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.

It seems that, in the end , there were no concerns. The original HCP was unsure, so took advice from the appropriate people, it would appear that the guidance given was sufficient to allay the fears and that was that.

This does all need to be recorded thoroughly though because if something serious was to occur then the records would be scrutinised.

What has happened for you to suspect that there were such things in your child's notes and, therefore, request copies?

There may be things on my kids notes but I've never had reason to be concerned about this.

CP isuues are on a 'need to know basis', so it will be noted in the medical records that a CP concern was raised but not the full details, it is against guidelines to go into detail on easy accessable records.

It sounds as though protocol was followed, you wouldn't initially discuss things with the parents, or at least it isn't compulsory, as it can put the DC in danger, things can be covered up, parent flees with DC etc.

The safeguarding team decided that there wasn't a CP concern to merit refering on, so didn't do so, by the sounds of it.

I think it should have been discussed with you at a later stage, though.

Rebecca - I needed to go onto methatroxate long term, had been putting it off but doctor insisted as been breast feeding for 18 months and cant breast feed on this.

mrsjamesmartin - i had requested the medical notes due to my sons misdiagnosis to decide whether to complain about the paed as I know several other people who had had problems with her and I want to prevent anyone elses child suffering the totally unecessary pain my son has suffered for so long. I have to see some good come out of all this.

birdsgottafly - will there be some other records then with more CP details and would these be accessible under DPA? Is there a requirement to discuss with us later especially as they knew we were accessing the records?

You and 18 month DD not bonding because you have her sitting on your lap facing outwards! Ridiculous! My DD2 is currently sitting on my lap outwards and is 2 months old... she hates being held in even for burping.

This may have been a concern if you were suffering from depression and that may have been why they were observing your interactions with the children. Child protection issues are not discussed with the parents if they feel this will endanger the child or if they are merely observing and then seeking andvice from ss.

No there isn't a requirement to discuss it with you, it's more about the open relationship that you want to create with parents.

The details will be noted elsewhere as they have to be kept incase anything else 'flags up' or a tradegy happens. If a serious case review is called there are notes kept by the L.A that don't appear anywhere, as such.
The safegusrding team will have to have written a report to say why theuy thought no further intervention was needed.
Are you looking to make a complaint or do you just want to discuss the whole thing?

Gotart - my daughter was distressed at times (not surprisingly as she had breastfed on demand for 18 months and was then being made to go cold turkey as she would not reduce gradually). If I had seen this distress I would have expected the mother to hold her close to the chest but accept that some children prefer different comforts and would have accepted the mothers explanation of the breastfeeding issue.

I am pleased to report that she is now the most amazingly cuddly happy little girl and will take milk from a cup and is left totally untraumatized by our awful experience. It is only me affected!

Depression is a reason to keep an eye on things and if in any doubt a HV should be discussing it with a safeguarding team. It is a lot of responsibility for a newly qualified HV to carry.

Do not feel this is a reflection on you, they have just done what they thought was right, you have been vindicated.

X posted with the medication that you were on. Parental illness and the possible side effects of any medication can also be a reason to 'be aware'.
Unfortunately as a HCP, you cannot accept the DM explaination of a situation.

You can have this gone through now.

I would have accepted your explanation, as its not something that sounds made up.

Birdsgottafly - Thanks for this. My intention was to complain about the paed to prevent her misdiagnosising any other children. Now I have found out about the CP concners I just dont know.

I guess I just want to understand so I can sleep at night but I am concerned that things such as the breastfeeding withdrawal can be so badly misrepresented that I think it should really be mentioned to ensure staff training is improved but not sure if this would then cause retaliation in the future. I certainly need to talk to someone to come to terms with everything especially the trauma my son has suffered with his dreadful misdiagnosis but probably not the HCPs involved!

Social care say they have no records so will records be held by the PCT safeguarding team? When you say the LA who do you mean?

I'm a HCP though work with adults. On occasions I've had concerns about client's I have seen and have contacted the local safeguarding team to ask for advice. This has been documented in their file as by law I have to keep up-to-date accurate records. If it's decided that it doesn't need to be taken further, then it won;t be, and that decision would be recorded. I've never informed the clients or their families that I was going to contact the safeguarding board, as at the initial stages this would only serve to damage my relationship with them for potentially no good reason. I've been lucky to never have needed to take a case further, so I don't have experience of what would happen next.

SurreyDads understanding of HPC documentation is a little odd. Of course I always document as accurately and objectively as I can, with the knowledge that the client could of course ask to see them under the FI act, or that they could be used in court. But it isn't always the best way to approach a situation for the client to know every single detail at that particular time, especially if there is uncertainty and more information is needed to make a decision / evaluate the situation fully.

OP I would feel as angry as you if I found notes on CP information in my DS's file, but you need to find out more information to get to the bottom of it.

L.A- Local Authority. They will be held on file so if an inspection of services needs to be done, they are still available.

It won't go against you to complain about your DS's misdiagnosis. Go ahead and do that, if that is the case.

Don't let this play on your mind.

The opportunity to explain things to you should be welcomed. It is always useful to find out possible reasons for behaviour but you have to understand that a HCP cannot take the chance.

