Caring for our children and young people: corporate parenting update 2018 to 2021

Chapter 7: Corporate Parenting Activities of Scotland’s Health Boards and Special NHS Boards

Introduction

In this chapter we review the corporate parenting activities of Scotland’s Health Boards and Special NHS Boards between 2018 and 2021. The chapter is based on the survey responses provided by 8 of Scotland’s 14 Health Boards, and 4 of Scotland’s 7 Special NHS Boards.^[14] Therefore, this review is limited by the relatively low rate of survey returns from Health corporate parents in comparison to other groups of corporate parents discussed within this report.

The information received presented a varied picture of the corporate parenting activity of Health Boards and NHS Special Boards across Scotland. Some Health Boards described thoughtful, detailed and focused work on specific health issues which they had developed and progressed alongside care experienced children and young people. Despite not working directly with children and young people, there were examples of some NHS Special Boards truly owning their corporate parenting roles and responsibilities, with particular efforts to develop high quality training resources for the NHS workforce, and to integrate a consideration of the needs of care experienced children and young people into service monitoring and review. Some corporate parents provided insightful reflections on the enablers and challenges they have experienced in their role, and an awareness of the particular health challenges that can be faced by children and young people with care experience, such as mental health and wellbeing matters.

We are mindful that the COVID-19 pandemic and its impact on health services has proved significantly challenging for Health Boards and has been cited by some as having a detrimental impact upon their ability to focus on corporate parenting activity. However, a number of Health Boards and NHS Special Boards did not articulate much ownership (and at times, understanding) of the role of a corporate parent in the survey returns provided, and demonstrated little specific corporate parenting activity, over and above the provision of services which are available to all children and young people. Whilst these services may contribute to the health and wellbeing of children and young people with care experience, the purpose of corporate parenting is in recognising the need to take additional specific actions to uphold the rights and enhance the wellbeing of care experienced children and young people.

Whilst some corporate parents made efforts to capture the impact of their activities, an area for further attention for most Health Boards and NHS Special Boards is in how to measure and understand the difference their corporate parenting activities are making to the lives of children and young people, and use this information to make further improvements.

Alert

It is the duty of every corporate parent to be alert to matters which, or which might, adversely affect the wellbeing of children and young people.

Health Boards, and in most cases, NHS Special Boards described activities which contributed to meeting this duty. A focus on training and awareness raising, and on corporate parenting responsibilities in relation to children’s mental health were particularly notable. Whilst some responses provided greater detail and clarity about the activities taking place, others provided limited detail and sometimes struggled to differentiate between their specific role as a corporate parent, and their universal services and support that are available to all children and young people.

Activities

Training and awareness raising

A range of training and awareness raising activity was noted in survey responses.

Some Health Boards and NHS Special Boards have introduced bespoke corporate parenting training and awareness raising sessions for staff and/or Board Members; introduced eLearning; and/or introduced changes to induction materials to highlight corporate parenting responsibilities.

Some Health Boards highlighted training and awareness raising, both for their staff and for the wider public, about research into Adverse Childhood Experiences (ACEs). Similarly, a small number of Health Boards outlined their approach to ensuring their workforces are trauma-informed, such as through implementation of the National Trauma framework, through the screening of films, introducing Trauma Champions, and refreshing training modules.

Spotlight

NHS Grampian introduced face-to-face corporate parenting training for various groups of staff, drop-in awareness sessions with health and social care partners, and held a seminar with Directors of the Board.

As well as providing training and learning opportunities and educational resources to key staff, and the Board and Senior Leadership Team, NHS Education for Scotland (NES) worked with Who Cares? Scotland to develop an open access Corporate Parenting eLearning module for all NHS staff.

NHS Tayside School and Looked After Children and Young People Nurses have implemented the National Trauma Framework to increase understanding of traumatic events and the different ways individuals can be affected.

NHS Borders include trauma-informed practice in the workforce in their induction materials, employed a Trauma Champion, and supported the screening of the Resilience film: Biology of Stress and Science of Hope.

