The following page provides information on two aspects of health and foster care: foster carer medicals and children's health and wellbeing. Foster carer medicals can be difficult to obtain therefore we surveyed services in England to find out what these difficulties are. We are now working towards a set of recommendations with others in the sector and relevant health bodies. Ensuring that the health and wellbeing needs of fostered children are met can be a complex matter. With the right training and support, foster carers can make a real difference to the lives of children and young people.
Foster carer medicals
In recent years fostering services have increasingly expressed concern about the difficulties with the system of obtaining health information about prospective foster carers. In response to this issue The Fostering Network, CoramBAAF and the Nationwide Association of Fostering Providers (NAFP) have jointly surveyed its fostering service members in England in Winter 2019/20 to understand more about the issue and its wider impact on fostering.
The Fostering Network, CoramBAAF and the National Association of Fostering Providers have agreed the following recommendations and we will work with the relevant bodies to take these recommendations forward:
- A national standardised approach to foster carer medicals, including a national recommended fee.
- To promote an understanding amongst health colleagues around their crucial role in the recruitment and retention of foster carers and the importance of foster carer medicals.
- To promote an understanding amongst health professionals completing medical reports of the role of the foster carer. This is necessary to ensure all relevant information is provided to the medical advisor for consideration.
- Ensure there is effective communication between the fostering provider and health colleagues at a local level.
- Review the medical report form (AH1) to ensure the content and format is fit for purpose (NB: CoramBAAF is already in the process of updating the AH form as part of review processes and has made additional changes in light of the covid-19 pandemic).
- Clarification of roles in assessing the suitability to foster using the information contained within the foster carer medical report. This includes clarifying the respective role of the assessing social
- worker and fostering service medical adviser in assessing the implications of information contained within the foster carer medical report on the foster carer’s suitability to foster.
- Clarity is needed regarding the sharing and storage of foster carer’s health information by GP surgeries, medical advisors and fostering services. Guidance would need to be informed by fostering regulations, the Data Protection Act 2018 and Working together to safeguard children 2018.
Children's health and wellbeing
Research consistently shows that the health of many children and young people in foster care is poorer than that of their peers. The circumstances that have resulted in them being in care may have left them with particular health needs. Others may have specific medical conditions or disabilities whilst others may need support with their mental health and emotional wellbeing. Also, some children may have moved frequently meaning that the details of their medical history are difficult to find.
When a child is in care, health related responsibilities are not only shared between their birth families and foster carers but also with social workers, specialist nurses, paediatricians, youth services and teachers who have responsibility as the ‘corporate parent’ .
With the right training and support, foster carers can make a real difference to the lives of children and young people, not only by helping to care for the health of children but also by acting as role models in the way they look after their own health and emotional wellbeing.
Principles of promoting health and wellbeing
- It is important that foster carers understand their responsibilities around health care, medical treatment and consent so that they can support a child’s physical, mental, and emotional health.
- Fostered children have a right to good health; all the professionals working with them have a responsibility to promote and support this while recognising that it is the foster carer who can make the biggest impact on the child’s experiences and environment.
- A holistic approach to health promotes children’s wellbeing and provides them with the support they need to make informed decisions about their own health.
Children and young people will live in a healthy care environment, will experience a stable secure relationship, live in a positive health promoting environment, have opportunities for self development, and receive effective healthcare, treatment and support.
Key points to consider
- Foster carers have a crucial role to play in identifying and responding to unmet health needs among children in their care.
- In order to do this fostering services should ensure that foster carers have an all around knowledge of childhood development and a basic knowledge of childhood health screening and immunisation programmes. .
- Fostering services should provide fFoster carers with the training and knowledge and skills to enable them to respond to potential health issues. These issues may include:
- Physical: some children have unmet health needs surrounding their development, dental care, vision, immunisations, healthy eating and physical activity levels.
- Mental health: all fostered children have been separated from their birth family and may also have suffered neglect, emotional abuse, physical or sexual abuse, bereavement or poverty.
Sexual: all young people need to develop and understand a holistic approach to their sexual health, that is the emotional elements of sexual relationships as well as the risks of unplanned pregnancies and sexually transmitted infections.
Consent for treatment
Foster carers do not have parental responsibility but should have delegated authority/decision-making power for consent for most treatments. They should be clear from the outset about their responsibilities if children require emergency medical treatment and if they require planned treatment.
Each situation is different but as a rule foster carers should be able to sign consents for routine medicals, eye and sight tests and routine dental examinations. Foster carers should be given delegated authority wherever possible to consent to immunisations and the placement plan should clarify who can give consent in a medical emergency.
Across the UK, young people aged 16 and over can give their own consent to surgical, mental or dental examination or treatment.