New Initial Health Assessments Standards: Delivering on child-led outcomes
An Initial Health Assessment (IHA) is a statutory health offer for every child or young person entering care in the UK. It covers physical, mental, and emotional wellbeing, ensuring access to the right support and services. Until now, there were no formal standards for IHAs. Practice is based on regulations and guidance. In England statutory guidance (DfE, 2015), outlines that:
- IHAs must be completed within 20 working days of entering care.
- Review Health Assessments (RHAs) follow every 6 months for children under 5, and annually for those aged 5–18.
The standards have been informed by insight from paediatricians, GPs, social workers, researchers, nurses and children and young people. Approximately 40 professionals took part in a series of writing groups to develop the standards.
The new IHA Delivery Standards (2025), by the Royal College of Paediatrics and Child Health (RCPCH), aim to improve children and young people’s experience of IHAs, their outcomes and their health and wellbeing. This will contribute to a reduction in the longer-term health disparities experienced by children and young people in care compared to their peers.
The Standards also aim to set a benchmark for the delivery of IHAs in the UK. They can inform discussions between healthcare professionals, social care, provider organisations and service planners. They are are designed to meet eight child-led outcomes. The outcomes are considered ‘child-led’ because they center the voices of children and young people; for example, ‘My IHA appointment considers my individual needs and any barriers that may make attending difficult. This makes me feel safe and helps me to engage.’
The Standards have been designed to empower clinicians across the four UK nations, allowing them to identify excellence and to recognise how practice might be improved. Some may seem ambitious, so each standard is accompanied by guidance to help foster improvement even if the standard itself is not yet attainable.
The standards apply to all children and young people in care regardless of where they live, including those placed out of area, children and young people seeking asylum and refuge, children in secure settings and children with disabilities receiving prolonged respite care.
The updated CoramBAAF child health forms published October 2025 were designed to align with the standards.
Ellie Johnson, Health Consultant, CoramBAAF.