5.9 Sexually Active Young People under the age of 18 in Knowsley |
BACKGROUND
This protocol was developed by a task group of Knowsley Safeguarding Children Board with representatives from Knowsley Safeguarding Children Board including:
- NHS agencies
- Voluntary organisations
- Knowsley Local Authority
- Merseyside Police Authority (in Merseyside)
- Connexions
The use of Lancashire County Council Local Safeguarding Board Teenage Pregnancy Group guidance in the production of this protocol is appreciated and acknowledged. The original guidance can be found on the Every Child Matters Website.
This chapter should be read in conjunction with Safeguarding Children and Young People from Sexual Exploitation Procedure.
Contents
1. Introduction
| 1.1 | This protocol has been devised and adapted with the understanding that most young people under the age of 18 will have an interest in sex and sexual relationships. |
| 1.2 | It is designed to assist those working with children and young people to identify where these relationships may be abusive, and the children and young people may need the provision of protection or additional services. |
| 1.3 | It is based on the core principle that the welfare of the child or young person is paramount, and emphasises the need for professionals to work together in accurately assessing the risk of significant harm when a child or young person is engaged in sexual activity. |
| 1.4 | All agencies that have contact with children and young people, should use this protocol to develop and implement local guidance for their own staff. |
2. Assessment
| 2.1 | All young people, regardless of gender, or sexual orientation who are believed to be engaged in, or planning to be engaged in, sexual activity must have their needs for health education, support and/or protection assessed by the agency involved. This assessment must be carried out in accordance with information and guidance set out in;
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| 2.2 | In assessing the nature of any particular behaviour, it is essential to look at the facts of the actual relationship between those involved. Power imbalances are very important and can occur through differences in size, age and development and where gender, sexuality, race and levels of sexual knowledge are used to exert such power. (Of these, age may be a key indicator, e.g. a 15 year old girl and a 25 year old man). There may also be an imbalance of power if the young person's sexual partner is in a position of trust in relation to them e.g. teacher, youth worker, carer etc. In the assessment, workers need to include the use of sex for favours e.g. exchanging sex for clothes, cds, trainers, alcohol, drugs, cigarettes etc. Young people could also have large amounts of money or other valuables which cannot be accounted for. |
| 2.3 | If the young person has a learning disability, mental disorder or other communication difficulty, they may not be able to communicate easily to someone that they are, or have been abused, or subjected to abusive behaviour. Staff need to be aware that the Sexual Offences Act 2003 recognises the rights of people with a mental disorder to a full life, including a sexual life. However, there is a duty to protect them from abuse and exploitation. The Act includes 3 new categories of offences to provide additional protection (Appendix 1) |
| 2.4 | In order to determine whether the relationship presents a risk to the young person, the following factors should be considered. This list is not exhaustive and other factors may be needed to be taken into account clearly the more factors present will increase the level of risk for the YP concerned-
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| 2.5 | It is considered good practice for workers to follow the Fraser guidelines when discussing personal or sexual matters with a young person aged under 16. The Fraser guidelines give guidance on providing advice and treatment to young people aged under 16 years of age. These hold that sexual health services can be offered without parental consent providing that;
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3. Process
| 3.1 | In working with young people, it must always be made clear to them that absolute confidentiality cannot be guaranteed, and that there will be some circumstances where the needs of the young person can only be safeguarded by sharing information with others. This discussion with the young person may prove useful as a means of emphasising the gravity of some situations. |
| 3.2 | On each occasion that a young person is seen by an agency, consideration should be given as to whether their circumstances have changed or further information has been given which may lead to the need for referral or re-referral. |
| 3.3 | In some cases urgent action may need to be taken to safeguard the welfare of a young person. However, in most circumstances there will need to be a process of information sharing and discussion in order to formulate an appropriate plan. There should be time for reasoned consideration to define the best way forward. Anyone concerned about the sexual activity of a young person should initially discuss this with the person in their agency responsible for safeguarding children. There may then be a need for further consultation with the Duty Social Worker or Team Manager in the relevant Social Care Children and Families Team. All discussions should be recorded, giving reasons for action taken and who was spoken to. It is important that all decision making is undertaken with full professional consultation, never by one person alone (agency procedures must include guidance on how this is to be undertaken within their own organisation). |
| 3.4 | If you have concerns that the young person may be at risk of sexual exploitation, please make a telephone referral to the relevant Children's Social Care team followed up in writing within 48 hours. Out of hours the Emergency Duty Team should be contacted. If the situation is an emergency, the local police should be contacted immediately as well as the Children's Social Care. |
