Agenda item

Kelly Dunning, Named Nurse Children in Care (LAC), Harrogate and District Foundation Trust will provide information to the Board.

The Chair welcomed Monica Smallman, Specialist Nurse Children in Care to the meeting to provide the Board with the HDFT Children in Care Performance Report and to share with the Board share with the board the new commissioning arrangements under the Tees Valley Children in Care (CiC) Service and to also update board with progress to date.

 

The specialist nurse firstly provided the board with some background information, advising the Board that from 01^st April 2022 the responsibility of initial health assessments (IHA’s) and review health assessments (RHA’s) for South Tees NHS Trust was amalgamated into a Tees Valley Children in Care contract.

 

HDFT is responsible for the timely co-ordination of Initial health assessments (IHA’s) which includes gathering consent and pertinent health and social information on a child entering the care system to inform the IHA appointment. The IHA appointment is completed by the acute hospital trust and disseminated to social care.

 

The Specialist nurse advised that it was the responsibility of the Tees Valley Children in Care (TV CiC) service to co-ordinate and undertake review health assessments for any child in care in the borough of Middlesbrough. Tees Valley Children in Care practitioners will also undertake RHA’s for a child placed out of area within a 30-mile radius of their home address.

 

The board were made aware that the Tees Valley Children in Care service was made up of the following:

·         0.5 WTE Band 8a Named Nurse Children in Care

·         1.0 WTE Band 7 Specialist Nurse Children in Care

·         4.1 WTE Band 6 Nurse Children in Care

·         4.1 WTE Band 5 Staff Nurse Children in Care

·         0.9 WTE Band 4 Data & Analyst Administrator

·         2.9 WTE Band 3 Administrator

Review health assessments are undertaken with the best interests of the child at the heart of interventions. The service liaise with caseload holders (Health Visitors and School Nurses) prior to and following the review health assessments to ensure that the assessment is informed and is a holistic approach.

Since the transfer of responsibility to HDFT are notified by the Local Authority of a child entering the care system and they collate notification consent and book the child onto the clinic via Cammis. These need to be completed within 20 days. The specialist nurse advised that the only time that there would be a delay in completed the initial health assessment would be if the doctor was on annual leave.

The report provided to the Board advised that there have been significant, ongoing challenges in relation to IHA compliance which HDFT, the local authority and the acute hospital trust recognise and are working in an attempt to rectify the situation.

All three partners meet on a weekly basis and discuss any outstanding IHA appointments, establish if additional clinic appointments are required and liaise in relation to child was not brought. HDFT have also raised with the local authority that a delay in providing notification consents is creating a delay in the child being booked to attend for an IHA.

It remains the responsibility of the social worker to notify the parent / carer of the appointment details and if for whatever reason the appointment is to be cancelled / rearranged then this must be agreed by the service manager.

 

Review health assessments

The report and specialist nurse provided some statistics surrounding the Review health assessments.

 

Compliance to Review Health Assessments (RHA) completed within the timeframe of 6 monthly for children under 5 years.

Middlesbrough Under 5-Year % in timescales
Q1 April	Q1 May	Q1 June	Q2 July
70%	83.3%	80%	75.0%

 

Compliance to Review Health Assessments (RHA) completed within the timeframe of 12 monthly for children over 5-15 years.

Middlesbrough 5-15 year % in timescales
Q1 April	Q1 May	Q1 June	Q2 July
56.3%	73.3%	56.2%	100%

 

Compliance to Review Health Assessments (RHA) completed within the timeframe of 12 monthly for children over 16+ years.

Middlesbrough 16+ year % in timescales
Q1 April	Q1 May	Q1 June	Q2 July
60%	66.7%	55.6%	71.4%

 

The Specialist nurse advised that challenges that have contributed to the timely compliance being less than desirable were as follows:

·         Child living out of area (beyond a 30-mile radius) and the RHA request not being undertaken within timescales.

·         Placement changes for Children in care and the Tees Valley Children in care service not being notified of the placement change.

·         Staffing capacity throughout the mobilisation of the Tees Valley Children in care service.

·         By request of the young person due to exams.

 

In previous meetings, the board has been made aware of issues of children in care receiving denatl care despite some children being subject to care orders.

 

Prior to HDFT becoming responsible for Children in care in Middlesbrough there was extensive work undertaken in relation to a Dental Health Pathway. This continues to be a work in progress and it is anticipated that it will be embedded in practice by November 2022.

 

The Specialist Nurse also advised the board of a School Based Immunisation & Children in care Pathway that ensures the immunisation uptake for Children in care is satisfactory. This has been devised and implemented into practice since May 2022 and as a result we have been successful in 3 Children in care having their outstanding immunisations administered.

The Specialist nurse advised that further data on the pathways programme would be able to be provided at the next presentation to the board.

 

AGREED- That the information provided be noted.