but the issues they raise underpin all the work I do as Commissioner.

This week I am publishing a report on the work of Help at Hand. Part 1 of this report outlines the operations of the Help at Hand service since I became Commissioner in March 2021. Part 2 sets out my ambition to reform the service, so it reaches more children and drives systemic responses to the issues children encounter.

Over the past 18 months, the Help at Hand team has supported more than a thousand children facing some of the most challenging situations imaginable. The children my team works with include those who have been abused, neglected, and sometimes criminally exploited. These children deserve the very best love and support from the care system, the best treatment from the NHS and the very best education from our schools. But in the cases where I intervene, this is not happening.

Every child’s story is unique, but there are a number of common themes that are highlighted in this report. Some of these issues are to do with the care system, such as the instability and frequent moves experienced by children in care. But other common issues come from the interaction between care, health, and education. Nearly all of the children my team helps have significant mental health issues, nearly all have struggled to access timely and consistent help from CAMHS. Both I, and the children I work with, are clear that better access to mental health care would stop problems escalating.

Equally important is education, yet a significant proportion of the children I help each year are not in education. Education is a fundamental right for all children, and yet is too often denied to the children who could most benefit.

I have real concerns about children with complex disabilities missing out on vital services and advocacy, whether this is to enable them to remain with their families, or to be safe, supported and heard while in the care of local authorities.

Overall, the pattern of cases I am seeing is causing me increasing concern. The most complex and acute cases – where children are without any suitable placement able to meet their needs – are becoming almost routine. There is not enough provision for these children and, as a result, more children are experiencing unwanted placement moves, are being denied consistent mental health care, and are ending up out of education.

I am also concerned about the frequent failure, by those making decisions on behalf of children, to listen to those children and consider their best interests. Too many cases where I intervene are the result of a professional consensus which has been allowed to proceed when someone should have challenged it and asked, ‘Is this what the child wants?’  or ‘Is this really the best we can do for them?’ The system as a whole needs to be much more ambitious for children in care, and this needs to start with being more open to challenge from, or on behalf of, a child.

I want my office, and particularly the Help at Hand team, to play a more central role in supporting systemic reform and improvement. Over the past year I have been considering how this can be done, and – crucially – asking children what they want from my service. Help at Hand only reaches a tiny fraction of the children and care leavers that it could help and I am committed to making it more accessible to those that need it. The children my team and I have spoken to have been very clear about the key points at which they want more help and information, and how they want to access it. The second part of this report lays out these findings and my ambitions to act on them.

Children are also clear that they want to see systems change so that others are not let down in the way they were. I am constantly moved by the commitment of children in care to their peers, and the energy they commit to sharing their experiences in the hope that something will change. We all owe it to these children not just to listen, but to act. This is why I want to change my team’s way of working so that we raise issues more systemically. This report details the findings of the consultation and the changes Help at Hand are already making, so that we can help more children, more effectively, and support wider efforts to reform the system.

Children and young people or their advocates can contact Help at Hand by calling 0800 528 0731, emailing [email protected], or through our online form: Get in touch | Children’s Commissioner for England (

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