Health Care Assessments and Care Plans

Each young person should have a Health Care Assessment soon after being placed and then at specified intervals, as set out below.

The purpose of Health Care Assessments is to promote a young person’s physical and mental health and to inform the young person’s Health Care Plan (which may be a separate plan or may be incorporated in to the Care Plan) and ensure that the placement meets the young person’s holistic health needs.

Health Care Assessments must be conducted by a suitably qualified medical practitioner, who should provide the social worker with a written report:

• The first assessment must be conducted before the young person’s first placement, or if not reasonably practicable, before the young person’s first Looked After Review – unless one has been conducted in the previous 3 months;
• Health Care Assessments must be conducted more frequently where the young person’s health needs dictate.

The social worker is normally responsible for ensuring that Health Care Assessments are undertaken, but this responsibility may be undertaken by the Service.

Young people aged 16 or 17

Young people aged 16 or 17 with mental capacity are presumed to be capable of giving (or withholding) consent to their own medical assessment/treatment, provided the consent is given voluntarily and they are appropriately informed regarding the particular intervention. If the young person is capable of giving valid consent, then it is not legally necessary to obtain consent from a person with parental responsibility.

For further details see Mental Capacity Act.

Each young person’s Placement Plan must include the health care needs for the young person and how they will be promoted by the Service if appropriate.

The matters that should be considered in drawing up the Health Care Plan (and addressed in the Placement or Care Plan as necessary) are as follows:

1. Whether there are any specific health care needs and how the Service will support with this such as attending medical appointments etc.
2. The use of non-prescribed medicines, home remedies or use of first aid; 
3. The involvement of the young person’s parents if appropriate or significant others in health issues during the placement;
4. Any specific medical or other health interventions which may be required, including whether it is necessary for any invasive procedures and how they will be undertaken;
5. The extent to which the young person is able to retain or administer medication, or requires support to do so;
6. Whether it is necessary for any immunisations/vaccinations to be carried out;
7. Any specific treatment or therapeutic interventions, strategies or remedial programmes required;
8. Any necessary preventative measures to be adopted;
9. Whether there are any illegal or other activities including self-harming which it is known or suspected the young person is engaged in which may be harmful to the young person’s health, and the interventions/strategies to be adopted in reducing or preventing the behaviour;
10. Whether the placement will contribute to any other health related assessments.

See also: First Aid and Accidents Procedure.

One of the key responsibilities of the Keyworker will be for promoting the young person’s health and educational achievement, liaising with key professionals, including the Clinical Nurse Specialist, the child's GP and dental practitioner.

The Keyworker will also ensure that up to date information is kept on the young person in relation to their health needs, illnesses, operations, immunisations, allergies, medications administered, dates of appointments with GPs and specialists.

The Keyworker must also ensure the young person is registered with a GP and other health care professionals as set out in Health and Wellbeing, Health Notification and Access to Services Procedure.

Legislation, Statutory Guidance and Government Non-Statutory Guidance

DfE and DoH Statutory Guidance on Promoting the Health and Well-being of Looked After Children (2015)

Good Practice Guidance

Children's Attachment: Attachment in Children and Young People who are Adopted from Care, in Care or at High Risk of Going into Care NICE Guidelines [NG26]