Health Needs of LAC
Looked after children often have poorer health outcomes than their peers due to pre-care experiences, trauma, and disrupted access to healthcare. The statutory health assessment framework aims to identify and address health needs proactively.
Statutory Health Assessments
Initial Health Assessment (IHA)
- Must be completed within 20 working days of becoming looked after
- Carried out by registered medical practitioner
- Comprehensive assessment of physical and mental health
- Results in health plan
Review Health Assessments (RHA)
- Every 6 months for children under 5
- Every 12 months for children 5 and over
- Can be done by registered nurse
- Reviews progress and updates health plan
Key responsibility: Social workers are responsible for ensuring health assessments happen on time and that recommendations are followed up.
Your Role in Health Assessments
Before the Assessment
- Request the assessment from LAC health team
- Provide consent (if LA has parental responsibility)
- Gather relevant health history
- Complete referral with known information
- Arrange for child to attend
Information to Provide
- Reasons for coming into care
- Known health history
- Current placement details
- Any current health concerns
- Family health history if known
Track Health Requirements
SpeakCase helps you monitor health assessment timescales and follow-up actions.
Try Free for 7 DaysThe Strengths and Difficulties Questionnaire (SDQ)
What It Is
A standardised screening tool for emotional and behavioural difficulties:
- Required for all LAC aged 4-16
- Completed by carer
- Provides score indicating level of difficulty
- Used to identify need for mental health support
Frequency
- On entry to care
- Annually thereafter
- After significant events
Using SDQ Results
- High scores indicate potential CAMHS referral
- Track changes over time
- Inform care planning
- Identify need for therapeutic support
Key Health Areas
Immunisations
- Check if immunisations are up to date
- Arrange catch-up if needed
- Consent arrangements
- Record in health plan
Dental Health
- Register with dentist
- Regular check-ups
- Treatment for any problems
- Often neglected before care
Vision and Hearing
- Eye tests
- Hearing checks
- Glasses or aids if needed
- Impact on education if unaddressed
Mental Health
- Trauma-informed understanding
- CAMHS referrals when needed
- Therapeutic support
- SDQ monitoring
The Health Plan
Contents
- Summary of health needs
- Actions and who is responsible
- Timescales
- GP and dentist details
- Medication and treatment
Review and Update
- Part of LAC review discussion
- Updated at each health assessment
- Shared with carers and relevant professionals
Consent Issues
Who Can Consent
- Under care order - LA can consent
- Section 20 - parents must consent
- Gillick competent young people - can consent themselves
- Document consent clearly
Delegated Authority
Carers may have delegated authority for:
- Routine medical treatment
- School medicals
- Dental treatment
- Minor first aid
Common Challenges
Missed Assessments
- Monitor timescales
- Chase LAC health team
- Escalate if needed
- Record reasons for delay
Children Who Refuse
- Explore reasons
- Provide information about purpose
- Consider alternative approaches
- Document refusal and follow-up
Conclusion
Good health is fundamental to children's wellbeing and development. Ensure health assessments happen on time, follow up recommendations, and advocate for the health services LAC need. Many health needs can be addressed—but only if identified and acted upon.