Agenda item

Update on Ofsted Recommendation – Timeliness of Initial Health Assessments


The Strategic Lead for Looked After Children addressed Members notifying them the report set out the actions taken by Children’s Social Care and Health colleagues to address the timeliness of Initial Health Assessments for Children who are Looked After.


She continued by explaining when a child or young person came into care, they would have an Initial Health Assessment (IHA). This was a statutory health assessment; the assessment is to be completed within 28 days of coming into care. A paediatrician or an appropriately trained medical practitioner completes the assessment.


It was further explained the Initial Health Assessment identified existing health problems and deficits in previous healthcare and provides a baseline for managing the child’s future health needs. The Strategic Lead for Looked After Children highlighted point 3.12 of the report and stated in April 2019 only 25% if IHAs were completed on time, but this had increased to 71% in December 2019, and increased again to 81.5% in January 2020. She stated that although there were still some difficulties, processes were now in place and regular meetings were being held between the social care team and healthcare colleagues.

The Chair stated that as there were challenges within the healthcare sector, she would raise it as an issue at the next Health and Wellbeing Overview and Scrutiny Committee. She asked why a child was only assessed once a year, once they reached the age of five. The Strategic Lead for Looked After Children replied that the IHA set a benchmark for the child’s health, but that if additional health needs were identified then additional sessions with a paediatrician would be arranged. She added that if a child was seen yearly it would ensure that no illnesses or problems developed, but a foster carer could take the child to the GP or A&E if problems arose in between IHA visits.

Councillor Liddiard asked who conducted the IHA, as GP’s were often fully booked, which it would make it difficult to schedule IHAs. The Strategic Lead for Looked After Children replied that the IHA was conducted by an approved paediatrician, but there were currently issues regarding a deficit in healthcare, which were outlined at 2.1 of the report. The Chair of the Foster Carer’s Association added that only two or three paediatricians were approved to carry out IHAs, which meant it was difficult to schedule appointments as they were often very busy. She stated that she had often had difficulties scheduling IHA appointments, as the doctor could only offer one or two slots, some of which were during school time. The Corporate Director of Children’s Services thanked the Foster Carer’s Association for the input, as it highlighted issues that may have otherwise not been addressed. She stated that she had invited health colleagues to the meeting, but they had been unable to attend as Thurrock commissioned NELFT to provide community paediatricians for IHAs. She felt that a child should not be taken out of school for an IHA, particularly as many children in care already had poorer attendance when compared to children not in care. She stated that although the IHA service had improved, there was still work to do and issues that needed to be resolved.

Councillor Akinbohun asked if the service was under pressure due to the number of Unaccompanied Asylum Seekers, and the Strategic Lead for Looked After Children replied that although the number of Unaccompanied Asylum Seekers had increased in the last quarter, they had not put the service under pressure. She stated that the system had been under pressure recently due to an increase in the number of referrals and large sibling groups being identified throughout February. The Head Teacher for Virtual School added that there was only a 10 day timeframe in place for Education Plans, which meant that the education system for Looked After Children was also under pressure, due to the large number of referrals. Councillor Akinbohun stated that she felt worried that the service would not be of good quality if new Unaccompanied Asylum Seekers arrived within Thurrock. The Strategic Lead for Looked After Children replied that the system pressure did non predominantly come from Unaccomapnied Asylum Seekers, but came from the lack of capacity within the system.


The Chair asked if an update report on IHAs could come before the next Corporate Parenting Committee.





  1. That Corporate Parenting Members were informed about Health and Children’s Services efforts to improve the timeliness of Initial Assessments for Children Looked After.
  2. That an update report be provided at the next meeting of the Corporate Parenting Committee


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