1.6.2 GPs, Dentists, Opticians, Hospitals

Contents

1. Introduction 
2. Notifications and Registrations 
3. Appointments 
4. Recording 
5. Medical Emergency
6. Promoting Health Care (Guidance)   

1. Introduction

All young people must be registered with a GP, Optician and dentist in the area.

All young people must have a Health Care Assessment, which must be arranged before the young person’s first Looked After Review and then annually. As part of these healthcare assessments, young people should have dental check and sight tests. See Health Care Assessments and Plans Procedure. 

All Staff have a responsibility to ensure that all our young people receive the best possible health care and advice.  Therefore, if a young person refuses to attend for the check-ups Staff must encourage them through positive re-enforcement and education, to attend.  

Each child’s file should contain a written medical consent form. 

See separate guidance on Consents, in Consents Guidance.

Any visits to doctors, dentists, opticians or other health professionals should be recorded (Section 4, Recording).

It is important that we take an active role in promoting all aspects of a young persons health, this should not be restricted to treatment of illness but also include education about alcohol, substance abuse, smoking, sex, and sexually transmitted diseases, HIV & AIDS etc.  Education can take a number of forms i.e. informal talks, information/training packs etc.

2. Notifications and Registrations

Amended March 2009: The whole of this section was amended in March 2009

For arrangements in relation to Health Care Assessments and Health Care Plans see Health Care Assessments and Plans Procedure.

When a child is placed in a home, the social worker must arrange for the Health Authority, in the area where a child is placed, to be notified of the placement.

The Manager of the home should arrange for the following:

• For the child to be allocated with a Link Worker (Keyworker) who will be responsible for promoting his/her health and educational achievement, liaising with key professionals, including the Clinical Nurse Specialist, the child’s GP and dental practitioner. The Link/Keyworker will also be responsible for ensuring that up to date with information is kept on the child in relation to his/her health needs, development, illnesses, operations, immunisations, allergies, medications, administered, dates of appointments with GPs and specialists (see Keyworker Guidance).
• For the child to be registered with a GP no later than 10 working days after the child is placed
• For the child to have access to a Dentist in the home's locality no later than 20 working days after the child is placed.
• For the child to be registered with an Optician in the home's locality.
• For a Health Care Assessment to be carried out in relation to the child within 14 days of the child's placement, as set out in Health Care Assessments and Health Care Plans Procedure.

Details of the registration or any changes must be recorded, by the social worker, in the Placement Information Record, a copy of which must be forwarded to the home, at the latest, within 14 days of the placement.

Additionally, the child's Medical Record should be updated.

3. Appointments

When appointments are made, account should be taken of the child’s wishes, for example, to see a practitioner of a preferred gender.  Also, appointments should preferably be made which do not disrupt the child’s education.

Parents, those with Parental Responsibility and the child’s Social Worker should, if possible, be consulted before making appointments; and they should be informed of the outcome.

See Consents Guidance, which also provides guidance on consulting young people or refusals to co-operate.

As appropriate, the Essential Information Record/Chronology should be updated to take account of these appointments.  Care should be taken to ensure that the top copy, held by the Social Worker, and the copy held in the home are updated.

4. Recording

Appointments/outcomes must be recorded in relevant daily/routine records and in the Medical Log Sheet and/or Client Information Record.

5. Medical Emergency

In the event of a medical emergency, Staff qualified to administer first aid (see Medication and First Aid Procedure) should take any action appropriate to minimise the casualty’s condition from becoming worse.

Other than for very minor injuries, professional medical attention must be sought as soon as possible (either take the child to see a medical practitioner or seek advice by telephone), even if the casualty’s condition seems to improve following the administration of first aid.

In the event of a medical emergency, Staff should seek medical assistance and support as a matter of priority, usually this will mean calling an ambulance or in some circumstances the assistance of other emergency services. These services can be contacted by dialling 999 from land lines and most mobile phones, however, on some mobile phones the European Union emergency number 112, is also valid.

When calling the emergency services Staff should ensure they are able to provide the following details:

• The telephone number from where they are calling.
• The location of the incident or patient requiring medical assistance.
• The type and gravity of injury or symptoms of the illness.
• The number, sex and approximate ages of any casualties and any information you may know about their condition and medical history.
• Details of any other hazards that may be relevant.

Where Staff ringing for the emergency services were asked to do so by the first aider, they must remember to report back to them confirming that this has been done.

Finally, once the casualty has been attended to by the professional emergency services, Staff must notify their line Manager who in turn should notify the operations Manager or the senior Manager on call.

If the incident constituted a Notifiable Event, senior Managers and others such as the Placing Authority and Regulatory Authority must be notified, see Notifiable Events Procedure.

6. Promoting Health Care (Guidance)

Staff should actively advocate that children have a dental check and sight test within the first six weeks after admission.  Regular checks-ups should then occur in accordance with professional recommendations i.e. six monthly for dental checks, yearly for sight tests etc.

Staff should also ensure that an accurate record of immunizations is obtained from the Social Worker or previous medical records and ensure that all immunizations are up-to-date and if not arrange for them to take place.

Children will also be advised of appropriate agencies for specific health advice, information and counselling, such as well women’s and young person’s clinics.  It is important that we take an active role in promoting all aspects of a children’s health, this should not be restricted to treatment of illness but also include our responsibility to educate about alcohol, substance abuse, smoking, sex and relationship education, sexually transmitted diseases, HIV & AIDS etc. and issues around protecting themselves from prejudice, bullying and abuse both within and outside the home. 

If they are to begin to take some responsibility for their own health, children will need to understand that nutrition, sleep, exercise and personal hygiene will all play a part in the overall level of their health, and that good health repays the effort by contributing to a sense of well-being.  Above all, there is a need to encourage them to have respect for their own bodies.

These may seem unattractive matters to many children and children who feel they have far more interesting things to attend to.  Nevertheless, it is part of Parenting, first of all to provide these things for them, and then to help and encourage them to take responsibility for themselves, based on acquired knowledge, self motivation and interest.

It is not always easy to get these concepts across, and where there is a need for urgent and immediate attention, there should be no delay in obtaining the appropriate medical treatment.  However, where a child is reluctant to co-operate in getting treatment, Residential Social Workers should take a pro-active approach and be ready to seize the right opportunity to raise the matter and follow through with an appointment.  For example, a child’s concern about bad breath could provide an opportunity for a much-needed visit to the dentist.

End