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G74(P) How to engage the difficult to reach looked after child: An audit of looked after children who did not attend or were not brought to their initial or review health assessment
  1. NM Williams,
  2. D Price Williams,
  3. T Chisholm
  1. Looked After Children, Hillingdon, London, UK


Missed Looked After Children (LAC) Health Reviews can lead to missed opportunities to identify and resolve health needs with reduced access to available services and health promotion. This leads to poor health outcomes and educational attainment and can have large administrative and financial impacts on the LAC Team.

Aim To evaluate the number and demographic details of DNAs for Initial and Review Health Assessments (IHA and RHA) and identify which groups may need more targeted input. To assess any issues with the LAC team’s DNA processes.

Methods We conducted a retrospective audit of all children who did not attend an IHA or RHA between 01/04/2015 and 31/03/ 2016.

Results Overall the LAC team conducted 96% (534/555) of the requested health assessments during the 12 month period. DNA rate was 2.9% for IHA and 3.8% for RHA, with 0.6% refusal rate for RHA. The majority of those that DNA were male (71% of IHA, 58% of RHA). A large proportion of those that DNA’d were unaccompanied asylum seekers (57% of IHA, 41.7% of RHA). 90% of those who DNA were aged >14. Reason for DNA included children being missing from placement (in particular those older unaccompanied asylum seekers), not wanting to miss college and in many cases the reason for non-engagement was unknown.

Conclusion Ensuring children and young people attend their health assessments requires child and family centred multidisciplinary interagency working between the child’s corporate parents and healthcare. We developed a cross-agency pathway for those who DNA including offers of telephone consultations and completion of health questionnaires aiming to increase engagement from those difficult to reach adolescents. We designed personalised health passports for young people approaching the age of leaving care to signpost useful services with advice on healthy lifestyle choices aiming to improve their access to health promotion.

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