Thank you!

We truly appreciate the incredible work you're doing in caring for this young person who has recently come into care. We understand there have likely been many changes, meetings and maybe some stress along the way. Our goal is to make this Initial Health Assessment (IHA) as relaxed and positive as possible. It’s an opportunity to ensure that the young person gets the support they need to thrive and also to listen to your concerns as their carer, so we can make a plan to address them.

Why Is This Health Assessment Important?

The government requires all young people entering care to have an Initial Health Assessment within 28 days. This assessment helps ensure the young person’s wellbeing across multiple areas, including:

• Listen to the young person - How they are coping and any concerns they may have.
• Physical health
• Mental health 
• Medication
• Vaccinations
• Education and development
• Sexual health and relationships
• Substance use
• Background and reasons for entering care

For more information on the legal basis of the Initial Health Assessment click here.

What Happens During the Health Assessment?

The IHA typically lasts around 1 hour and includes:

• Discussion of key areas: We talk about the topics listed above. We understand that some discussions may be sensitive and young people can indicate if a subject feels too emotional to continue.
• Carer’s Report: We review the carer's comments to understand their perspective.
• Physical examination: Lasting about 15 minutes, this includes checking height, weight, skin, ears, throat, chest, abdomen, spine and joints. Typically, underwear is left on (except for babies), unless further examination is needed. We handle these situations with great sensitivity, ensuring everyone feels comfortable and if they don't then we consider alternative options. Intimate examinations are rare, but if needed, the use of a chaperone will be discussed beforehand to ensure everyone is comfortable.
• Care Plan: The final 5 minutes focuses on creating a plan for the young person, addressing actions to support recovery and long-term well-being.

For information as a video in an age appropriate format for the child to understand what will happen, click on the links below:

• Under 12 years
• 12-17 years

Chaperones

We always provide the option of a chaperone during Initial Health Assessments (IHAs) to ensure the comfort and professionalism.

How Are Chaperones Involved in IHAs?

• For older children, there is an opportunity during the appointment to discuss sensitive topics, such as relationships or substance use, privately without a carer present. If no other adult is present in the room, a chaperone will be there to support the young person and help them feel at ease.
• During children's medical assessments, typically underwear remains on (except for babies) unless a specific issue requires further examination. Intimate examinations are rare, but if needed, the use of a chaperone will be discussed beforehand to ensure everyone is comfortable.

If you feel that a chaperone is necessary at any point during the appointment, please don’t hesitate to ask.

Should the Carer Attend?

If possible, yes! We find your input extremely valuable alongside that of the young person. If you can’t attend, please inform the social worker, who may attend instead. Make sure they’re aware of any concerns you have and that the carer completes and returns the Carers report.

How Long Does the Appointment Last?

Appointments typically last 1 hour, though they may be slightly shorter or longer.

What if Multiple Siblings Need an Appointment?

If multiple siblings require an appointment, there are two options to consider when booking the appointment:

• Individual appointments: Best for addressing complex or sensitive issues that may be difficult to discuss in front of siblings. This option is also ideal if the siblings are placed with different carers.
• Group appointments: Up to 3 consecutive appointments can be arranged. This approach is convenient when siblings share a lot of information, helping to create a comprehensive picture. Bringing snacks and activities for the children during the appointment can make the experience smoother.

What if English is Not the Young Person’s First Language?

If English is not the young person’s first language, or they aren’t confident speaking it, please inform us and the social worker in advance. The social worker will arrange an interpreter to ensure clear communication. We have extensive experience working with interpreters, helping young people feel comfortable and supported in expressing themselves fully.

We have some useful resources for Unaccompanied Assylum Seeking Children which includes an introduction to Initial Health Assesments in Pashto, Tigrinya and Arabic.

Where does the information go after the Initial Health Assessment (IHA)?

Following the Initial Health Assessment (IHA), the report is shared with the social worker, birth parents, GP, school nurse and the local Children in Care team. A copy of the report is added to the child’s medical records. As the carer, you will receive a copy of the plan.

