Higher numbers of children entering local authority care along with a shortage of paediatricians means more youngsters are having to wait longer for potentially crucial health checks.

Councils are tasked with ensuring an initial health assessment of physical, emotional, and mental health needs is completed for every child within 20 working days of becoming looked after.  But there has been a major drop in the proportion of these being carried out in a timely fashion.

In the example of Redcar and Cleveland in the third quarter of 2023/24 – October, November and December – just 19.6% were completed within the 20 days.

This compares to 81% in the same quarter in 2021/22, a report compiled for the council’s corporate parenting board showed.

The report by the North East and North Cumbria Integrated Care Board said demand for the assessments had risen by more than 37% over the past two years.

It said: “[This] will have had a substantial impact on the opportunity to achieve compliance because of the requirement for extra clinic appointments and paediatricians to undertake the assessments.”

The report said compliance with completing initial health assessments in the desired timescale “remains challenging”, although there had been signs of improvement quarter-on-quarter.

The majority of delays (85%) were down to clinic availability, although other reasons included difficulties with obtaining the required medical consent to do the checks and children refusing to attend for them.

Health services for children in care are overseen in the South Tees area by the Harrogate and District NHS Foundation Trust, which has the contract for the work, with clinics being provided by local health trusts.

‘Something we need to carefully monitor’ Councillor Karen King, who chairs the corporate parenting board in Redcar and Cleveland, a committee that aims to ensure responsibilities and duties towards children in care are carried out, said: “I have expressed concern about this and it is something we need to carefully monitor.

“The main issue is the access to [clinic] appointments.”

Cllr King said the board had received reassurances on the matter from a representative attending a recent meeting in terms of “turning this around and getting it back to where it was”.

She added: “We are aware of the issues and are continuing to push for improvements so we can provide the best for our children.

“We will monitor progress and hold [people] to account if they don’t improve.”

In a statement provided to the Local Democracy Reporting Service, David Purdue, chief nurse at the North East and North Cumbria Integrated Care Board, said: “Like many areas, Redcar and Cleveland has seen an increase in the number of children in care at the same time as a national shortage of paediatricians.  “Winter pressures on the NHS have stretched our staff even further.

“We are very much aware of the importance of initial health assessments for children entering care and we are working with local NHS trusts to address the issue.

“With new ways of working in place, we hope to be able to provide extra clinics over the next few weeks to turn the problem around.”

This week analysis produced by the University of Liverpool for a cross-party group of MPs found that while the North of England had 28% of the country’s child population, it had 36% of the children in care.

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The research pointed to deeply-rooted social inequalities creating a North-South divide in the rates of children entering care with higher rates in the former costing an extra £25bn over the past four years.

Lead author Dr Davara Bennett said: “Local authorities are trapped in a cycle of ever-greater spend on children in care, at the expense of investment in effective support for families in need.”

She said there had been a failure to address child poverty in the North and policymakers needed to tackle the problems “head-on”.