Exploring innovations in Transition to adulthood (EXIT Study)

Young people leaving care often experience complex social & emotional needs alongside reduced life outcomes compared with their non-care peers. Faced with these challenges & barriers, young people leaving care deserve a system in which both policy & practice supports them. Initiatives such as Corporate Parenting & NICE recommendations are continually being rolled-out. However, these may not produce improved outcomes for young people. The purpose of this research is to investigate & build an evidence base for innovation in services & processes designed to improve outcomes for care leavers. We then support the translation of study findings into professional & organisational practice.
Innovation is dynamic & beyond simply a good idea at the local-level, needs to spread & be adopted more widely. This is challenging because spread of innovation is influenced by social & professional networks, groups & practices, alongside broader context. Sometimes, innovations can be hollow, taken up as an act of faith because they're seen as desirable or easy to implement yet make minimal difference. Meanwhile, promising innovations sometimes fail because they're employed too rigidly & not adapted to the context. Leadership can be a key factor for innovation success along with engagement of different professional groups & service users. In this study we (1) explore what innovations are already in place for young people leaving care (2) identify what helps or hinders how those innovations are put into practice. We then (3) find ways about how the wider spread of innovation across care systems can be better supported so innovation makes a difference to young people. Following which, we (4) evaluate outcomes of innovation across leaving care processes in four ways: how it spreads; how it is adapted; how it affects young people leaving care; implementation costs. Finally, (5) we ask what adaptations are necessary for an innovation to spread & the effect of this on outcomes.
To answer these questions, we bring together literature & empirical methods across different fields such as organisation science & health research. Our overall research strategy is informed by comparative case study design & qualitative interviews with care professionals & care leavers. Examples are taken from 3 areas: West Midlands, Newcastle & Tyneside & Bedfordshire. Complex young people that are most vulnerable to identity, attachment & mental health issues are central to our study. 6 young people leaving care will participate in our research team as researchers. Our study will follow a collaborative model & engage with stakeholders supporting young people leaving care at local & national-levels; e.g. encompassing Care Leaver's Association, Local Councils & nationwide agencies involved in health, social care, education & justice. The study team includes researchers drawn from Warwick, Newcastle & Bedfordshire Universities enabling insights & impact throughout England, alongside a partnership with Monash University (Australia), facilitating international comparison.
Co- production will be central to the study. This will happen in number of ways. First, by establishing 'Communities of Practice' where researchers, care professionals & care leavers collectively engage with the study & disseminate knowledge directly into services. Second, a Strategic Advisory Board comprised of representative stakeholders from public service & voluntary agencies including young people leaving care, & an End User Group of young people leaving care. Further engagement will happen through cross-professional events for health & social care practitioners with an interest in young people leaving care. Finally, we will disseminate findings via a dedicated study website offering online training tools, quarterly blogs & Study Bites (short briefings), combined with social media activity that outreaches to public services, voluntary sector & service users.

The following impacts arise from our work:
1. YPLA, policymakers, commissioners & providers will gain intelligence about types of innovation to support transition of YPLA into adulthood
2. YPLA, policymakers, commissioners & providers will gain intelligence about effects of above innovations, including YPLA experience
3. Capacity will be developed amongst YPLA, policymakers, commissioners & providers to sustain action around implementation & diffusion of evidence-based innovation to support YPLA transition into adulthood
4. Through close working with end users, academic researchers will gain contextual understanding of challenges & solutions around YPLA transition into adulthood
The impact will happen in the following way:
1. We will establish a Strategic Advisory Board (SAB) consisting of the main beneficiaries of this research. SAB will have the following representatives: senior level managers & practitioners in health, public health, social care, education, criminal justice, voluntary sector agencies, as well as YPLA (10 members, meet every 6 months). SAB will facilitate dissemination opportunities at local, regional, national & potentially, international levels.
2. End User Advisory Group (EUAG, 10 members), consisting of YPLA, will feed into SAB. Alongside SAB will provide a forum for knowledge exchange & a platform to distil & translate research outcomes into accessible formats for wider dissemination;
3. Development of a Community of Practice (CoP) within each of the case settings, where practitioners, researchers & end users voluntarily come together to discuss interventions to support transition of YPLA in the area, engage with research findings, & further support the diffusion of evidence-based innovation;
4. Annual workshop for stakeholders heavily engaged in study & end of study workshop for wider group of national level stakeholders interested in YPLA to disseminate research findings & engage in wider discussion of YPLA transition support. We will work with the NIHR CLAHRC/ARC network to organise (workshops held at The Shard WBS premise)
5. We will produce short 'EXIT Study Bites', which are short briefings, available in hard copy & virtually about what works & how to implement what works. PI Currie will produce quarterly 'EXIT Study Blogs';
6. EXIT Bites and Blogs will be shared with the National Institute for Health & Clinical Excellence (NICE) with CI (Kaner) being a longstanding member of NICE Public Health Advisory Commission C;
7. Research will be used to develop an online training tools, including a MOOC aimed both at health & social care, education, criminal justice, voluntary sector professionals & managers delivering interventions for YPLA;
8. CI Skouteris (Monash) will disseminate internationally, specifically across the Australian State system through networks she is already deeply embedded in that focus upon YPLA;
9. Stakeholders already engaged in developing the outline bid are: Care Leavers' Association; YPLA representative groups from North Tyneside, Bedfordshire, Coventry; Coventry City Council; Strategic Commissioning People Group Warwickshire; Birmingham Community Healthcare NHS Trust; Victoria State Department of Health & Human Services. They will continue their involvement in co-production & dissemination of research throughout the study. Other local care providers will be engaged on award of funding within the geographical areas covered by our empirical cases. We will also engage national level stakeholders, indicatively these are: Association of Directors of Children's Services; National Network of Designated Doctors & Nurses; Department of Health; NHS England; Department for Education; The Fostering Network; NICE (National Institute for Health & Care Excellence); SCIE (Social Care Institute for Excellence); relevant charity organisations, such as Action for Children & A National Voice. All will be invited to participate in 4 & 7, & receive 5 above.