| 3.5 | When a referral is received by the Children's Social Care, all relevant Children and Young People's information systems (See Appendix 5) will be checked as part of the Initial Assessment process and dependant on the outcome of the assessment, a Strategy Discussion may be convened with partner agencies in line with the procedures set out in Part 4 of this manual - Managing individual cases where thre are concerns about a child's safety and welfare. This discussion should be informed by the assessment undertaken using this protocol and, in the majority of cases, may be largely for the purposes of consultation and information sharing. In many cases, it will not be in the best interests of the young person for criminal or civil proceedings to be instigated. However, Police, Children's Social Care and other agencies may hold vital information that will assist in any clear assessment of risk. |
| 3.6 | Following any referral to the Children's Social Care and after a Strategy Discussion with the Police and/or any other agencies, there may be one of these responses:
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| 3.7 | Any girl, either under or over the age of 13, who is pregnant, must be offered specialist support and guidance by the relevant services (Please see Appendix 6). These services will also be a part of the assessment of the girl's circumstances, and must be included within local guidance. |
4. Young People Aged Under 13
| 4.1 | Under the Sexual Offences Act 2003, children under the age of 13 are considered of insufficient age to give consent to sexual activity. The police must be notified as soon as possible when a criminal offence has been committed or is suspected of having been committed against a child unless there are exceptional reasons not to do so. (Recommendation 12 of Sir Michael Bichard's report, page 15) |
| 4.2 | In all cases where the sexually active young person is under the age of 13, a full assessment must be undertaken. (Please see Appendix 4 for factors to be considered) Each case must be assessed individually and consideration must be given as to whether to make a Safeguarding referral to Children's Social Care - in accordance with Part 4 of this manual - Managing individual cases where thre are concerns about a child's safety and welfare. In order for this to be meaningful, the young person will need to be identified, as will their sexual partner if details are known. |
| 4.3 | A decision not to refer can only be made following a case discussion with the designated lead for Safeguarding Children within the professional's employing agency. Please refer to your agency's guidance. When a referral is not made, the professional and agency concerned is fully accountable for the decision and a good standard of record keeping must be made, including the reasons for not making a referral. |
| 4.4 | When a girl under 13 is found to be pregnant, a referral to the Children's Social Care must be made and they will hold a Strategy Discussion with the police and/or other agencies. At this stage a multi-agency support package should be formulated. |
5. Young People Aged between 13 and 16
| 5.1 | The Sexual Offences Act 2003 reinforces that, whilst mutually agreed, non-exploitative sexual activity between teenagers does take place and that often no harm comes from it, the age of consent should still remain at 16. This acknowledges that this group of young people is still vulnerable, even when they do not view themselves as such. |
| 5.2 | Sexually active young people in this age group will still have to have their needs assessed using this protocol. (Please see Appendix 4 for factors to be considered.) Discussion with the Children's Social Care will depend on the level of risk/need assessed by those working with the young person. |
| 5.3 | This difference in procedure reflects the position that, whilst sexual activity under 16 remains illegal, young people under the age of 13 are not capable to give consent to such sexual activity. |
6. Young People between 17 and 18
| 6.1 | Although sexual activity in itself is no longer an offence over the age of 16, young people under the age of 18 are still offered protection under the Children Act 1989 and the Sexual Offences Act 2003. Consideration still needs to be given to issues of sexual exploitation and abuse of power in circumstances outlined above. (Please see Appendix 4 - Prompts for Professionals for factors to be considered and also Safeguarding Children and Young People from Sexual Exploitation Procedure). Young people, of course, can still be subject to offences of rape and assault and the circumstances of an incident may need to be explored with a young person. Young people over the age of 16 and under the age of 18 are not deemed able to give consent if the sexual activity is with an adult in a position of trust or a family member as defined by the Sexual Offences Act 2003. |
7. Sharing Information with Parents / Carers
| 7.1 | Decisions to share information with parents and carers will be taken using professional judgement, consideration of Fraser guidelines and in consultation with the Safeguarding Children Procedures. Decisions will be based on the child's age, maturity and ability to appreciate what is involved in terms of the implications and risks to themselves. This should be coupled with the parents' and carers' ability and commitment to protect the young person. Given the responsibility that parents have for the conduct and welfare of their children, professionals should encourage the young person, at all points, to share information with their parents and carers wherever safe to do so. |
| 7.2 | This protocol is written on the understanding that those working with this vulnerable group of young people will naturally want to do as much as they can to provide a safe, accessible and confidential service whilst remaining aware of their duty of care to safeguard them and promote their well being. |
8. Review
| 8.1 | It is intended that this protocol will be reviewed 12 months after adoption or following changes in legislation and/or a change in national guidance. |
Appendix 1 - Additional Information
Definitions
Sexual Grooming
Section 15 of the Sexual Offences Act 2003 makes it an offence for a person (A) aged 18 or over to meet intentionally, or to travel with the intention of meeting a child under 16 in any part of the world, if he has met or communicated with that child on at least two earlier occasions, and intends to commit a "relevant offence" against that child either at the time of the meeting or on a subsequent occasion. An offence is not committed if (A) reasonably believes the child to be 16 or over.
