Dorset Clinical Commissioning Group

Looked After Children (LAC)

 

The CCG has a major role in ensuring the timely and effective delivery of health services to looked-after children and is required to do so under section 10 of the Children Act 2004.

A Designated doctor and nurse are employed as strategic leads to assist the CCG and other commissioners of health services in fulfilling their responsibilities to improve the health of looked-after children

Contact Details

CCG Designated Nurse - Penny Earney 01305 213626

CCG Designated Doctor - Dr Naeem Mughal 01202 458745

CCG Deputy Designated Nurse for Safeguarding and looked after Children - Helen Duncan-Jordan 01305 213646

Admin Support - Elaine Milburn 01305 213644

 

Health Offer

 

Notification for LAC being placed in Dorset Process

Dorset  Clinical Commissioning Group has dedicated Children in Care Health Teams collocated with the  Local Authorities who are able to support the health needs of children and young people placed within Poole, Bournemouth or Dorset by other local authorities

The CiCHT teams are able to complete Review Health Assessments under a Service Level Agreement, using the national tariff recommended in ‘Payment By Results’ Document.

These can be requested by sending the appropriate paperwork by secure email to the email addresses below or by post (recorded delivery). CiCHT will return the SLA for agreement. The team can also provide some follow up health support, again subject to arranging via an additional SLA.

Bournemouth: LACnurseshealthteam@bournemouth.gov.uk   Tel: 01202 458745             

Poole: cichealthteam@poole.gcsx.gov.uk            Tel: 01202 735946

Dorset: Sam.best@dhuft.nhs.uk   Tel:    01305-228200

Quality Improvement

Link to QA Poster

Links to Safeguarding

For staff, further information on safeguarding is available on the intranet.

Commissioned Providers

Dorset CCG commission services for Looked after Children through Poole Hospital Foundation Trust and Dorset HealthCare.

Poole Hospital Foundation Trust (PHFT) delivers the medical services for Looked after Children. This consists of a Designated Doctor who works closely with the Designated Nurse in supporting the health agenda for LAC, and three Medical Advisors who together complete all Initial Health Assessments (IHAs) Pan Dorset. They also complete Adoption medicals for children and review and give advice on adult medicals for Adopters and Foster Carers; advising Panels monthly for Bournemouth, Poole and Dorset.

Dorset Healthcare (DHC) delivers direct nursing services to all children in care residing in Poole, Bournemouth and Dorset. They do this by supporting the IHA process and completing the statutory Review Health Assessments. They deliver preventative and direct implementations to address identified health needs for this population, provide training to local authorities, health professionals, and foster carers and parents on the health needs of LAC. The health teams are co-location of within Children Social Care. They work closely alongside joint funded dedicated child and adolescents mental health service (CAMHS) for Looked after Children, their carer’s and professionals

   

 Who is a Looked After Children

 The term “Looked after Child” (LAC) refers to a child who is being looked after by the state (local authority). The term has a specific legal meaning based on the Children Act 1989. They may also be known as a child in care.

Children who are “looked after” may be living:

  • with foster parents
  • at home with their parents under the supervision of social services
  • in residential children's homes
  • other residential settings like schools or secure units.
  • be place away from home on a planned basis for short breaks or respite care

Looked after Children are children and young people (0 to 18 years rising to 24 years where there is an Education and Health Care plan in place). They may have been placed in care voluntarily by parents struggling to cope, or, by children's services who may have intervened because a child was at significant risk of harm, neglect or exploitation.

A “Looked after Child” may have been accommodated under a Care Order (Sec. 31 of Children Act), or Voluntarily Order (Sec. 20 of Children Act).

The number of looked after children nationally has continued to rise; it has increased steadily over the last eight years. There were 70,440 looked after children at 31 March 2016, an increase of 1% compared to 31 March 2015. The rise reflects a rise of 1,470 in unaccompanied asylum seeking children, compared to a rise of 970 in all looked after children

The Health and Social Care Act 2012 places a legal duty on CCGs to work with local authorities to promote the integration of health and social care services.

The Mandate to NHS England, Statutory Guidance on Joint Strategic Needs Assessments and Joint Health and Wellbeing Strategies and The NHS Constitution for England, make clear the responsibilities of CCGs and NHS England to looked-after children (and, by extension, to care leavers).

In fulfilling those responsibilities the NHS contributes to meeting the health needs of looked-after children in three ways:

  • commissioning effective services,
  • delivering through provider organisations,
  • and through individual practitioners providing coordinated care for each child.

 

 Unaccompanied Asylum Seekers

As of the 1st July 2016 all local authorities will be asked to accommodate those children and young people under the age of 18 who have been allowed entry to the UK seeking asylum but who are not accompanied by a parent or carer.

These children will automatically become “Looked after Children” and will require their health needs assessed and a health package put in place for them.

All children and young people will be seen for an Initial Health Assessment (IHA) within 20 days by the LAC Medical Advisors. At this appointment the Medical Advisor will make onward referrals for all UASC for both physical and emotional health needs identified.

 

Care Quality Commission Inspection

The Care Quality Commission have published an inspection report of their findings from their review (November 2015) of how health services in Dorset keep children safe and contribute to promoting the health and wellbeing of looked after children and care leavers. We have also published an action plan  in light of the findings.

 

Relevant guidance

  1. Promoting the health and well-being of looked after Children DfE, DH 2015
  2. The Children Act 1989 Report DfE. 
  3. Statutory Guidance on Joint Strategic Needs Assessments and Joint Health and Wellbeing Strategies 2012 DfE
  4. Children Act 2004 section 10 - Legislation.gov.uk
  5. Statistics at DfE - Department for Education - GOV.UK
  6. H House of Commons-Inquiry for England April 2016
  7. Public Health England's Health Profiles 2014 
  8. Police CSE report reveals 17 children's homes, 14 hotels, special school and even supermarket target of predators 
  9. Rotherham CSE Inquiry 
  10. Intercollegiate Role framework, Looked after children: Knowledge, skills and competences of health care staff. March 2015
  11. The Handbook for the inspections of local areas’ effectiveness in identifying and meeting the needs of children and young people who have special educational needs and/or disabilities April 2016.
  12. SEND BILL DH September 2015
  13. Child sexual exploitation and children missing from home, care or education January 2016.
  14.  New Court of Appeal Guidance in Adoption cases 2013: 

Child's Voice

My Views Young People in Care