Activities

Establishing groups and collaborations

Different approaches to staying alert to the needs of care experienced children and young people through forming groups and collaborations were noted in a small number of Health Boards. These included establishing a corporate parenting focus in a strategic planning group; holding multi-agency meetings to review the care and needs of care experienced children, and collaborating with organisations such as Who Cares? Scotland.

Spotlight

NHS Highland established a Children and Young People Strategic Planning Group, with a care experience/corporate parenting work stream.

Activities

Being ‘alert’ via services for children and young people

Under the ‘alert’ duty, some Health Boards referenced the provision of services such as School Nursing, the Family Nurse Partnership programme and Health Visiting, which provide services to all children including those with care experience. One Health Board highlighted the role of Looked After Children and Young People’s nurses.

One NHS Special Board reported activities relating to public protection, modern slavery, and adult protection. Whilst not specifically ‘corporate parenting’, these are indirectly linked and therefore were included in the survey response.

Spotlight

NHS Tayside highlighted their implementation of the new model of Looked After Children and Young People nursing with a dedicated team to focus on care experienced children and young people (up to 26) who are particularly vulnerable with complex needs: including working in partnership with CAMHS and Complex Disabilities nurses where appropriate.

Activities

Using data and evidence

Several references were made to different ways data is gathered and used to learn about, and stay alert to, the needs of care experienced children and young people.

One NHS Special Board has begun establishing whether children and young people in contact with certain services are care experienced, and recording this information. Another NHS Special Board has disseminated a refreshed ‘toolkit’ entitled ‘Improving the health of Looked After Children’.

One Health Board outlined work to develop new health and wellbeing indicators affecting the lives of care experienced young people, and another described using findings from reviews of drug deaths and child deaths to inform future learning related to care experienced children and young people.

Spotlight

NHS Health Scotland (now Public Health Scotland) produced the Children and Young People’s Profile of Health and Wellbeing Indicators, which includes indicators specifically related to care experienced children and young people. These indicators are regularly updated and incorporated into the Scottish Public Health Observatory (ScotPHO) profiles for use by public and third sector partners to plan services.

NHS Tayside Looked After Children and Young People’s nursing service has been developing work on new health and wellbeing indicators for care experienced young people and care leavers up to their 26th birthday. For example, in relation to the impact of unemployment.

Activities

Focus on mental health

A common theme across most survey responses was a recognition of the need to provide enhanced mental health support, to benefit care experienced children and young people. A range of ways of staying alert to this issue were noted, including links between CAMHS services and Champions Boards, focused participation activity with children and young people to inform service improvement, establishing stakeholder groups, expanding mental health service provision, and gathering the views of care experienced people who use particular mental health services.

Spotlight

NHS Grampian have made formal links between CAMHS, Corporate Parenting and Transitions, through the oversight of the CAMHS service manager. Additionally, CAMHS provided updates to Aberdeen City’s Champions Board about service developments, and had established a stakeholder group to inform service improvements. Who Cares? Scotland were part of this work, noting work was paused due to the pandemic.

Since 2019, the Mental Welfare Commission have routinely collected information about whether the individuals they are visiting in hospitals or in the community are care experienced. This has involved amending pre-visit information so services are aware prior to visits that individuals with care experience will be offered additional opportunities to meet with the Commission.

Activities

Being ‘alert’ in the context of COVID-19

By being alert to the COVID-19 pandemic’s impact on vulnerable children and families, some Health Boards reported changes to their corporate parenting activities. This varied from expanding the reach of services by extending the range of multidisciplinary partners at key meetings to ensure widening areas of inequality were recognised, to focused assessment and support for care experienced children and young people’s needs in the pandemic.

Spotlight

NHS Ayrshire and Arran changed the format of the meetings of the Infant, Children and Young People Transformational Change Programme Board in response to risks from COVID-19, to widen the range of multidisciplinary partners, consider a wider range of data, and ensure holistic responses were provided in response to widening inequalities affecting children.

NHS Greater Glasgow and Clyde reported that the Vulnerability Health Team implemented ‘NHS Near Me’ for assessment of support for care experienced children and young people’s emerging needs at the start of the COVID-19 outbreak, and the successful elements of this approach are to be carried forward into a blended appointment model in the future.