The section is intended to cover situations where an adult (A) establishes contact with a child through for example, meetings, conversations or communications on the internet and gains the child's trust and confidence so that he can arrange to meet the child for the purpose of committing a "relevant offence" against the child.
The course of conduct prior to the meeting that triggers the offence may have an explicitly sexual content, such as (A) entering into conversations with the child about sexual acts he wants to engage him/her in when they meet, or sending images of adult pornography. However, the prior meetings or communication need not have an explicitly sexual content and could for example simply be (A) giving swimming lessons or meeting him/her incidentally through a friend.
The offence will be complete either when, following the earlier communications, (A) meets the child or travels to meet the child with the intent to commit a relevant offence against the child. The intended offence does not have to take place.
The evidence of (A's) intent to commit an offence may be drawn from the communications between (A) and the child before the meeting or may be drawn from other circumstances, for example if (A) travels to the meeting with ropes, condoms and lubricants.
Subsection (2)(a) provides that (A's) previous meetings or communications with the child can have taken place in or across any part of the world. This would cover for example (A) emailing the child from abroad (A) and the child speaking on the telephone abroad, or (A) meeting the child abroad. The travel to the meeting itself must at least partly take place in England or Wales or Northern Ireland.
The Sexual Offences Act 2003
The Age of Consent
The legal age for young people to consent to have sex is still 16, whether they are straight, gay or bisexual. The aim of the law is to protect the rights and interests of young people, and make it easier to prosecute people who pressure or force others into having sex they don't want.
For the purposes of the under 13 offences, whether the child consented to the relevant risk is irrelevant. A child under 13 does not, under any circumstances, have the legal capacity to consent to any form of sexual activity.
Protecting People with a mental disorder
The act has created three new categories of offences to provide additional protection with a mental disorder.
- The Act covers offences committed against those who, because of a profound mental disorder, lack the capacity to consent to sexual activity.
- The Act covers offences where a person with a mental disorder is induced, threatened or deceived into sexual activity.
- The Act makes it an offence for people providing care, assistance or services to someone in connection with a mental disorder to engage in sexual activity with that person.
Children and Families: Safer from Sexual Crime - (The Sexual Offences Act 2003)
Although the age of consent remains at 16, the law is not intended to prosecute mutually agreed teenage sexual activity between two young people of a similar age, unless it involves abuse or exploitation. Young people, including those under 13, will continue to have the right to confidential advice on contraception, condoms, pregnancy and abortion.
Bichard Inquiry - Recommendation Number 12
"The government should reaffirm the guidance in 'Working Together to Safeguard Children' so that the Police are notified as soon as possible when a criminal offence has been committed, or is suspected of having been committed against a child - unless there are exceptional reasons not to do so".
Working Together to Safeguard Children (2010)
Paragraph 5.23
In deciding whether there is a need to share information, professionals need to consider their legal obligations, including whether they have a duty of confidentiality to the child. Where there is such a duty, the professional may lawfully share information if the child consents or if there is a public interest of sufficient force. This must be judged by the professional on the facts of each case. 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 practitioners will be justified in sharing some confidential information in order to make decisions on sharing information or taking action - the information shared should be proportionate.
