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3.11.1 Health Assessment and Health Plans

AMENDMENT

This chapter was slightly updated in October 2011 to take account of the changes in the Care Planning, Placement and Case Reviews (England) Regulations 2010 and Associated Guidance, in regard to the change from Health Care Assessment to Health Assessment and the arrangements for Health Assessments.

SCOPE OF THIS CHAPTER

This procedure applies to all Looked After Children.

It summarises the arrangements that should be made for the promotion, assessment and planning of health care for Looked After children.

This Chapter should be read in conjunction with:

Health Assessment Flowchart - to follow

LAC Health Assessments Documents

Also see Department for Education website and LAC Health Assessment Documents Guidance on the duty of local authorities to promote healthcare of looked after children.

Also note as from the 6th June 2011 an requestd for Health Assessments/BAAf Forms must be sent to lh.childprotection:nhs.net.cjsm.net.

AMENDMENTS

 This chapter was updated in June 2011 to include Consent for Health Assessments and Young Person refusing Health Assessment Flowchart


Contents

  1. Frequency of Health Assessments
  2. Arrangements for Health Assessments
  3. Consent for Health Assessments
  4. Health Plans
  5. FSI Health Assessment Flowchart 
  6. Young Person refusing Health Assessment Flowchart


1. Frequency of Health Assessments

Each Looked After Child must have a Health Assessment soon after becoming Looked After, then at specified intervals as set out below.

Health Assessments must be conducted by a suitably qualified medical practitioner; who should provide the Social Worker with a written report (See Section 2, Arrangements for Health Assessments)

  • The first Assessment (see shaded area below) must be conducted within a month of the child first becoming Looked After - usually in time for the first Looked After Review.
  • For children under five years, further Health Assessments should occur at least once every six months.
  • For children aged over five years, further Health Assessments should occur at least annually

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 Home with a copy of the child’s Health Plan.

If no plan exists, the Social Worker should arrange an assessment within a month of the placement so that a plan can be drawn up.


2. Arrangements for Health Assessments

A Health Assessment Consent Form triggers the arrangements for Community Health to arrange a health assessment.

Please read this section in conjunction with Health Assessment Flowchart (to follow) which summarises the steps that must be taken in arranging a Health Assessment.

The following BAAF forms are used by health professionals:

 
Form IHA – C Initial health assessment for children up to 9 years
Form IHA – YP Initial health assessment for young people 10 years and older
Form RHA – C and YP Review health assessment
Form MB – M Maternal, pre-natal & obstetric information
Form MB – B

Neonatal information

N.B. Form B is attached to Form M and will need to be separated
Form PH Health of birth Parents and birth family

It is essential that a Health Assessment Consent form which gives permission to request health information on the birth family and the child is completed.  Without this form the Medical Adviser, the LAC nurses and the other doctors performing statutory health assessments (i.e. the Looked After Children Team of Lewisham Community Health) are not allowed to request any information from other health professionals and agencies. See Section 3: Consent for Health Assessments.

Please Note: To improve the quality of Health Assessments, in some circumstances it may be essential that on the Health Assessment Consent Form, personal details, for example, birth Parents contact details are not disclosed. If this is the situation, clearly write in bold capitals 'CONTACT DETAILS NOT TO BE DISCLOSED'.


3.Consent for Health Assessments

When a child is Accommodated under Section 20, in normal circumstances it is the parent with Parental Responsibility (PR) who signs the consent form for health assessments (HA). This is consent for an non invasive assessment and should treatment arise out of the assessment a further discussion would be required with the person who has PR.

There are occasions when the person with PR is not available, competent or willing to sign a consent form for a HA.

Following discussion with the person with PR, if consent is not forthcoming, the Children Act provides for a possible proxy under s3(5)

"A person who  -

  1. Does not have parental responsibility for a particular child; but
  2. Has the care of the child

    May do what is reasonable in all the circumstances of the case for the purpose of safeguarding or promoting the child's welfare"

The Service Manager for Looked After Children can sign consent forms for Health Assessments after consideration of the circumstances of the person with PR being unwilling or unable to do so. When  the consent form signed in this way, a statement "Pursuant to s3(5) Children Act 1989" under the signature should be included.


4.Health Plans

A copy of the Health Plan must be given to Carers or Children’s Home’s Managers.  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 Assessment or as circumstances change.


5. FSI Health Assessments Flowchart

To follow


6. Young Person refusing Health Assessment  Flowchart

Click here to view Flowchart.

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