6. Referral and assessment

Text Size:

6.1

Introduction

6.2

The Common Assessment Framework

6.3

Assessment Framework

6.4

Referral criteria

6.4.4

Indicator table

6.5

Receiving a referral

6.5.3

Checks and information gathering

6.5.21

No further action

6.6

Initial assessment

6.6.11

Information from previous LAs / countries

6.6.15

Notifying the police

6.6.17

Outcome of initial assessment

6.7

Core assessment

6.8

Pre-birth referral and assessment

6.8.1

Referral

6.8.5

Pre-birth initial assessment

6.8.6

Pre-birth strategy meeting / discussion

6.8.11

Pre-birth s47 enquiry and core assessment

6.8.14

If it is suspected that a child may be born at home

6.9

Good practice checklist

6.10

Quick referral flowchart

For quick referral flowchart, see section 6.10

6.1.1

In all assessment processes, the safety of the child should remain paramount at all times and in all circumstances.

6.1.2

Early assessment and intervention is important because incidents of neglect and abuse within families are on a continuum and situations where abuse is developing can, at times, be resolved by preventative services outside the child protection procedures.

6.1.3

At all stages of referral and assessment, consideration must be given to issues of diversity, taking into account:

• The impact of cultural expectations and obligations on the family;
• The family's knowledge and understanding of UK law in relation to parenting and child welfare;
• The impact on the family if recently arrived in the UK and their immigrant status;
• The need to use interpreters for discussions about parenting and child welfare, even though the family's day-to-day English may appear / be adequate (see section 5.50. Working with interpreters / communications facilitators).

6.1.4

All assessments must:

• Be holistic in approach;
• Involve children and their families (in addition to collating verbal and written contributions from relevant agencies);
• Build on strengths as well as identifying difficulties.

6.1.5

Types of assessment include:

• Common assessment undertaken by practitioners in any of the agencies or organisations providing services for children and their families (see section 6.2. Common Assessment Framework);
• Initial assessment undertaken by LA children's social care with the involvement of other professionals, the child and family, using the Framework for the Assessment of Children in Need and their Families (Department of Health et al, 2000. the Assessment Framework (see section 6.6 Initial assessment);
• Core assessment undertaken by LA children's social care with the involvement of other professionals, the child and family using the Assessment Framework (see section 6.7 Core assessment);
• Other specialist assessments undertaken by health, education or other specialist professionals (e.g. special educational needs assessments or medical / psychiatric diagnoses).

6.1.6

Assessments should, as far as possible, build on rather than repeat recent and previous generic (common assessment) and specialist assessments.

6.2.1

The Common Assessment Framework (CAF) offers a basis for early identification of children's additional needs, sharing of this information between organisations and the co-ordination of service provision. Where it is considered a child may have additional needs, with the consent of the child or parents/carers, professionals may undertake a common assessment in accordance with the national practice guidance to assess these needs and to decide how best to support them.

6.2.2

The common assessment is designed for when:

• There are concerns about how well a child is progressing in terms of their health, welfare, behaviour, progress in learning or any other aspect of their well-being;
• The child's needs are unclear or broader than a single service can address.

6.2.3

A common assessment should be completed when a professional in any agency (all health, childcare, early years settings, schools, education, Connexions, adult social care, crime reduction and the third sector) has concerns that a child will not progress towards the five Every Child Matters priority outcomes (being healthy, staying safe, enjoying and achieving, making a positive contribution and achieving economic well-being), without additional services. Professionals should consult their local guidance and protocols in relation to thresholds for referral in their Local Safeguarding Children Board area.

6.2.4

Completing a common assessment should:

• Enable the professional to identify the child's needs;
• Provide a structure for systematic gathering and recording of information;
• Record evidence of concerns and a base-line for measuring progress in addressing them;
• Potentially provide a framework for a referral discussion to LA children's social care for an initial or core assessment or to another service for a specialist assessment.

6.2.5

The findings from the common assessment may however give rise to concerns about a child's safety and welfare. Professionals should be particularly concerned regarding children whose parents or caregivers are experiencing difficulties in meeting their needs as a result of domestic violence, substance misuse, mental illness and/or learning disability (see section 5 Children in specific circumstances). All staff members who have or become aware of concerns about the safety or welfare of a child or children should know:

• Who to contact in what circumstances, and how; and
• When and how to make a referral to local authority children's social care services or the police (including whether local protocols allow for use of the common assessment profroma as a referral).

