Notifying GPs where a Child is the Subject of an Early Help Assessment (EHA), Team around the Family (TAF), or Child in Need (CIN)

1. Introduction

Every child has the right to live free from abuse or neglect, and is entitled to be protected from maltreatment. Everyone who comes into contact with children, young people and families has a role to play in ensuring all children are safeguarded from harm (HM Government 2015).

GP's and their practice teams are not a statutory child protection agency and as such are not responsible for investigating child abuse and neglect. However, GPs do have a responsibility for raising concerns, sharing information and working together with other services and agencies to contribute to the 'early help', 'child protection' and 'child in need' processes (RCGP/NSPC).

2. Background

The procedures outlined below have been developed and agreed in response to the Serious Case Review concerning Child A, who was in born June 2014 and died in September 2014. The review undertaken following the tragic death of the baby, due to alleged abusive head trauma, identified a number of complex parental needs which were seen to impact on the care and attachment afforded to the infant (Wate 2015). Citing a lack of communication between services, specifically with the GP service, the review acknowledged the fundamental need to share information across services and agencies. Issues with information sharing which were identified within the review resulted in an inadequate assessment of risk at all levels of care. Services and agencies were working in silos, without full knowledge of all the facts, and opportunities for an appropriate and comprehensive analysis of risk were missed.

This procedure is designed to challenge some of the barriers to sharing appropriate and timely information. GP services are a crucial partner to protective and early help services, and as such, the information they hold is vital to any assessment and care planning process. This procedure seeks to address two specific issues which were recommended in the Child A Serious Case Review:

• An agreed process to ensure GPs are informed when children are supported by Child in Need or Early Help Assessment meetings;
• There is a clear method by which the GPs will inform and feedback into the Child in Need or Early Help assessment and meeting process.

Achieving the above requires agreement and cooperation by all partners across universal, early help and safeguarding services.

3. Child Protection Processes

When a decision is made that there will be an Initial Child Protection Conference, information from the GP is automatically sought via a standard letter sent by Doncaster Children's Services Safeguarding & Standards Department. An invitation to attend the conference is sent out, along with a request to submit a report in writing. The GP has responsibility to cooperate and comply as outlined in Sections 10 and 11 of the Children Act 2004. The GP does not require permission to share this information, all information appropriate to the care and safety of the child is required, including information in respect of parents / carers and significant others (HM Government 2015).

4. Team Around the Family / Early Help Assessment

All referrals into the Multi-Agency Safeguarding Hub (MASH) are screened the by Doncaster Children's Services, and a decision made in respect to the level of support required for a child at that specific time. If a decision is made to initiate an Early Help Assessment (EHA) or commence with a Team Around the Family (TAF), the Children's Services will agree and assign a Lead Professional (LP) to coordinate and direct the assessment and on-going plan. This Lead Professional will be the most appropriate professional identified to undertake this responsibility.

Once a decision is made to progress an EHA, the process to engage GP service will be as follows.

• The LP will make contact with the child and family. There is an expectation that this will be a face to face contact. During this contact the LP will obtain and clarify the GP details for the child, family and significant others. It is important that the GP details of all those that are significant within the child's life are sought, this may involve a number of GP practices;
• During the initial face to face contact with child and family, the LP will obtain written consent that will allow all relevant information to be shared between all surrounding services and professionals needed to ensure a comprehensive assessment and plan;
• Following the initial contact and with written consent, the LP will send a standard letter to each GP service that has been put forward by the child and family. This letter will inform the GP of the child's current Early Help status. A copy of the completed consent form will be sent to the GP with each letter;
• The GP will see a return slip at the bottom of the letter. This slip is an acknowledgment of receipt of the letter and declaration of any information to be shared. The GP will return the completed slip to the LP. The GP is not expected to offer specific information on the return letter and is advised to await further contact by LP. If the GP feels there is significant information to be shared that is seen to impact on the safety and wellbeing of the child, the GP must follow the Referrals Procedure. The GP will notify the LP of his/her actions;
• If the return slip sent by the GP declares that the GP does hold information in respect to the child or family members, the LP will initiate telephone communication with the most appropriate person given by the GP on the completed slip;
• