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Statutory guidance for promoting the health and wellbeing of looked after children stipulates that children and young people in the care system should receive health assessments on entry to care, and thereafter at six-monthly intervals for children aged under five and annually for those aged five to 18 years. Heart of England NHS Foundation Trust works in partnership with the local authority and clinical commissioners to meet the needs of local looked after children. It was found that many of these children and young people were refusing to have health assessments. This longitudinal study identified blocks to engagement, and explored alternative strategies to build compliance and participation. Findings have demonstrated that using a multi-agency and child-centred approach is effective in engaging 'hard to reach' children and young people. [ABSTRACT FROM AUTHOR]