Discussion of concerns about a child's safety and welfare

6.2.6

Irrespective of whether a common assessment has been undertaken, where there are concerns that a child may be a possible child in need, and in particular where there are concerns about a child being harmed, relevant information about the child and family should be discussed with a manager, or a named or designated health professional or a designated member of staff depending on the organisational setting. Concerns can also be discussed, without necessarily identifying the child in question, with senior colleagues in another agency, (for example, children's social care services) in order to develop an understanding of the child's needs and circumstances.

6.2.7

A common assessment can be considered, along with the provision of services without first completing a CAF, if a child is not considered to be a possible child in need under section 17 of the Children Act 1989.

6.2.8

If it is agreed that the child may be a child in need under the Children Act 1989, then a referral to children's social care should be discussed with the child and parents. If they consent, then the child should be referred to local authority children's social care and the processes set out in this chapter followed.

6.2.9

If the child is believed or suspected to be suffering significant harm a referral should always be made to children's social care (see 6.5 Making and receiving a referral). If concerns arise about a child who is already known to local authority children's social care, the allocated social worker should be informed immediately of these concerns.

6.2.10

There should always be the opportunity to discuss concerns about a child's safety and welfare with, and seek advice from, colleagues, managers, a designated or named professional, or other agencies but:

• Never delay emergency action to protect a child from harm;
• Always record in writing concerns about a child's welfare, including whether or not further action is taken; and
• Always record in writing discussions about a child's welfare in the child's file. At the close of a discussion, always reach a clear and explicit recorded agreement about who will be taking what action or that no further action will be taken.

6.3.1

The Framework for the Assessment of Children in Need and their Families (Department of Health et al, 2000) (the Assessment Framework) provides a systematic multi-agency approach to analyse and record what is happening to a child within their family and the wider context of the community in which they live. See appendix 5 for a summary and diagram of the Assessment Framework.

6.3.2

The assessment stages involve gathering and analysing information about the three domains of the Assessment Framework. These are the:

• Child's developmental needs;
• Parents' or caregivers' capacity to respond appropriately;
• Impact of the wider family and environmental factors on parenting capacity and the child.

6.3.3

Staff in all agencies should be competent in contributing to the assessment of a child using the Assessment Framework.

6.3.4

Where appropriate staff should also be competent to use HOME Inventory and the Family Pack of Questionnaires and Scales which accompany the Assessment Framework (see appendix 6. Questionnaires and scales to evidence assessment and decision making) The HOME (Home Observation and Measurement of the Environment) Inventory is user-friendly and is well received by families. It involves an hour long semi-structured interview in the home with the main caregiver and child to collect information about the nature and variety of the child's day-to-day experiences and the parenting capacity of the caregivers and to explore a range of other aspects of the child's world and the life of the family. The HOME Inventory has been shown to be a good predictor of outcomes for children.

6.4.1

Professionals in all agencies have a responsibility to refer a child to LA children's social care when it is believed or suspected that the child:

• Has suffered significant harm (see section 4. Recognition and response and/or section 5. Children in specific circumstances);
• Is likely to suffer significant harm (see section 4. Recognition and response and/or section 5. Children in specific circumstances);
• Has developmental and welfare needs which are likely only to be met through provision of family support services (with agreement of the child's parent).

6.4.2

Other than in cases where it is immediately clear that a child is, or is likely to be, at risk of significant harm, professionals should complete a common assessment and discuss this with their agency's nominated safeguarding children adviser, LA children's social care or the police, to help them reach a decision that the concerns they have about a child are sufficiently serious for a referral to be made to LA children's social care. See section 6.2. Common Assessment Framework.

6.4.3

If, as a result of consultation, LA children's social care conclude that a referral is required, then the referrer should comply by making the referral without delay using the appropriate referral form.

Indicator table

6.4.4

The table below is an indicator guide of the difference within LA children's social care between a s47 core assessment and an initial assessment. This table is intended as a guide and is not exhaustive. Each local area will have their own arrangements for the Common Assessment Framework (see section 6.2. Common Assessment Framework) and the wider children in need population. See section 5. Children in specific circumstances.

LA children's social care assessments

6.5.1

New referrals and referrals on closed cases should be made to the LA children's social care duty social worker. Referrals on open cases should be made to the allocated social worker for the case (or in their absence the manager or the duty social worker). The referrer should have the opportunity to discuss their concerns with a qualified social worker.

