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BACKGROUND: Young people with learning disabilities are frequently underrepresented in research accounts. This study describes the experiences of young people moving from the care system. METHODS: We scoped the English and Swedish literature for first-hand accounts and interviewed four young people with learning disabilities leaving the English care system. We combined findings from both sources. FINDINGS: “Grey” and campaigning literature are more likely than academic studies to include the voices of service users, but even then, the voices tend to be those of professional or family carers. Both the literature and interviews demonstrate young peoples’ awareness and understanding of the social as well as financial benefits of work. Good foster care could be precarious, and young people in unhappy placements lacked direction. Exploitation around a young person's housing and finances could be problems. There was evidence of “threshold” difficulties in accessing services. CONCLUSIONS: Despite an NHS commitment to listening to users in the UK, and similar aspirations in Sweden, our search of the literature identified few studies reporting care leavers' with learning disabilities own words. Our data add to the voices of a group frequently silent or silenced. We found evidence of resilience and hope as well as difficulties and frustrations. The accounts in the literature and our interviews provide data on what it can be like to try to operate “the system.” The people we spoke with and those whose accounts we found in the literature were thoughtful and engaging. They provide an important source of knowledge for policy and practice.

Young unaccompanied asylum seekers have been portrayed as vulnerable, resilient or both. Those granted residency in Europe are offered support by health and social care systems, but once they leave the care system to make independent lives, what part can these services play? Our review of research with migrants who have been in care in Sweden and the United Kingdom found evidence of unmet need, but little research describing their own views of services. The limited published evidence, supplemented by interviews with care leavers in a UK inner city, suggests that in defining health needs, young people emphasise housing, education, employment and friendship over clinical or preventative services. Some felt well supported while others described feeling vulnerable, anxious, angry or sad. These experiences, if linked with the insensitivity of even one professional, could lower young people’s expectations of healthcare to the extent that they avoided contact with service providers. In supporting young migrants’ resilience to meet everyday challenges, friendly support from peers, carers and professionals was important. They needed determined advocacy at key moments. The different challenges for the Swedish and UK health and welfare systems along with the resilience/vulnerability trajectory are described.

This paper explores the priorities of young people who arrived in England or Sweden as unaccompanied minors and are leaving the care of the state to transition to adult life. Policy and practice for these young people are themselves in transition in Europe, and we aim to contribute to the slender first person qualitative evidence base for those delivering services. Our methods comprised a scoping review of scholarly and grey literature, and group and individual interviews. Despite a commitment in both countries to listening to the voices of young people, we identified few studies representing the voices of unaccompanied care leavers. In both the literature and our interviews, health in a clinical sense was rarely among their priorities. Their accounts focused on the determinants of health, and in particular housing, education, food and employment. In Sweden, where services are universal rather than targeted, the Health and Social Care Board (Socialstyrelsen) notes the paradox of unaccompanied children being surrounded by adult supporters, none of whom takes overall responsibility for the young person and his/her everyday life. Those we spoke to describe the vital role played by foster carers, health and social care professionals and friends that they could rely on. The young people whose narratives appear in the research literature and those in our own sample are working hard to cope with multiple transitions and to manage health in its widest sense, whether by finding the right place to live or attending to their education or training.

Social Work Practices (SWPs) were established in England in 2009 to deliver social work services to looked after children and care leavers. The introduction of independent social work-led organisations generated controversy focused on issues such as the privatisation of children's services and social workers' conditions of employment. This paper reports early findings from the evaluation of four of these pilots, drawing on interviews with children and young people, staff, and local authority and national stakeholders. The SWPs assumed a variety of organisational forms. The procurement process was demanding, with protracted negotiations over matters such as budgetary control and providing a round-the-clock service. Start-up was facilitated by an established relationship between the SWP provider and the local authority. Once operational, SWPs continued to rely on local authorities for various functions; in most cases, local authorities retained control of placement budgets. Levels of consultation and choice offered to children and young people regarding the move to an SWP varied considerably. Children's understanding about SWPs was generally low except in the pilot where most children retained their original social worker. These early findings show some dilution of the original SWP model, while the pilots' diversity allows the benefits of particular models to emerge.