When a child in your care is unwell

Somewhere around week three, most new foster carers get their first proper scare. A temperature that climbs after tea. A rash on a forearm that wasn’t there at bath time. And underneath it, a question nobody rehearses: am I actually allowed to take this child to a doctor? Here is what to watch for, and who to ring.

Please note: this is general information, not medical or personal advice. The exclusion periods and immunisation details below are correct as at September 2026. Always follow the advice of the child’s GP or NHS 111, and check the current position on NHS.uk and the UKHSA guidance.

Most of it is the ordinary stuff

Children in care catch the same coughs, stomach bugs and sore throats as every other child in the country. They pick them up in the same places: the classroom, the swimming pool, the top deck of the bus. A cold is a cold. There is a real pull, when a child has only been with you a fortnight, to treat every sniffle as a crisis. Resist it. What you need is not medical training, but a clear sense of the few moments that are genuinely different, and the numbers to hand.

What counts as a high temperature, and the ages that change the answer

A high temperature in a child is 38C or above. That part is simple. What trips people up is that the number which should send you to the phone depends on the child’s age, and the younger they are, the lower the bar. The NHS says to call 111 for urgent advice if a child:

• is under 3 months old and has a temperature of 38C or higher
• is 3 to 6 months old and has a temperature of 39C or higher
• has had a high temperature for 5 days or more
• has a rash or other signs of illness alongside the temperature
• is dehydrated: nappies that are barely wet, sunken eyes, no tears when crying
• does not want to eat, is not acting like themselves, and you are worried

That first line matters here. GLF is actively recruiting carers for babies, and a baby under two can sleep in a cot in your own room, so a spare bedroom is not always needed. If you are caring for a newborn, 38C is your number, and it is not a wait-until-morning number.

The signs that mean 999, not wait and see

Some symptoms skip the phone-advice stage. These are the ones the NHS says warrant 999 or A&E, covering both the meningitis and the sepsis picture:

• a rash that does not fade when you press a glass against it
• a stiff neck, or being bothered by light
• blue, grey, blotchy or unusually pale skin, lips or tongue
• unusually cold hands and feet, or a temperature below 36C
• breathing very fast, or any difficulty breathing
• being drowsy and hard to wake, or not responding as they normally do
• a first febrile seizure, where the shaking does not stop
• no wee for 12 hours in a child under five
• a weak, high-pitched or continuous cry in a baby

The NHS advice is not to drive to A&E yourself: ask someone to take you, or call 999 for an ambulance. And yes, you may feel foolish standing in a corridor at 2am with a child who turns out to have a common virus. Ring anyway.

How long to keep a child off school or nursery

This question comes up weekly, and guessing at it causes real friction with schools. UKHSA publishes the list, last updated on 7 September 2026, and it is shorter than most people expect:

• chickenpox: 5 days after the rash first appears
• measles: 4 days after the rash starts
• mumps: 5 days after the swelling starts
• scarlet fever: 24 hours after starting antibiotics
• impetigo: until all blisters have scabbed over, or 2 days after starting antibiotics
• diarrhoea and vomiting: 2 days after it has stopped
• whooping cough: 2 days of antibiotics, or 21 days from the start of symptoms without them
• no time off needed at all for slapped cheek, hand foot and mouth, conjunctivitis, head lice, threadworm or glandular fever

The chickenpox one surprises nearly everybody: five days from the rash appearing, not the old playground rule about waiting until every spot has crusted over. And the half that gets forgotten: if a child misses more than a few days, tell the school office and their social worker. Missed school shows up in a Personal Education Plan, and a fortnight of unexplained absence looks very different on paper to a fortnight of chickenpox.

