land as well as providers of services should ensure that there are effective arrangements in place to share information about a child’s health. These arrangements should balance the need to know with the sensitive and confidential nature of some information. Fear about sharing information should not get in the way of promoting the health of looked-after children.15 38. The lead health record for a looked-after child should be the GP-held record. The initial health assessment and health plan, and subsequent review assessments and plans, should be part of that record. 39. Information on the principles of confidentiality and consent is at Annex C. Health assessments, plans and reviews Health assessments and plans 40. Local authorities are responsible for making sure a health assessment of physical, emotional and mental health needs is carried out for every child they look after, regardless of where that child lives. Regulation 7 of the Care Planning, Placement and Case Review (England) Regulations, 2010 requires the local authority that looks after them to arrange for a registered medical practitioner to carry out an initial assessment of the child’s state of health and provide a written report of the assessment. 41. The initial health assessment should result in a health plan, which is available in time for the first statutory review by the Independent Reviewing Officer (IRO) of the child’s care plan. That case review must happen within 20 working days from when the child started to be looked after.16 42. The statutory health assessment should address the areas specified in section 1 of Schedule 1 of the care planning regulations. These areas are: • the child’s state of health, including physical, emotional and mental health 15 NHS organisations and local authorities shou