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Contents

1. Health Assessments
2. Health Action Plans
3. Responsibilities of PCT where a Child is Placed Outside the County

1. Health Assessments

The purpose of Health Assessments is to promote children’s physical and emotional health and to inform the child’s Health Action Plan.

When a child becomes looked after, the child’s social worker must, within one working day, notify the Designated Nurse for Looked After Children, who will inform the appropriate health professional of the need to carry out an Initial Health Assessment. (This is usually the Health Visitor in Oxfordshire).

The first Health Care Assessment must be conducted by a registered medical practitioner, usually the child's GP. The health professional will give the Health Assessment Form to the GP, who will carry out a medical examination of the child. The staff/carer should make an appointment with the GP for this purpose.

Subsequent assessments may be carried out by a registered nurse or registered midwife under the supervision of a registered medical practitioner, who should provide the Social Worker with a written report.

The health professional will then pass the Health Assessment Form to the GP, who will carry out a medical examination of the child.  The staff/carer should make an appointment with the GP for this purpose.

 A copy the Initial Health Assessment Form will be sent by the Designated Nurse for Looked After Children to the child’s social worker, who will provide copies to the child (depending on age), the parents and the staff/carers.

The health professional will then draw up a Health Action Plan - see Section 2, Health Action Plans.

• The first Health Assessment must be conducted and a Health Action Plan drawn up before the first placement or, if not reasonably practicable, in time for the first Looked After Review (unless one has been done within the previous three months);
• For children aged between two and five years Review Health Assessments should occur every six months;
• For children aged over five, Review Health Assessments should occur annually.

The Designated Nurse for Looked After Children will send Health Assessment Forms to the appropriate health professional when further Health Assessments become due under the above time-scales.  The health professional will contact the child’s social worker to exchange relevant information and then contact the staff/carer and if appropriate the child to arrange to meet the child. They may also arrange an appointment for a medical examination if necessary.

Where a child is placed outside the borough, the Designated Nurse for Looked After Children will contact the relevant local heath trust/ GP or local Designated Nurse to make the necessary arrangements for Health Assessments.

In order for the Health Assessment to be conducted, the social worker must ensure that the Consents section of the child’s Placement Information Record has been completed and signed by the parent. 

The social worker will inform the child, parents and staff/carer of the purpose of and arrangements for the Health Assessment, and accompany the child and parents (or arrange for staff/carers to accompany the child, as appropriate). 

2. Health Action Plans

The health professional who carries out the health assessment will draw up the child’s Health Action Plan based on the information in the Health Assessment, in conjunction with the child, staff/carer, GP and any other relevant professional.    It will then be sent to the Designated Nurse for Looked After Children who will collect data and send it on to the child’s social worker.  The social worker will arrange for copies to be sent to the child (depending on age), the parents and the staff/carers.

The child’s social worker is responsible for implementing Health Action Plans for Looked After Children, and will do this with the assistance of the named health professional who completed the Health Assessment and drew up the Plan and the Designated nurse.  The specific responsibilities of the staff/carers will also be identified in the Plan.

Each Looked After Child’s Placement Plan / Placement Information Record must incorporate the Health Action Plan. 

The first Health Action Plan must be written in time for the first Looked After Review.

 This Plan must be reviewed after each subsequent Health Assessment or if health circumstances change, and at every Looked After Review.

The Health Action Plan will set out what the health and /or emotional issues are for the child, how the health and emotional needs will be addressed and by whom, including the following matters:

1. Are immunisations up to date or overdue? Which immunisations are due in the next 6 or 12 months?
2. When it is necessary for the next dental check to be carried out?
3. Is it necessary for any hearing, vision or developmental checks to be carried out in the next 6 to 12 months?
4. Whether there are any specific health needs - and how they will be met, including future hospital appointments, referrals to specialist services and/or any specific treatment, strategies or remedial programmes required;
5. Whether there are any issues of health education to be addressed, for example, nutrition, sexual health and relationships, substance misuse, personal hygiene;
6. Whether there are any illegal or other activities including self harming which it is known or suspected the child is engaged in which may be harmful to the child’s health or emotional wellbeing, and the interventions/strategies to be adopted in reducing or preventing the behaviour.

See also in relation to the provision of advice to Looked After children on sexual health, sexual relationships and contraception, Working with Sexually Active Young People under the Age of 18 in Oxfordshire Guidance

3. Responsibility of PCT where a Child is Placed Outside the County

The position since 1 April 2007 is that where a Looked After child is placed outside the county, the PCT responsible for commissioning or providing health services remains the PCT with responsibility for the child immediately before the placement – even where the child changes his or her GP.

NB This only applies to new placements made on or after 1 April 2007.  The change is contained in the National Health Service (Functions of Strategic Health Authorities and Primary Care Trusts and Administration Arrangements) (England) (Amendment) Regulations 2007.

For children who were placed outside the county before that date, the responsibility for providing health services will remain transferred to the PCT for the local authority area where the child is placed.

End