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Co-production of health passports for children in care: May 2018

Children in care across Birmingham and Solihull are entitled to have their own NHS health passport to provide a record of a child or young person’s health history and contribute to their emotional and social wellbeing. It is made available for children on school entry and up to the age of 17 years. The passport will stay with them through their care journey and beyond, providing them with very useful information into adulthood.

This document is a hard backed A5 folder containing sections within it for the young person to complete (with support), it covers areas of health including birth history, immunisations, health appointments, wellbeing and health information such as sexual health advice and substance misuse.

Earlier this year the co-production of health passports in Birmingham was featured in the British Association for Community Child Health (BACCH) as an example of good practice.

Why were new health passports required?  

The process was undertaken following a care leavers' forum where young people discuss general experiences of health and their satisfaction of their leaving care summaries -  a statutory document which should be issued to young people who have been in care at the last health assessment before their 18th birthday.

After much debate and discussion, it was noted that whilst the leaving care summary was helpful, it was too late for young people to be receiving information about their own bodies and health history. A solution was required to allow a recorded history to be made, which met young people’s needs to have ownership over information about themselves, and access to basic health information.

The young people at the care leavers' forum suggested a “red-book type document” which would be held by the young person in care, and could be transferred to various placements. We discovered that various similar passport style documents were being used across the UK, and were generally paper bound. To develop a robust health passport, we applied and received funding from NHS England to support the development. Our communications team supported the design, branding, physical production and young people’s engagement sessions.

Who was involved in co-producing health passports?

Over the last 18 months, our designated nurse for children in care, the Rights and Participation team from Birmingham local authority, The Care Leavers forum/Children in Care Council and CCG communications colleagues worked together to create the NHS health passport.

How were young people involved?

Health passport viewsAs part of this engagement process, a debate was led by young people within the council chambers of the city council. 50 young people discussed various topics related to being in care, particularly their thoughts on mental health services, health assessments, stigma of being in care and confidentiality. The thought provoking and enlightening discussions were filmed and video footage is available to view here.

Further development was undertaken to ensure simple and appropriate information was held within the passport e.g. a section was included within the passport for young people to make their own notes at meetings or appointments.

Over a number of sessions young people told us what they liked about these documents and wanted; we concluded what need to be included within the passport to meet their needs and informed the design, contents and inserts of the passport.

Health passportIn May 2018 – the health passport was launched, a full 18 months after the first care leaver’s forum where it was suggested. The process was not rushed, it was thorough, fit for the future and co-designed with young people to meet their needs.

At the launch, some young representatives said that the process left them feeling listened too, and their opinions valued, they felt proud to be making a difference for other young people who would be going through the care system. This reciprocal benefit for service and service user, is the fundamental value of co-production. The process, although challenging and time consuming was empowering and positive for all involved.

Further steps to embed learning for healthcare professionals

Parents, carers, social workers and health professionals have a very important part to play in ensuring that the health passport is explained and offered to the children, taking into account a child/young person’s wishes ability to consent to having it, and that it is taken along to health appointments and to encourage safe storage of the information.

Training videos were developed for professionals to help them understand the rights and needs of young people and their responsibilities around meeting the specific needs of Children in care.

More debate footage is available to view below:

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