Paragraph 5.24
The child's best interests must be the overriding consideration in making any such decision including in the cases of underage sexual activity on which detailed guidance is given below. The cross-Government guidance, Information Sharing: Practitioner's Guide, provides advice on these issues. Any decision whether or not to share information must be properly documented. Decisions in this area need to be made by, or with the advice of, people with suitable competence in child protection work such as named or designated professionals or senior managers.
Paragraph 5.27
Cases involving under 13s should always be discussed with a nominated child protection lead in the organisation. Under the Sexual Offences Act, penetrative sex with a child under 13 is classed as rape. Where the allegation concerns penetrative sex, or other intimate sexual activity occurs, there would always be reasonable cause to suspect that a child, whether girl or boy, is suffering or is likely to suffer significant harm. There should be a presumption that the case will be reported to the Children's Social Care and that a strategy discussion will be held in accordance with the guidance set out in paragraph 5.56 of the Working Together to Safeguard Children 2010. This should involve Children's Social Care, police and relevant agencies, to discuss appropriate next steps with the professional. All cases involving under 13s should be fully documented including detailed reasons where a decision is taken not to share information.
Additional References
- Enabling young people to access contraceptive and sexual health information and advice: Legal and Policy Framework for Social Workers, Residential Social Workers, Foster Carers and other Social Care Practitioners.
(Department for Education and Skills Teenage Pregnancy Unit 2004). - Best practice guidance for doctors and health professionals on the provision of advice and treatment to young people under 16 on contraception, sexual and reproductive health.
(Department of Health July 2004) - What to do if you are worried a child is being abused Children's Services Guidance.
(Joint publication from the Department of Health, Home Office, Office of the Deputy Prime Minister, Lord Chancellor, Department of Education and Skills). - Handling Allegations of sexual offences against children.
(Local Authority Social Services Letter LASSL (2004) 21 August 2004). - Guidance on offences against children.
(Home Office Circular 16/2005)
Further Information Available From
Home Office website
Brook website
Department for Education website
Department of Health website
Appendix 2 - DOH Best Practice Guidance for Doctors and Other Health Professionals
Summary
This revised guidance replaces HC (86)1/HC (FP) (86)1/LAC (86)3 which is now cancelled.
Doctors and health professionals have a duty of care and a duty of confidentiality to all patients, including under 16s.
This guidance applies to the provision of advice and treatment on contraception, sexual and reproductive health, including abortion.
Research has shown that more than a quarter of young people are sexually active before they reach 16.
Young people under 16 are the group least likely to use contraception and concern about confidentiality remains the biggest deterrent to seeking advice. Publicity about the right to confidentiality is an essential element of an effective contraception and sexual health service.
The Government's ten year Teenage Pregnancy Strategy, launched in 1999, set a goal to halve the under 18 conception rate by 2010. This is a Department for Education and Skills Public Service Agreement jointly held with the Department of Health. Progress towards meeting local under 18 conception rate reduction targets is one of the NHS Performance Indicators for Primary Care Trusts (PCT).
The contribution of PCTs to improving young people's access to contraceptive and sexual health advice is a key element of all local Teenage Pregnancy Strategies, linked to implementation of the Sexual Health and HIV Strategy, and is performance managed by Strategic Health Authorities.
The Sexual Offences Act 2003 does not affect the duty of care and confidentiality of health professionals to young people under 16.
1 Wellings, K., Nanchahal, K., Macdowall, W., McManus, S., Erens, R., et al. (2001) Sexual Behaviour in Britain: early heterosexual experience. Lancet 358: 1843-50
Action
- PCT commissioners and clinical governance leads should bring this guidance to the attention of all health professionals responsible for the care of young people in any setting. All services providing contraceptive advice and treatment to young people should:
- Produce an explicit confidentiality policy making clear that under 16s have the same right to confidentiality as adults.
- Prominently advertise services as confidential for young people under 16, within the service and in community settings where young people meet.
- Health professionals who do not offer contraceptive services to under 16s should ensure that arrangements are in place for them to be seen urgently elsewhere.
- Directors of Social Services should ensure that social care professionals working with young people are aware of this guidance and the Teenage Pregnancy Unit guidance - 'Enabling young people to access contraception and sexual health information and advice: the legal and policy framework for social workers, foster carers and other social care practitioners'.