Assess

It is the duty of every corporate parent to assess the needs of those children and young people for services and support it provides.

All Health Boards and NHS Special Boards provided information about activities which contribute to assessing the needs of children and young people receiving their services. In the majority of cases, this extended to specific activities to assess the particular needs of care experienced children and young people, as per the corporate parenting duties. Health Boards provided a range of information about different specialist health assessments available to children and young people, and a focus on the use of a variety of data and evidence to inform services (ranging from baseline measurements and indicators, to listening the views of children and young people themselves, albeit indirectly). Whilst this is positive, limited information was provided to suggest that children’s views are routinely sought in relation to the health assessments they receive.

Activities

Providing specialist health assessments

Understandably, given their differing roles and remits, the provision of various forms of health assessments were a common feature of the responses of Health Boards, rather than Special NHS Boards.

Some Boards described their provision of specialist health assessments for looked after children, both initial (taking place within 4 weeks of learning that a child has become ‘looked after’), and review assessments. One Health Board had introduced changes to improve the utility of the assessment itself, and several Boards described working to improve the timely completion of initial health assessments.

One Health Board noted the role of the Looked After Children’s Medical Advisor in complex cases, and/or where younger children are moving through permanence proceedings.

Two Health Boards highlighted the development of tailored assessments for children and young people with more distinct needs: in one case for unaccompanied and asylum seeking children , and in the other to develop a more age appropriate health assessment for older care experienced people.

Spotlight

NHS Borders have embedded review health assessments for looked after children aged 5+ into the school nursing pathway, which involved developing guidance and training within universal services. This approach aimed to increase consistency and equity of approach and advanced the knowledge and skills of practitioners in universal services.

NHS Grampian introduced measures including social workers liaising directly with GPs to increase completion of initial health assessments within 4 weeks, as well as introducing Strengths and Difficulties Questionnaires (SDQs) at the initial assessment to detect early those children who may require CAMHS support.

NHS Greater Glasgow and Clyde’s Vulnerability Health team developed a new approach to assessing the needs of unaccompanied and asylum seeking children, supporting them using a more tailored approach to assessment to produce more accurate child’s plans.

Activities

Providing specialist health assessments

One Health Board highlighted their intensive maternity assessment and support for care experienced expectant mothers.

One NHS Special Board highlighted their introduction of Health Inequalities Impact Assessments across all of their programmes of work, as direct response to considering how to meet the Corporate Parenting duties.

Spotlight

In their maternity services for care experienced expectant mothers, NHS Forth Valley work collaboratively between midwives, health visiting and Family Nurses to ensure pre-birth planning, assessment and provision of support, including referrals to social work services were necessary.

Public Health Scotland (formerly NHS Health Scotland) undertake Health Inequalities Impact Assessments in all work programmes to ensure there is no discrimination, to widen access opportunities, and to promote the interests of people with protected characteristics.

Activities

Role of universal services

Assessment of need through universal services was referred to by some Health Boards, at times with some consideration of how these meet the needs of children and young people with care experience. Universal services particularly mentioned were in relation to the universal health visiting pathway, use of the GIRFEC National Practice Model for assessment in midwifery, the use of Strength and Difficulties Questionnaires (SDQs) by school nurses, and assessment tools in sexual health contexts.

Spotlight

NHS Tayside noted that the GIRFEC National Practice Model and Risk Assessment Framework provide a common and standardised approach and tool for Midwives, Health Visitors, Family Nurses, School Nurses and Looked After Children’s Nurses to assess information and analyse risk and need in an informed, structured and evidence-based way. These are used alongside the views of children and young people, parents and carers to inform holistic health assessments.

NHS Highland noted the progression of work with health visitors in two areas to improve the recording of care experience in their management information systems as part of the universal health visitor pathway.

Activities

Mental health

A small range of activities relating to mental health assessments were noted by some Health Boards. Activities included the provision of consultations by CAMHS practitioners to multiagency professionals, and adhering to transitions guidance issued by the Scottish Government.

