1. © British Association for Adoption and Fostering 2015 Should you wish to reproduce or adapt or exhibit in public this material, please get in touch with the Communications Department, BAAF, Saffron House,6-10 Kirby Street, London EC1N 8TS. Email mail@baaf.org.uk Charity registration 275689 A presentation from Caroline Selkirk, Chief Executive Health services for LAC and adoption Launch of revised health guidance 26 March 2015

2. High levels of health inequalities Experiences of poverty, poor housing, parental ill health especially mental health, chaotic lifestyles, domestic violence, parental substance misuse Missing out on routine health care and school attendance Abuse and neglect Loss of family and friends Placement instability High incidence of mental, emotional and behavioural health difficulties and attachment difficulties

3. © British Association for Adoption and Fostering 2015 What should health services look like? Child centred Delivered by a team of health professionals with appropriate skill mix and competencies Good understanding of legal requirements, consent and confidentiality issues Statutory holistic health assessment with written summary and care plan Comprehensive child and family health history Advice and support to children and young people, professionals and carers at all stages

4. Progress since initial guidance 2002 Steady year on year improvement – currently: annual health check - 88% developmental assessment in under 5s - 87% immunisations up to date - 87% dental check - 84% LAC aged 16+ lowest rates of above measures Increased focus on mental health and emotional well-being - SDQ completed on LAC 4 - 16 years old © British Association for Adoption and Fostering 2015

5. Changing scene in the NHS Commissioning / workforce issues Poor understanding of LAC needs and specialist nature of services Lack of designated professionals – and expertise Huge pressures re PI eg 28 day timescales for IHA Multidisciplinary and specialist services more effective but services often fragmented Financial restraints  insufficiently resourced Intercollegiate competencies available - used?  Revised guidance - sufficient resources are allocated to meet the identified health needs of LAC © British Association for Adoption and Fostering 2015

6. Out of area placements Who pays? guidance  agree arrangements in advance Delay in health assessment while payments discussed – “overriding principle of patient care” contravened National tariff for HA health assessments – links with quality assurance Sharing of information Do OOA LAC receive different services than local LAC?  Revised guidance - commissioners - resource allocation to include OOA - receiving CCG is expected to cooperate re HA © British Association for Adoption and Fostering 2015

7. Care leavers Services should empower young people to take responsibility for own health and access services Should have a good understanding of health history and have a written summary Require support for transition to adult services Mental and emotional health is particularly important, yet access to CAMHS is difficult, as don’t meet service criteria  Revised guidance - transition planning at least 6 months in advance - identify and facilitate support including voluntary sector © British Association for Adoption and Fostering 2015