3. Sharing information |
Contents
3.1 |
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3.1.4 |
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3.2 |
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3.3 |
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3.3.1 |
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3.3.6 |
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3.3.10 |
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3.3.11 |
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3.3.15 |
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3.3.23 |
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3.3.29 |
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3.4 |
Sharing information where there are concerns about significant harm |
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3.5 |
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3.5.2 |
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3.5.5 |
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3.5.6 |
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3.5.8 |
If the information is confidential, has consent to share been obtained? |
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3.5.9 |
Is there a statutory duty or a court order to share information? |
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3.5.16 |
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3.5.20 |
If the decision is to share, is the right information being shared in the right way? |
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3.5.21 |
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3.6 |
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3.6.1 |
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3.6.5 |
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3.6.9 |
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3.6.15 |
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3.7 |
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3.7.1 |
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3.7.9 |
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3.8 |
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3.1 |
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3.1.1 |
A key factor in many serious case reviews has been a failure to record information, to share it, to understand the significance of the information shared, and to take appropriate action in relation to known or suspected abuse or neglect. Often it is only when information from a number of sources has been shared that it becomes clear that a child is at risk of, or is suffering, harm. |
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3.1.2 |
Information sharing is vital to safeguarding and promoting the welfare of children and improving information sharing practice is therefore a cornerstone of the Government's Every Child Matters: Change for Children strategy to improve outcomes for children. |
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3.1.3 |
The Every Child Matters: Change for Children programme includes new ways to help people working with children to communicate across professional boundaries. Through a common approach to assessing children's needs and improved information sharing, local authorities and their partner agencies are expected to achieve:
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3.1.4 |
In addition to the statutory guidance following from the Children Act 2004, the key legal concepts, legislation and terminology relevant to information sharing are contained in: These are summarised in appendix 4. Information sharing legal framework. |
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3.2 |
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3.2.1 |
The statutory guidance on s11 of the Children Act 2004 states that in order to safeguard and promote children's welfare, the agencies covered by s11 should make arrangements to ensure that:
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3.2.2 |
The statutory guidance on s10 of the Children Act 2004 makes it clear that effective information sharing supports the duty to co-operate to improve the well-being of children. |
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3.2.3 |
Local authorities and their partner agencies should ensure that their employees:
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3.2.4 |
Agencies should:
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3.3 |
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Confidentiality |
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3.3.1 |
In deciding whether there is a need to share information, professionals need to consider the legal obligations including:
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3.3.2 |
Not all information is confidential. Confidential information is information of some sensitivity, which is not already lawfully in the public domain or readily available from another public source, and which has been shared in a relationship where the person giving the information understood that it would not be shared with others. |
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3.3.3 |
For example, a teacher may know that a pupil has a parent who misuses drugs. That is information of some sensitivity, but may not be confidential if it is widely known or it has been shared with the teacher in circumstances where the person understood it would be shared with others. If however it was shared with the teacher by the pupil in a counselling session it would be confidential. |
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3.3.4 |
Confidence is only breached where the sharing of confidential information is not authorised by the person who provided it or to whom it relates. If the information was provided on the understanding that it would be shared with a limited range of people or for limited purposes, then sharing in accordance with that understanding will not be a breach of confidence. Similarly, there will not be a breach of confidence where there is explicit consent to the sharing. |
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3.3.5 |
Even where sharing of confidential information is not authorised, professionals may lawfully share it if this can be justified in the public interest. Seeking consent should be the first option, if appropriate. Where consent cannot be obtained to the sharing of the information or is refused, or where seeking it is likely to undermine the prevention, detection or prosecution of a crime, the question of whether there is a sufficient public interest must be judged by the professional on the facts of each case. Therefore, where a professional has a concern about a child, a refusal of consent should not necessarily preclude the sharing of confidential information. |
