 or section 84 order, as the agency is required to provide summaries written by the medical adviser on the health of the child and the prospective adopter. Where a case is being presented to the adoption panel, the medical adviser must advise the adoption panel clerk whether to send to the adoption panel the child’s health report, other medical and psychiatric reports, and health information about the child’s birth parents. Where a child’s case is not being referred to the adoption panel but direct to the decision-maker, the medical adviser should be ready to answer any medical question arising from their written summary or other papers asked by the decision-maker. 1.8. It is recommended that the agency make arrangements for the appointment of its medical adviser with a local clinical commissioning group’s designated doctor for looked after children. Each group should appoint such a designated doctor to assist it to fulfil its responsibilities as a commissioner of services to improve the health of looked after children. The designated doctor is likely to be a senior paediatrician with substantial clinical experience of the health needs of looked after children. In some circumstances, the designated doctor may also be able to fulfil the role of the medical adviser. Alternatively, the designated doctor should be able to recommend another doctor to become the agency’s medical adviser. A VAA may seek advice from a group’s designated doctor on arrangements for the appointment of a medical adviser. Chapter 2 provides guidance on access to health information. Adoption reports 1.9. Reports, such as the child’s permanence report and the prospective adopter’s report, are essential to the fundamental decisions that are made at key points during the adoption process. Such adoption 