Agenda item

The Board will consider the Kirklees Looked After Children Annual Health Report for April 2021 – March 2022.

Contact:

Gill Addy, Designated Nurse - Looked After Children and Care Leavers

The Board considered the Kirklees Looked After Annual Health Report (March 2021- April 2022) presented by Gill Addy, Designated Nurse for Looked After Children. It was highlighted that:

·         During 2021-22 alternative hybrid methods of working were necessary to comply with Covid-19 restrictions in Initial Health Assessment clinics.

·         There was a rise in demand for support related to increased child health complexities, unaccompanied asylum-seeking children (UASC), and involvement with children accommodated in Kirklees by other local authorities.

·         There had also been an increased amount of telephone and IT communication.

·         The increased number of agencies using the electronic child health record System-One amplified the number of communications via tasks, and the volume of information available to inform assessments.

·         The wealth of material was an asset but added significantly to the time taken in the preparation of assessments.

·         A Business Case related to the team capacity and resource has been submitted to the joint commissioner for consideration and discussions had been held with senior managers. This was still ongoing.

·         Completion of the Review Health Assessments (RHA’s) within statutory timescales continued to present a challenge.

·         To alleviate pressure, a temporary 6-month measure was introduced to complete the RHA’s in the month they were due, but Statutory guidelines were reintroduced in March 2022.

·         An audit looking at reasons for breach in Quarter 1 of 2022, illustrated that children and their families were at the heart of the planning, prioritising family, work, school, and outside activity commitments before timescales.

·         Dental access had improved from the time of the pandemic and was supported by the ‘Flexible Commissioning’ programme.

·         Immunisation rates averaged 91.5% across all ages. Teenage boosters remained the most common outstanding immunisations.

·         The manual return rates of ‘Strength and Difficulty Questionnaires’ (SDQ’s) had remained low.

·         It was noted that this was a time consuming but statutory task and the electronic portal was unable to facilitate any system improvement.

·         The redevelopment of the Local Authority Placement Support Service (PSS) provided a multi-agency approach alongside the SDQ’s.

·         The inclusion of a trauma screening assessment for UASC by a Locala GP, added a valuable dimension to the support options.

·         The Ages and Stages Social and Emotional (ASQ–SE) questionnaire, continued to provide a resource to measure the emotional health of children and babies under 4 years old.

·         Liaison with the sexual health, and substance misuse outreach workers continued, reinforcing the collaborative working model. Drop-in’s had also resumed recently.

·         Medical reports continue to be completed by the Medical Advisors, and all adoption panels in Kirklees and Calderdale had a Medical Advisor present for advice and support.

·         The ‘Health Outcome Audit’ project enabled data collection to continue.

·         This measured the health needs of children as they entered care and a comparison of improvements to their health for those who remained in care, at the point of their first Review Health Assessment (RHA). A re-audit was planned during 2022-23.

·         A recent review identified that it was not possible to resume pre-pandemic levels of performance.

·         The service had required modification to meet the needs of a changed society and vulnerable group of children.

·         Further adjustments may be needed, as challenges in relation to changes to practice and demands on the service continued.

·         During the reporting period 741 RHA’s were completed including requests from other authorities.

·         236 adult medical reports for foster and special guardianship orders, 77 adult and 69 child medical reports for adoption plans and 26 meetings with prospective adopters, were carried out by the Medical Advisor

The Board welcomed the report as very comprehensive. Responding to a question from the Board in relation to the assessments of UASC and follow up work, Gill Addy advised that there was a shortage of this specialist work. Referrals were currently submitted through the placement support service and picked up by wellbeing team to identify where support may be available.  The Board noted value in identifying where there may be capacity to support young people’s needs. Gill Addy further added care leavers were now included in the screening assessment mad by the GP, and the Board welcomed that this work was being undertaken at an early stage.

RESOLVED: The Board noted the Kirklees Looked After Annual Health Report