The Head of Children and
Maternity Integrated Commissioning - Amanda Tuke, Senior
Commissioning Manager - Laura Saunders, and the Head of
Commissioning and Procurement Children's, Family and Education -
Pasquale Brammer introduced the report and highlighted the
- Statutory guidance
required that initial health assessments (IHAs) were delivered
within twenty working days of the child becoming looked after.
Notification to the Children Looked After nursing team would be
received within three working days and the IHA would be delivered
within sixteen working days. If the referrals were received
punctually then the statutory deadline was almost always met.
Health nurses would often speed up the assessment to try and hit
the twenty working day deadline.
- The data, included in
the report, showed that there had been a significant improvement on
timeliness of IHAs compared with previous years, however, they were
still looking at strengthening the quality of the
- Ensuring the
management of repayments to outside boroughs were prioritised to
maintain a good reputation with commissioners.
- Young people
declining health assessments was a challenge, particularly with out
of borough children.
- The Health and
Wellbeing of Children Looked After Strategic Board chose themes and
determined what was working well and where there were areas for
improvement; longer term plans were then created and introduced.
The Board focused on individual cases, and monitored whether there
were any trends with the statistics.
- Focus was emphasised
to those young people who had not attended or had declined their
health assessments to encourage them to have their assessments; it
was not mandatory for the young people to have their assessments
after the age of 16 and they had the right to decline.
- The percentage of
children in care for the last 12 months who had updated health
assessments was 91.4%, as opposed to the two previous years which
was 66.5% and 79.4%.
- There was an ongoing
review to improve how health pathways for unaccompanied asylum
seeking children (UASC) could be completed in a timely manner and
to improve inclusivity; the challenges with UASC were often
- Approximately 100
children in care were referred to South London & Maudsley NHS
Foundation Trust (SLaM) per year, and Off The Record provided
support to approximately 150 looked after children, of which almost
100 children were UASC.
- There were high
waiting times for young people and a high threshold for young
people to meet the requirements of the available services. This was
a national challenge, which was continuously improving, and it was
noted that Croydon were performing to a higher standard than a lot
of other areas across the country.
- From February 2020,
the existing multi-agency Single Point of Contact (SPOC) service
would expand to include emotional wellbeing and mental
- Practitioners from
SLaM would be co-located at Bernard Weatherill House, along with
specialists from: social care, early help, health visiting
services, education, safeguarding, police, and housing
- A new online referral
form had been developed to ensure all information sharing and user
confidentiality concerns had been addressed.
- The service would be
evaluated over the next six months after implementation to
determine how it was working and identify future developments. This
would continually improve the service and ensure there was a more
flexible offer to meet the need of the young people.
- A neighbouring
borough had held specific training for foster carers regarding
mental health and this could be introduced to Croydon.
- SPOC would provide
clearer statistics to ensure the health service could be monitored
Dr Julia Simpson, CLA
Designated Health Professional, introduced herself and highlighted
- She had held a focus
group with young people regarding initial health assessments and it
was expressed that they wished to know who would be completing
their assessment; what the medical professional looked like, their
name and what would be discussed.
- The data collected
regarding the assessments undermined what was being achieved with
the young people as they would discuss friendship groups, peers and
school life with them; the data collected was quantative and
focused on areas such as vaccinations and dental
- An analysis of IHAs
was being carried out by Public Health to inform a health report
focused on looked after children, which would be completed by the
next Corporate Parenting Panel.
- Social workers had
been trained to complete new health and safety questionnaires to
identify children who should be referred to SLaM.
- There was a staff
training day arranged in February 2020 which would focus on the
support of UASC.
In response to queries raised
by EMPIRE, in regards to health checks for looked after children
and confidentiality with GPs, Dr Julia Simpson clarified the
All information collected at the GP was confidential
and this would only be shared with other health providers. If the
information was to be shared further, for example with foster
carers, then the young person would need to give
Young people may see a different clinical nurse at
their health assessment review; however, initial health assessments
were usually completed by the same nurse to ensure
Doctors would have appointments with any looked
after child without their carer once they were verbally capable.
There had been recent training to improve the narrative between the
health professional and young person to ensure they were able to
discuss issues regarding their placement without the foster carer
Social workers should be involved in the process of
health assessments to help the young person and ensure they have an
understanding of their health needs; social workers were
responsible for reviewing the health assessment in their capacity
as a corporate parent. It was added that the young people should
not leave an assessment without knowing their health needs and the
next steps; health action plans should be shared with the young
person and foster carer.
The young people could make initial contact via
telephone and could arrange an appointment with the doctor on their
own from the age of 13.
A record of every health assessment with the GP
would be on a young person’s file; however, once a young
person turned 18 then hospitals and other services would not have
access to this information unless the individual chose to share it
A foster carer co-optee member
present noted that he had seen a vast improvement in 2019-20 with
health assessments, and requested that information regarding the
new referral process be sent to foster carers, including those who
live outside of the borough. The Head of Commissioning for
Children’s, Families and Education confirmed that a narrative
would be provided to explain how to make a referral to CAMHS for
carers, GPs, young people and schools.
– That the Panel agreed:
to the targets, actions and deadlines as appropriate
to improve the timeliness of initial health assessments, coverage
of review health assessments and access to emotional wellbeing and
mental health services,
that the outcomes of the CLA health needs
assessment, commissioned by the Health and Wellbeing of Children
Looked After Strategic Board, would be reported to Corporate
Parenting Panel as part of an annual CLA health report and added to
the forward plan.
1839 hours the Panel adjourned for a short break
1846 hours the Panel resumed the meeting