What is an IHA?

An IHA is an Initial Health Assessment which is a mandatory health check required by the government for all young people entering care, to be completed within 28 days of entry into care. The IHA is crucial in ensuring the child’s overall well-being across multiple areas, including:

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

The IHA plays a key role in creating a comprehensive care plan to support the young person's physical and emotional needs.

Read more about what an Initial Health Assessment (IHA) involves here.

What is the Initial Health Assessment for Looked After Children?

An Initial Health Assessment (IHA) for Looked After Children is a mandatory health check required by the government for all young people entering care, to be completed within 28 days of entry into care. The IHA is crucial in ensuring the child’s overall well-being across multiple areas, including:

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

The IHA plays a key role in creating a comprehensive care plan to support the young person's physical and emotional needs.

Read more about what an Initial Health Assessment (IHA) involves here.

What does IHA stand for?

IHA stands for Initial Health Assessment. It is a government-mandated health check required for all young people entering care and it must be completed within 28 days of their entry into the care system. The IHA helps assess and support the child’s overall health and well-being.

What happens at an Initial Health Assessment (IHA)?

At an Initial Health Assessment (IHA), a young person's well-being is evaluated across several key areas, including:

• Physical health
• Mental health
• Medication
• Vaccinations
• Education and development
• Sexual health and relationships
• Substance use
• Background and reasons for entering care

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.
• 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.

Find more information on IHAs based on your age group or role at the links below:

• Under 12 years
• 12-17 years

Are Chaperones Available for Medical Assessments?

Yes, we always provide the option of a chaperone during medical assessments to ensure comfort and professionalism.

• 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.
• 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.
• We approach these situations with sensitivity and if at any point you feel uncomfortable, alternative options will be considered. You can request a chaperone at any time during the appointment.

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

What is a Needs Assessment for Children in Care?

A Needs Assessment for Children in Care is known as an Initial Health Assessment (IHA). This assessment is vital in ensuring the young person’s overall well-being by evaluating various areas of their life, including:

• Physical health
• Mental health
• Medication
• Vaccinations
• Education and development
• Sexual health and relationships
• Substance use
• Background and reasons for entering care

The IHA helps create a personalised care plan, addressing actions to support recovery and long-term well-being.

Read more about what an Initial Health Assessment (IHA) involves for Under 12's, 12-17y and for Carers.

What is a health assessment for Children in Care?

A health assessment for Children in Care is known as an Initial Health Assessment (IHA).

Read more about what an Initial Health Assessment (IHA) involves for Under 12's, 12-17y and for Carers.

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.

There is a page of specialist information to support Unaccompanied Asylum Seeking Children (UASC) with resources in various other languages here.

What Should I Do Before the IHA Appointment?

Before attending the Initial Health Assessment (IHA) 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 watch videos 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

If you are a carer bringing a young person to an IHA, click here for more information.

What Should I Bring to an Initial Health Assessment (IHA)?

To ensure a smooth Initial Health Assessment (IHA) appointment, please bring the following items:

• 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.

If you are a carer bringing a young person to an IHA, click here for more information.

How Can a Young Person Learn More About an Initial Health Assessment (IHA)?

To help young people understand what to expect during an Initial Health Assessment (IHA), we recommend watching age-appropriate videos. These videos explain the IHA process:

• Under 12 Years
• 12-17 Years

Watching these videos can help ease concerns and provide a clear understanding of the appointment.

There are also some resources available for Unaccompanied Asylum Seeking Children (UASC) with information interpreted into some of the languages commonly spoken by the young people.

If you are a carer bringing a young person to an IHA there is information for you on what to expect and what to bring.

Should Carers Attend Initial Health Assessments (IHAs)?

Yes, carers should attend Initial Health Assessments (IHAs) whenever possible. 

Their input, alongside that of the young person, is highly valuable during the assessment.Carers offer essential insights into the young person's health and well-being, which can significantly enhance the assessment process.

What If a Carer Can't Attend the IHA?

• Notify the social worker in advance. The social worker may attend the appointment instead, but make sure they are aware of any concerns you have.
• Make sure to communicate any concerns and complete the Carer's Report so that the social worker can pass along the necessary information.

For more detailed information about attending an Initial Health Assessment as a carer, click here.