Confidentiality
The duty of confidentiality owed to a person under 16, in any setting, is the same as that owed to any other person.
All services providing advice and treatment on contraception, sexual and reproductive health should produce an explicit confidentiality policy which reflects this guidance and makes clear that young people under 16 have the same right to confidentiality as adults.
Confidentiality policies should be prominently advertised, in partnership with health, education, youth and community services. Designated staff should be trained to answer questions. Local arrangements should provide for people whose first language is not English or who have communication difficulties.
Employers have a duty to ensure that all staff maintain confidentiality, including the patient's registration and attendance at a service. They should also organise effective training which will help fulfil information governance requirements
Confidentiality: protecting and providing information. General Medical Council, London. 2004.
Code of professional conduct. Nursing and Midwifery Council 2002
An example of an effective training resource is 'Confidentiality and young people: improving teenager's uptake of sexual and other health advice'. This publication is endorsed by the Royal College of General Practitioners, the British Medical Association, the Royal College of Nursing and the Medical Defence Union.
Deliberate breaches of confidentiality, other than as described below, should be serious disciplinary matters. Anyone discovering such breaches of confidentiality, however minor, including an inadvertent act, should directly inform a senior member of staff (e.g. the Caldicott Guardian) who should take appropriate action.
The duty of confidentiality is not, however, absolute. Where a health professional believes that there is a risk to the health, safety or welfare of a young person or others which is so serious as to outweigh the young person's right to privacy, they should follow locally agreed child protection protocols, as outlined in Working Together to Safeguard Children. In these circumstances, the over-riding objective must be to safeguard the young person. If considering any disclosure of information to other agencies, including the police, staff should weigh up against the young person's right to privacy the degree of current or likely harm, what any such disclosure is intended to achieve and what the potential benefits are to the young person's well-being.
Any disclosure should be justifiable according to the particular facts of the case and legal advice should be sought in cases of doubt. Except in the most exceptional of circumstances, disclosure should only take place after consulting the young person and offering to support a voluntary disclosure.
Duty of Care
Doctors and other health professionals also have a duty of care, regardless of the patient's age.
A doctor or health professional is able to provide contraception, sexual and reproductive health advice and treatment, without parental knowledge or consent, to a young person aged under 16, provided that:
- She/he understands the advice provided and its implications.
- Her/his physical or mental health would otherwise be likely to suffer and so provision of advice or treatment is in their best interest.
However, even if a decision is taken not to provide treatment, the duty of confidentiality applies, unless there are exceptional circumstances as referred to above.
The personal beliefs of a practitioner should not prejudice the care offered to a young person. Any health professional who is not prepared to offer a confidential contraceptive service to young people must make alternative arrangements for them.
Copies can be obtained from Department of Health, PO Box 777, London SE1 6XH.
Good practice in providing contraception and sexual health to young people under 16
It is considered good practice for doctors and other health professionals to consider the following issues when providing advice or treatment to young people under 16 on contraception, sexual and reproductive health.
If a request for contraception is made, doctors and other health professionals should establish rapport and give a young person support and time to make an informed choice by discussing:
- The emotional and physical implications of sexual activity, including the risks of pregnancy and sexually transmitted infections.
- Whether the relationship is mutually agreed and whether there may be coercion or abuse.
- The benefits of informing their GP and the case for discussion with a parent or carer. Any refusal should be respected. In the case of abortion, where the young woman is competent to consent but cannot be persuaded to involve a parent, every effort should be made to help them find another adult to provide support, for example another family member or specialist youth worker.
- Any additional counselling or support needs.
Additionally, it is considered good practice for doctors and other health professionals to follow the criteria outlined by Lord Fraser, also commonly known as the Fraser Guidelines:
- the young person understands the health professional's advice;
- the health professional cannot persuade the young person to inform his or her parents or allow the doctor to inform the parents that he or she is seeking contraceptive advice;
- the young person is very likely to begin or continue having intercourse with or without contraceptive treatment;
- unless he or she receives contraceptive advice or treatment, the young person's physical or mental health or both are likely to suffer;
- the young person's best interests require the health professional to give contraceptive advice, treatment or both without parental consent.
Sexual Offences Act 2003
The Sexual Offences Act 2003 does not affect the ability of health professionals and others working with young people to provide confidential advice or treatment on contraception, sexual and reproductive health to young people under 16.
