1. Working in Partnership to improve outcomes of Children looked after. Laurie Ward Specialist Nurse Children Looked after and Care leavers

2. CLA & Care Leaver Health Service Works in partnership with HCC children’s services to improve health outcomes for Children Looked After Signpost and support young people, carers, health & children's services staff.

3. Issues that may impact on health Children often enter care, with a worse level of health, than their peers Teenage conceptions & early parenthood Alcohol & drug misuse and other self harming risk taking activities School exclusion Being in young offender institutions & prison Being within the mental health system Being homeless Sexual exploitation

4. Statutory Health Assessments Process in place to co-ordinate administration of health assessments on behalf of HCC When a child comes into Care – Initial Health Assessment (IHA) undertaken by a Doctor. Review Health Assessments (RHA) undertaken by a nurse every 6 months under 5 years and annually up to the age of 18 years.

5. What is a Health assessment A time for the young person to have a confidential discussion with a health professional A safe environment for a young person to raise their concerns An opportunity to establish the young persons Emotional, Physical and Sexual health needs A summary and action plan developed

6. Why a school nurse? Local school nurse seeing child locally Aware of local resources Relationship with key school staff i.e. Designated teacher Continuum of care

7. Partnership support Training Support and advice CLA nurse undertake school age RHA if required The link between health and social care

8. Which of the topics discussed did you find useful?

9. Jess is a 14yr old girl who entered care at 11yrs old. Category: Full Care Order for Neglect. Parental misuse of drugs / Alcohol Initial Health Assessment by GP Review Health Assessment (1) completed by School Nurse in School. Co- Ordination difficulty & Vision problems identified School Nurse liaised with School: concerns raised by School Matron CLA Nurse Contacted by Social Worker – concerns from carer re. concentration / child talking to herself Liaison with Paediatrician Referral to Orthoptist – Glasses prescribed. Referral to School Nurse by Teachers for support around bullying. Liaison with Carer Liaison from Hospital Paediatric Liaison Nurse Re. A/E admission for fracture Review Health Assessment (2) seen in school by School Nurse Support /Contact around bullying Actions Liaise with School Nurse & Carer Home visit by CLA Nurse. (Young Persons choice of venue & time) Actions Liaison with School Nurse Referral to CAMHS by School Nurse - Social Worker aware Regular monitoring in School by School Nurse School Nurse