One Health Board noted plans to identify and address inappropriate referrals to CAMHS, whilst another noted a planned pilot programme to monitor cases where CAMHS appointments were not attended, to identify opportunities for service improvement.

Spotlight

CAMHS in NHS Forth Valley provide multidisciplinary consultations to professionals working with children, in order to plan jointly and meet children’s needs in a timely way. Similarly, NHS Tayside report the routine involvement of CAMHS clinicians in multi-agency looked after children’s planning meetings.

Following analysis of CAMHS waiting lists, NHS Greater Glasgow and Clyde have introduced a new neurodevelopmental pathway for children affected by autism, to ensure they are supported through non-clinical interventions rather than being inappropriately referred to CAMHS where they require non-clinical interventions.

Activities

Using data to inform services

Some Health Boards described gathering a range of data to assess and understand need. In two cases, this involved developing, collating and reporting against specific indicators for child health, and interpreting and analysing the findings in relation to care experienced children and young people, including at a joint strategic level across Community Planning Partnerships.

The role of needs assessment in developing Integrated Children’s Services Plans was briefly mentioned by one Health Board.

One NHS Special Board described measures to amend data collection processes to ensure information about individual’s care experience could be captured.

In addition to indicators and measures, one Health Board and one NHS Special Board described listening to the views and needs of care experienced people in developing their plans. On both occasions this appears to have been indirectly, one via advice from Who Cares? Scotland, and the other through local authorities partners.

Spotlight

NHS Ayrshire and Arran established a data working group to ensure the principles of the Looked After Children Data Strategy 2015 were embedded into practice, and systems are set up to provide an accurate picture of the needs of the looked after children population. This involved the establishment of baseline measures of need, and collating and reporting on indicators monthly.

The Mental Welfare Commission amended its data collection process regarding the children and young people admitted to non-specialist wards for treatment of mental illness, to find out if they are care experienced. These findings were included in the Commission’s annual young person’s monitoring report.

Activities

Collaborating to assess

In some cases, the benefits of collaborating with partners to assess and understand needs were commented on. This included one example of integration with Child Protection Committees, and one of multiagency review meetings.

The Scottish Ambulance Service reported that integration locally and nationally with Child Protection Committees had helped the service to better understand the needs of care experienced young people in Scotland.

Promote

It is the duty of every corporate parent to promote the interests of those children and young people.

All Health Boards and most NHS Special Boards articulated activities they had undertaken to promote the interests of care experienced children and young people. For Health Boards, this sometimes involved efforts to involve or incorporate the views of care experienced young people into services, or provide additional advocacy or supports to promote their interests within services. NHS Special Boards focused more on promoting employment opportunities and disseminating information to promote the interests of care experienced children and young people.

Activities

Responding to views and experiences

A range of activities designed to promote the interests of care experienced children and young people either through, or as a result of, paying attention to their views, needs and experiences were outlined by some Health Boards.

Activities included involving children and young people in co-producing corporate parenting plans; attending conferences with workshops delivered by care experienced young people; attending meetings with Champion’s Boards; and seeking feedback from children and their families at review meetings.

One Health Board used their findings from local needs assessments of looked after children, and national trauma data, as the basis to inform a Board Development Day focused on corporate parenting.

Spotlight

NHS Greater Glasgow and Clyde highlighted the support provided by the Health and Social Care Partnership (HSCP) to the People Achieving Change (PAC) Champions Board to design and deliver their own research into care experienced children and young people’s experiences of mental health support in Glasgow.

NHS Western Isles highlighted taking an increased emphasis on listening to and recording the views of children in health assessment processes, as opposed to giving parents/carers views prominence.

NHS Ayrshire and Arran used data around local need and national trauma data (including the impact if appropriate responses are not made to needs) to structure a Board development day with care experienced young people and Who Cares? Scotland. They reported this approach brought statistics to life and strengthened the commitment to improve outcomes for all care experienced people.

Activities

Providing additional services, support and advocacy

A number of Health Boards and NHS Special Boards undertook activities to promote the interests of care experienced children and young people by introducing particular services, or additional supports to promote their interests within existing services. This sometimes included advocacy support for children and young people, and also extended to highlighting the interests and needs of care experienced children and young people in influencing and policy work.