Immunisations, and the gaps you may find

A child who has moved home several times often arrives with an incomplete immunisation record, or none at all. That is fixable, but raise it early rather than discovering it at a school vaccination session. The schedule has changed recently too, so even experienced carers work from old information. Chickenpox joined the routine NHS schedule on 1 January 2026, as the combined MMRV vaccine:

• born on or after 1 January 2025: two doses, at 12 months and 18 months
• born between 1 July and 31 December 2024: two doses, at 18 months and 3 years 4 months
• born between 1 September 2022 and 30 June 2024: one dose, at 3 years 4 months
• a single-dose catch-up is planned for children born between 1 January 2020 and 31 August 2022
• the old Hib/MenC vaccine (Menitorix) has been dropped, and an 18-month appointment added

The full schedule, current from 1 July 2026, is on GOV.UK. If a child has come from another country, their GP can advise on additional vaccinations. One thing to get straight before booking anything: consent.

Who says yes to treatment

This is the bit that worries prospective carers most, and the answer is tidier than you would guess. Every child in care has a health plan, built from a health assessment that statutory guidance says should happen within 20 working days of them coming into care. Review assessments then run twice a year under five, and once a year from five upwards. The plan says who can agree to what.

• day-to-day health care, like a GP appointment for a cough: normally yours to arrange
• immunisations, anaesthetic and anything non-routine: check the plan, because this depends on the child’s legal status and what the local authority has delegated to you
• a young person aged 16 or 17 can consent for themselves, and a parent cannot override that
• a younger child who fully understands what is involved may be able to consent too
• in a genuine emergency, you get help first and make the phone calls afterwards

Sort this out in your first week, at the kitchen table with your supervising social worker, rather than in a waiting room with a receptionist asking who holds parental responsibility. Ten minutes then saves an uncomfortable half hour later.

Stopping it going round the whole house

If you have other children at home, one stomach bug can turn into three weeks of them. The basics do most of the work, and modelling beats instructing: wash your hands where the child can see you doing it, and for long enough to be obvious about it. When somebody is ill, wipe the door handles and light switches as well as the counter. Stop the sharing of towels, flannels, hairbrushes, cups or cutlery for a week. Sterilise bottles and dummies if there is a baby, and keep disinfectants locked away.

Medicines need the same care and more paperwork. Keep everything out of reach, agree with your supervising social worker what you may give, and write down the dose and the time. That record feels fussy on a Tuesday night. It is what you will be glad of when a GP asks what the child has already had.

You won’t have to do this alone

Nobody expects a foster carer to know whether a rash is nothing or something. We expect you to notice, and then to pick up the phone. GLF carers have a supervising social worker who knows the child, an out-of-hours line for the evenings and weekends when these things always seem to happen, and training that covers medication and first aid before anyone asks you to use it. The child’s health plan means you are not guessing at their history either.

GLF pays a single weekly fee of 479.50 pounds for a child under 11 and 507.50 pounds for a child aged 11 or over, per child while they are living with you, with an enhanced fee of roughly 100 to 200 pounds a week more where a child has higher needs. Ofsted inspected us from 21 to 25 July 2025 and rated us Outstanding in all three judgements. It is completely normal to have questions, and you can read more about the support foster carers receive, what fostering involves day to day, or caring for a child with additional needs. If you are weighing up becoming a foster carer, a cough in the night is not the thing that should stop you.

Frequently asked questions

Can I take a child in my care to the GP myself?

For everyday things, yes, and registering the child with a GP is one of the first jobs when they move in. Routine appointments are normally part of the care delegated to you. Anything beyond routine, including immunisations and dental work under anaesthetic, depends on the child’s legal status and what their health plan says. Your supervising social worker will go through it with you.

Do I need to tell anyone if a child in my care is unwell?

Tell your supervising social worker about anything more than a mild cold, and write it in your daily recording. Anything involving a hospital or a new diagnosis should be reported the same day. If the child will miss school, tell the school office too.

Can I give a child in my care paracetamol?

Usually, but check first rather than assuming. What you can give is agreed with your supervising social worker and recorded in the child’s plan, because some children take prescribed medication that interacts with it. Write down the dose and the time, every time.

What if a child arrives with no health records?

It happens often, particularly where a child has moved several times or come from another country. Raise it with your supervising social worker straight away so it can be picked up in the health assessment. The GP can then work out which immunisations are outstanding.