Findings for looked after children are not generalisable

Editor—Hill et al's paper on meningococcal C immunisation in looked after children showed that looked after children were more than twice as likely not to receive meningococccal vaccine as were children at home. ¹ They say that their findings are likely to be generalisable. This is not the case.

As part of the children's services planning process in the Southern Health and Social Services Board in Northern Ireland, we tagged the records on the child health system of looked after children in one of our health and social services trusts (Craigavon and Banbridge Health and Social Services Trust) in October 2001. The table shows the findings.

Table 1.

Child health system records of looked after and other children, Craigavon Banbridge Health and Social Services Trust, October 2001. Values are numbers (percentages) of children born 1 January 1987 to 31 December 1999

Record	Looked after children (n=75)	Other children (n=23 936)
Breast fed	0 (0)	4869 (20.3)
Mothers who smoked	21 (28)	4011 (16.8)
Completed immunisations:
Primary	67 (89.3)	22979 (96)
Meningococcal C	68 (90.6)	22260 (93)
Measles, mumps, and rubella	69 (92)	22979 (96)
Statement of special educational needs	20 (26.6)	230 (0.96)

These findings do not support Hill et al's findings. In Northern Ireland, health and social services have been integrated since the 1970s, which may partly explain the differences. Out of area placements are also less common in Northern Ireland compared with other parts of the United Kingdom.

The child health system can provide up to date “snapshot” pictures of the health of looked after children. In the Southern Health and Social Services Board we are introducing protocols to ensure information from the child health system is available to the looked after team shortly after the child becomes “looked after.” Integrated health and social services can be an effective means of protecting the health of vulnerable children in society.