Older children can either review your copy of the plan or they can request their own copy: 

• 16+ years old then it will be a full copy of the report 
• 13+ years old and they have capacity to make decisions for themselves then it will be a copy of the plan.

We will be conscious that the young person may be reading the report when we write it, but please be aware that sometimes there may be some information contained as they read it which they find traumatic. We'd be grateful if you could carefully support them through this please.

They may also request that certain information not be shared with specific individuals and we do our best to respect these wishes.

If referrals to other healthcare professionals are necessary, relevant information from the assessment will be shared to ensure the child receives appropriate care.

There may be times when information needs to be shared against the young person's consent if there is a Safeguarding concern eg if there are Child Criminal Exploitation or Child Sexual Exploitation concerns.

What to Do Before the Appointment?

Before attending the appointment, it’s important to complete any questionnaires sent to you at the time of booking. These provide crucial information to ensure a thorough assessment, including:

• Carer’s Report: A valuable opportunity to share any concerns or observations about the young person's health or well-being.
• SDQ (Strengths and Difficulties Questionnaire): For children aged 5-16, this helps identify areas where additional support may be needed. Learn more about the SDQ here.

We also recommend that the young person watches a video to help them understand what to expect during the appointment. These videos are available tailored to different age groups:

• Under 12 Years
• 12-17 Years

What Should I bring?

Please bring the following items to ensure a smooth appointment:

• Carer’s Report: A vital document to share any concerns or observations.
• SDQ Questionnaire: For children aged 5-16, this helps identify areas where additional support may be needed.
• Red Book: If available, bring the child’s health record for reference.
• Health information or appointment records: Any relevant health documents, such as past medical reports or treatment records.
• Refreshments or activities: If the young person may need something to occupy them during the appointment.

What Should I Do if I Need to Cancel or Change the appointment?

We understand that unexpected situations may arise and sometimes you may need to cancel or change the Initial Health Assessment (IHA) appointment. 

1. Prioritise the Appointment: The IHA is a key part of the young person’s health evaluation,and it needs to be completed within 28 days of the young person entering care, so please try to keep the scheduled time if possible.
2. See below if the young person is refusing to attend.
3. Speak to the Social Worker: Social workers may be able to help facilitate the appointment going ahead.
4. If Changes Are Necessary: If the appointment must be rescheduled, please email us at [We are awaiting a secure NHS.net email address. In the meantime please use hello@bakerbakerhealth.com with no personal information] as soon as possible to arrange a new appointment.

What if the young person is refusing to attend?

If the young person is refusing to attend the Initial Health Assessment (IHA), here are some steps you can take:

1. Put Them at Ease: Show the young person our videos (Under 12 or 12-17) and discuss how the IHA can help address any concerns or issues they may have. Reassure them that it's a safe space to talk about their health and well-being.
2. Speak to the Social Worker: Social workers are experienced in helping children who may be hesitant or anxious. They can offer advice on how to handle the situation and work closely with you to encourage the young person to attend.
3. Consider a Remote IHA or a Planning Meeting: If the young person is still unwilling to attend, we can arrange a remote IHA or a "Planning Meeting" via Teams. This meeting can include the young person, their carer and the social worker to discuss next steps. The face to face appointment can also be quickly converted to a virtual consultation if needed with minimal notice. If the appointment needs changing please email [We are awaiting a secure NHS.net email address. In the meantime please use hello@bakerbakerhealth.com with no personal information].

Feedback

At Baker Baker Health, we value feedback from young people and carers to help improve our services. We regularly do surveys to request feedback from young people and their carers. However if you have any comments, suggestions, or ideas for improvement, please email us at hello@bakerbakerhealth.com.

Finally…

We aim to make this appointment a calm and constructive experience for both you and the young person. Our goal is to put plans in place that address any areas of concern, helping the young person heal, thrive and reach their full potential.