The role of the Designated Nurse and Designated Doctor for Children in Care focuses on improving outcomes, quality and safety for the most vulnerable children across the healthcare services that NHS Shropshire, Telford and Wrekin commission by:

• Raising key issues with commissioners and providers of health services for children in care
• Providing expert advice to increase quality, productivity, and to improve health outcomes for children in care and care leavers
• Developing, leading and monitoring quality assurance processes and service improvement of health services for children in care
• Ensuring all health services commissioned meet the statutory requirement to promote the health and wellbeing of children in care
• Ensuring the voice of children in care and their carers are taken into account locally including those children in care placed out of the local area
• Ensuring that there is enough provision within the local area to meet the needs of any Unaccompanied Asylum Seeking Children placed within the area

• An Unaccompanied Asylum Seeking Child (UASC) is defined by the Home Office as a young person under the age of 18 making an application for asylum in his or her own right and who ‘has no adult relative or guardian to turn to in this country’. These young people may have arrived in the UK by themselves or with an adult who later abandoned them or who does not present as suitable carer or guardian;
• UASC are supported within the framework of the Children Act 1989 and this should be guided by the principle that they are ‘children first and foremost’. Following an initial age assessment, a young person judged to be under 18 years of age, is entitled to the same rights as other children and young people in care, including accommodation, some finance, education, statutory health assessments, support and reviews;
• Research shows that the adversities affecting many unaccompanied young people include traumatic experiences as part of their flight, as well as separation from or loss of family members, and that an increasing number fall victim to international trafficking for exploitative purposes. Unaccompanied children have significant physical and mental health needs relating to communicable (infectious) Diseases (e.g. Tuberculosis screening and vaccination), dental health, nutrition (e.g. anaemia), sexual and reproductive health and post-traumatic stress disorder. It is therefore vital that their health needs are assessed and met in a timely manner.

1. The Statutory Guidance, ‘Promoting the Health and Wellbeing of Looked After Children, March 2015’ aims to ensure looked-after children have access to any physical or mental health care they may need. This guidance is for:

• Local authorities
• Commissioners of health services for children
• NHS England
• Designated and Named Professionals for looked-after children/children in care
• GPs, Optometrists, Dentists and Pharmacists
• Managers and staff of services for care leavers, and personal advisers
• Teachers
• Health visitors, School nurses and any other professional who is involved in the delivery of services and care to looked-after children, UASC and Care Leavers.

2. The NICE ‘Looked-after children and young people’ Public Health guideline [PH28], May 2015 aims to improve the quality of life (that is, the physical health, and social, educational and emotional wellbeing) of looked-after children and young people. It focuses on ensuring that organisations, professionals and carers work together to deliver high quality care, stable placements and nurturing relationships for looked-after children and young people.Its recommendations set out how agencies and services in a complex, multi-agency environment can improve the quality of life for looked-after children and young people through more effective collaboration that places them at the heart of all decision making. The recommendations cover local strategy and commissioning, multi-agency working, care planning and placements, and timely access to appropriate health and mental health services.
3. The UASC Health website has been developed and launched, September 2016 by East Kent Children's Commissioning Support Team to share learning, tools, templates and guidance with other local authority and ICB areas to help meet the needs of unaccompanied asylum-seeking children.