Guide to improve healthcare for looked-after children issued by


Specialist doctors and nurses should be given increased time to assess and support looked-after children, according to new guidance for healthcare providers. Latest guidance recommends doctors see no more than four looked-after children per clinical session.

Published by the Royal College of Paediatrics and Child Health, Royal College of Nursing and Royal College of GPs, the guidance recommends that named doctors for looked-after children are allocated at least four hours per week to handle a caseload of 400 children in care.

It adds that named doctors should see no more than four children per clinic to ensure a comprehensive assessment. In addition, each specialist nurse should have a caseload of 100 looked-after children.

Looked after children: Knowledge, skills and competences of healthcare staff supersedes guidance from 2012 and aims to ensure all children in care receive the best support for their health and wellbeing needs.

The guide has been produced in response to NSPCC statistics showing that looked-after children are more likely to have higher incidence of long-term conditions such as speech and language delays, asthma, bedwetting, and unrecognised visual and hearing impairment. They also have higher incidences of drug and alcohol abuse, and teenage pregnancies, with up to 72 per cent also suffering emotional health and mental health problems.

Dr Renu Jainer, lead for looked-after children on the child protection standing committee of the RCPCH, said: “Many of the children who come into care are suffering from poor health, as the majority come via the safeguarding route and have experience of neglect, trauma, family dysfunction and poor parenting, so it’s crucial that when they 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.”



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