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New advice issued on protecting looked after children

Joint guidance to protect UK’s most vulnerable children

Adrian O'Dowd

Monday, 30 March 2015

GPs along with other health professionals are being encouraged to read new guidance designed to ensure proper care and protection for looked after children.

Updated intercollegiate guidance* has been published by the Royal College of Paediatrics and Child Health, Royal College of Nursing and RCGP.

Looked after children are children who have become the responsibility of the local authority and this can happen voluntarily by parents struggling to cope or through an intervention by children's services because a child is at risk of significant harm.

In March 2013 – the most recent figures available – there were 92,728 looked after children in the UK. Many of these children have complex health and wellbeing needs.

The new guidance is an update from the 2012 edition and is designed help all staff in health care settings develop an understanding of their responsibilities towards looked after children and achieve the required improvement in outcomes

It provides a framework for all groups of professionals – from healthcare professionals to non-clinical staff who could be involved with looked after children – to ensure this vulnerable group of children are supported.

Statistics given in the guidance reveal that looked after children have:

  • a higher incidence of long term conditions – speech and language delay, bedwetting, asthma, allergies, coordination difficulties and unrecognised visual and hearing impairment
  • up to 72% have mental health and emotional health problems
  • a higher incidence of drug and alcohol abuse and teenage pregnancy
  • much more likely to experience poor health, educational and social outcomes in adulthood.

The updated guidance now includes additional information on:

  • defined model job descriptions for named and designated doctors and nurses, medical  advisors and specialist nurses so that they understand their responsibilities towards looked after children
  • advice that named doctors for looked after children should be allocated at least 4 hours per week for every 400 looked after children in their care
  • advice that there should be a minimum of one full time specialist nurse per 100 looked after children
  • advice that named doctors should see no more than 4 children per clinic to ensure a comprehensive assessment.

Dr Vimal Tiwari, child safeguarding lead for the RCGP, said: “Looked after children are some of our most vulnerable patients and they frequently need care and support for complex physical and mental health needs.

“Caring for children is a major part of a GP's work and it is essential that we work together with other healthcare professionals, such as nurses and paediatricians, to ensure they receive the best possible care throughout their childhood, whatever their situation.”

Dr Renu Jainer, lead for looked after children on the child protection standing committee of the Royal College of Paediatrics and Child Health, said: “It's crucial that when they [looked after children] enter the care system, the professionals that they see – whether that's in health, education, social work or any other field – are well trained to deal with their often complex needs.”


* Looked after children: Knowledge, skills and competences of health care staff. Intercollegiate Role Framework, March 2015.

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