6.5.2

For all referrals to LA children's social care, the child should be regarded as potentially a child in need, and the referral should be evaluated on the day of receipt (and no later than within one working day), and a decision made regarding the next course of action.

6.5.3

Local authority children's social care should ensure that the social work professionals who are responding to referrals are supported by experienced first line managers competent in making sound evidence based decisions about what to do next.

Checks and information gathering

6.5.3

When taking a referral, LA children's social care must establish as much of the following information as possible:

• Full names (including aliases and spelling variations), date of birth and gender of child/ren;
• Family address and (where relevant) school / nursery attended;
• Identity of those with parental responsibility;
• Names and date of birth of all household members;
• Ethnicity, first language and religion of children and parents;
• Any special needs of children or parents;
• Any significant / important recent or historical events / incidents in child or family's life;
• Cause for concern including details of any allegations, their sources, timing and location;
• Child's current location and emotional and physical condition;
• Whether the child needs immediate protection;
• Details of alleged perpetrator, if relevant;
• Referrer's relationship and knowledge of child and parents;
• Known involvement of other agencies / professionals (e.g. GP);
• Information regarding parental knowledge of, and agreement to, the referral;
• The information held on ContactPoint, where available. If there is a flag, establish the reasons for this.

6.5.4

At the end of the referral discussion the referrer and LA children's social care should be clear about proposed action, timescales and who will be taking it, or that no further action will be taken.

6.5.5

All referrals from professionals should be confirmed in writing, by the referrer, within 48 hours.

6.5.6

If the referrer has not received an acknowledgement within three working days, they should contact LA children's social care again.

6.5.7

The social worker should gather information through:

• Discussion with the referrer;
• Consideration of any existing records for the child and for any other members of the household;
• Involving other agencies as appropriate (including the police if an offence has been or is suspected to have been committed or probation if the child is at risk of harm from an offender).

6.5.8

This process should establish:

• The nature of the concern;
• How and why it has arisen;
• What the child's and the family's needs appear to be;
• Whether the concern involves abuse or neglect; and
• Whether there is any need for any urgent action to protect the child or any other children in the household or community.

6.5.9

Personal information about non-professional referrers should not be disclosed to third parties (including subject families and other agencies) without consent.

6.5.10

The parents' permission should be sought before discussing a referral about them with other agencies, unless permission-seeking may itself place a child at risk of significant harm. See section 3.3.15, about whose consent to share information should be sought.

6.5.11

Interviews with family members (which may include the child) should also be undertaken in their preferred language and where appropriate for some people by using non-verbal communication methods.

6.5.12

A decision to discuss the referral with other agencies without parental knowledge or permission should be authorised by a LA children's social care manager, and the reasons recorded.

6.5.13

LA children's social care should make it clear to families (where appropriate) and other agencies that the information provided for this assessment may be shared with other agencies, and contribute to the exemplar completed at the end of the assessment.

6.5.14

This checking and information gathering stage must involve an immediate assessment of any concerns about either the child's health and development, or actual and/or potential harm, which justify further enquiries, assessments and / or interventions.

6.5.15

The LA children's social care manager should be informed of any potential s47 enquiries and authorise the decision to initiate action. In most cases this will first involve an initial assessment, which may be brief when the threshold for child protection enquiries is met (see section 7. Child protection enquiries, 7.3. Threshold for s47 enquiries and the core assessment). If the child and / or family are well known to professional agencies or the facts clearly indicate that a s47 enquiry is required, it may be appropriate to hold a strategy meeting / discussion immediately.

6.5.16

The threshold may be met for a s47 enquiry at the time of referral, following checks and information gathering or at any point of LA children's social care involvement.

6.5.17

The police must be informed at the earliest opportunity if a crime may have been committed. The police must decide whether to commence a criminal investigation and a discussion should take place to plan how parents are to be informed of concerns without jeopardising police investigations.

6.5.18

The immediate response to referrals may be:

• No further action at this stage;
• Provision of services;
• A fuller initial assessment of needs (which may be very brief if the criteria for initiating a s47 enquiry are met);
• A core assessment if indications exist that the case is particularly complex or several initial assessments have previously been completed;
• Emergency action to protect a child;
• A s47 strategy meeting / discussion (where child and/or family are well known or the facts clearly indicate that s47 enquiry is required).

6.5.19

A LA children's social care manager must approve the outcomes of a referral and ensure an ICS chronology has been commenced and/or updated.

6.5.20

LA children's social care must acknowledge all referrals within one working day.

