Annex 2: adult fostering medical assessments and reports during the COVID -19 crisis

The Fostering Panels (Establishment and Functions) (Wales) Regulations 2018, regulation 7(2) and Schedule 1, Part 1, paragraph 2 requires that a fostering service provider should, as part of the assessment process, ‘obtain details of health (supported by a medical report)’.

We are informed that, during the COVID-19 crisis, GP’s are not likely to be available to either provide a patient’s records to any other medical practitioner or conduct face to face examinations with prospective foster parents.

We are further informed that there is a possibility that community paediatricians who act as Medical Advisers to fostering services providers may not have the resources to undertake work in this field if the pandemic continues and they are required elsewhere in the NHS.

It is important that the task of assessing prospective foster parents continues during the period of the crisis in order to meet the needs of children requiring placements, both during and after the crisis.

Please note: this change relates to medical assessments only, all other requirements set out in the Regulations remain in force.

In place of the Regulation (as stated above), the CoramBAAF ‘Self-Declaration of Health Form for use during the COVID-19 pandemic’ will be introduced for use by those fostering service providers who are affected by the inability to progress health assessments for prospective foster carers. A copy of the form is attached to this document.

To aid the current situation there will be two separate processes available that Fostering Agencies can follow for the implementation of medical assessments:

• for those services who remain able to access a full Adult Health Report via the applicants G.P (utilising methods to undertake a remote medical using the patient’s records), the usual CoramBAAF AHR form should be completed
• for those services who are not able to access any form of medical assessment from a GP, the CoramBAAF ‘Self-Declaration of Health Form should be utilised, and where a Medical Advisor is available to provide comment upon this form, it should be obtained

These processes will be in place between 11th May and 30th September 2020 or until normal running is resumed, whichever is the sooner. Given these uncertain times, Welsh Government will inform fostering service providers the date they will need to revert to business as usual.

The self-declaration form can be found at the CoramBAAF website 

The process below outlines the various stages of the process that fostering service providers need to follow when using the CoramBAAF self-declaration of health form:

1. during any initial enquiries, applicants are asked if they have any health concern(s)
2. if the answer is yes and the concern(s) appears to the practitioner to require a medical assessment, then implications associated with the current crisis are explained to the applicant and they are invited to return to the fostering services provider at a time specified in the future for further discussion
3. if the answer is no, and if all other eligibility criteria are met, the applicants are invited to proceed, after which Stages 1 and 2 of the assessment process commence concurrently
4. the assessment of a connected person during either the Public Law Outline (PLO) process or within care proceedings may need to proceed even though there is a history of health concerns. In this event, the local authority should inform the court at an early stage of the proceedings and, where appropriate, seek a direction
5. the applicant is asked to fill in part B of the self- declaration form, sign it and return it to the fostering service provider
6. the fostering service provider fills in Part A of the form and sends it to the Medical Adviser to fill in the summary (if they are available)
7. if, by the conclusion of the assessment the COVID-19 restrictions have been lifted, a medical assessment and report will be sought, as directed by Regulation 7(2), Schedule 1, Part 1, paragraph 2
8. If there is no medical assessment or report available at the conclusion of the assessment, it is for the panel to recommend and decision maker to decide whether to approve the applicant as a foster parent without a medical assessment and report. Please Note: each case will need to be dealt with on an individual basis

(i) A recommendation and decision cannot be made on condition that a medical is subsequently undertaken. However, a panel, under regulation 5(2)(b) may request the fostering services provider to obtain any other relevant information which the fostering panel considers necessary. This could result in the extension of the assessment period until such information is sought, analysed and presented back to the panel.

(ii) The terms of approval for those applicants where assessments conclude without a full medical report, may be restricted to ‘short term’ to reflect the limitations in place at the time of the assessment.

(iii) All approvals made by services utilising the CoramBAAF ‘Self-Declaration of Health’ Form will be subject to an early annual review process. The review to take place as soon as possible, and no later than 6 months, following the current restrictions being lifted. The early annual review should include a full adult health assessment and report, to inform the review and any recommendation in respect of continued approval and status of such approval.