Looked After Children (LAC) – resources and guidance

This term typically denotes children cared for by Government, though exact definitions vary between the four nations. More than 93,000 children in the UK are in care, 70,000 in England. Most are taken into care over fears of abuse or neglect. They are vulnerable to health inequalities, and exhibit significantly higher rates of mental health issues, emotional disorders (anxiety and depression), hyperactivity and autistic spectrum disorder conditions.

RCPCH lead

Dr Vicki Walker leads on looked after children on the RCPCH Child Protection Standing Committee. She also collaborates with the British Association of Adoption and Fostering (Coram BAAF) Health Advisors Group Committee.

COVID-19 vaccination programme

February 2022

Children and young people in care must not be forgotten in the COVID-19 vaccination program. COVID-19 vaccinations for children and young people are not regarded as “routine” at present but are clearly in the best interests of children and young people eligible for the vaccine in line with recommendations from the JCVI (Joint Committee on Vaccination and Immunisation), including those children in care. Professionals should ensure, consent from parents for health matters, including delegated consent/ authority covers “routine childhood vaccinations and any COVID-19 vaccinations as recommended by JCVI”.

Every effort should be made to discuss and allay concerns in carers/parents who are vaccine hesitant to ensure the child can have the COVID-19 vaccination as recommended. Young people who wish to have COVID-19 vaccinations and are deemed to be Gillick competent to make the decision for themselves but their parents or carers with parental responsibility disagree, can be supported to have the vaccination.

RCPCH summary: COVID-19 vaccination for children and young people

NICE guideline

October 2021

This guideline covers how organisations, practitioners and carers should work together to deliver high quality care, stable placements and nurturing relationships for looked after children and young people. It aims to help these children and young people reach their full potential and have the same opportunities as their peers.

NICE: Looked after children and young people

COVID-19 Initial and review health assessments

December 2020 | The RCPCH produced these joint statements with the Royal College of Nursing for LAC during the recovery phase of the pandemic.

Initial Health Assessments for LAC (UK) - RCPCH and RCN, Dec 2020 (274.8KB pdf) VisualV1 - Download Created with Sketch. Completion of Review Health Assessments for LAC (England) - RCPCH and RCN, May 2020 (164.5KB pdf) VisualV1 - Download Created with Sketch.

Roles and competencies of healthcare staff

December 2020

Developed in partnership with the Royal College of Nursing and the Royal College of General Practitioners,  Looked after Children: Roles and competencies of healthcare staff provides a framework for healthcare staff to understand their role and responsibilities for meeting the needs of looked after children.

It sets out the required knowledge, skills, attitudes and values required with the aim of improving life experiences for some of the most vulnerable children in society. It also includes model job descriptions.

This intercollegiate document was revised and republished in December 2020, and can be used to support paediatricians working in this area with updated descriptions of roles and responsibilities and to consider appropriate training for all heath care staff.

RCN and RCPCH: Looked after Children – Roles and competencies of healthcare staff

Promoting health and wellbeing – statutory guidance

March 2015

The Department of Health and the Department of Education produced statutory guidance on the planning, commissioning and delivery of health services for looked after children in England. The guidance is relevant for local authorities, clinical commissioning groups (CCGs) and NHS England, alongside health professionals and professionals working in children’s services.

Department for Education and Department of Health and Social Care: Promoting the health and wellbeing of looked after children

VisualV1 - Arrow Created with Sketch. VisualV1 - Arrow Created with Sketch.