Improving the Health of Looked after Children in Scotland: 1. Using a Specialist Nursing Service to Improve the Health Care of Children in Residential Accommodation

The first of two studies reported here by Donna Hunter, Gerry McCartney, Susan Fleming and Fiona Guy investigated whether a specialist nursing service could improve the health care of 162 children in residential care in Renfrewshire, West Dunbartonshire and Argyll & Bute. It found that after the introduction of the service, the proportion of children with completed carer-held health records (BAAF health record booklets) increased from three per cent to 77 per cent; the proportion receiving a ‘pre-admission medical’ increased from 38 per cent to 48 per cent; the proportion adequately immunised increased from nine per cent to 56 per cent; the proportion with at least one outstanding medical referral decreased by at least four per cent; the number registered with a dentist increased from 14 per cent to 62 per cent and the proportion who received a ‘comprehensive health assessment’ increased from 17 per cent to 58 per cent. Thematic analysis of free text journals suggested that universal health services were much more accessible in Argyll & Bute due to well-developed interagency working, low numbers of children in residential care and low rates of staff turnover. In the more urban areas, the main advantage of the service was thought to be in the facilitation of interagency working. The service was received positively by residential care workers and children in residential establishments. This study suggests that the provision of a specialist nursing service can improve the health care of children in residential accommodation.