The safeguarding team has the experience and they will have given an explaination to the HCP as to their findings, so the whole process is useful.

Birds "Unfortunately as a HCP, you cannot accept the DM explaination of a situation." Really. I feel like HCP's should be trained to ask a series of questions that could get an acceptable explanation before assessing a situation like this as non-bonding. A toddler having a distressful moment is subjective and can't really be assessed objectively.
If that's the case, my neighbours must think I'm a horrible mother because DD2 cries the house down on occasions through the day; when I put her down to go to the washroom, make meals, bath DD1 or try to get out of the house.

Thanks for this. Sorry I am still not clear. Is the LA separate to both the PCT and Social Care then? Is this safeguarding supervision or is that something separate?

Hi. Did you go under another name for a while? Did you write about thinking you were being accused of Munchausens?(Apologies if that was not you).
Why did you request your dcs Medical Records? I assume you had a niggle that something was not right somewhere-apart from your ds mis-dx by the Pead. If HCP did suspect possible Munch. then that would be a reason Not to tell you.(Not saying their suspicions were right).
One way to maybe piece together what was going on, is to request your dc Records from ALL agencies involved with them. So, this would include the Pead, CAMHS, School etc.
We did this for different circumstances, but it became obvious who was saying what, including e-mails and phone calls. It shouldnt cost much money-most agencies charged us £10.00.

Not aware of any munchausens concerns but I guess it would explain their not being open with us and for it not being on the records but cant see how it would apply to us as none of my children have ever been in hospital but I guess it is as possible as any other reason.

Initially I just requested the medical records to find out why the paed had not been able to diagnose correctly and to see if I should complain. When I found the CP concerns I requested records from every other agency ie GP/consultant/HV/ed psch/sch nurse etc. Most charged me £50 per child so it has not been cheap. Unfortunately whilst is makes horrendous reading nothing is really clear from these records this hence my post.

Hi. The local authority is completely separate to the PCT. If they are health notes, which it sounds as if they are, the LA won't have anything to do with them due to data protection, confidentiality and information sharing laws.

Child protection is taken very seriously in PCTs and most HCPs would prefer to wrongly have a concern rather than overlook something. Most PCTs have safeguarding teams which can be accessed for advice only. I have accessed such teams for advice, keeping the child / family I've had a concern about anonymous to protect their confidentiality whilst seeking this advice. If the safeguarding team don't feel further action is needed, it will be left as is. It does need to be documented, though, to ensure the records are complete and accurate. It is also documented in case further concerns arise in the future (quite often in child protection cases an isolated incident may not seem a concern until it is seen in light of other information so all concerns need to be documented).

HCPs will also document everything so, if need be (e.g. if there is ever a serious case review) it can be proven they have followed procedure and sought appropriate advice...even if their original concern is later thought to be unfounded or inaccurate.

I haven't in the past discussed concerns with parents as, after seeking advice from the safeguarding team, it turned out it wasn't truly a child protection concern after all. To have discussed it would have been premature, it would not have been of any use and, as another poster mentioned, would have undermined the working relationship. It was purely something I needed to seek advice on.

If true child protection concerns were identified and further action needed to be taken (i.e. referral to social care) this would be discussed with parents unless it put the child in further danger.

I know it may seem shocking that a HCP had a concern about you and your child but they were following correct child protection procedures. They obviously came to the conclusion it was inaccurate and unfounded as no further action was taken.

of course bonding can be a cp concern - attachement is pretty much the first thing to be assessed if a child is referred to social services. realtes to bowlby's models of attachement see here

i am a sw. to me ( and i am speculating based on info provided here) it sounds as if the hcp has followed cp protocol to the letter and by the letter i mean the guidelines 'working together to safeguard children, 2006, which is the practical application of the children acts 1989 and 2004) which is, when having concerns, to contact other agencies involved (in this case within health) to see if the concerns are shared by any other professionals. they must have decided between them that (probably because your explanation was consistant to all) no further action was required but they have documented again as per protocol. you have not been referred to ss unless you have been visted by a duty sw - and you would have been by now as they are legally required to see the child within 24 hours of a referral. if you were referred THEN it in within cp policy to be open and honest with parents throughout any investigation of significant harm (abuse/neglect etc).

i realise these events may have been a bit distressing but i assure you these hcps were doing their jobs well.

Sorry i am on call, so had to go out.

GOTART- HCP as in HV cannot and should not be trained any further than they are, there are separate roles to be played in CP and Children and Family services, for good reason.

The fact that the safeguarding team has not taken any further action shows that the system is not over zealous. The HV are the rightful contact between families and professionals, any further training would change that role.

They should have a relationship based on trust. I feel that this would be damaged if things were to change as 'the public' are very mistrustful of anyone working in CP, they seem to see us as 'kiddy snatchers' and not there to help.

It doesn't really matter what your neighbours think, they aren't trained to spot abusive situations.

'Investigations' and investigative questioning needs a different level of skill and has to be in accordance with the law, to be fair but thorough, it isn't as easy to leglislate for as people think it is.

There are going to be changes to improve services
www.education.gov.uk/munroreview