Dorset CCG commission services for Children in Care through Poole Hospital Foundation Trust and Dorset HealthCare.

Poole Hospital Foundation Trust (PHFT) delivers the medical services for Children in Care. This consists of a Designated Doctor who works closely with the Designated Nurse in supporting the health agenda for Children in Care, and 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 Carer’s and act as medical advisor for Aspire Adoption, Adoption Panel.

Dorset Healthcare (DHC) delivers direct nursing services to all children in care and care leavers 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 our Children in Care & CL population, provide training to local authorities, health professionals, and foster carer’s and parents on the health needs of Children in Care. The health teams are co-located within Children Social Care. They work closely alongside joint funded dedicated child and adolescent’s mental health service (CAMHS) for Children in Care, their carer’s and professionals.

The term “Children in Care” 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
• Living with supported lodging carer’s if post 16yrs
• Semi-independent living post 16yrs
• Independent living post 16yrs

Children in Care are children and young people (0 to 18 years rising to 24 years for care leavers or 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” legal status is defined by the Children’s Act 1989 which means they may be accommodated under a Voluntarily Order (Sec. 20 of Children Act) or a Care Order (Sec. 31 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 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.

As of the 1^st 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 “Children in Care” 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 Children in Care Medical Advisors. At this appointment the Medical Advisor will make onward referrals for all UASC for both physical and emotional health needs identified.

1. Promoting the health and well-being of children in care 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. 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: 

Children In Care and Care Leavers Annual Report 2020-21

DCCG Executive Strategic Summary 2017-18

Specialist nursing annual report 2017-18

CCG annual report 2018-19

Poole Hospital Foundation Trust annual report 2018-19

Dorset HealthCare Foundation Trust annual Report 2018 – 19

Specialist nursing annual report 2017-18

Poster Quality Improvement EH & WB LAC Care leavers

Poster Quality Improvement Young Peoples Voices

Poster Quality Improvement Notification

Young People in Care and Care Leavers Consultation Events 2016