There are an estimated 92,000 children in care across the UK, many with complex health and well-being needs – and professionals caring for them are crucial to ensuring the poor health, education and social outcomes they too often experience are reversed.

Updated intercollegiate guidance, published by the Royal College of Paediatrics and Child Health, Royal College of Nursing (RCN) and Royal College of GPs, provides a framework for all groups of professionals – from healthcare professionals to non-clinical staff who could be involved with looked after children – to ensure this vulnerable group of children are best supported.

Statistics reveal that looked after children have:

  • A higher incidence of long term conditions – speech and language delay, bedwetting, asthma, allergies, coordination difficulties and unrecognised visual and hearing impairment
  • Up to 72% have mental health and emotional health problems
  • A higher incidence of drug and alcohol abuse and teenage pregnancy
  • Much more likely to experience poor health, educational and social outcomes in adulthood

This guidance is an update from the 2012 edition and is designed help all staff in health care settings develop an understanding of their responsibilities towards looked after children and achieve the required improvement in outcomes. It now includes:

  • Defined model job descriptions for Named and Designated Doctors and Nurses, Medical  advisors  and specialist nurses so they are understand their responsibilities towards looked after children
  • Advice that there should be minimum of one full time specialist nurse per 100 looked after children
  • Advice that named doctors for looked after children should be allocated at least 4 hours per week for every 400 looked after children in their care
  • Advice that named doctors should see no more than 4 children per clinic to ensure a comprehensive assessment
  • Responsibility of Chief Executive Officers, Trust and Health Board Executive and  non-executive directors/members, commissioning body directors for looked after children  for service specifications

Fiona Smith, Professional Lead for Children and Young People's Nursing, RCN, said:

“Evidence shows that many children in care credit their specialist nurse above all others with helping them to turn their lives around. Nurses work tirelessly to provide the best levels of service, however a recent report from the RCN found that they were being severely let down by a lack of service capacity, role clarity and understanding of the importance of the health care they deliver.

“This framework is a welcome step towards helping all health professionals in this field to deliver their roles effectively in order to provide the standards of care these children need and deserve. Our recommendations lay the groundwork for much needed improvements and also raise awareness of the importance of healthcare for looked after children.”

Dr Renu Jainer, lead for Looked After Children on the Child Protection Standing Committee of the Royal College of Paediatrics and Child Health, 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.

 “Evidence shows that when looked after children have access to highly skilled and knowledgeable health professionals, outcomes are really improved and they have the opportunity to fulfil their potential. That's where this guidance should make a real difference”

Dr Vimal Tiwari, Child Safeguarding Lead for the Royal College of GPs (RCGP), said:

“Looked after children are some of our most vulnerable patients and they frequently need care and support for complex physical and mental health needs.

“Caring for children is a major part of a GP's work and it is essential that we work together with other healthcare professionals, such as nurses and paediatricians, to ensure they receive the best possible care throughout their childhood, whatever their situation.

“This guidance is a welcome example of joint working and understanding, so that we can provide high quality care to looked after children, keeping them safe and well, in body and mind.”