Looked after children

There are around 83,000 looked after children (children in public care) in the UK in 2012. This page highlights key guidance and standards for caring for looked after children, including updates on RCPCH work in this important area of safeguarding children and young people.

shutterstock_27321535 Child Fists.jpg


These include children in foster or residential homes or those still living with their parents but subject to a 'Care Order'. It also includes children who are temporarily looked after for respite on a planned basis. Just under two thirds of looked after children come into care following child protection concerns such as neglect or abuse. References



Looked after children: knowledge, skills and competence of health care staff

Intercollegiate Role Framework, RCN, RCPCH May 2012

This document demonstrates the importance of meeting the healthcare needs of looked after children and aids paediatricians in understanding their role and responsibilities, with the ultimate aim of improving life experiences for some of the most vulnerable children in society.

Download the document (PDF, 635KB, 34 pages)


Why are looked after children a priority?

Health, educational and social outcomes for looked after children remain poor with a high rate of teenage pregnancies, smoking and substance misuse, mental health problems, school drop-out rate with poor educational attainment and criminality. In conjunction with local authorities and other agencies, we have a corporate parenting responsibility to try and improve the health and wellbeing of these children and young people.

Since 2000, there has been a series of Government initiatives to raise awareness of the needs of looked after children and to try and improve outcomes for them.

Promoting the quality of life of looked-after children and young people (PDF, 636KB, 164 pages) NICE, 2010. This guidance sets out how agencies and services can work together to improve the quality of life of looked-after children and young people. The focus is on putting the child or young person at the centre of every activity that affects their life. (Date of Endorsement: March 2011)

The Quality Protects programme: 2000/01, transforming children's services DH, 1999

Promoting the health and wellbeing of looked after children - revised statutory guidance DH, 2009

Every child matters: change for children UKBA, 2009

Care matters: time for change DFES, 2007 

Promoting the quality of life of looked-after children and young people NICE, 2010


Current legislative and regulatory framework for looked after children

This can be found on page 8-9 of the Statutory Guidance on Promoting the Health and Wellbeing of Looked After Children DH, 2009


Statutory health assessments

Every child who enters care should have a holistic health assessment within 28 days of entering care. The initial health assessment should ideally be conducted by a registered medical practitioner with an interest in the needs of vulnerable children with the production of a comprehensive health care plan. A review health assessment should take place at six-monthly intervals for children under five, and annually for children over five. See pages 24-26 and practice guidance section in Statutory Guidance DH, 2009.


What are the roles of designated doctors/nurses for looked after children?

These are clearly set out in the Stat Guidance pages 42-43 and 74-75. A further ICC health competences for staff working with looked after children has been developed and should be used in conjunction with the Stat Guidance recommendations – ICC document link here (please link to RCPCH link).


Looked after children at RCPCH

Since 2010, there has been an appointed Looked after Children Lead who sits on the RCPCH Child Protection Standing Committee. The current lead is Dr Renu Jainer.

Renu also links and collaborates closely with the British Association of Adoption and Fostering (BAAF) Health Advisors Group Committee.




  1. www.legislation.gov.uk/ukpga/1989/41/contents
  2. http://www.nspcc.org.uk/Inform/resourcesforprofessionals/looked_after_children_statistics_wda79691.html
  3. http://www.nspcc.org.uk/Inform/resourcesforprofessionals/looked_after_children_definition_wda80510.html
  4. http://www.legislation.gov.uk/ukpga/1989/41/section/20/enacted  - (voluntary accommodation)
  5. http://www.legislation.gov.uk/ukpga/1989/41/section/31/enacted(care and supervision order)