No further action

6.5.21

Where there is to be no further LA children's social care action, feedback should be provided to family and referrers about the outcome of this stage of the referral.

6.5.22

In the case of referrals from members of the public, feedback must be consistent with the rights to confidentiality of the child and their family.

6.6.1

The initial assessment should be taken in accordance with the Assessment Framework (see appendix 5 for a summary and diagram of the Assessment Framework). Where a common assessment has been completed, this information should be used to inform the initial assessment.

6.6.2

The initial assessment must be completed within a maximum of ten working days of the date of the referral. There are no circumstances in which national guidance permits extension to the above timescales. Where it becomes apparent that a timescale will require extension, a LA children's social care first line manager must review the file, record the reason for the extension and agree the new timescale.

6.6.3

The initial assessment must be led by a qualified and experienced LA social worker who is supervised by a highly experienced and qualified social work manager. The social worker should, in consultation with their manager and the other agencies involved with the child and family, carefully plan action with clarity about who is doing what:

• When to interview the child/ren (within an appropriate timescale);
• Whether the child/ren should be seen and spoken to with or without their parents;
• When to interview parents and any other relevant family members;
• What the child and parents should be told of any concerns;
• What contributions (historical and contemporary information) to the assessment from other agencies should be and who will provide them;
• Whether information from abroad is required. If it is, then professionals from each agency will need to request information from their equivalent agencies in the countries in which the child has lived.

6.6.4

Personal information about non-professional referrers should not be disclosed to third parties (including subject families and other agencies) without consent.

6.6.5

The parents' permission should be sought before discussing a referral about them with other agencies. If the manager decides to proceed with checks without parental knowledge or permission, they must record the reasons, e.g. that doing so would:

• Prejudice the child's welfare;
• Aggravate seriously concerning behaviours of the adult;
• Increase the risk of further significant harm to the child;
• Prejudice a criminal investigation.

See section 3.3.15, about whose consent to share information should be sought.

6.6.6

The checks should be undertaken directly with involved professionals and not through messages with intermediaries.

6.6.7

The relevant agency should be informed of the reason for the enquiry, whether or not parental consent has been obtained and asked for their assessment of the child in the light of information presented.

6.6.8

All discussions and interviews with family members (which may include the child) should be undertaken in their preferred language and where appropriate for some people by using non-verbal communication methods.

6.6.9

LA children's social care should make it clear to families (where appropriate) and other agencies that the information provided for this assessment may be shared with other agencies and contribute to the written form completed at the end of the assessment.

6.6.10

If during the course of the assessment it is discovered that a school age child is not attending an educational establishment, the LA education service where the child resides should be contacted to establish the reason for this. LA education must take responsibility for ensuring that the child receives education as soon as possible.

Information from previous LAs / countries

6.6.11

If the child and their parents have moved into the LA children's social care area, all practitioners should seek information from their respective agencies covering previous addresses in the UK and abroad.

6.6.12

For information from foreign countries, see section 5.48 Accessing information from abroad. In some cases, specialist assessments and information can be undertaken or obtained through independent consultants or through specialist agencies such as International social services (UK) (see section 5.48).

6.6.14

It is never acceptable to delay immediate action required whilst information from foreign countries is accessed.

Notifying the police

6.6.15

It will not necessarily be clear whether a criminal offence has been committed, which means that even initial discussions with the child should be undertaken in a way that minimises distress to them and maximises the likelihood that they will provide accurate and complete information, avoiding leading or suggestive questions.

6.6.16

The police must be informed at the earliest opportunity if a crime may have been committed. The police will decide whether to commence a criminal investigation.

Outcome of initial assessment

6.6.17

The focus of the initial assessment is the welfare of the child. In the course of an initial assessment, LA children's social care should ascertain:

• Is this a child in need? (s17 Children Act 1989);
• Is there reasonable cause to suspect that this child is suffering, or is likely to suffer, significant harm? (s47 Children Act 1989).

6.6.18

The possible outcomes of the initial assessment are:

• No further action;
• An initial plan for immediate provision of child in need services to promote the child's heath and development;
• Instigation of a s17 core assessment for a more in-depth assessment of the child's needs and circumstances;
• Instigation of a strategy meeting / discussion, a child protection enquiry and a s47 core assessment;
• Emergency action to protect a child (see section 7. Child protection enquiries, 7.2. Immediate protection).