The Act states that, a person is not guilty of aiding, abetting or counselling a sexual offence against a child where they are acting for the purpose of:
- protecting a child from pregnancy or sexually transmitted infection
- protecting the physical safety of a child,
- promoting child's emotional well-being by the giving of advice.
In all cases, the person must not be causing or encouraging the commission of an offence or a child's participation in it. Nor must the person be acting for the purpose of obtaining sexual gratification.
This exception, in statute, covers not only health professionals, but anyone who acts to protect a child, for example teachers, Connexions Personal Advisers, youth workers, social care practitioners and parents.
Appendix 3 - Guidance Note and Flow Chart
Introduction
| 1. | This process applies to any contact in Knowsley with a health professional, youth worker, Connexions advisor and voluntary agency worker, with someone who is sexually active and under 18, including requests in non-NHS settings for emergency contraception; Chlamydia screening or repeat issuing of condoms. It does not apply to condom distribution campaigns where there is no one-to-one consultation, nor does it apply to the sale of condoms. |
| 2. | The Note and Flow Chart have been put together by a wide range of statutory agencies (education, health and police), and partners in the voluntary and community sectors. It is aimed at providing staff with guidance on how contact with sexually active under 18s should be managed. Its use MUST be in conjunction with local Safeguarding Children Procedures |
| 3. | In designing the flow chart, the agencies are clear that at the centre of our contact with the young person is their health and well-being. We have a duty to ensure that we work together to minimise risks to potentially vulnerable young people and in so doing, we must respect an individual's legal rights to privacy and confidentiality. |
The Process |
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| 4. | The decision making process must consider the relationship between the professional and the young person, and seek to build trust as far as possible. The amount of information that will be forthcoming will vary from one setting to another, and will be affected by whether the professional has any prior knowledge of the young person. Therefore, a pharmacist issuing emergency contraception as a one-off will probably only gain some of the answers to the questions or prompts the guidance proposes. As a result, the threshold for discussions with a designated staff, the Children's Social Care or the police, may be lower than for a GP who is more confident they will see the young person again. |
| 5. | Some of the answers to these questions may be gained over the course of several consultations. It is up to the professional to use their judgement as to how much information they can seek each time. |
| 6. | Where a professional worker expects to discuss a case with Named/Designated staff, and/or also with the line manager, or to have an informal conversation outside the NHS thus breaching confidentiality, then this should be done in consultation with the young person, except where the professional believes it is not in their best interests to be informed. |
| 7. | Where a serious crime is suspected, advice should be sought from the police at the earliest opportunity to safeguard the child and minimise the risk of any evidence, such as e-mails or pictures, being destroyed before they can begin their investigation. All staff must be aware that the police must formally record contact made by an agency. An incident will be recorded as a crime where on the balance of probability an offence defined by law has been committed and there is no evidence to the contrary |
| 8. | Any referral or potential referral should be discussed in the first instance with the young person. The organisation making the referral then has a Duty of Care to the individual to secure their physical and mental well-being and offer support during that time. |
| 9. | In law, children under 13 are deemed to be unable to give informed consent to sexual activity, so professionals working with such children need to ensure that they have taken all reasonable steps to protect the child's welfare and prevent them from harm, and that they have operated within the guidance issued by their organisation. |
| 10. | The degree to which a young person is regarded as Fraser Competent needs to be assessed on an individual basis and documented. This will vary with age, maturity and with the implications of the treatment or advice they are seeking. Young people under sixteen who are Fraser competent can consent to treatment. A child or young person can say they wish to withhold consent to their information being shared with another agency. A professional, however, may override this if they are of the firm view that not to do so may jeopardise the safety and welfare of the child or young person. |
| 11. | Where the young person is under 13 years of age, an assessment must be undertaken as to risk, and advice or guidance obtained from the organisation's Safeguarding lead, the Designated/Named clinician, or line manager. The actions taken by the professional MUST BE RECORDED and the rationale for these actions clearly given. |
