RCN promotes the role of designated nurse for looked-after children

All clinical commissioning groups (CCGs) should employ full-time designated nurses for looked-after children (LAC) in order to improve their health outcomes, the RCN has said.

The college has made a number of recommendations, including that the designated and named nurse roles for LAC should be distinct from each other and should have separate postholders. 

The RCN published a position statement on the two roles last week to reinforce existing national guidance. 

It said that if a designated nurse for LAC is not employed by a CCG, a contractual agreement should be in place. 

Responses to the college's survey of nurses working with LAC, published this year, included examples of the role of designated nurse being subsumed into the role of designated nurse for safeguarding. 

Central London Community Healthcare NHS Trust designated nurse for LAC and care leavers and nurse consultant for LAC Lin Graham-Ray said this is commonplace in London CCGs. 

Ms Graham-Ray, a former Nursing Standard nurse of the year, said: ‘The designated nurse for LAC has to be clinically competent. Many of the safeguarding roles are about supervision rather than direct clinical practice. That is a real issue.’ 

RCN professional lead for children and young people’s nursing Fiona Smith said: ‘The government needs to ensure that CCGs have the funds and resources to improve the health outcomes of LAC. 

‘Designated and named nurses can provide vital expertise in supporting children in care and can bring together key partners to commission and deliver strong, integrated support for those in the care system.’ 

The RCN also said the designated nurse role should be a strategic post with no responsibilities for individual children or young people, while the named nurse should be a ‘high-level operational role’ that supports LAC to reach their full potential. 

Ms Graham-Ray said that the ‘competencies for the two roles are very clear’ but that she has seen examples of them being conflated into one post.

She added: ‘It has been done as a cost saving exercise rather than looking at the bigger picture. Looked-after children are the most vulnerable and the highest risk. If you want to stop further health problems, we need to put the expertise in now.’ 

Click here for the RCN's statement.