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to be concerned about these NICE guidelines?

(43 Posts)
StarlightMcKenzie Wed 22-Jul-09 10:53:09

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StarlightMcKenzie Wed 22-Jul-09 10:54:00

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sarah293 Wed 22-Jul-09 10:55:59

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StarlightMcKenzie Wed 22-Jul-09 10:57:27

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MrsMellowdrummer Wed 22-Jul-09 10:59:39

I haven't read the guidelines in full, but reading the above, I would think it's quite reasonable.

It's not saying that those courses of action are neglectful is it? It's saying that in a broader picture they may be symptoms of neglect, which it is a jolly good idea that health professionals are alert to. If parents choose to opt out of immunisations/reviews etc for well thought through reasons, and take responsibility for those choices I would hazard that doesn't constitute neglect apropos those guidelines.

puffylovett Wed 22-Jul-09 11:00:59

well in that case, I'm neglectful.

1.2.9 - administered natural creams as opposed to prescription hydrocortisone to DS eczema

1.3.10 - despite telling them I wouldn't be vaccing, they sent repeated appts through which I ignored

1.3.11 - not vacced, reasons thoroughly explained to HV - so far been left alone but suspect I will get it at 2.5 yr check up
But attended all reviews so far. hmm

I suppose they do have a duty of care to the children, so the guidelines are in place for a reason. But it does still make me a bit hmm

onagar Wed 22-Jul-09 11:03:17

It's been going that way for a while now. Whatever is fashionable now in goverment circles is right and anyone doing things differently will be in trouble.

I get unwanted calls from my GP now. Can just imagine how it will be for many people.

"Hi, this is Ethel from Dr Smith's surgery. Would you like to come in for our new 'whole body health consultation"

"No thank you. I'm busy right now"

"....oh well we can always DISCUSS it with SS if you are not going to cooperate!"

shonaspurtle Wed 22-Jul-09 11:05:16

I get what you're saying (and Riven that's awful and I certainly consider it neglect of your dd by the services that should be supporting her) but it is just "consider" as in possible flags.

It doesn't mean that in the majority of circumstances the hcp wouldn't briefly consider and then reject any of these as signifying neglect.

There are lots of flags for maltreatment that in many circumstances don't signify it. Doesn't mean that hcps shouldn't be aware that sometimes they do.

Any hcp who takes one flag, ignores the circs and suggests abuse isn't doing their job. Not unheard of mind you.

sausagerolemodel Wed 22-Jul-09 11:08:10

Considering that NICE is supposed to be all about using available evidence, I would hazard a guess that the list they have put there has been a consistent feature in children who have been found to be neglected, therefore they are only using that data to work backwards and flag up to health care professionals to consider whether negelect might be happening if these contacts and engagements with health care providers are not made. They are not suggesting that you neglect your child by not engaging with them or following immunisation regimes etc. I don't think there is any reason for raised eyebrows at all.

Surfermum Wed 22-Jul-09 11:11:48

I think these are just possible indicators of abuse and would be considered in conjunction with lots of other factors.

sad Riven.

lal123 Wed 22-Jul-09 11:12:14

I think they are perfectly reasonable - the guidelines don't say that any of the above are neglect in themselves - just that they may be signs of neglect?

ANd I don't think the guidelines are very different from current practice anyway?

tiredemma Wed 22-Jul-09 11:14:33

I think that these are reasonable tbh.

onagar Wed 22-Jul-09 11:15:54

If all those using the guidelines are sensible, mature, experienced people who understand the difference between an indicator and a crime there is no problem whatsoever...


expertinscunthorpe Wed 22-Jul-09 11:17:17

I think the key word here is consider.

Probably come about in the wake of the Baby P stuff.

StarlightMcKenzie Wed 22-Jul-09 11:17:57

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expertinscunthorpe Wed 22-Jul-09 11:23:10

I don't think a suggestion to top up with formula falls under "failure to administer essential prescribed treatment".

You are starting to sound a little bit hysterical now, tbh.

MrsMattie Wed 22-Jul-09 11:25:09

'Consider neglect' - I think they're saying 'take into account as one of a range of potential warning signs'.

Perfectly reasonable in my opinion.

Surfermum Wed 22-Jul-09 11:26:09

A suggestion to top-up is entirely different to not giving a medication that has been prescribed.

edam Wed 22-Jul-09 11:27:46

I kind of agree with people who say they are sensible IF they are used with basic intelligence as possible symptoms of neglect.

But the problem is we know many HVs are daft as a brush, esp wrt breastfeeding. And we do come across instances of health professionals being bullish and steaming in without thinking of other possible explanations. You'd need a good GP on your side - they are trained in 'exclude all other possibilities first before leaping for the least likely explanation'.

OmicronPersei8 Wed 22-Jul-09 11:28:13

I used to teach a child whose mother never took them to their SALT appointments - they really needed help but the SALT service gave up trying in the end. I'd consider that kind of behaviour what the NICE guidelines are about.

edam Wed 22-Jul-09 11:31:03

Depends on the definition of 'essential prescribed treatment' and 'essential follow up appts that are necessary'. MANY healthcare profs would take a rational view of this. Some might not.

There have been cases where parents and docs/nurses have disagreed vehemently about what is in the best interests of a child. And the docs in those instances have been very quick to reach for the courts - threatening to send an ambulance and forcibly take a child to hospital and force that child to undergo treatment they have rejected (thinking of that 12yo (ish) who decided to die rather than undergo further horrible treatment for cancer).

StarlightMcKenzie Wed 22-Jul-09 11:33:30

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Highlander Wed 22-Jul-09 11:34:13

I have a friend who is a trainee GP, and her trainer said that the HV reviews (those pointless development things) are purely used to screen for potential abuse. They are very keen on the 2 year old one as it's the last chance they get to assess and medically assess (undress) a toddler.

She said that I should have benn red flagged as I declined all baby clinic weigh-ins and reviews (other than the 8 week one).

trellism Wed 22-Jul-09 11:39:28

I've read the rest of these guidelines. Taken as a whole they seem pretty reasonable. It's easy to pick out odd things and take exception to them.

The reason things like non attendance at checkups are flagged is because they can (not do) signify a certain level of parental neglect and apathy when taken in combination with the other red flags that are listed in the guidelines.

Also note that it says "engage" with health screening. If you're able to put together a cogent argument about why you're not bringing your baby to yet another weighing session, I'd say that's engagement.

lal123 Wed 22-Jul-09 11:42:31

ffs - OK so there are a few thick HVs out there - just like there are a few thick mnetters. BUT the majority of HVs are very sensible people, who do a very hard job and who have to deal with kids who are being brught up in terrible conditions. Given my limited knowledge of the case loads of our local HVs, they will be trying to decide if having a heroine addicted prostiture mother is grounds for neglect and certainly won't be calling in social services because someone isn't breastfeeding. get a grip!

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