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3.3.6 |
A public interest can arise in a wide range of circumstances e.g. to protect children or other people from harm, to promote the welfare of children or to prevent crime and disorder. There are also public interests, which in some circumstances may weigh against sharing, including the public interest in maintaining public confidence in the confidentiality of certain services. The key factor in deciding whether or not to share confidential information is proportionality (i.e. whether the proposed sharing is a proportionate response to the need to protect the public interest in question). In making the decision professionals must weigh up what might happen if the information is shared against what might happen if it is not, and make a decision based on a reasonable judgement. |
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3.3.7 |
Where there is a clear risk of significant harm to a child, or serious harm to adults, the public interest test will almost certainly be satisfied. However there will be other cases where professionals will be justified in sharing some confidential information in order to make decisions on sharing further information or taking action - the information shared should be proportionate. |
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3.3.8 |
Circumstances in which sharing confidential information without consent will normally be justified in the public interest are:
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3.3.9 |
Professionals must record the context in which the information was shared, the perceived level of risk of harm at the time, the data requested, the data shared and with whom. Agencies may have a standard form for this or ensure that there is a signed and dated entry in the case notes. |
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3.3.10 |
Consent issues can be complex, and lack of clarity about them can sometimes lead professionals to incorrect assumptions that no information can be shared. Professionals in all agencies should be clear about:
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3.3.11 |
Consent must be freely given and informed (i.e. the person giving consent needs to understand why information needs to be shared, who will see their information, the purpose to which it will be put and the implications of sharing that information). |
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3.3.12 |
Consent can be explicit or implicit. Obtaining explicit consent is good practice and it can be expressed either orally or in writing, although written consent is preferable since that reduces the possibility of subsequent dispute. If verbal consent has been obtained details must be recorded in case notes. |
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3.3.13 |
Implicit consent can also be valid in many circumstances. Consent can legitimately be implied if the context is such that information sharing is intrinsic to the activity, and especially if that has been explained at the outset, for example when conducting a common assessment. A further example is where a GP refers a patient to a hospital specialist and the patient agrees to the referral; in this situation the GP can assume the patient has given implied consent to share information with the hospital specialist. |
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3.3.14 |
Consent does not entitle a professional or agency to collect an unlimited range of information. The information must relate to the performance of one of the agency's functions (i.e. the agency must be acting intra-vires in seeking the information). |
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3.3.15 |
Professionals may also need to consider whose consent should be sought. Where there is a duty of confidence it is owed to a person who has provided the information on the understanding it is to be kept confidential and, in the case of medical or other records, the person to whom the information relates. A young person aged 16 or 17, or a child under 16 who has the capacity to understand and make their own decisions, may give (or refuse) consent to sharing. |
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3.3.16 |
Children aged 12 or over may generally be expected to have sufficient understanding. Younger children may also have sufficient understanding. When assessing a child's understanding you should explain the issues to the child in a way that is suitable for their age, language and likely understanding. Where applicable, you should use their preferred mode of communication. |
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3.3.17 |
The following criteria should be considered in assessing whether a particular child on a particular occasion has sufficient understanding to consent, or refuse consent, to sharing of information about them:
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3.3.18 |
In most cases, where a child cannot consent or where a professional judges that they are not competent to consent, a person with parental responsibility should be asked to consent on behalf of the child. Each agency should have procedures to determine who has parental responsibility for a child. |
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3.3.19 |
Where parental consent is required, the consent of one parent is sufficient. In situations where family members are in conflict professionals should talk to their agency's information lead and child protection adviser to decide whose consent should be sought. If the parents are separated, the consent of the resident parent would usually be sought. If a child is judged to be competent to give consent, then their consent or refusal to consent is the one to consider even if a parent disagrees. |
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3.3.20 |
In cases where there is conflict between the wishes of the parent and the child, particularly if the child is older or a teenager, professionals should make a decision aimed at securing the best outcome for the child. Acting in the best interests of the child, may require overriding refusal to consent by either or both the child and the parent/s. |
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3.3.21 |
The need to renew consent should be reviewed and the person who gave consent should be kept informed of circumstances in which the data is shared, wherever this is appropriate. |
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3.3.22 |
