Agenda item

Caroline Waldron, Safeguarding Children and Children in Care and Health Colleagues, NHS Lancashire and South Cumbria Integrated Care Board and Young People, LINX (Lancashire's Children in Care Council)

 

To discuss Health issues relating to children looked after and care leavers, including mental health, dental, health checks.

Caroline Waldron, Maureen Huddleston, Lancashire and South Cumbria Integrated Care Board NHS, Jenny Donnelly, Lancashire 0-19, HCRG and Young People, LINX (Lancashire's Children in Care Council presented the item.

 

The Board received a health presentation (attached to the minutes) from LINX (Lancashire's Children in Care Council), who talked about what health is to them.  They reported that health is very important to them and that it affects them physically, mentally and emotionally and that mental health is a key aspect that is often spoken about among young people.

 

The young people engaged the Board in a health quiz, discussed the permanence plan and the priorities for young people, shared personal experiences from young people's groups and talked about how young people can support the process of health and issues regarding the health passport.

 

In terms of the Corporate Parenting Board priorities young people reported that they felt the main ones that should be focused on first are:

 

·  Improving sufficiency to provide the right home at the right place

·  Improving social, physical, emotional and mental health support and outcomes

 

Young people commented that the reasons they felt those two priorities were key were:

 

·  That home is a place where you need to be stable, and if your home is not stable then you cannot be stable.

·  They felt that for some living on their own between 18-25 can be too early as they feel isolated and are not ready or prepared to live on their own.

·  Their health and mental health are affected if they are not feeling prepared to live on their own.

·  They may feel they are not equipped to look after themselves, for example, eating right, getting enough sleep, and having clean and tidy spaces.

 

The Board noted that young people had agreed for some of their experiences to be shared with the Board as follows:

 

A 13-year-old in one of the groups, shared that they had been on a six-year waiting list for braces. Recently, after discussing this at a previous meeting, they had been contacted by the hospital for a referral code and has then contacted the brace specialist. They now have an appointment for January and hopefully this appointment will lessen their waiting time. They have had a front tooth knocked out and has a temporary implant, which they need to be replaced regularly and this pushes their teeth out at the front. For this young person not having straight teeth is causing other people at school to bully them and is affecting their mental health.

 

The Board noted that the Rossendale Dental Pilot that had previously been presented to the Board, should be revisited and rolled out across Lancashire.  It was also suggested that links could be made with UCLAN and the Dental Hospital as they may be able to provide further support to Children in Care and Care Leavers.  Caroline Waldron, NHS Lancashire and South Cumbria Integrated Care Board informed the Board that building on from the Rossendale Pilot, there is now an Integrated Care Board Steering Group to drive the dental offer/model forwards across Lancashire.  Links have also been made with Orthodontists via the Dental Commissioners, with a request to having dedicated resources for Children in Care and Care Leavers for dental provision and to ensure they are prioritised.  The Board were also informed that Dentists can refer children to an Orthodontist years before they are needed, to ensure they are in the system if they require treatment later in childhood.  The Board noted that it will receive a Dental Model at a future Board meeting which will outline some of the detail of what will be available to Children in Care and Care Leavers.

 

Another young person reported that the mental health part of health is most important to them as their personal experience of mental health affects their day-to-day living. The young person shared that it affects them getting a job, their eating habits, sleeping habits and every aspect of life.  They felt that if you are applying for a job, your mental health needs to be in order.  The young person is actively looking for work and has had a bad experience with their first job, where they were sacked after management wanted them to open up and run a restaurant after four days of being employed with no training advice or support on how to do so. This left the young person stressed and suicidal at how they were treated and how the situation went and has now left them in a position of worry for any future jobs.  The young person has now done a self-referral and assessment with Minds Matter and is comfortable talking to their friendship network and Participation Colleagues April Rankin and Adam Riley when things get too difficult or to share what is on their mind.  Advice was offered on an individual basis on Trade Union support for those who wish to receive it.  Support was also offered to the young person to work with an Officer to write a letter to the restaurant and raise the issue formally with them as a Corporate Parent and to support the young person in looking for other employment opportunities.

 

Another young person reported to the Board that their good and bad experiences of health.  Their bad experience was having to wait a long time to be seen following an epileptic fit after surgery.  They waited six hours to be seen and afterwards another month to see an Epileptic specialist about their condition.  They are still waiting now to be prescribed different medication as they had a reaction to the first prescribed drug.  The young person reported that they had had a positive experience with nurses recently, as they were no judgemental and the young person felt that they supported them as much as possible when the young person felt they were wasting the professionals time of which they reassured them, that it was better to be safe than sorry and said positive things to the young person which helped them in that situation.

 

The young people reported how they felt they could support the health process and that they understand that more money or more staff is not always an option.  Therefore, as participation influencers they can show their support for health by offering to do the following:

 

·  Become health champions – Young People along with the Participation Team will look at this training in the new year which will enable Care Experienced Young People to be trained to deliver sessions about health on specific modules within the course to younger members of the groups and within the wider participation groups.

