Looked After Children (LAC) – resources and guidance
This term typically denotes children cared for by Government, though exact definitions vary between the four nations. More than 100,000 children in the UK are in care. This page sets out the RCPCH Lead for Looked After Children, key relevant resources and statutory guidance.
RCPCH lead
Dr Lynn Snow is the Looked After Children Lead on the RCPCH Child Protection Standing Committee. She also collaborates with the British Association of Adoption and Fostering (Coram BAAF) Health Advisory Committee.
Initial Health Assessment (IHA) Delivery Standards
The IHA Delivery Standards were published in November 2025 by RCPCH and are badged by CoramBAAF.
The standards aim to improve outcomes for children and young people who are looked after in the UK, by providing a benchmark for the delivery of IHAs. They can inform discussions between healthcare professionals, social care, provider organisations and service planners.
Safeguarding competencies
The 5th edition of the Intercollegiate document, Safeguarding children and young people & children and young people in care: Competencies for health care staff was published in autumn 2025 on a dedicated website. It outlines competencies for each of the five levels of health care staff who support children and young people and for senior managers and executives.
This revision incorporates a review and update of two documents, the intercollegiate knowledge, skills and competencies for Safeguarding Children and Young People: Roles and Competencies for Health Care Staff (2019) and Looked after Children: Roles and Competencies for Health Care Staff (2020).
NHSE Key principles for ensuring continuous health records of adopted children
In June 2024, NHS England set out key principles for merging an adopted child’s health records with their new post-adoptive details. This creates a continuous health record for the child that is valuable for their health, wellbeing and understanding of their medical history. It is also efficient for the wider health system. NHSE Key principles for ensuring continuous health records of adopted children
In September 2024, NHSE Safeguarding published a statement setting out the process to protect the continuity of the adopted child’s records. Download below.
Children and young people seeking asylum and refugees
Children and young people seeking asylum and refugees (CYPSAR) who are not accompanied by a legal parent or guardian are automatically a looked after child. This means that they are under the care of the Local Authority.
RCPCH Children and young people seeking asylum and refugees – guidance for paediatricians
NHSE eLearning module: safeguarding and looked after children
October 2021
NHSE staff with Healthcare Hub access may be interested in completing the looked after children module of the safeguarding e-learning, which meets level 3 training requirements.
The module was written by Assistant Officer for Child Protection Dr Vicki Walker (author) and RCPCH Lead for Looked After Children Dr Lynn Snow (advisor).
NHSE E-Learning module on safeguarding and looked after children
NICE guideline for looked after children
October 2021
This guideline covers how organisations, practitioners and carers should work together to deliver high quality care, stable placements and nurturing relationships for looked after children and young people. It aims to help these children and young people reach their full potential and have the same opportunities as their peers.
Promoting health and wellbeing – statutory guidance
March 2015
The Department of Health and the Department of Education produced statutory guidance on the planning, commissioning and delivery of health services for looked after children in England. The guidance is relevant for local authorities, clinical commissioning groups (CCGs) and NHS England, alongside health professionals and professionals working in children’s services.
The guidance is currently being rewritten by an advisory group including the RCPCH.