SCOPE OF THIS CHAPTER
This procedure applies to all Looked After Children. Children remanded other than on bail will be looked after children. Different provisions will apply In relation to those children/young people - see Remands to Local Authority Accommodation or to Youth Detention Accommodation Procedure, Care Planning for Young People on Remand.
This procedure summarises the arrangements that should be made for the promotion, assessment and planning of health care for Looked After Children.
The local authority, through its corporate parenting responsibilities, has a duty to promote the welfare of looked after children, including those who are eligible and those children placed in adoptive placements. This includes promoting the child’s physical, emotional and mental health; every Looked After Child needs to have a health assessment so that a health plan can be developed to reflect the child’s health needs and be included as part of the child’s overall care plan.
The relevant clinical commissioning group (CCG) and NHS England have a duty to cooperate with requests from the local authority to undertake health assessments and provide any necessary support services to Looked After Children without any undue delay and irrespective of whether the placement of the child is an emergency, short term or in another CCG. This also includes services to a child or young person experiencing mental illness.
The Local Authority should always advise the CCG when a child is initially accommodated. Where there is a change in placement which will require the involvement of another CCG, the child’s ’originating’ CCG, outgoing (if different for the ‘originating CCG) and new CCG should be informed.
Both Local Authority and relevant CCG(s) should develop effective communications and understandings between each other as part of being able to promote children’s wellbeing.
The social worker has an important role in promoting the health and welfare of Looked After Children:
Each Looked After Child must have a Health Care Assessment at specified intervals as set out below.
If a child is transferred from one Looked After Placement to another, it is not necessary to plan an assessment within the first month. In these circumstances, the social worker should furnish the carer/residential staff with a copy of the child's Health Care Plan.
If no plan exists, the social worker should arrange an assessment so that a plan can be drawn up and available for the child’s first looked after review which will take place within 20 working days.
The social worker should liaise with the carer/residential staff to arrange the first assessment with the child's GP or Designated Nurse for Looked After Children.
Before a Health Assessment takes place, social workers must complete Part A of the BAAF 'Initial Health Assessment Form' to ensure it is available at the time of the appointment.
In order for the Health Assessment to be conducted, the social worker must ensure that the parent(s) have given consent - this will usually be recorded on the Placement Information Record.The health professional conducting the assessment will complete a relevant BAAF Form and a Health Plan, which should be passed to the child's social worker - who should give copies to carers/residential staff
Each Looked After Child’s Care Plan must incorporate a Health Plan in time for the first Looked After Review, with arrangements as necessary incorporated into the child’s placement plan/placement information record.
This Plan must be reviewed after each subsequent Health Care Assessment and at the child's Looked After Review or as circumstances change.
Understanding a Looked After Child’s emotional, mental health and behavioural needs is as important as their physical health. All local authorities are required to use the Strength and Difficulty Questionnaires (SDQs) to assess the emotional needs of each child.
The SDQ Questionnaire, along with any other tool which may be used to assist, can be used to identify the needs and be part of the child’s Health Plan.
Where an Out of Authority placement is sought, the responsible authority should make a judgment with regard to the child’s health needs and the ability of the services in the proposed placement area to fully meet those needs. The placing authority should seek guidance from within its own partner agencies and the potential placement area to seek such information out.
The originating CCG, the current CCG (if different) and the proposed area’s CCG should be fully advised of any placement changes and to ensure that any health needs or heath plan are not disrupted through delay as a result of the move.
Where these are placements at a distance the Care Planning, Placement and Case Review (England) Regulations 2010 (as amended) make it a requirement that the responsible authority consults with the area of placement and that the Director of the responsible authority must approve the placement.Where the child’s health situation is more complex, it is likely that both health and Social Care services will need to be commissioned; this will need to be undertaken jointly within the originating agencies’ respective fields of responsibility together with the health and social care services in the area where the child is placed.