LAC: Promoting good health in Care Leavers through training for Personal Advisors


National Institute for Health (NIHR) Health Service & Delivery Research (HS&DR) Ref. 17/108/06

What is the research question?

Can we enhance the health and wellbeing of Care Lavers by training their Personal Advisors with relevant public health knowledge and skills?

What is the problem?

Children in care have often had difficult lives. Many were badly treated before coming into care, and have behavioural, emotional and other health problems that affect their day-to-day lives. Foster care can help children to recover, but many children will still have mental and physical health problems.

Some also have disabilities and long-term health conditions, and some spend a lot of their lives in residential settings. Despite all these challenges, young people in care cease to be ‘looked after’ on their 18th birthday, and many leave care as young as 16 years old.

The government knows that leaving care so early is a problem, and has taken steps to provide more support to care leavers. Some care leavers can now remain with their foster parents after the age of 18, and all care leavers can now receive support from children’s services until they are 25 years old.

This support is often provided by someone called a Personal Adviser (PA). The PA can be someone the care leaver already knows, but is often someone employed by the local authority. The PA should work in partnership with the young person to ensure that he or she has all the information and support they need to manage their own health and wellbeing (feeling good about life). This includes helping young people make the move from children’s services (like Child and Adolescent Mental Health Services) to services for adults, which are organised very differently.

What is the aim of the research?

Care leavers say that, at the moment, PAs focus mainly on practical issues like housing and money. Of course, solving these practical problems is extremely important, but it is not enough. Emotional issues like feeling sad or lonely, and other things like sexual health, having a good diet, getting enough exercise, and knowing when and how to talk to your GP, also matter. We think that PAs could make a real difference to care leavers’ health and wellbeing if they had the right training and support. This study is about finding out how best to do that.

How will this be achieved?

First, we are going to find out what PAs should know about how to support care leavers’ health needs. We will find out what has already been shown to be helpful and talk to care leavers about what they want, and what they think PAs need to know and do. We will also talk to health and social care professionals. We will then use all of this information to develop a training course for PAs, which we will ‘test run’ with a small group of PAs.

In the second part of the study we will evaluate the training programme in three or four local authorities in order to find out how helpful the training is. We will use a design called a randomised controlled trial. By doing something like ‘tossing a coin’ we will select half the teams in each local authority to receive the training. We will compare the experiences and health of care leavers who receive support from PAs we trained, to care leavers supported by PAs who did not have this training. We will also talk to PAs, care leavers and other people about their experiences.

Who is leading the research?

Prof Geraldine Macdonald, Professor of Social Work, School for Policy Studies, University of Bristol.

Further information:

Prof Geraldine Macdonald

For more information or to get involved in this project, please contact

The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.