Agenda item

INFORMATION REPORT - Harrow Children Looked After Health (CLA) Annual Report

Report of the Central and North West London NHS Foundation Trust (CNWL)


The Panel received a report of the Head of Children’s Services and Operations, CNWL NHS Foundation, which set out the delivery of health services to Harrow’s Children Looked After (CLA) during 2016/17 in line with national guidance.  The report reviewed performance indicators, clinical work undertaken by the CLA health team, service improvements, including gaps or challenges identified.


Emma Hedley, Named Nurse – CLA Harrow/CNWL, introduced the report and reported initially on the key aspects of the quarterly position, as follows:


·                     bi-monthly monitoring meetings between the CCG and the Council  continued, including the monitoring of tuberculosis (TB) and blood screening referrals. Whilst the data obtained was good, officers would continue to  look at methods of improving data collection and monitoring;


·                     training had been delivered to ten social workers and students and weaning sessions with foster carers would continue.  In response to a question from a Member, Emma Hedley clarified that information and training on weaning, including attachments, would be provided to carers and that the official advice from the Department of Health stated that babies should start to be weaned from milk alone onto solid foods at six months;


·                     she was proud to have attended the CLA awards ceremony at The Hive Football Stadium, a wonderful event which celebrated the achievements of CLA and their carers;


·                     the creative and advocacy work being undertaken in relation to health assessments, as set out in the examples in the report, indicated that multi-agency approach was paying dividends.


Emma Hedley also reported on the Annual Report on Children Looked After Health Service (Harrow) 2016/17, as follows:


·                     partnership working had strengthened and partners were developing procedures and processes in order to maintain high standards of care.  Emma explained that due to CNWL administrative issue 93% of Review Health Assessments (RHAs) were achieved in June compared to 100% every month  despite the high increase in the number of CLA.  Comparatively, 93% of RHAs was higher than the England average but slightly lower than statistical neighbours;


·                     the data collected on the RHAs was good and that every assessment was quality assured.  A dip sample had shown that all CNWL assessments were graded either excellent or good;


·                     immunisation data required attention but the direction of travel was positive. It would take a few years to improve the take up. The number of dental checks had increased by 4.6% to 93% and, in the last year, 100% of children under five had had up to date developmental assessments;


·                     in relation to emotional health, improvements had been made in the levels of CLA who had completed Strengths and Difficulties Questionnaire (SDQ) due to a concerted effort from the social workers and CLA health team.


·                     medical summaries for all CLA was requested from GP’s practicing in and out of the borough. Members welcomed this approach;


·                     tuberculosis (TB) screening process was working well but it was important to recognise that the NHS had introduced new processes.  The CLA health team worked closely with the TB service at Northwick Park Hospital and had implemented a process for all UASCs to be referred for new entrant TB screening.  Recently, this had been replaced with a directive from the NHSE, where for those over 16 who were eligible for IGRA screening, were referred to their GP.  In response to this change the CLA health team were undertaking a project to ascertain the impact on UASC. Since the publication of the annual report, the original TB screening process that the CLA health team had introduced had been re-instated;


  • the development of health passports, including a health questionnaire from non-attendees, had had a positive start.  This initiative had allowed officers to obtain views about the service from CLA and Care Leavers to obtain their views about the service.  It was intended to move from health passports for 16-17 year olds to each child at the point when they entered the care system.  The CLA health team had undertaken a survey focusing on the health needs of CLA and had also completed its first client satisfaction audit;


  • an audit of the health needs of Harrow’s CLA had shown the following order of ranking:  (1) immunisation, which included TB screening (2) dental health (3) substance use (4) emotional needs.  Transparent partnership working and co?location had helped to reap benefits in these areas and health was now rated ‘good’ by Ofsted instead of ‘inadequate’.  In response to a question from a Member, Emma outlined the practical steps and strategies - access to mosaic, compiling lists of all CLA, communicating effectively with social workers, carers, IROs and GPs – that were applied to improve the immunisation process.  She added that some 16-17 year old CLA were refusing immunisation and parents were refusing their children MMR vaccine.  Moreover, additional vaccines were being recommended which had resulted in a number of anomalies.  Due to the mobile nature of CLA, GPs were now requested to look at the history of CLA rather than make assumptions.


Members were pleased with the outcomes and it was acknowledged by all that the service had come a long way. Members were pleased with the transformation achieved and applauded the partners for their efforts in weaving together the various services to achieve positive outcomes for CLA. They noted that the feedback received was shared with CLA, particularly those that chose to exclude themselves from making use of the health services available with a view to encouraging their participation. Members noted that a further report on sharing of information and the methods adopted would be presented to a future meeting.




(1)           the Annual Report of Children Looked After Health Services (Harrow) 2016/17, including the interim health report of CLA for October and November 2017, be noted;


(2)           it be noted that a report on the sharing of information and methods adopted would be presented to a future meeting.

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