to expect health professionals to advise of child protection concerns

[namechange4advice]

AIBU to expect health professionals to advise parents if they have child protection concerns about the family?

I thought they were meant to be advise the parents and discuss the concerns with them in most cases with the exceptions being where it might cause serious harm to the child such as in a munchausens by proxy or perhaps sexual abuse case.

Usually concerns are raised directly with families. Occasionally agencies may seek further advice re a plan of action before raising concerns eg if uncertain if concerns are reaching child protection threshholds or if family needs different type of support.
What's your situation?

yes we need more details before we can pronounce YABU/YANBU

has something happened to you and your family to bring you to the attention of SS/HCPs?

It is very hard to say in an individual case without more detail, but Brevity is correct.

We have recently discovered several professionals stated they had child protection concerns about my children and some had discussions with the safeguarding team for further advice. This is obviously then all recorded in our childrens medical notes with us totally unaware that this had gone on. It is not very clear to us why their concerns were raised as child protection issues but it had been noted that I had placed my daughter on my knee facing away from me which was deemed to be due to my not bonding.

The professionals actually knew on this day that I was trying to stop breastfeeding her at age 18 months, having fed on demand until then and she was refusing a bottle and I had to face her away otherwise she smelt my milk and got even more distressed and tried to rip open my top. It took a further 3 to 4 weeks before she settled down totally and took cows milk and was back to herself so there were 2 further occasions when she may have been witnessed distressed but I had told everyone this and even sought advice in how to stop feeding.

This was my third child and both the elder two had stopped breastfeeding naturally by this age so I had not anticipated this reaction. I had to stop feeding on my doctors advice to change my own medication so I had to persist reluctantly. Aside from this 4 week period my daughter has been the happiest child ever and is still gorgeous.

At my daughters one year check the health visitor had recorded excellent attachment and documented that she had seen me breastfeed. Even if they claim they were unaware that I was trying to stop breastfeeding would this crying and method of comforting really raise child protection concerns or should I not have been told of these concerns so we could have discussed it?

Is there a protocol that should be followed before child protection concerns are documented on a childs medical records?

Have no idea how that could be construed as a cp issue! Can you request your notes, find out exactly what has been recorded and why?

It sounds really odd for the HCP to seek advice over just this one issue and not really a CP concern. What was the outcome- did they refer you on to Childrens social care?
If the concern raised by the hcp turned out not to be a safeguarding issue, then she would have been signposted as to where to get further advice and this would have also been in the notes. If there were no ongoing concerns then I assume they did not need feel the need to raise it with you, although usually families do know if further advice is being sought.

All the above is taken from my childrens medical records. I would have had no idea of any of this without having read all the records. I guess lots of verbal discussion must have gone on that is not in the notes and I am now trying to make sense of it all without all the information.

Outcome is absolutely nothing as far as I know of course. No concerns now, again as far as I know but then I never knew there were any concerns at the time so who knows!!

I am just trying to find out what the concerns were and why it is written in my childrens files.

Is non bonding not a child protection concern?

Does HCP mean any health care professional?

I would have thought that writing details in your / your child's records without your knowledge is illegal under the Data Protection Act. You can request a copy of the records under the Medical Records Act or the Datqa Protection Act. How Health Care 'Professionals' expect their patients to trust them and be open and honest when they exhibit this sort of behaviour is beyond me. Your better off having as little interaction with these people as possible.

In most cases it's appropriate for parents to be involved in CP concerns. There are a few cases (specifically Fabricated or Induced Illness - FII - which used to be known as Muchnausens by Proxy) where it is recommended that the parent is not told as it is more harmful for the child.

Why were you and your 18 month old being observed in the first place?

LineRunner - I had absolutely no idea we were being observed we were just at appointments for my eldest son who had a medical condition that a paediatrician was been unable to diagnose and she then referred him on to rule out ASD instead. My youngest daughter was just there as I didnt have child care for her!

SurreyDad - I have found all this out by reading my childrens medical records under the DPA.

Bloody hell!

Well that just all sounds a bit mental, tbh. Certainly grounds for challenge.

I would suspect it all stems from that particular paediatrician's lack of diagnosis - thus shifting the spotlight onto you for a while, and this staying on your records.

This all sounds a bit odd actually namechange.....very odd in terms of not discussing things with you.

