Agenda item

This report presents data on Initial Health Assessments for Medway’s Children in Care covering the 12?month period from April 2025 to March 2026.

Estimated time: 25 minutes

Discussion:

The report presented data on Initial Health Assessments for Medway’s Children in Care covering the 12 month period from April 2025 to March 2026.

The Committee considered the report presented by the Associate Director and Designated Consultant Nurse for LAC and UASC NHS Kent and Medway, noting that this would be her final attendance at the Committee. The Chairperson expressed appreciation for her contribution, inviting questions from Members. Members paid tribute to her work, highlighting her professionalism, openness and commitment, particularly in addressing challenges relating to initial health assessments, including those for children placed out of area. It was noted that her approach had demonstrated accountability and care, and Members expressed the hope that her successor would maintain similar standards.

Delays - In response to questions regarding delays in initial health assessment requests, the complexities at the start of a child’s care journey, including the sensitive and legal processes required, were explained. Findings from a recent deep dive analysis were highlighted, which identified Section 20 voluntary arrangements as a significant factor, particularly due to delays in obtaining parental consent. Additional factors included situations where children, particularly babies, remained in hospital at the point when an assessment would usually take place. It was noted that an action plan was being developed to address these issues.

The Committee was reassured that processes were in place to monitor performance, including regular meetings between social care and health colleagues. Early indications since the deep dive suggested improvements, although challenges around consent remained an issue.

Data sharing - The Committee discussed the need for improved data sharing and consistency across Integrated Care Boards (ICBs), particularly in relation to children placed out of area. It was clarified that current work was focused on developing a tool to better understand the health profile of children in care to better inform commissioning decisions and allocation of resources.

Quality - It was explained that, unlike local provision, the ICB could not directly ensure the training and standards of clinicians in other areas. As a result, some reports were returned for further work where they did not meet required standards, which contributed to delays. However, maintaining quality was essential to ensure that assessments were meaningful in informing children’s health outcomes.

It was suggested that where reports had to be sent back, other local authorities should be advised as they may not be aware. The Committee were advised that escalation processes were in place but officers would investigate mechanisms for strengthening feedback and escalation.

Succession - In response to questions, the Director of Safe Guarding, Kent & Medway NHS outlined the ICB’s commitment to children in care, and recruitment of specialist staff. The Committee stressed the importance of maintaining strong leadership and safeguarding organisational knowledge and expressed concern about wider workforce pressures and the loss of experienced staff within the ICB. In response to a question it was confirmed that exit interviews were undertaken and that feedback informed organisational improvement plans.

On behalf of the Committee, the Chairperson again thanked Nancy Sayer (Associate Director and Designated Consultant Nurse for LAC and UASC NHS Kent and Medway), for her significant contribution and wished her well for the future.

Decision:

a)            The Committee noted the report as set out at Appendix 1 to the report.

b)       The Committee requested that officers explore mechanisms for strengthening feedback and escalation with relevant bodies regarding out of area poor-quality initial health assessment reports.