RF26 Quantifying inequalities in looked after children in england

Background The proportion of Looked After Children (LAC) in England is rising. The high burden and consequences of child maltreatment are well documented, yet little is known about the drivers of children being taken into care in England. In order to inform policy, this analysis aimed to determine whether there were inequalities in the sustained rise in LAC in in recent years. Methods We analysed routinely available local authority level data from 152 English upper tier local authorities between 2003–4 and 2017–18. The principal outcome was the rate of children taken into care each year. Numbers of LAC were drawn from the ‘children looked after data return’, submitted by local authorities to the Department of Education annually. Child population data were sourced from Office of National Statistics mid-year population estimates. Local authorities were assigned to quintiles according to their income deprivation score based on 2015 Indices of Multiple Deprivation, the main exposure of interest. Trends were analysed descriptively. Longitudinal mixed effects models were used to assess changes in social inequalities in LAC over time. Analyses were performed in R version 3.5.2. Results There was a 29.8% increase in children taken into care between 2008 and 2018 in England, which was not experienced evenly across the population. In 2008 the absolute inequalities gap between most and least deprived areas was 143 children per 100,000 (95% CI 108 to 179). Between 2008 and 2018, the greatest increase in risk of becoming looked after occurred in the most deprived local authorities, with the gap widening by 6 children per 100,000, per year (95% CI 3 to 8). Ongoing analyses will determine how rising inequalities were distributed across age groups and children’s category of need upon entering care. Fixed effects models will be used to assess the relationship between changes in determinants of children entering care, such as child poverty and expenditure on preventative services, and changes in risk of becoming looked after. Conclusion This study provides evidence that the dramatic rise in children taken into care has been greater in the poorest areas of the country. Policies that address the determinants of children entering care at local area level are important for tackling the inequalities picture, and the rise in LAC. A limitation of this analysis relates to the use of 2015 income deprivation scores, which may not accurately reflect the relative status of local authorities across all years.