If there is a significant change in the use to which the information will be put to that which has previously been explained, or in the relationship between the agency and the individual, consent should be sought again. Individuals have the right to withdraw consent after they have given it, although in practice this is rarely exercised. |
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3.3.23 |
There are many situations in which a professional can share information legally without obtaining consent from a child or his carer. These are not limited to situations where there is an imminent danger or risk of harm to a child. Frequently, when an initial assessment of the risk factors affecting a child or family is being undertaken, information will be shared without consent (relying upon statutory powers and duties). |
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3.3.24 |
A number of examples of statutory powers and duties to share information are set out in Information Sharing: Further Guidance on Legal Issues (DfES, 2006). The guidance also describes the broad powers and duties which clearly can only be fulfilled if information is obtained about children and their families or about the entire population in an area. |
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3.3.25 |
It is good practice for all professionals to obtain consent before sharing information, even when there is no legal requirement. |
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3.3.26 |
Consent will almost always be needed at the stage where services are offered unless there are very serious child protection concerns where there is a statutory duty to intervene. In most cases telling a child and/or their family when information about them has been shared or seeking their consent to do so, develops their trust in the professional / agency. This may be particularly important with older children (e.g. for Connexions personal advisers). |
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3.3.27 |
Agencies should provide an information leaflet and obtain written consent in the form of a standard consent letter. |
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3.3.28 |
When a professional seeks consent for information to be shared, the following information should be provided as a minimum:
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3.3.29 |
See section 3.4 below; all sharing of sensitive information, with or without consent, should be recorded including details of the risk of harm. In addition, if a professional shares information without seeking consent, this should be clearly recorded, including the reasons for not seeking consent. |
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3.4 |
Sharing information where there are concerns about significant harm |
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3.4.1 |
Professionals who work with, or have contact with children, parents or adults in contact with children should always share information with LA children's social care where they have reasonable cause to suspect that a child may be suffering or may be at risk of suffering significant harm. |
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3.4.2 |
While, in general, professionals should seek to discuss any concerns with the family and, where possible, seek their agreement to making referrals to children's social care, there will be some circumstances where professional should not seek consent e.g. where to do so would:
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3.4.3 |
In some situations there may be a concern that a child may be suffering or at risk of significant harm or of causing serious harm to others, but professionals may be unsure whether what has given rise to concern constitutes 'a reasonable cause to believe'. In these situations, the concern must not be ignored. |
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3.4.4 |
Professionals should always talk to their agency's nominated child protection adviser and, if necessary and where they have one, a Caldicott Guardian - who will have expertise in information sharing issues, though not related to child protection. The child's interests must be the overriding consideration in making any decisions whether or not to seek consent. |
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3.4.5 |
Significant harm to children can arise from a number of circumstances, it is not restricted to cases of deliberate abuse or gross neglect. A baby who is severely failing to thrive for no known reason could be suffering significant harm but equally could have an undiagnosed medical condition. If the parents refuse consent to further medical investigation or an assessment, professionals are still justified in sharing information for the purposes of helping ensure that the causes of the failure to thrive are correctly identified. |
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3.4.6 |
Similarly, serious harm to adults is not restricted to cases of extreme physical violence. The cumulative effect of repeated abuse or threatening behaviour or the theft of a car for joyriding may well constitute a risk of serious harm. A professional is likely to be justified to share information without consent for the purposes of identifying a child for whom preventative interventions in relation to such behaviour are appropriate. |
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3.5 |
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3.5.1 |
In deciding whether or not to share information professionals should use eight key questions: [The questions are taken from Information Sharing: Professionals' Guide (DfES, 2006).]
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3.5.2 |
A professional requested to, or wishing to, share information about a child, must have a good reason or legitimate purpose to share the information. |
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3.5.3 |
For professionals who work for a statutory service such as education, social care, health or youth justice, or for a private or third sector agency and are contracted by one of the statutory agencies to provide services on their behalf, the sharing of information must be within the functions or powers of that statutory body. |
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3.5.4 |
In order to comply with the law relating to confidentiality, data protection and human rights professionals should establish a legitimate purpose for sharing information. They can do so using the following questions: [The questions are taken from Information Sharing: Professionals' Guide (DfES, 2006).]
