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4. Roles and Responsibilities of Councils
Duties to children
4.1 Councils must now put in place arrangements to ensure every looked after child has their health needs assessed on entering care and has a health plan setting out how the assessed needs will be met. Arrangements must also be in place for the health plan to be regularly reviewed.
4.2 As effective corporate parents, it is essential that councils advocate on behalf of the children in their care to ensure that they access the health services they need. Councils will need to work in partnership with PCTs at both strategic and operational levels to ensure effective delivery of services.
4.3 Each local Council also has a duty to establish and maintain a clear protocol for sharing relevant information about care placements and health. This will include who has access to what information, arrangements for seeking consent to share information, how carers contribute to and receive information. The protocol should also cover arrangements for sharing information with other councils and with PCTs.
Management and delivery of services
4.4 Councils should ensure that a senior manager within social services has designated responsibility for the health of looked after children. This designated manager will have responsibility for ensuring effective liaison with health services and establishing clear lines of communication between organisations and within the Council. A crucial role will also be to ensure that the notifications to the relevant Councils and PCTs are being made when children and young people move placement.
4.5 At an operational level, the child's social worker will have primary responsibility for ensuring that each stage of the health assessment, plan, implementation and health review is initiated and delivered. Where problems are encountered, these should be reported to the designated manager.
4.6 Placements outside the Council area are known to create added difficulties in meeting the health needs of the child and accessing health services. Such placements should not be made without having made arrangements to secure appropriate health services for the child. Councils should continue to monitor whether the child's health needs are being met in the area in which they have been placed.
The parenting role
4.7 Competent parents are aware that bringing up healthy children involves a range of tasks requiring them to act as champions or advocates on behalf of their children in accessing and using services.
4.8 Carers will also play a key role in ensuring that a child's health needs are identified and met. The responsibilities of foster carers, carers and residential staff will include:
- an understanding that achieving optimum health involves a range of tasks which include the provision of good quality care and which provides a child with a positive sense of identity and self- esteem;
- encouraging and supporting each child in achieving optimum health and in particular exercising the corporate parent's responsibility as health educator;
- providing a home environment which actively encourages and supports a healthy lifestyle;
- ensuring the child attends health appointments and clinics as necessary;
- contributing to the child's health plan and care plan;
- ensuring and facilitating contact and communication with the child's parents and family in accordance with agreed plans;
- ensuring that the child or young person makes maximum benefit from education and broader life experiences offered by leisure activities, hobbies and sport.
Children in special circumstances
4.9 It is vitally important that councils in their role as corporate parent are conscious of the specific health inequalities and increased needs of discrete groups of children and young people within the looked after population. Many of these children will have greater health needs and are likely to experience greater barriers to accessing services. This group of children includes:
- looked after children with a disability and/or special educational needs;
- children from black and ethnic minorities who are likely to suffer both the health disadvantages of looked after children plus the health inequalities related to their ethnicity;
- refugee children or unaccompanied asylum seeking children (UASC);
- care leavers and their transition to independence;
- children in secure settings - health expectations and services for these children can be lower, yet their health needs often greater.
4.10 Section 6 of the main guidance sets out in more detail the particular health needs of these groups of children and young people and how services should be tailored to meet their needs.
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