1. Nancy Sayer, Designated Consultant Nurse for Looked After Children (LAC), introduced the report and responded to comments and questions from the Panel, including the following:-
a) asked how young people felt about having health assessments, Mr Graves and Ms Sayer explained that the LAC nurses had attended a meeting of the OCYPC to talk about the health assessment and review process for children and young people in care. This conversation had been very helpful and from this had been gained valuable feedback which was being addressed. Health reviews were less medical than the initial health assessment which was undertaken when a young person first came into care. The take up of appointments was generally good;
b) although a child in care might move between several placements and may not be able to go to the same GP, LAC nurses sought to ensure that they could continue to see the same nurse each time, as far as possible, and have the opportunity to build up a trusting relationship. This would be difficult, however, if a child moved a long way across the county. The Clinical Commissioning Groups had recently provided further funding for the LAC nursing team which had provided for an additional three full-time nurses to be employed, thereby increasing the capacity of the service and enabling further support and 1:1 work to be built into the service to support improved outcomes;
c) asked about the take-up of vaccinations among children in care, Ms Sayer advised that the County Council’s public health team was looking at this as the take-up rate had dropped recently. Many UASC arrived in the county without any information about their vaccination history so had to start from scratch and could take a long time to catch up with all the vaccinations they should have had for their age. The way in which performance monitoring for vaccinations was recorded for the 903 return made it difficult to show the differences in population need. This issue had been raised at the national LAC Clinical Reference Group and with NHS England, who were asking for the question in the 903 return to be amended to reflect the differences in the population need and status of vaccination history, but the support of the County Council was also being sought;
d) asked what issues around the health assessment had been raised by young people, Mr Graves and Ms Dunstan said that being called out of class to attend a health review appointment marked a child out as being in care (although this did not happen so much now) and that if a child did not know the LAC nurse, talking to them about personal issues could be uncomfortable. These issues made health appointments more difficult than they needed to be; and
e) asked how the LAC nursing service dealt with the issue of consent, Ms Sayer explained that a LAC nurse would always explain the purpose of the appointment at the start and ask if the young person was happy to participate. Ms Carpenter added that young people tended to have a more positive view of the process once they understood the reasons for it.
2. It was RESOLVED that the information set out in the report be noted, with thanks, and that lobbying to change the standard monitoring questions to make them more appropriate be supported.