6.6.19

The outcome of the initial assessment should be:

• Discussed with the child and family and provided to them in written form. Exceptions to this are where this might place a child at risk of harm or jeopardise an enquiry;
• Taking account of confidentiality, provided to professional referrers.

6.6.20

A LA children's social care manager must approve the outcomes of an initial assessment consistent with the Initial Assessment Record (DoH 2002). The manager must also record and authorise the reasons for decisions, future actions to be taken and also that:

• The child/ren has been seen or there has been a recorded management decision that this is not appropriate (e.g. a s47 enquiry and police investigation initiated which will plan method of contact with child);
• The needs of all children in the household have been considered;
• An ICS chronology has been completed and / or updated;
• Written feedback has been provided to the family, other agencies and referrers about the outcome of this stage of the referral in a manner consistent with respecting the confidentiality and welfare of the child.

6.6.21

If the criteria for initiating s47 enquiries are met at any stage during an initial assessment, the assessment should be regarded as concluded.

6.7.1

A core assessment should be undertaken when a more in-depth assessment is necessary to understand the child's developmental or welfare needs and circumstances and the parents' capacity to respond to those needs, including the parents' capacity to ensure that the child is safe from harm now and in the future.

6.7.2

The decision to undertake a core assessment may be taken:

• At the conclusion of an initial assessment which recommends further assessment;
• When a strategy meeting / discussion initiates a s47 enquiry;
• When new information is obtained on an open case.

6.7.3

A core assessment should be based on the Assessment Framework (see appendix 5 for a summary and diagram of the Assessment Framework). It must be led by a qualified and experienced LA social worker.

6.7.4

The core assessment must provide a rigorous analysis of the child's needs and the capacity of the child's parents to meet these needs within their family and environment. Based on this analysis the key questions to be answered are:

• What is likely to happen if nothing changes in the child's current situation?
• What are the likely consequences for the child?

The answers to these questions should inform decisions about what interventions are required to safeguard and promote the welfare of a child and where possible to support parents in achieving this aim.

6.7.5

The core assessment must be completed within a maximum of 42 working days, including the maximum seven working days taken to complete an initial assessment. It may be necessary to commission specialist assessments (e.g. from child and adolescent mental health services) which it may not be possible to complete within this time period. This should not delay the drawing together of the core assessment findings at this point.

6.7.6

Where it becomes apparent that a timescale will require extension, a LA children's social care first line manager must review the electronic record, record the reason for the extension and agree the new timescale. Any request to LA children's social care from another agency for a core assessment must be given serious consideration and if there is a decision not to undertake the core assessment the decision and the reasons for it must be recorded in the child's electronic record and conveyed in writing to the referring agency.

6.7.7

A LA children's social care manager must approve the outcomes of a core assessment and ensure that:

• There has been direct communication with the child alone and their views and wishes have been recorded and taken into account;
• All the children in the household have been seen and their needs considered;
• The child's home address has been visited and the child's bedroom has been seen;
• The parent has been seen and their views and wishes have been recorded and taken into account;
• The analysis has been completed;
• The assessment provides clear evidence for decisions on what types of services are needed to provide good outcomes for the child and family;
• The ICS chronology is up-to-date.

6.7.8

A core assessment is deemed complete once the assessment has been discussed with the child and family and the team manager as viewed and authorised the assessment.

6.7.9

If the assessment is that further support is required, a child in need plan should be agreed with family and other agencies. This should be monitored and reviewed regularly at maximum intervals of six months.

Referral

6.8.1

Where agencies or individuals anticipate that prospective parents may need support services to care for their baby or that the baby may be at risk of significant harm, a referral to LA children's social care must be made as soon as the concerns are identified. See section 4. Recognition and response, 4.4 Potential risk to an unborn child.

6.8.2

The referrer should clarify as far as possible, using the Common Assessment Framework, their concerns in terms of how the parent's circumstances and / or behaviours may impact on the baby and what risks are predicted.

6.8.3

A referral should be made at the earliest opportunity in order to:

• Provide sufficient time to make adequate plans for the baby's protection;
• Provide sufficient time for a full and informed assessment;
• Avoid initial approaches to parents in the last stages of pregnancy, at what is already an emotionally charged time;
• Enable parents to have more time to contribute their own ideas and solutions to concerns and increase the likelihood of a positive outcome to assessments;
• Enable the early provision of support services so as to facilitate optimum home circumstances prior to the birth.