NHS Tayside have commenced improvement work to minimise disruption to CAMHS services for looked after children who moved to another Health Board area.

NHS Grampian have piloted the delivery of developmental trauma workshops for kinship and foster carers.

The Mental Welfare Commission described work to investigate cases where care experienced young people have had difficulty accessing secure care provision, to learn about the issues and ensure rights are upheld. Following this, they submitted evidence to the 2019 Scottish Parliament’s Justice Committee Inquiry into Secure Care.

Activities

Employment and employability

One Health Board and three NHS Special Boards highlighted promoting the interests of care experienced young people through activities related to employability, work experience, Modern Apprenticeships and employment.

Spotlight

Public Health Scotland detailed their Modern Apprentice scheme, which has resulted in four care experienced staff members progressing within the organisation to become valued permanent employees.

The Scottish Ambulance Service have worked with Who Cares? Scotland to attend job fairs and promote work opportunities.

Activities

Promoting interests through collaboration

Several Health Boards described utilising collaboration in their activities to promote the interests of care experienced children and young people, including at an individual level in children’s care and planning, as consultants in complex cases, and, in one example, on a more systemic level.

Spotlight

NHS Forth Valley cited their partnership between pre-birth planning services for care experienced expectant mothers, and the local authorities throughcare and aftercare teams, to enable joint planning and consequently reduce the number of planning meetings.

NHS Grampian have redesigned their CAMHS looked after children consultation service. The new Complex Case Consultation Service provides reflective space and support for professionals working with children (many of whom are care experienced) with complex mental health needs.

NHS Forth Valley cited joint work they have undertaken with the Citizen’s Advice Bureau in tackling child poverty, with a particular emphasis on care leavers.

Activities

Disseminating information

Three NHS Special Boards highlighted activity to promote the interests of care experienced children and young people by dissemination of information, both to their own staff and to partner organisations

Spotlight

The Mental Welfare Commission published good practice guidance regarding capacity and consent to treatment, following a particular case involving a care experienced young person.

Public Health Scotland promoted opportunities to staff to become panel members, and to become involved in mentorship schemes for care experienced young people.

NHS Education Scotland promoted the eLearning resources they have developed to other corporate parents.

Opportunities

It is the duty of every corporate parent to seek to provide those children and young people with opportunities to participate in activities designed to promote their wellbeing.

Provision of some opportunities were described by Health Boards and NHS Special Boards to contribute to meeting this duty. Participation was a notable theme, and in some cases, meaningful opportunities to participate in service development were described. However, in others, there was limited detail offered on the opportunities provided and the impact of these. Provision of employment, work experience and Modern Apprenticeship opportunities were described by a number of Boards, and some Boards outlined social and recreational opportunities available for care experienced children and young people.

Activities

Opportunities to be heard, and to participate in service development

Some Health Boards and one NHS Special Board described activities which provided care experienced children and young people to be heard, and to participate in service development in a range of different ways.

Three Health Boards cited their involvement with or attendance at Champions Boards as a valuable means to consider the feedback and views of care experienced children and young people.

One NHS Special Board described scoping work to develop a youth forum.

In two Health Boards, examples were outlined of ‘you said, we did’ approaches to ensuring children and young people had opportunities to meaningfully influence service improvement.

Spotlight

NHS Ayrshire and Arran carried out qualitative work with children and young people about their experiences of healthcare services from their corporate parents. This directly impacted service improvement, particularly the development of a new dental pathway for care experienced children and young people, and highlighted the integral role of children’s views for service development.

“We never went to the dentist every 6 months. Mum was very forgetful and would have issues with the dentist and stuff …I’m still petrified to go to the dentist because of the past” (voice of Care Experienced Young Person, NHS Ayrshire and Arran Health Needs Assessment 2018)

NHS Tayside’s looked after children’s nurses worked with care experienced people to discuss and change services. Examples included producing a new leaflet about the service, and involving young people in the recruitment of looked after children’s nurses. NHS Tayside CAMHS service also consulted with care experienced young people and carers in developing their new website.

