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As Children’s Commissioner, I am proud to run a support and advice service for children in care, open to children’s services or 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. Often due to gaps in the services that exist to protect, support, love, care for, or 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, their voices and experiences, underpin all the work I do as Commissioner.

Part 1 of this report outlines the operations of the Help at Hand service since I became Commissioner. Part 2 sets out my vision for the service, so it reaches all the children who need it, and drives systemic improvement to address the issues children face.

Since I became Children’s Commissioner, my Help at Hand team have supported over a thousand children and young people, facing some of the most challenging situations imaginable. The children my team works with include those in care or hospital, those who have been abused, those who are unaccompanied asylum-seeking children and those who have been criminally or sexually 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 always happening.

Every child’s story is unique, but there are some 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. Other themes come from the interaction between care, health, and education. Nearly all the children my team helps have significant mental health issues, and nearly all have struggled to access timely and consistent support 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 too many children I speak to and my team help, are not in education but are the children who would most benefit from a fantastic education.

I am concerned 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.

The most complex and acute cases, which used to be extremely rare, are becoming more frequent. Provision for these children is patchy and inconsistent. As a result, more children are experiencing unwanted placement moves, their mental health care is often inconsistent, and some are ending up out of education.

I want everyone working with and for children, those making decisions on behalf of children, to listen to children and consider their best interests, every time. I want everyone in a child’s life to be asking: ‘Is this what the child wants?’. Children in the care system are ambitious for themselves, for their future. So, the whole system needs to match that ambition. This includes being open to challenge from, or on behalf of, a child.

An example of this is Tiffany, who was due to be moved from her home, a supportive foster family, to an institution, against her and her foster family’s wishes. Numerous professionals had been involved in this decision, but it hadn’t been challenged, nor more creative solutions considered by putting in more support at home. Although this decision was reversed after my intervention, I want that challenge, and the right decision to be made locally, every time, for every child.

There are many dedicated and child-centred professionals working to help children like Tiffany, and I’d like to pay testament to them too. Many of these professionals call Help at Hand to get assistance for a child they are working with. You will see in the report the stories of children who have no home and nowhere to go. They may fall between social care and mental health services; they may have such significant self-harming behaviour where the risk of caring for them is high. There are others with learning needs, who have only managed find somewhere to live far from home and where there is no school for them to attend.

The more of these children I work with, the more determined I become to see reform across the system. For a system that works cohesively around children and families. That works for every child, every family, every time. Regardless of their needs or circumstances. To raise the standards of care that all children can expect. I know this is an ambition shared by many people across the system, and I have spoken to so many dedicated professionals and leaders who live this ambition too.

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 want they want from my service. Help at Hand only reaches a 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 I and my team have spoken to have been 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 other children are not let down in the way they were. I am constantly moved by the commitment and altruism 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.