Agenda item

Maria Farrow-Tait, Interim Designated Nurse Safeguarding Children/ Children in Care (Tees Valley),  will provide an update to the Board from health information relating to our Children Looked After.

The Interim Designated Nurse Safeguarding Children/Children in Care NENC ICB presented a report, the purpose of which was to:

•           Demonstrate the duty to safeguard and promote the welfare of children in             care.

•           Assure the corporate parenting board that health services to children in care             were provided without undue delay or geographical prejudice.

•           Demonstrate the aim of the Looked After Health team was for sustained

            improvement in the health and wellbeing of children in care and those             leaving care.

•           Ensure the child’s voice around health issues were included wherever             possible.

•           Report on compliance to statutory targets from the Looked After Health Team             for Harrogate and District NHS Foundation Trust.

The report considered compliance for initial health assessments, review health assessments, health registrations and health passports.

Local Authorities were responsible for ensuring a health assessment of physical, emotional, and mental health needs was completed for every child within 20 working days of becoming looked after.  Statistics relating to the  Initial Health Assessments undertake in Quarter 3 were detailed at Table 1 of the submitted report.

Review Health Assessments had to take place at least every six months before a child’s fifth birthday and at least once every twelve months after the child’s fifth birthday within the month they became looked after.  Statistics relating to the Review Health Assessments undertaken in Quarter 3 were included at Table 2 of the submitted report.

Compliance with initial health assessments within timescales was less than 10% and with review health assessments, less than 90%.

Challenges faced included:

•           Delays in receiving medical consent for initial health assessments was 100%             in Q3.

•           A lack of available clinics for initial health assessments accounted for over             89% of the delays.

•           Throughout Q3 the Harrogate and District Foundation Trust team had             experienced significant sickness within the team, which impacted the             team’s capacity to undertake review health assessments.

Actions taken to address the issues were as follows:

•           Rapid improvement workshop remained in place.

•           A service review with the Designated Nurses and the Senior Clinical             Commissioning Officer was in progress and regular contract meetings             remained in place.

•           Tees Valley CiC service introduced the RHA risk assessment tool to ensure             that children and young people had their health reviewed in accordance with             need as opposed to due date.

•           This risk assessment had been used throughout Quarter 3 to assess the risk             in relation to the team’s capacity. The Named Nurse risk assessed the health             records of all the children who had been allocated to the staff members not at             work. It was reassuring to see that out of 36 risk assessments, there was only             one young person who had increasing risk and needed seeing as a matter of             urgency.

A Member queried the delays in receiving medical consent for initial health assessments (IHA).  It was clarified that the consent had to be obtained by the Social Worker and signed by parents to agree to their child receiving an IHA.  Social Workers had been reminded to ensure that they obtained the consent at the same time as the Section 20.  However, it was reiterated that this was not delaying the IHAs being undertaken as this was due to the lack of clinic availability.   It was highlighted that social care and health needed to look urgently at how the current position could be improved.

It was noted that data on actual health needs was not information that would generally be shared with the Board.  The requirements of the commissioning arrangements were that assessments were done within timescale and that children’s health needs were met. 

AGREED that the information provided was received and noted.