Initial health assessment

Looked-after children are more likely than other children to have been physically abused, injured and neglected. As a result of their experiences, children in foster care are more likely than other children to have physical, emotional and mental health problems.

Promoting the health of children and young people in foster care is very important if they are to grow into mature, stable, well balanced adults. Children often have poor health when they first become looked after, and we have a duty to promote the health and development of children placed with foster carers.

What is an Initial Health Assessment?

Regulation 7 of the Care Planning, Placement and Case Review (England) Regulations, 2010 and Statutory guidance on promoting the health and wellbeing of looked after children 2015 requires us to arrange for a registered medical practitioner to carry out an initial assessment of the child’s state of health and provide a written report of the assessment.

These statutory Initial Health Assessments (IHAs) are holistic health assessments focussing on the child’s physical, emotional and mental health needs and are carried out for every child entering in to care and result in a written report and an individual Health Action Plan. This Health Action Plan forms part of the child’s overall care plan that should be available by the time of the first statutory review of the Care Plan by the Independent Review Officer, within 20 working days of becoming looked after.

Your role

You play a crucial role in the life of the looked after child that is placed with you and your contribution to the IHA is invaluable. As IHAs are carried out shortly after coming in to care, the examining paediatrician might not hold any previous health or social care information, so you are the only one who can provide an accurate picture of the child's current physical and emotional health, behaviour and development.

As the time frame for completing this statutory IHA is very tight, every effort is made by health services to offer the appointments within 5 working days of receiving the request. Someone from the NHS will call you to arrange the appointment. If for any reason you are unable to keep your planned appointment, you should speak to the child's social worker, who might be able to make alternative arrangements to bring the child to the appointment so that the IHA can be completed to meet the statutory time frame.

If you are unable to accompany the child  their IHA, the examining paediatrician may contact you to get information about your experience and observation of the child to inform the IHA report.

If you cannot make the appointment please remember to cancel it so that it can be offered to another child.

What happens at the Initial Health Assessment?

  • The paediatrician carrying out the IHA ensures appropriate consent has been obtained before proceeding.
  • The examining paediatrician sees the child with their carer and an interpreter (as appropriate) and both offered consultation on their own to have a confidential discussion regarding the health and wellbeing of the child.
  • Depending upon the age and level of understanding of the child, the examining paediatrician asks detailed questions about their general health, development, eating and sleeping habits, school, hobbies/interests and any worries or question they might have for their health and will also offer age appropriate health promotion advice.
  • The paediatrician carries out child Developmental Assessment (if appropriate) and general physical and systemic (medical) examination.
  • The paediatrician prepares a health action plan to address the current and future health needs, in agreement with the child, carer and social worker with the time line for the completion of the action and the person responsible for the completion of the action. All the necessary referrals are made that are covered by the consent for the IHA and the social worker is requested to seek consent for further investigations if required.

What happens after the Initial Health Assessment?

  • The paediatrician prepares a written report of the assessment carried out and Health Action Plan agreed.
  • The report is typed, checked and sent to GP, Looked After Children’s Nurse, School Nursing services and the social worker.
  • A copy of the summary and Health Action Plan is sent to the young person if they have requested one.
  • A copy of the Health Action Plan is sent to the foster carer who along with child's social worker ensures that all the recommended actions are completed within the agreed specified time frame.

Contact the NHS

For any further information or for IHA appointment queries:

  • East and South Kent teams - call East Kent Hospitals University NHS Foundation Trust on 01227 866372. 
  • West and North Kent teams - email Kent Community Health Foundation NHS Trust at kcht.vsklacinitial@nhs.net.