122 Health information at looked after children review meetings

Abstract

<h3>Aims</h3> 1. Improve health of Children and Young People (CYP) in care by evaluating the health contribution at Looked After Children (LAC) Review meetings: • Whether health recommendations are reviewed and health actions undertaken. • Whether appropriate health professionals are invited, attend or supply information. • Whether minutes are received by relevant health professionals. 2. Work jointly across social care and health to review the same cases using separate local data systems. <h3>Methods</h3> • Social care (two local authorities) identified all Looked After Children review meetings in one week (March 2019) - 40 cases (split 20/20) were chosen at random and reviewed. • Set questions were determined by the multiagency working group and a dataset created. • For each CYP identified, health and social care reviewed records and submitted results separately. • Social care reviewed the minutes, social worker report and last available health assessment; health members reviewed electronic health records, and last two health assessment reports (if available). • The answers, free text comments and observations by professionals were analysed. <h3>Results</h3> <h3>Data analysis</h3> • The majority of meetings were 6 month reviews of CYP in foster care. • Public Health and LAC nurse were most commonly invited. • 95% of CYP had statutory health assessments prior to meeting; 75% of meetings discussed IHA/RHA specifically; 80% recorded this in the minutes. • 65% recorded health recommendations discussed and 52.5% recorded whether recommendations had been completed. • &lt;10% had a record of shared minutes with GP and LAC nurses. • Good practice highlighted with paediatrician and CAMHS attendance at different complex meetings. • 100% had ‘health’ discussed at the review meeting. <b><i>Challenges:</i></b> Only SystmOne electronic health records were reviewed, therefore information from services not using this could not be seen. Invitations to Looked After Children review meetings were not consistently recorded. Not all types of cases were reviewed e.g. across all age groups, UASC (unaccompanied asylum seeking children). Some questions could be considered subjective e.g. who would be best to invite. It was not possible with the way the data was analysed to link the two parts of the audit i.e. health + social care answers for each child. Different data systems, ways of recording and limits on access to health records added a level of difficulty gaining accurate information. <h3>Conclusion</h3> This audit resulted in recommendations for social care and health which has led to service improvements monitored with a specific action plan. This included: • Agreed report titles across agencies, to aid sharing, storing and accessing relevant information. • Pathway for escalation and communication should statutory health assessments not be available for the first 20 day Looked After Child review and subsequent meetings. • Recommendations for standard invites and sharing of minutes • Health input to social care-led update of Looked After Children review meetings. The report and results were shared widely amongst partner organisations and across the children in care network for learning. It has served as an excellent audit for service improvement but also strengthened and demonstrates the benefits of the multiagency partnership.