·  Talk about and share experiences with other professionals or other young people. They feel that if this is done within their groups, it might break down barriers of other young people feeling lonely or isolated or share what may have worked for that particular young person and might work for someone else.  This can be in all aspects of health.

·  For all participation groups to look at fundraisers for NHS or health charities.

·  Requested that they would like additional training on mental health, basic first aid, healthy eating, anxiety, panic attacks, epilepsy, and asthma in order to help friends, peers, families, staff and communities.

 

Young people asked the Board if they could help with any of the following:

 

·  Direction

·  Advice

·  Information

·  Help

·  Assistance

·  Guidance

·  Solution

·  Competence

 

Any details provided by members, would be collected and contact would be made following the meeting.

 

Following discussions further offers/suggestions were that:

 

·  Caroline Waldron would report back to the Integrated Care Board on the asks from the young people regarding training and to find out what the NHS can offer and report back to the Board.

·  Elected Members agreed that a report be presented to Cabinet on behalf of the Corporate Parenting Board requesting that Cabinet considers offering fully funded training in mental health first aid and emergency first aid for all young people in the care of Lancashire County Council.  This was proposed by County Councillor Scott Smith and seconded by County Councillor Julie Gibson.

·  All Care Experienced Young People should be made aware of who their councillors are (including a list of Lancashire County Councillors who are all Corporate Parents) and to receive training on the Two-Tier Council system, particularly about which Council offers what service.

 

In terms of the Health Passport, young people reported that after having discussed it, most care leavers within the group had not heard of it or received it.  Therefore they had some questions of members of the Board on:

 

·  When did the Health Passport come out?

·  Why have all care leavers still under the Local Authority not received this?

·  What is the best way to receive it?

·  Is there a way to backdate it to make sure all the care leavers receive this? If not, why?

 

Caroline Waldron, NHS Lancashire and South Cumbria, Integrated Care Board, welcomed the young people's comments and questions and would feed this back into the system with professionals who support children in care and care leavers at the next focused activities meetings which was on Health Passports.  It is also recognised by health professionals that it is not in line with how people receive information and that this needs addressing alongside ensuring those that need to receive a copy, get one.  Young people's ideas on the design of the Health Passport and what information they feel should be included are also welcome.

 

The Board noted that health colleagues contact young people's Personal Adviser's to find out how young people wish to receive their Health Passports. There is a Task and Finish Group for Lancashire and South Cumbria to review Health Passports and seek feedback from young people as to how they wish to receive the information.  Young people's involvement in this piece of work will be key to its success.  A consistent approach is being sought by all partners including Health and Children's Services, to ensure all Care Leavers receive the passport at the right time.

 

The Board noted that the Permanence Service is keen to ensure that Personal Advisers speak with Social Workers when a young person is transitioning and that work between them both commences at around 16 years of age to ensure a smooth transition and that all information is shared as necessary.

 

Young people were asked that if they do not have a Health Passport, to speak with their Social Worker/Personal Adviser who in turn will contact the Children in Care Nurses who will ensure the information is received by the young person.

 

LINX (Lancashire's Children in Care Council) were thanked for their comprehensive presentation.

 

Caroline Waldron, Maureen Huddleston, Lancashire and South Cumbria Integrated Care Board NHS, Jenny Donnelly, Lancashire 0-19, HCRG provided an overview of activity that has been happening in the health system and how they support children in care.

 

The Board received further information on the following:

 

·  Integrated Care Boards

·  Statutory Health Assessments – Lancashire Arrangements

·  HCRG Care Group offer in Lancashire:

Ø  Who they are?

Ø  What they do?

Ø  What can they support with?

Ø  How can they be contacted?

·  Enhanced Children in Care Teams

·  Strengths, Weaknesses, Opportunities and Threats (SWOT) - Health of Children in Care

 

The Board were informed that a key priority going forwards was to work more closely with Children's Social Care on the Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis.

 

It was requested that Health be an item on every other meeting of the Board going forwards.

 

­­­­­­­­­­­­­­­­­Resolved:  That the Corporate Parenting Board:

 

i)  Noted the update from the Young People, Caroline Waldron, NHS Integrated Care Board and other health professionals.

ii)  Agreed that Brendan Lee, Permanence Service, Lancashire County Council present a report to Cabinet in January 2023 requesting that it considers offering fully funded training in mental health first aid and emergency first aid for all young people in the care of Lancashire County Council.

iii)  Agreed that the Permanence Service, Lancashire County Council will ensure that all Care Experienced Young People be made aware of who their councillors are and that they receive training on the Two-Tier Council system, particularly about which Council offers what service.

iv)  Agreed that Caroline Waldron, NHS Lancashire and South Cumbria Integrated Care Board, would find out what training might be available for young people from the NHS Integrated Care Board and report findings back to the Board.

v)  Health colleagues will consult with the Participation Team and the Young People with regards to requirements/improvements for the Health Passport.

vi)  Health and the Permanence Team will carry out a data assessment on young people to see who are in receipt of Health Passports and to ensure all young people have a Social Worker or Personal Adviser and report back to a future meeting of the Board.

vii)  That Health be an item on alternate Board meetings.