Agenda item

To receive an update on Safeguarding and Looked After Children.

The meeting was presented with an update from Amelia Brummet on the latest information regarding Safeguarding Children and Looked After Children.

An action taken from the last specialist advisory group was to explore the quality assurance process of the health advice provided to inform EHCP’s for Children in Care. There was not a specific quality assurance process specifically for Children in Care, however, there would be a QA process for all children with an EHCP.

The health information as part of EHCP’s would be quality assured by the Designated Clinical Officers (DCO) and their administrators. This team co-ordinated the requests for EHCP health information and would send them out to teams for completion with strict return dates.

If the information would not meet the standards expected, it would be returned with guidance notes for completion. Returns for poor quality were low

The DCO in BWD also provided feedback via the SEND improvement meetings and repors back quality themes, areas of good practice and areas for further development.

The 0-19 teams would be in the process of delivering a number of ‘what a good EHCP looks like’ training to all health practitioners within BwD 0-19 that complete health advice. This was generally offered every couple of years and has been shown to ensure exceptions regarding poor quality are minimal.

Amelia informed the group that access to dental healthcare had been identified as a national challenge and this had been reflected locally via the Local Authority Chat Data.

The priority care pathway was for priority patients including Children in Care, alongside other priority patient groups e.g. care for cancer patients and cardiac care. Clarity was being sought as to whether the priority care criteria would include care leavers.

NHSE explored the logistics regarding the single point of access including the means in which this would be facilitated, by phone referral/by email etc.

The expectation would be that the dental practice provide care through this pathway following referral will retain registration of the child following initial treatment.

If a child/ young person was to move placement out of area, a re-referral would need to be completed. The pathway launched in January 2023, NHSE identified dental practices willing to participate throughout Lancashire and South Cumbria.

Communications, included method of referral would be provided to share with Social Care, Foster Carers, PA’s and wider health providers.

Amelia highlighted as part of the BwD Health Subgroup an action was identified around the Pre-Adoption processes and the completion of an overarching multiagency pathway for pre-adoption medicals that ensured timely and quality assured assessments to inform the child permanence plans.  Adoption is complex and agencies often worked individually and were not aware of the intricacies each individual agency undertakes. Therefore, meetings had been held with relevant agencies to undertake this pathway. The pathway enabled clear time frames for each agency. Escalation and quality assurance are also key to the pathway.

Updates had been made to the pathway and V4 had been shared with the chairs of the BwD health subgroup. The pathway would be discussed at the next meeting and following that for members of the subgroup to comment and feedback. The draft pathway had been shared with the children’s commissioners for their information and to share with the community paediatric network.

The Group heard that during Quarter 2, there were 22 IHA requests and 18(82%) were completed within timescales. In Quarter 1, there were slightly fewer requests, 18, of which, 10 (56%) were completed in time. The number of requests for IHAs this quarter had increased; however, the compliance rate had similarly increased. This may have be due to availability of the ELHT Paediatricians to complete IHAs, children being brought to appointments and the relevant documents being received more timely from BwD CSC which would lead to more IHAs being completed within the statutory in timescale.       

In ELHT there was devised Quality Assurance tool that needed to be completed by the CNP Administrator, the Children in Care Nurse and the Doctor completing the IHA.

ELHT completed 3 monthly Quality Audits and 6 monthly deep dive quarterly audits in conjunction with the ICB, Quality of the IHA’s is consistently very good.

In Quarter 2, there were 49 RHAs requested and 42(86%) completed within timescales. Similar numbers were requested in Quarter 1, there were 45 RHAs requested and 42 (93%) completed within timescales.

Finally the Group were informed the Enhanced CIC Nurses quality assured 100% of all RHAs completed by Blackburn with Darwen (BwD) Children and Families Teams and LSCFT Special Needs School Nurses Team. If RHA’s did not meet the quality threshold as set out in statutory guidance, the RHA would be returned to the practitioner with guidance and support on areas to improve the quality or the health assessment.

RESOLVED – That the update be noted.