Helping children in care access quality healthcare

We’re marking a decade of our Pathway to Good Health clinics, which provide health assessments and care for children in out-of-home care. 

In 2011, the Centre for Community Child Health was approached to provide clinical expertise to help ensure that children entering out-of-home care (on Child Protection orders) had their health needs assessed and addressed in a timely way.

Supporting the health needs of children is important because children entering care have often been living with many adversities and are at risk of poorer health, development and wellbeing in childhood and adulthood. Intervening early to identify and address their health needs and challenges helps to prevent the lifelong impact of adversity in early childhood.

Developing a pathway to good health

The Child Protection intervention provides an opportunity to connect or reconnect children in care with health services and ensure that each child’s health needs are identified, and then appropriate care provided.

A/Prof Jill Sewell chaired a Clinical Advisory Group in 2011, with Dr Karen McLean as the project officer, to support the development of a pathway to care for children in OoHC. In 2013, the Centre, in partnership with the Royal Children’s Hospital Melbourne, opened our doors to the multi-disciplinary Pathway to Good Health Clinic. This clinic was one of three assessment clinics in North-west metropolitan Melbourne for children who had recently entered care.

The Pathway to Good Health Clinics

Children are seen by a paediatrician, speech pathologist and clinical psychologist for a comprehensive assessment of needs. This includes hearing from carers, educators and the children, and a lot of play-based observation amidst more formal assessments. To make things easier for carers, sibling groups are often seen together, and we are well supported by our audiology and immunisation centre colleagues who will often make time on the day of the assessment to provide additional services.

With funding from the Department of Health, we have been able to expand our services and care offerings. The service now employs clinical nurse consultants who have been outposted to the local Child Protection offices to support the identification of health needs and navigation of the health system.

In 2022, a training clinic was established to develop the future paediatric workforce by including an advanced trainee in Community Child Health in the multi-disciplinary team. Since February 2023 we have also offered six-month positions to established paediatricians to up skill in the area of multi-disciplinary assessment for this cohort.

Looking back and moving forward

In an effort to understand the services and need across the state, Dr McLean added research to her clinical role in 2017. She carried out her PhD studies in the same field, exploring barriers and enablers to assessment and identifying the benchmark rates of health service use by Victorian children, in the first year after they entered care. Since 2021, she has been working with the Centre for Excellence in Child and Family Welfare to identify the impacts of the COVID-19 pandemic upon children and young people living with adversity, and in OoHC, and to develop solutions to address these impacts.

The progress over the decade has been slow and steady, but it continues to gain momentum. In May 2023, we passed the ten-year milestone for the first children seen in clinic, and hundreds of children have attended over that time. In the same month, the Victorian government announced new funding to expand access to health support for children entering care across the whole state of Victoria. Karen continues to lead the team, working within RCH and the Murdoch Children’s Research Institute, and externally as the Vulnerable Child Health Lead to promote and deliver equitable healthcare for those in out-of-home care.

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