Introduction

Looked after children have traditionally experienced poorer health outcomes than their peers, and are less likely to engage with health services. 

The Scottish Government is committed to improving the health outcomes for all looked after children and young people and care leavers. The Better Health, Better Care: Action Plan, published in December 2007, outlines this commitment: 'We will implement the recommendations of 'Looked After Children and Young People: We Can and Must Do Better' to improve the emotional, mental and physical health of these children and ensure that NHS Boards provide the support that the children require, including access to primary care and dentistry.

NHS Education

As part of this commitment, NHS Education for Scotland has been commissioned to develop a competency framework to support the training and development of specialist nurses for looked after and accommodated children.'

For all children, the NHS provides services to assess, identify and treat health issues and to promote good health. Health for All Children 4, guidance issued by the Scottish Executive in 2005, sets out the programme for screening, surveillance and health promotion which every child and young person should receive from birth to the end of secondary school. For looked after children and young people, these services must be provided both on an individual and a strategic level to focus on the particular health needs of this group.  

The Action Framework for Children and Young People (Scottish Executive, 2007) indicates that 40% of looked after children will have mental or emotional health problems; this is considerably higher than their non-looked-after peers. They are less likely to engage with universal health services such as GPs, dentists and sexual health advisers and are likely to have missed health promotion and prevention opportunities. Looked after children are also more likely than their peers to need specialist health services, including Child and Adolescent Mental Health Services, Learning Disability Services and help with addictions. 

As they move into adulthood, it is essential that young people are engaged with health services to meet their changing needs. For example, looked after young people express the same needs for information about sexual health matters as other children and young people. Parents and carers may require training in delivering support to young people and should be aware of sexual health counselling and advice services locally. 

Professionals in health and education also have a responsibility to make sure that looked after children and young people are aware of services. Care should be taken to ensure that the young people do not feel that they are being picked out for special treatment or that the treatment they are being given is in any way different from that accessed by other young people.

Curriculum for Excellence - Health and wellbeing

Curriculum for Excellence has an important role to play in promoting the health and wellbeing for children and young people. The Curriculum for Excellence website has information on Health and wellbeing experiences and outcomes.

Local authority duties and powers

To support activities relating to health, local authorities have specific duties and powers.

Under the Children (Scotland) Act 1995, a local authority placing a looked after child must, as soon as is practicable, give written notice of the placement and relevant information about the placement to, amongst others, the health board where the child will be living. 

Section 21 of the Children (Scotland) Act 1995 makes provision for local authorities to request help from appropriate persons to help carry out certain functions. Appropriate persons include health boards and NHS Trusts.

Everyone who supports looked after children, young people and care leavers, whether through direct support or strategic developments, has a role to play in improving outcomes in health. This could be anything from providing a parent with financial support to allow a child to take part in activities in a local sports centre, to the development of partnerships on a local level which strategically support improved health outcomes.