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Health of LAC

Health does not only refer to physical health, but also emotional health. Good health is vital as a child to ensure that they are able access all opportunities available to them as they grow older. Children must live in a healthy environment where their all their health needs are met and promoted and where they are able to access the services as required. This page looks at how to achieve this, with subsequent pages looking at specific areas such as health assessments and substance misuse screening.

Children who are looked after by the local authority will have very individual health needs, with this rooted in their family history to date and their life experiences.  When accommodating a child there are therefore a number of different areas where the child and family's  knowledge need to be passed over and recorded to ensure consistency in the care that is being provided.

Research suggests that children in care will share many of the same health risks as their peers, but that this is often to a greater degree.  Children who are coming into care can often be at a worse level of health than their peers in part due to their experiences up until the point of coming into care.

Needs in relation to mental health have also been shown to be disproportionately higher for children in care.

Finally, evidence suggests that when children then come to leave care many aspects of their health worsens in the year after leaving care.

It is therefore very important to get the right information and support for the child at the right time.

What's needed when placing a child for the first time?

Consent to medical treatment

It is important to ensure that consent to medical treatment is discussed with the parents, and as far as reasonably possible obtained and as near the start of the process as possible. 

For children and young people who are accommodated (e.g. s20) it is essential that written, signed consent is obtained from the parents at the outset. In these cases parents retain parental responsibility and therefore the local authority do not have the ability to authorise any medical treatment.  This information is found on the Placement Information Record and when signed the form should be copied and input onto the child's electronic file.

It is good practice to gain similar consent when children are subject to Interim Care Orders/Care Orders, however it is not essential as the local authority will share Parental Responsibility with the parents in these situations and therefore medical treatment can be sought.

Medical history

For younger children you can ask if the parents will provide you with their red book (Personal Child Health Record (PCHR)) which sets out the involvement of the Health Visitor over the child's life so far.  Parents of older children may still have the PCHR and have further information available.

Details of GP, dentist, optician and other involved health professionals

Wherever possible the child should receive continuity of care from the health professionals they were seeing prior to being placed in care. If this is not possible then it is important that the details of who is currently involved are passed to any new providers to ensure information can be transferred between the providers.

Allergies, health conditions, medication

Essentially any information that may impact on the day to day care of the child should be obtained.

Where possible any current medication should be requested from the parent and passed to the carer, ensuring that it is clearly labelled as to who should have the medicine, how much they should have and when.  If medication is to be provided by the carer then consent should be obtained from the parents.

What's needed in the first few weeks of the child being in care

At this stage, the most important matter to be addressed is the health assessment which will inform the health plan.  The process around this is detailed on the next page.  The health plan, once written, will then guide the support that is provided to the child, placement and carers.

It is also important early on in the child's care experience for Strengths and Difficulties Questionnaires to be completed.  This allows a baseline to be established in relation to the child's mental health, as well as identifying if any support is urgently required.

For children of secondary school age a substance misuse screen should be completed.

What's needed on an ongoing basis?

The child's health needs should be considered as part of the review of arrangements and an integral part of the care plan.

Substance misuse screening and Strengths and Difficulties Questionnaires should be reviewed annually as a minimum.

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