Paediatrics: Assessment by social care

Assessment by social care

Social care and the police will undertake an assessment. They will collect the relevant information from all professionals involved. Referrals may result in:

•   No further action being taken.

•   Provision of support and help for the child and their family.

•   A fuller assessment of the needs and circumstances of the child.

Strategy meeting

This is a meeting between professionals from all the relevant agencies (social services, police, education, health) to decide on the next action or steps.

Child protection conference

This will be convened if there are concerns about significant harm. The timing will vary and may be after discharge from hospital as long as the child is in a place of safety. A plan is needed to ensure the child’s wel-fare and safety is addressed. When a child is considered at risk, then following the conference:

•   He/she will be the subject of a child protection plan.

•   A more comprehensive assessment (core assessment) will be arranged and undertaken.

•   A key worker will be appointed.

•   A review conference will be arranged within 3mths.

Children not considered at risk have:

•   A support plan organized.

•   Follow-up between the family and other professionals arranged.

Report writing for child protection conferences

Those members of the medical team directly involved in the initial assessment and/or subsequent management of the child should write a medical report. Parents have the right to see reports before a case conference. There are a number of important key points in writing these reports:

•   They should distinguish fact from observation and allegation.

•   Relevant information should be used from current and past records.

•   Medical terms should be explained for the benefit of laypersons.

•   Include observations and relevant statements from child and carer.

•   State clearly whether the injury is unexplained or does not fit with history.

•   State medical opinion only.

Confidentiality and disclosure of medical information

Guidance regarding confidentiality and information disclosure is pro-vided by the UK General Medical Council (GMC). There are various reports from 2004 onwards that can be found on the GMC website (see www.gmc-uk.org/). In addition, there is a useful consultation document that can be downloaded called ‘Protecting children and young people: the responsibilities of all doctors’ (2011).

• Information can be disclosed without consent in cases of serious crime (including child abuse).

• If information is not disclosed the doctor should be prepared to justify their decision.

• In the absence of consent, confidential medical information about parents or third parties should be shared when relevant and necessary to protect the safety and welfare of the child. The more sensitive this information is, the greater the child’s needs must be to justify disclosure.

• Normally permission from parents should be obtained unless it is reasonable to conclude that this would hinder enquiries or place the child at greater risk.