Securing the health and wider wellbeing of looked after children and young people is of fundamental importance. Good health makes an active and enjoyable life possible, as well as underpinning achievement in school and in due course in the work place.

That is why promoting health is an integral part of care planning. Looked after children and young people share many of the same health risks and problems as their peers, but often to a greater degree. They frequently enter care with a worse level of health than their peers in part due to the impact of poverty, abuse and neglect.

The way in which health needs should be considered alongside the other things which are important in a child’s life – where they live (placement), where they go to school or college (education), where they are going to live in the longer term (permanence) – is vital to their welfare.

The requirements placed on a local authority (LA) in relation to addressing health needs as part of the process of care planning are set out in the Care Planning, Placements and Case Review (England) Regulations 2010 and the Care Planning, Placements and Case Review Regulations 2010, statutory guidance.

Promoting the health of looked after children is not the job of any one person. Effective multi-agency working between social workers, health professionals and carers is essential. In addition to the statutory guidance on care planning the Department has published a stand-alone volume of statutory guidance on promoting the health and well-being of looked-after children.

This statutory guidance, published in November 2009, replaces the version published in 2002, and applies to LAs as well as Primary Care Trusts and Strategic Health Authorities (and from 2013 their successor bodies).

Emotional and behavioural health of looked-after children: Strengths and difficulties questionnaire

Foster carers frequently report that there are problems associated with the emotional well-being and mental health of the young people in their care.

Evidence from some previous studies suggests that looked after children are nearly five times more likely to have a mental health disorder than all children. This clearly indicates a need to improve the mental health of children and young people who are looked after.

From April 2008 all LAs in England have been required to provide information on the emotional and behavioural health of the children they look after.

Data is collected by LAs through a strengths and difficulties questionnaire (SDQ) and a summary figure for each child (the total difficulties score) is submitted to the Department through the SSDA903 data return.

Guidance explaining the background and how the data should be collected is available to download from this page. It also provides further information on how the SDQ can be further used to support the emotional and behavioural health of looked after children, as well as some frequently asked questions that you might find useful.

Healthy Care programme

The programme developed by the National Children’s Bureau aims to promote a healthy care environment where looked after children and young people

  • experience a genuinely caring, supportive, stable and secure relationship with at least one committed, trained, experienced and supported carer
  • live in an environment that promotes health and well-being within the wider community
  • have opportunities to develop personal and social skills to care for their health and well-being now and in the future
  • receive effective healthcare, assessment, treatment and support.

The programme provides a multi-agency framework for local partnerships to achieve the five Every Child Matters outcomes for children.

More information and resources are available from the Healthy Care section of the NCB website.