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3.5.5 |
In most cases the information covered by these procedures will be about a named child. It may also identify others, such as a parent or carer. If the information is anonymised, it can lawfully be shared as long as the purpose is legitimate. If the information allows a child and others to be identified, it is subject to data protection law and professionals must follow these procedures and where appropriate take legal advice in deciding whether or not to share the information. |
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3.5.6 |
There are three different types of confidential relationship:
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3.5.7 |
Public bodies which hold information of a private or sensitive nature about individuals for the purposes of carrying out their functions (e.g. LA children's social care) may also owe a duty of confidentiality, as people have provided information on the understanding that it will be used for those purposes. In some cases the body may have a statutory obligation to maintain confidentiality, for example in relation to the case files of looked after children. |
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3.5.8 |
See section 3.3.10 - 3.3.29 (above). |
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3.5.9 |
In some situations professionals are required by law to share information, for example, in the NHS where a person has a specific disease about which environmental health services must be notified. There will also be times when a court will make an order for certain information or case files to be brought before the court. |
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3.5.10 |
These situations are relatively unusual and where they apply professionals will know or be told about them. In such situations professionals must share the information, even if it is confidential and consent has not been given. Wherever possible, professionals should inform the individual concerned that the information is being shared, why, and with whom. |
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3.5.11 |
There will be occasions when it is necessary for the police to seek information held on other agency databases / files in order for the Crown Prosecution Service to use the information for prosecution in a criminal trial. There will also be occasions when legal representative for defendants in criminal trials will seek access to such information in a trial. |
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3.5.12 |
At these times, consideration must be given with legal advisors to the question of public interest immunity, a series of legal rules intended to protect the confidential nature of information held on files as a result of confidential relationships between individuals and public services. |
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3.5.13 |
Separate protocols exist both for the above purpose and in the situation where LA children's social care need to present information held on police files in the pursuit of civil care proceedings brought to protect children. These protocols are agreed between the Metropolitan Police Service and the judiciary and the police service and the Association of London Directors of Social of Children's Services (ALDCS). |
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3.5.14 |
Where an agency and its legal advisor do not believe the protocols to be appropriate that agency will need to consider legal advice about its responsibilities to share information to protect children weighed against its responsibilities to uphold the principles of public interest immunity in respect of information held. |
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3.5.15 |
See also the Protocol on the Exchange of Information in the Investigation and Prosecution of Child Abuse Cases (2003), developed by CPS, ACPO, LGA, ADSS; endorsed by HO, DfES and Welsh Assembly, at: the CPS website. |
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3.5.16 |
If consent is refused, professionals should apply the public interest test. That is, considering whether the public interest in maintaining confidence in confidentiality is outweighed by the public interest in protecting a child at risk of significant harm or serious harm to an adult. There will be cases where sharing some information without consent is necessary to enable professionals to reach an informed decision about whether further information should be shared or action should be taken. |
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3.5.17 |
In deciding whether the public interest justifies disclosing confidential information without consent, professionals should be able to seek advice from a line manager or a nominated individual whose role is to support professionals in these circumstances. If professionals are working in the NHS or a local authority the Caldicott Guardian may be helpful. Advice can also be sought from professional bodies, for example the General Medical Council or the Nursing and Midwifery Council. |
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3.5.18 |
If the concern is about possible abuse or neglect, all organisations working with children will have a named person who undertakes a lead role for child protection, so consulting this person may also be helpful. |
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3.5.19 |
If professionals decide to share confidential information without consent, this should be explained to the child or their parent, unless to do so would put the child at risk of harm. |
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3.5.20 |
If the decision is to share, professionals should share information in a proper way. This means:
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3.5.21 |
Professionals should record all decisions whether or not to share information and why. If the decision is to share, the record should include what information was shared and with whom. |
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3.6 |
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3.6.1 |
What To Do If You're Worried A Child is Being Abused (2006) supersedes Guidance to Doctors Working with Child Protection Agencies. |
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3.6.2 |
The General Medical Council guidance entitled Confidentiality: Protecting and Providing Information (2004) emphasises the importance in most circumstances of obtaining a patient's consent to the disclosure of personal information but makes clear that information may be released without consent to third parties (e.g. statutory agencies such as LA children's social care and police) in exceptional circumstances if a failure to disclose information may expose the patient, or others, to risk of death or serious harm. |
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3.6.3 |
The General Medical Council has confirmed that its guidance refers to information about third parties who are of direct relevance to child protection (e.g. adults who may pose a risk to a child, or children who may be the subject of abuse). |
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3.6.4 |