6.8.4

Concerns should be shared with prospective parent/s and consent obtained to refer to LA children's social care unless obtaining consent in itself may place the welfare of the unborn child at risk e.g. if there are concerns that the parent/s may move to avoid contact with investigative agencies.

Pre-birth initial assessment

6.8.5

A pre-birth initial assessment should be undertaken on all pre-birth referrals, and when appropriate a strategy meeting / discussion held, where:

• A parent or other adult in the household, or regular visitor, has been identified as posing a risk to children (see section 13. Risk management of known offenders);
• A sibling in the household is subject of a child protection plan;
• A sibling has previously been removed from the household either temporarily or by court order;
• The parent is a looked after child;
• There are significant domestic violence issues (see section 5.12. Domestic violence);
• The degree of parental substance misuse is likely to impact significantly on the baby's safety or development (see section 5.34. Parents who misuse substances);
• The degree of parental mental illness / impairment is likely to impact significantly on the baby's safety or development (see section 5.32. Parental mental illness);
• There are significant concerns about parental ability to self care and / or to care for the child e.g. unsupported, young or learning disabled mother;
• Any other concern exists that the baby may be at risk of significant harm including a parent previously suspected of fabricating or inducing illness in a child (see section 5.13. Fabricated or induced illness) or harming a child;
• A child aged under 13 is found to be pregnant (see section 5.42. Sexually active children and section 5.43. Sexually exploited children).

Pre-birth strategy meeting / discussion

6.8.6

The need for a s47 enquiry should be considered and, if appropriate, initiated at a strategy meeting / discussion held as soon as possible following receipt of the referral. The expected date of delivery will determine the urgency for the meeting.

6.8.7

Consideration of the need to initiate a s47 enquiry should follow the procedures described in section 7. Child protection enquiries.

6.8.8

The strategy meeting / discussion should follow the procedures described in section 7. Child protection enquiries, 7.5. Strategy meeting / discussion. It should take place at the hospital where the birth is planned or expected, or where the responsible midwifery service is or would be if the parents have not booked for service provision prior to birth.

6.8.9

The meeting must decide:

• Whether a s47 enquiry and pre-birth core assessment is required (unless previously agreed at any earlier ante-natal meeting);
• What areas are to be considered for assessment;
• Who needs to be involved in the process;
• How and when the parent/s are to be informed of the concerns;
• The actions required by adult services working with expectant parent/s (male or female);
• The actions required by the obstetric team as soon as the baby is born. This includes labour / delivery suite and post-natal ward staff and the midwifery service, including community midwives;
• Any instructions in relation to invoking an emergency protection order (EPO) at delivery should be communicated to the midwifery manager for the labour / delivery suite.

6.8.10

The parents should be informed as soon as possible of the concerns and the need for assessment, except on the rare occasions when medical advice suggests this may be harmful to the health of the unborn baby and / or mother.

Pre-birth s47 enquiry and core assessment

6.8.11

In undertaking a pre-birth s47 enquiry and core assessment, LA children's social care, the police and relevant other agencies must follow the procedures described in section 7. Child protection enquiries and section 6.7. Core assessment.

6.8.12

In summary, the enquiry should identify:

• Risk factors;
• Strengths in the family environment;
• The factors likely to change, the reasons for this and the timescales.

6.8.13

The enquiry must make recommendations regarding the need, or not, for a pre-birth child protection conference which should wherever possible be held ten weeks prior to the expected delivery date or earlier if a premature birth is anticipated.

See section 8. Child protection conferences, and section 8.14. Pre-birth conference.

If it is suspected that a child may be born at home

6.8.14

The local Primary Care Trust (PCT) and LA children's social care service have a duty to contact any relevant agencies if they have a concern about an unborn child. If professionals are concerned that a child may be born at home or is likely to be delivered before getting to the hospital, a referral should be made to the London Ambulance Service.

6.8.15

There is an agreement between the police and the London Ambulance Service for information to be shared where a pre-birth child protection conference has decided that the baby is likely to suffer significant harm and should be taken into police protection when s/he is born.

6.8.16

The local police child abuse investigation team (CAIT) will inform the London Ambulance Service of all relevant details concerning the unborn baby and mother. Any change of details obtained by agencies should be passed to the local CAIT, who will forward the information to the London Ambulance Service. 

6.9.1

Information from serious case reviews continues to highlight that, when faced with the complex circumstances of a child's life, professionals find it difficult to keep the focus on the child and the key elements which should contribute to ensuring his / her safety.

Professionals should consider regularly checking their actions against this checklist as a good practice prompt: