Area of Research: Children and Families
Section 1: Summary of main strands/themes for research
The Unit will undertake research to support effective evidence-based health policy (including both clinical and public health) for children and families. This will include responsive work, research to build the evidence base for effective policy, and methodological work to develop the quality of the evidence base supporting policy.
The Unit will also need to be able to undertake research to develop the evidence base for effective and cost-effective policy to improve health outcomes for children and families.
Policy priorities include:
- early years interventions to ensure there is support for vulnerable children so that all children get the best start in life;
- the effectiveness and cost-effectiveness of experiences and interventions in childhood that reduce health inequalities and improve health outcomes across the lifecourse, including among children and young people with learning disability and/or autism;
- the determinants that promote mental health and wellbeing and build resilience in children and young people;
- determining the most effective interventions to address the short- and long-term impacts of domestic violence, childhood abuse or neglect, and sexual exploitation;
- preventing violence against women and children, including domestic violence, childhood abuse or neglect, sexual exploitation and female genital mutilation;
- understanding children and young people’s health and risk behaviours (e.g. smoking, drinking, drug misuse, unplanned pregnancy, gambling, pornography etc);
- the impact of recent health system restructuring (Health and Care Act and establishment of Integrated Care Systems) on the provision of services for children and young people;
- the effectiveness of safeguard approaches for children aged 5-19 and 0-5; and
- parenting and other family approaches in improving child outcomes.
Through all its work, the Unit will pay regard to the health and wellbeing of vulnerable or disadvantaged children, including those living in deprived communities; and children from ethnic minority groups. In addition, we are interested in improving outcomes in looked-after children; children with learning disability and/or autism, children at risk of or with a history of childhood abuse or neglect; children in households with experience of domestic violence; and children experiencing multiple disadvantages including children living in workless households; living in households with mental health issues and/or substance abuse; and children with protected characteristics.
In all these policy areas, the Unit will be encouraged to take a whole system approach, especially to research question framing and research methodology. This will address the lived reality that any individual intervention does not operate in a silo environment and is influenced by, and creates influences on, the system in which it is delivered.
For topics where there is sufficient evidence on determinants and potential impact to indicate a need for policy, the Unit is encouraged to focus on research which would support the translation of evidence into effective policy. This could include, for example, modelling or evaluating the effectiveness and cost-effectiveness of policies or interventions; and identifying the ‘active ingredients’ of effective interventions.
The Unit will also be expected to incorporate engagement and co-production with children and young people and their parents/carers in the design and evaluation of any research projects.
The Unit is encouraged to develop resources and/or infrastructure to support improved quality of the evidence base for policy to improve the health of children and families. This might take different forms, but illustrative examples might include:
- Validating outcome measures of child development, mental health and wellbeing at different ages including 2 years, 5 years and adolescence; this could potentially include development among children with neurodiverse conditions, learning disability and / or autism, disability;
- Developing and sharing tools to support research and evaluation using secondary datasets, such as data dictionaries, methodological guidance, or sharing work to reduce barriers to research using cross-sector data linkages (for example across health, education or social care);
- Developing and disseminating tools to support practitioner engagement with children and young people, including children with particular needs such as learning disability or a history of trauma.
Section 2: Policy context and background
Improving outcomes for vulnerable or disadvantaged children is a focus of several cross-governmental strategies and programmes supported by the Department of Health and Social Care (DHSC). This includes:
- The Start for Life Programme which provides 75 local authorities with funding totalling £302m to establish Family Hubs and Start for Life services, levelling up opportunities for children of all ages and their families.
- The Supporting Families Programme which further develops the aim of improving outcomes for children who grow up in workless families and face multiple disadvantages.
The breadth of the policy agenda is illustrated by key documents including, but not limited to:
- The Best Start for Life:_a vision for the 1,001 critical days
- Supporting Families Programme
- A public health informed approach to vulnerability in childhood
- Tackling child sexual exploitation - progress report
- Transforming Children and Young People's Mental Health Green Paper
- Tackling violence against women and girls strategy
- Tackling Domestic Abuse Plan
- From Harm to Hope: a 10 year drugs plan to cut crime and save lives
- National strategy for autistic children, young people and adults: 2021 to 2026
- The forthcoming Women’s Health Strategy
- Sexual and Reproductive Health Action Plan (in development)
As a minimum, applicants should be familiar with the relevance of the following documents:
- NHS Long Term Plan
- Fair Society, Healthy Lives: the Marmot Review and The Marmot Review 10 years on
- Relevant guidance from the National Institute for Health and Care Excellence (NICE)
Tackling health inequality will be central to this Unit’s work, and all work should pay regard to groups with poorer health outcomes, vulnerable people, and people sharing characteristics protected under the Equality Act 2010.
Section 3: Justification for research topics
The work of the Unit will support the policy aim of improving the nation's health so that everyone can expect to live more of life in good health, and on levelling up health disparities to break the link between background and prospects for a healthy life. Research is needed to feed into policy-making processes at various points from the initial discussions of policy options through to evaluation of key policies and their associated interventions. Effective policy in this area has large potential impacts for patients and the public. Health in childhood affects health outcomes throughout life and addressing health disparities in childhood can help to break the intergenerational inequalities.
The findings of the Unit’s research will inform the strategic and policy work of a range of Directorates within DHSC and across government including (but not limited to) the Office of Health Improvement and Disparities (OHID), NHS England and UK Health Security Agency (UKHSA), Department for Education (DfE) and the Home Office by supporting better health policy and cross-cutting policy to reduce health disparities and improve outcomes for disadvantaged children and young people.
The findings of the Unit’s research will support the Department’s compliance with the public sector equality duty under the Equality Act 2010 and the Secretary of State for Health’s health inequalities duty under the National Health Service Act 2006 as amended by the Health and Social Care Act 2012. In addition, the Family Test needs to be applied to Government policy making to ensure the potential impacts on family relationships are considered and the Unit’s work may be drawn on.
Section 4: Other related research activity of which the Unit will need to be aware
The National Institute of Health and Care Research (NIHR) and a number of other funders of health research already have significant investments in the health of children and young people. In particular, applicants should avoid duplication with existing NIHR research programmes and current calls for research (an example of a recent relevant call is 22/23 Interventions to prevent male violence against women and girls). The Unit should complement and make links, as appropriate, with the NIHR Public Health Programme, the NIHR infrastructure such as the School for Public Health Research, School for Primary Care Research and the Applied Research Collaborations.
Applicants should also be aware of the ‘What Works: evidence centres for social policy’, including the Early Intervention Foundation and the upcoming Centre for Children’s Social Care. Applicants should demonstrate that they understand the unique contribution of this new programme of work and the audience for outputs.
The Unit will be expected to develop links with other PRUs, including those covering Public Health, Maternal and Neonatal Health, Mental Health and Healthy Weight. The Unit will be expected to develop links with research and intelligence teams at DHSC, OHID, NHS England and UKHSA, and to actively share learning with these organisations.
Other organisations also conduct research and policy analysis in the fields of child health and violence reduction, including DfE and the Department for Work and Pensions. The Unit is expected to be aware of relevant publications from such organisations, including (but not limited to), NICE, the Office for National Statistics, the UCL Institute of Health Equity, the King’s Fund, the Joseph Rowntree Foundation, The Health Foundation and the medical Royal Colleges and Faculties.
Section 5: Other issues relevant to this programme of research
The Unit will be expected to demonstrate awareness of ethical issues of conducting research involving children, young people and vulnerable groups, and to work within a governance framework which assures this.
We expect that there will be a relatively high proportion of the Unit’s work dedicated to responsive work to address short- and medium-term Ministerial and policy requests.