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UK and international comparative research on socioeconomic inequality in early childhood, conducted by University of Bristol in conjunction with international colleagues, has profoundly influenced a variety of UK policy initiatives since 2010. Reliable evidence on the extent of learning deficits among recent cohorts of socio-economically disadvantaged children in early childhood has led to widespread acceptance in government that policy to promote equality of opportunity must begin in the preschool period. Analysis of the factors underpinning the disparities has led to and informed the development of official UK indicators to monitor progress in this area and specific policies to support parents, with outstanding potential to impact positively on the life chances of disadvantaged children. These include, for example, free childcare places for disadvantaged two-year-olds, an increased number of health visitors and the launch of telephone and online services for parents.
The Millennium Cohort Study (MCS) has influenced health policy and practice at local, national and international levels. Breastfeeding research based on MCS data has made a particularly important contribution to health education, and important insights have been provided on immunisation and obesity. The study has also helped to shape policy thinking and public discussion on issues such as social mobility, family poverty and child development. The MCS has not only created an invaluable resource for researchers in the UK and other countries, it has also served as a model for other cohort studies. Leading researchers around the world say it sets the benchmark against which other child cohort studies will be measured.
For the most part, looked-after children have poorer physical and mental health than other children, and do less well educationally. Their employment prospects are poorer and they are over-represented amongst young offenders. But this is changing for the better in Northern Ireland, where research at Queen's has helped to improve the stability and quality of placements provided to looked-after children, and the support given to them when they leave care. The 2010 Demos report on children in state care in the UK used illustrations of best practice from Northern Ireland.
Statistical analysis and methodological development carried out by Imperial College London on data from the Bristol Royal Infirmary Inquiry and the Shipman Inquiry have led to new monitoring systems in healthcare. Using routinely collected healthcare information, we have highlighted variations in performance and safety, impacting the NHS through direct interventions and/or policy change. For example: (i) findings and recommendations arising from our research for the Bristol Inquiry were reflected in the final inquiry outputs, which highlighted the importance of routinely collected hospital data to be used to undertake the monitoring of a range of healthcare outcomes, (ii) a range of monitoring recommendations have arisen as a direct result of the research on data from the Shipman Inquiry, (iii) analytical tools based on our methodological research are used by managers and clinicians in over two thirds of NHS hospital trusts, (iv) Imperial's monthly mortality alerts to the Care Quality Commission were major triggers leading to the Healthcare Commission investigation into the Mid Staffordshire NHS Trust.
The University of Nottingham's Children's Brain Tumour Research Centre developed new NHS evidence-accredited referral guidelines, published in 2008, to reduce diagnostic delays for children with brain tumours. Their messages were disseminated through an awareness campaign, `HeadSmart — Be Brain Tumour Aware', launched in 2011. Three months post-launch, 11% of the UK population (over 14 million people) and 73% of paediatricians were aware of HeadSmart, and diagnostic confidence among paediatricians had risen from 32% to 54%. The time from symptom onset to brain tumour diagnosis reduced from 14.4 weeks in 2006 to 6.9 weeks in 2013. This strategy is a `world first' in paediatric brain tumour, now being emulated internationally.
Loughborough University's Improving Outcomes of Services for Children in Need research is a programme of interlinked studies that has had a substantial impact on the development of national and international policy and professional practice for the most vulnerable children. It has influenced the development of government policy on safeguarding children from abuse and neglect, placement in out-of-home care, and adoption throughout the United Kingdom and in Australia, Canada and countries in Western and Eastern Europe. The researchers have translated a number of findings into tools designed to shape professional practice: these include a computer application that introduces transparency into the comparison of costs and outcomes of services.
pGALS (paediatric Gait, Arms, Legs, Spine) is a quick, accurate and child-friendly examination technique that identifies children who need to be referred to a paediatric rheumatology specialist. pGALS has been widely disseminated since 2008 and integrated into both undergraduate medical student teaching and the membership examination for the Royal College of Paediatrics and Child Health. pGALS was developed by Newcastle researchers in response to their findings of a self-reported lack of confidence among clinicians when conducting musculoskeletal examinations of children. Research also showed that delays and inappropriate investigations were being conducted before the child was referred to a specialist. pGALS is now taught in at least 15 of the 32 medical schools in the UK and has been described in a number of leading textbooks. It is becoming known and used worldwide, adapted for local cultural and social contexts.
Research by Dr Una Convery and Dr Linda Moore (respectively Lecturer and Senior Lecturer in Criminology) has significantly influenced rights-compliance in policy, legislation and practice regarding youth custody in Northern Ireland and beyond. Most notably, it impacted decisively on the development of innovative regimes and policies at NI's only custodial centre for children and improved their conditions. It also influenced decisions on reduced custodial levels and the removal of children from the penal system. By providing a solid evidence base, utilised by lobbyists and political representatives, the research influenced the inclusion of independent reviews of the penal and youth justice systems within the multi-party Hillsborough Agreement (2010). Its findings also assisted the Northern Ireland Human Rights Commission (NIHRC) in its successful campaign for enhanced investigatory powers.
Accurate recording of adult SPC activity using the revised MDS has resulted in the transformation of SPC services. The MDS provides economic benefits by informing the planning and funding of local services by capturing full service costs and is being used to develop a new NHS funding system for SPC. Informing accurate audit and national benchmarking of services, it shows how revised service composition, enhanced day care, and seven day services, are contributing to reduced hospital admissions. This has both policy and economic benefits. It demonstrates how services are addressing SPC provision for non-malignant disease, a key policy driver.
The worst of institutional child care came to the attention of the public and policy-makers in the 1990s following the fall of Ceauşescu in 1989 when pictures of children in Romanian orphanages were broadcast around Europe and America. Following this, a series of projects at the University of Birmingham (funded by the European Union Daphne programme and the World Health Organisation Regional Office for Europe) charted the extent and consequences of institutionalised care for children across Europe, and devised best practice recommendations for deinstitutionalisation. Among the key findings were that institutionalisation was much more widespread across the EU than previously thought; that it is particularly harmful before the age of three; and that alternative care with superior outcomes for children is also less expensive to implement. During the REF period the research team has significantly expanded their role in disseminating their findings, producing policy reports and briefings, and in providing training. During this time their key findings have made a major contribution to changes in child-care policy recommendations by NGOs such as UNICEF and the UN. Following discussion at the UN General Assembly in 2009 specific guidelines were produced for all 193 member states, which implemented key recommendations from the research about the timing of deinstitutionalisation and how to achieve it (`Guidelines for the Alternative Care of Children', 2009). Their research has led to changes to national child-care policies in a number of countries, including the Czech Republic, Hungary and Serbia. Through the activity of UNICEF the impact is now extending beyond Europe to central and South America. These changes have demonstrable benefits for the health and psychological welfare of children, as well as bringing cost savings to the national childcare systems that implement them.