I would not have thought twice about what you have described if I knew you were trying to discontinue breastfeeding. Certainly a bonding issue would not have crossed my mind at any point in this situation as you describe.

Generally if I need to ask for advice I start with the parents who can often tell me why situations are like they are.

Talking to the Safeguarding Team probably is NOT social care but the local health safeguarding health team who can advise if we have a concern and are not sure where to go with it. I move heaven and earth NOT to go to social care unless I absolutely have to as often things can be addressed without this involvement.

I'd be inclined to wonder how experienced the HCP who wrote this was.
If he/she WAS experienced then I'd wonder why on earth she could not have seen your reasoning. All a bit odd imo - and it's not YOU being odd either.

It does sound strange. Possibly could be that this HCP raised concerns, so these have to be noted. But that the rest of the staff involved thought the HCP was very wrong to raise this as an issue. So nobody told you because they thought there was absolutely no grounds at all for the HCP to raise concerns.

Normally if concerns are raised, this would be followed up with phone calls for examples to other professionals involved and a visit to you, to find out if any concerns have any basis on reality. The fact that none of this seems to have happened does suggest that everyone else thought the HCP was totally wrong. But they would still have to record what the HCP said.

Sorry only just realised that several professionals had expressed concerns which makes this even odder.

I am a Childminder and if I had serious concerns about a child I wouldn't discuss with the parents I would call our local safeguarding board who would advise me whether to contact social services, if it was a minor issue eg cleanliness I would try and raise it with the parents but if there were several issues indicating neglect I would follow my safeguarding policy and ring the safeguarding board, I have to document everything so i would have thought it should be on medical records?

SurreyDad's understanding of the law is, again, a bit ropey. We can write in anyone's medical notes and don't need permission.

I'm not sure what the issue is. Your Health Visitor had a concern, recorded it in the notes as she must, and took advice from others. Regardless of the basis of those concerns, surely if a health care professional has concerns this is what they should be doing?

Also worth adding that we do need to write everything in the notes, whether or not patients want us to. The medical record has to be a complete, accurate & contemporaneous record. Mistakes can be corrected or further developments can be added by further notes but nothing can be deleted.

Bartlet - My expectation would be that the health professional should discuss any concerns with the family to improve the situation for the child not just hold it on file.

I think my concern is that I was not aware that there were child protection concerns and would never have known if I had not requested the medical records. Am now trying to understand why this evidence is documented as a child protection concern.

I am sure there must be more to this than is in the notes and things must be being withheld from me.

Can any health care professionals explain how this should work. Surely if I access the records it should explain the reasons for any CP concerns and then the actions taken and an outcome and if concerns were deemed to be unfounded this should be stated?? As Bartlet says the records should be complete and accurate which this cannot be if I cant see if concerns still exist!

surely if the cp concern raised by the hcp was of a sufficient degree it would have been passed to social services and the outcome may not then necessarily appear on your medical records?

Any hcp's on here could confirm the procedure. maybe the hcp who noted the concern followed a reporting procedure, and case was "dismissed" at social services end without a requirement to investigate it by talking to you (I am fairly sure that a few years ago a single concern would be checked as an office procedure and cp staff would decide whether a home visit/contact was required or whether it would be filed as no further action (in which case you wouldnt knwo about it).

From what I can understand the concern was on file for several months at least. There is a note on file to warn school of CP concerns before meeting with us so the information was being shared. Surely if a decision was made to pass concerns to SS then that should be on file as the outcome.

I would expect if anyone picked up a file they would be able to establish the full situation when such serious accustions are made. I would also expect an explanation as to why the decision was made not to share concerns with parents if the concerns were ongoing.

Any HCP able to confirm the correct procedure or direct me to the guidelines. Thanks

Any HCP able to advise on situation? Just to clarify social care have confirmed that they have never received a referral so we have to presume that the CP concerns were dropped.

I am obviously very upset that there are CP concerns on our medical notes and that we would never have known of this unless we had requested all the records under the DPA. I cant believe that the records are so unclear as to the reasons for this and the subsequent actions.

It sounds horrendous to me but I guess it is quite unusual that people request all their families records as it is made so costly and time consuming so maybe it is not that uncommon to have CP concerns on file but other people are just unaware.

What was the medication you were on?