| 12. | Throughout the process it will be important to remember the perpetrator of abuse might be: the patient; male or female; of the same sex; in a caring role for the individual. Similarly not all abuse is recognised as such by the victim at the time, and this is notably the case where a young person is being groomed. |
| 13. | In accordance with guidance from the Department of Health, the health professional is responsible for deciding when a referral is or is not made. Where there is any uncertainty and a referral is not made, the reasons and rationale must be documented in the young person's notes at the time, and for all under 13s this must be recorded because the law treats them as unable to give informed consent to sex |
| 14. | Wherever possible, informal discussions should be carried out in such a way as not to breach confidentiality. In some areas, the police have a Public Protection Unit, through which a Named Doctor or Nurse could routinely check details in person of the individual and their partner on the Sex Offenders Register without breaching confidentiality. Where Social Services are co-located in such buildings, similar checks can be made with the Manager of the List of Children with a Child Protection Plan, although current systems would generate a "flag" to show an enquiry had been made; most/all systems create an automatic referral when several "flags" have been recorded. |
| 15. | Initiating a Safeguarding Children Procedure may involve discussion with a Named/Designated Doctor or Nurse. Where a Youth Worker, Connexions Advisor or any other professional is working in a sexual health service for young people, the arrangements for confidentiality, responsibility and reporting arrangements in respect of child protection/safeguarding procedures MUST be clarified in advance. This must be part of Induction and on-going training. |
| 16. | Each agency must recognise that they only hold some pieces of the "jigsaw". For example, health professionals would not routinely have access to the Sex Offenders register, the List of Children with a Child Protection Plan, or to wider multi-agency intelligence about a young person, their partner, or their family, without making a referral. |
| 17. | It is important to recognise that any information passed to the Children and Families Division, even in confidence, can be released by a Court Order by a judge in the Family Court. The same does not apply to the Police, who are entitled to withhold information under Public Interest Immunity. This should be considered when disclosing any information that could later put a patient or informant at risk. |
Appendix 4 - Prompts for Professionals
To only be used in conjunction with Guidance Note and flow chart, and relevant child protection guidance issued by your organisation
| Context: | General (Reasonable level of Trust established with the young person, you have confidence that the young person will be either returning to you for support/treatment, or that you can maintain contact with the young person after the face to face contact has ended) |
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| 16/17 year olds | Under 16s | |
| Initial prompts for workers |
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As for 16 and 17 year olds, plus:
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| 16/17 year olds | Under 16s | |
| Issues to clarify if uncertain or concerned |
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As for 16/17 year olds, plus:
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| Opportunistic -
(No significant trust established) Likely to be a one-off contact with young person, or where you are uncertain if you will see them again |
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| Initial prompts for workers |
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| Issues to clarify if uncertain or concerned |
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Appendix 5 - Children and Young People's Information Systems
Unique Identification records Schools
Unique NHS Records
Social Care Records - SWIFT/ ICS
Child Index (where appropriate)
Appendix 6 - Specialist Support and Guidance Services
| Armistead / Gay Knowsley |
| T: 0870 990 8996 |
| Brook Advisory Centre |
| T: 0151 207 4000 |
| Family Planning Centre |
| T: 0151 284 2500 |
| GUM Clinic (Genito-Urinary Medicine) Liverpool |
| T: 0151 706 2620 |
| GUM Clinic (Genito-Urinary Medicine) St Helens |
| T: 01744 458 383 |
| THINK |
| T: 0800 138 6559 |
| CALM (Campaign Against Living Miserably) |
| T: 0800 585 858 |
| CAMHS (Children & Adolescent Mental Health Services) |
| T: 0151 489 6137 |
| FRANK |
| T: 0800 776 600 |
| Young Persons Substance Misuse Team |
| T: 0151 546 9087/8369 |
| Youth & Play Drug & Alcohol Team |
| T:0151 443 5323 |
| Reintegration Service |
| T: 0151 443 5681 |
| Connexions Huyton |
| T: 0151 949 5700 |
| Connexions Kirkby |
| T: 0151 545 5400 |
| Children's Social Care Halewood |
| T: 0151 443 4515 |
| Children's Social Care Huyton |
| T: 0151 443 5023/5033 |
| Children's Social Care Kirkby |
| T: 0151 443 4261 |
| Childline |
| T: 0800 1111 |
| YPAS (Young Persons Advisory Service) |
| T: 0151 707 1025 |
| YWCA |
| T: 0151 547 7800 |
| Sexual Health Outreach Team |
| T: 0151 443 5338 |
End