Activities

Social, recreational and leisure opportunities

Some Health Boards and one NHS Special Board described activity relating to opportunities for care experienced children and young people to benefit from social, recreational and leisure opportunities. This varied from opportunities to socialise with corporate parents such as on camping trips or at Christmas dinners, accessing leisure facilities, to monitoring work to ensure appropriate recreational (and other) opportunities are available in settings where they are required.

Spotlight

NHS Grampian, in partnership with Moray Council, developed free and reduced cost options for accessing leisure services, and evaluated the implementation of the programme. On listening to feedback from young people that they did not want to use leisure facilities on their own, additional passes are now available to friends or carers.

Activities

Collaborating to enhance opportunities

Three Health Boards made reference to collaborating with partners (such as prisons services and education staff) to enhance opportunities. It was not always clear whether this was directly linked to care experienced children and young people’s opportunities, or developing collaborations which contributed to the broader corporate parenting agenda more generally.

NHS Forth Valley cited collaborations with education staff which enabled allied health professionals to influence the provision of both general and targeted services within schools, based on the needs of young people.

Activities

Employment and employability

Two Health Boards and two NHS Special Boards highlighted the development or provision of work experience, mentoring support, and employment opportunities for care experienced young people.

Spotlight

NHS Borders have facilitated eight care experienced Modern Apprenticeships in four years. They have provided training for their mentors, and the young people have developed skills and confidence, and had opportunities to progress to other employment within the organisation.

NHS Education for Scotland have worked with the NHS Scotland Employability and Apprenticeship Network to promote and support care experienced young people to join the NHS workforce, and raise awareness of funding for apprenticeship programmes with other Boards.

Access

It is the duty of every corporate parent to take such action as it considers appropriate to help those children and young people to:

• access opportunities;
• make use of services, and access support, which it provides

All Health Boards and most NHS Special Boards provided some information about activities they had undertaken to support or improve access to their services, through specialist services, fast-track appointments and awareness raising activities. A focus on mental health services was again notable in the responses from Health Boards. Often the activities described related to services and supports which may have contributed indirectly to the corporate parenting agenda, with little reference to specific actions taken to support or improve access for care experienced children and young people in particular.

Activities

Specialist services and extended criteria

The majority of Health Boards and two NHS Special Boards described activities relating to accessing services. A significant amount of information given referred to different types of specialist services available to children, young people, families and carers(whether or not they are care experienced): for example substance abuse programmes; speech and language services; sexual health services; digital resources re diet, exercise, stress and wellbeing; and health visiting and family nurse partnership services.

In a few examples, information was given about services available to all children and families, but that further efforts had been made to support care experienced children and young people to access these services.

Three Health Boards described either additional services for care experienced children and young people, or extended criteria to ensure care experienced children and young people could access services which they otherwise would not have been eligible for.

Spotlight

NHS Forth Valley described improved access for care experienced children and young people in relation to their mental health through the Looked After Psychology Service, in partnership with Falkirk Council.

NHS Borders have extended the Family Nurse Partnership service to all care experienced mothers up to the age of 24.

The Scottish Ambulance Service noted activities to promote access to their services generally through different communications channels, adding further work was needed to ensure their activities also strengthen the access of care experienced children and young people.

Activities

Fast-track services

Two Health Boards described activities to improve care experienced children and young people’s access to services via fast-track/priority referrals.

Spotlight

NHS Forth Valley fast-tracked referrals for care experienced children and young people for sexual health, paediatrics and CAMHS services, working together with the referrer to ensure detailed referral information is included.

NHS Grampian prioritised care experienced children and young people for dental services.

Activities

Mental health services

Five Health Boards described activities particularly related to children and young people’s access to mental health services (both specialist services, and wellbeing programmes within schools), and improvements where young people were making a transition from child to adult mental health services. Whilst there were one or two examples of specific steps taken to support the access of care experienced children and young people to mental health services, in general this activity was focused on the whole children and young person population.

