Health Assessment of Children Being Adopted: Practice, Challenges and Dilemmas


The medical adviser in adoption is a statutory role, usually undertaken by an experienced community paediatrician. A key task of the medical adviser is the provision of a comprehensive preadoption health report on a child for whom the local authority plan is adoption. The vast majority of children being placed for adoption come from the care system and are likely to have adverse childhood experiences. The medical adviser collates information about the birth family health history, the child's prenatal and birth information, early development and health, alongside early life experiences and advises on the relevance of this information. Close working links between the medical adviser in adoption and other key professionals are important in order to achieve the best outcomes for this special group of children, including the provision of postā€adoption support. Dilemmas and challenges are commonly encountered by those who undertake this role.

Key Concepts

  • The medical adviser in adoption has a key role in collating all available health information and sharing this with the adoption agency and prospective adoptive parents.
  • A quality preadoption health assessment and report are essential for matching a child with prospective adoptive parents.
  • A preadoption health report should include information about the health of the child's birth family, the child's birth and identified antenatal factors, early health and development and life experiences with guidance provided around the potential future implications of these factors.
  • Adoption is a lifelong journey and new/additional health information in the birth family may come to light at any point. Mechanisms are required to ensure that this is shared and discussed appropriately.
  • Close working relationships between the medical adviser in adoption and adoption agency staff/local authority social workers are crucial.
  • Dilemmas and challenges are commonly encountered by those who undertake this role.
  • The needs of the child are paramount in the process of adoption.

Keywords: adoption; medical adviser; preadoption health assessment; adopted children; adoptive parents; adoption support


Adoption Agencies (NI) Regulations (1989)

Adoption Agencies Regulations (2005) (England).

Adoption Agencies (Wales) Regulations (2005).

Adoption Agencies (Panel and Consequential Amendments) Regulations (2012) (England).

Adoption Agencies (Amendment) (Wales) Regulations (2012).

Adoption Agencies (Miscellaneous Amendments) Regulations (2013) (England).

Adoption and Children Act (2002) (Eng and Wales).

Adoption (NI) Order (1987).

BAAF (2004) Using BAAF Health Assessment Forms: Setting Standards of Health Practice Across all Agencies, Practice Note 47, London: BAAF.

BAAF (2006) Genetic Testing and Adoption, Practice Note 50,. London: BAAF.

BAAF (2008a) Guidelines for the Testing of Looked After Children Who are at Risk of a Blood‐Borne Infection, Practice Note 53, London: BAAF.

BAAF (2008b) Model Job Descriptions and Competencies for Medical Advisers in Adoption and Fostering. London: BAAF.

Bellis MA, Ashton K, Hughes K, et al. (2016) Adverse Childhood Experiences and their Impact on Health‐Harming Behaviours in the Welsh Adult Population. Cardiff: Public Health Wales/Liverpool: Centre for Public Health, Liverpool John Moores University.

Department for Education (2016) Children Looked After in England (including adoption and care leavers).‐looked‐after‐in‐england‐including‐adoption‐2015‐to‐2016

Department of Health, Social Services and Public Safety (2016) Children's Social Care Statistics for Northern Ireland 2015/16‐‐adopted‐care‐northern‐ireland‐201516

Lord J and Cullen D (2013) Effective Adoption Panels: Guidance on Regulations, Process and Good Practice in Adoption and Permanence Panels. London: BAAF.

Office of National Statistics (2017) Historic Adoption Tables.‐in‐england‐and‐wales/2010/historic‐adoption‐tables.xls

RCPCH and RCN (2015) Looked After Children: Knowledge, Skills and Competences of Health Care Staff – Intercollegiate Role Framework. London: RCPCH.

Welsh Government (2016) Adoptions Outcomes and Placements for Children Looked after by Local Authorities.‐adoptions‐outcomes‐placements‐children‐looked‐after‐local‐authorities‐2015‐16‐revised‐en.pdf

Further Reading

Department for Education and Department of Health (2015) Promoting the Health and Well‐Being of Looked After Children. London: DfE and DH.

Merredew F and Sampeys C (eds) (2015) Promoting the Health of Children in Public Care: The Essential Guide for Health and Social Work Professionals and Commissioners. London: BAAF.

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How to Cite close
Sampeys, Carolyn, and Barnes, Peter(May 2017) Health Assessment of Children Being Adopted: Practice, Challenges and Dilemmas. In: eLS. John Wiley & Sons Ltd, Chichester. [doi: 10.1002/9780470015902.a0027008]