Paragraph 29 states: 'If a professional believes a patient to be a victim of neglect or physical, sexual or emotional abuse and that the patient cannot give or withhold consent to disclosure, the professional must give information promptly to an appropriate responsible person or statutory agency, where the professional believes that the disclosure is in the patient's best interests. If, for any reason, a professional believes that disclosure of information is not in the best interests of an abused or neglected patient, the professional should discuss the issues with an experienced colleague. If the professional decides not to disclose information, the professional must be prepared to justify their decision.' |
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3.6.5 |
What To Do If You're Worried A Child is Being Abused (2006)) supersedes Child Protection: Guidance for senior nurses, health visitors, midwives and their managers. |
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3.6.6 |
The Nursing and Midwifery Council has produced a code of professional conduct which contains the advice that disclosure of information may occur:
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3.6.7 |
The Health Professionals Council, which governs therapies and professions allied to medicine, has produced a statement on confidentiality and individual professional bodies produce their own, essentially similar guidance. |
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3.6.8 |
When in doubt, health professionals should consult their agency's nominated safeguarding children adviser/s (i.e. the named professional for safeguarding children who may in turn seek advice from the designated doctor or nurse and / or the Caldicott Guardian or solicitor of the Trust). |
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3.6.9 |
The police are lawfully able to supply information to relevant third parties for defined categories of request, as follows:
See the Protocol on the Exchange of Information in the Investigation and Prosecution of Child Abuse Cases (2003), developed by CPS, ACPO, LGA, ADSS; endorsed by HO, DfES and Welsh Assembly. |
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3.6.10 |
Any request for information that does not fall within these categories will be declined. |
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3.6.11 |
Where there is doubt, the police officer will consult the police legal services or the data protection unit. |
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3.6.12 |
Information will be provided by the police on the strict understanding that it is confidential in nature, will only be used for the purposes of a child protection or child in need assessment and that it may not be passed on to any third party without the express permission of the police. |
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3.6.13 |
Outside of the context of a s47 enquiry or criminal investigation, completion of 'information request forms', processed in accordance with police standards, will usually be required (see Form 87B, available at: www.londonscb.gov.uk). |
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3.6.14 |
In urgent cases, information shared as part of a s47 enquiry may be provided verbally prior to being confirmed in writing on form 87D (see Form 87B, available at: www.londonscb.gov.uk). |
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3.6.15 |
Education professionals have a professional responsibility to share information with other professionals in order to protect children, particularly with investigative agencies such as, the police and LA children's social care. This responsibility applies to teaching staff and other school-based staff, including PCT school nurses, as well as those working for LA education. |
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3.6.16 |
Section 27 Children Act 1989 also imposes a duty on local education authorities to assist LA children's social care in the exercise of its functions (e.g. child protection), if requested to do so and if it is not prejudicial to the discharge of their own function. |
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3.6.17 |
The Education Act 2002 introduced additional duties on local education authorities, governing bodies and teaching staff to share information that may be relevant to child protection with LA children's social care. |
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3.7 |
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Confidential information exchange |
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3.7.1 |
The professional requesting information about a child and their family from another agency and the professional in that agency who provides it must record the event contemporaneously and date it, in accordance with their own agency procedures. Both professionals must also record the reason for request and the level of risk of harm in play at time of request. |
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3.7.2 |
The recording must indicate if the consent of the subject child or their parent/s was sought and obtained, sought and refused or not sought. |
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3.7.3 |
If information was provided without consent, the reason/s for doing so must be made clear and the record must also indicate whether the subject child or their parent/s was subsequently informed of the information transfer. |
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3.7.4 |
Unless they are already known, a telephone call received from a professional seeking information must be verified before information is divulged, by calling their agency back. |
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3.7.5 |
A record of any information given or received by 'phone or in person must be made, as well as reasons for not informing at time or subsequently, alongside details of the risk of harm as in section 3.7.1 above. |
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3.7.6 |
Transmission of personal and sensitive information by fax should only happen when unavoidable. The number / address to which it is being sent should be checked very carefully (preferably by a colleague) and reassurance provided and recorded about the security of its handling by the other agency. |
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3.7.7 |
All faxes containing confidential information should have a cover sheet which contains a confidentiality statement (e.g. 'This fax is confidential and is intended only for the person to whom it is addressed'). Faxes should be sent to 'Safe Haven' fax machines. If there is any doubt about being able to ensure confidentiality agreement should be reached by both parties that the recipient will stand by the fax machine and provide confirmation to the sender that the fax has been received. |
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3.7.8 |
Confidential information should only be sent by secure electronic systems and not by internet e-mail. E-mails containing confidential information should have a confidentiality warning (e.g. 'This e-mail is confidential and is intended for the person to whom it is addressed'). |
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3.7.9 |
Professionals in all agencies must ensure that in the child (or adult who is a parent)'s file, they:
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