In partnership with Highland Council, NHS Highland has expanded their specialist trauma-informed CAMHS team for care experienced children and young people. Where care experienced children and young people have required admission to the Raigmore Children’s Unit with distressed behaviour, there have been learning reviews across teams to improve children’s experiences of hospital care going forward.

Activities

Awareness raising

One Health Board and two NHS Special Boards described awareness raising activities aimed at improving care experienced children and young people’s access to services and opportunities.

Spotlight

NHS Grampian sent letters to each local authorities corporate parenting Lead with details about visits, work experience and placements for care experienced young people.

NHS Education for Scotland engaged with Equality and Diversity leads across NHS Scotland to consider educational resources which could contribute to raising awareness of the needs of care experienced young people.

The Mental Welfare Commission wrote to agencies which support young people with mental health issues or learning disabilities to publicise their services which are designed to ensure people’s rights are upheld, e.g. their advice line and web-based information resources.

Activities

Access in the context of COVID-19

One Health Board described specific activity they had undertaken to support care experienced children and young people to access services in the light of the COVID-19 pandemic. Another Health Board described activity taken in a specialist service to which care experienced young people had extended eligibility.

Spotlight

NHS Ayrshire and Arran established a working group to respond to the needs of children and young people in residential houses during the pandemic. A bespoke pathway to respond to possible COVID-19 cases was established, which took children’s needs for stability and feeling safe into account. The working group continued to meet regularly and respond to emerging issues throughout the pandemic.

NHS Borders worked with Connecting Scotland to deliver the Family Nurse Partnership programme via video-calls when home visits were not possible.

Improve

It is the duty of every corporate parent to take such other action as it considers appropriate for the purposes of improving the way in which it exercises its functions in relation to those children and young people.

We asked Health Boards and NHS Special Boards how they have reviewed their performance as a corporate parent, to help bring about improvements for care experienced children and young people. Responses gave an overarching description of internal reporting, monitoring, auditing and review processes, and on a few occasions made links to participating in the review activities of other corporate parents, for example at a Children’s Services Planning level. Some reference was also made to sharing information and collaborating with other corporate parents, particularly local authorities, in reviewing performance.

Activities

Internal reporting and monitoring processes.

A range of activities to monitor and report on corporate parenting activity were outlined, often including reference to the Corporate Parenting Plan and the oversight of strategic leadership groups.

Some Health Boards referred to the use of trend data to understand need, and to inform improvements to services and service design. Two Health Boards also described having a process of internal case reviews to share learning, however it was unclear whether this was specific to corporate parenting cases, or audit processes more generally.

Spotlight

NHS Western Isles described undertaking an annual audit of medical assessments offered to care experienced children and young people.

NHS Golden Jubilee (a specialist hospital and research institute, with a focus on assisting NHS Board’s to reduce waiting times) noted that they monitor the demographics of those who use their services, but numbers of care experienced children and young people are minimal, due to the service they deliver.

The Mental Welfare Commission reported their Executive Director and their Children and Young People’s group continue to regularly review the necessity for specific themed pieces of work to promote the needs of care experienced children and young people.

Activities

Participating in joint corporate parenting processes

In two Health Boards, some information was given about participation in the corporate parenting reporting and strategies of wider groups.

NHS Borders noted they contribute to the annual Scottish Borders corporate parenting report and strategy.

NHS Greater Glasgow and Clyde form part of the Glasgow HSCP whose corporate parenting activity is overseen by the Integrated Joint Board.

Activities

Sharing information and collaborating

Some activities were noted by two Health Boards and one NHS Special Board regarding sharing information and liaising with partners (generally in local authorities) to monitor performance and seek to improve.

Spotlight

NHS Grampian liaised with local authorities about health outcomes data on specific topics, such as waiting times for looked after children.

NHS Highland have been working with two local authorities to improve uptake of health assessments for looked after children, and approaches to mental health assessments.

In summary

The information received from the health boards presents a varied picture of corporate parenting activity by health services. Whilst some Health Boards and NHS Special Boards clearly demonstrated an understanding and ownership of their role in supporting the health and development of children and young people with care experience, this unfortunately was not necessarily common or consistent. More could be done to ensure the vital role of health services as corporate parents is fully realised.