Health Services: Children and Young People

Local authorities are responsible for making sure a health assessment of physical, emotional and mental health needs is carried out for every child they look after, regardless of where that child lives. Integrated care boards (ICBs) commission a health provider to undertake initial health assessments (IHAs). The service specification for this service is aligned to the current Children Act 1989 regulations.

The regulations for health assessments are set out in the Care Planning, Placement and Case Review (England) Regulations 2010, the Children Act 1989 guidance and regulations colume 2: care planning, placement and case review and supported within the statutory guidance Promoting the health and wellbeing of looked-after children.

Regulation 7(3) of the Care Planning, Placement and Case Review (England) Regulations 2010 states that IHAs are required to be undertaken within twenty days of a child coming into the care of the local authority. The current regulations for the Children Act 1989 state that the IHA should be undertaken by a registered medical practitioner.

This is different to a review health assessment, which may be carried out by a registered medical practitioner, or by a registered nurse or registered midwife, under the supervision of a registered medical practitioner, as stated in regulation 7(3).

No assessment has been made on the potential merits of allowing additional appropriately skilled professionals using a competency-based framework to undertake IHAs.

If IHAs are not happening on time, ICBs are the first line of statutory safeguarding assurance, which includes identifying early warning signs and responding to risks at local levels. NHS England, through ICBs, also undertake annual checks on how safeguarding, and other statutory commitments, are working in practice and across the system. NHS England is working with ICBs to improve the timeliness of IHAs and review health assessments.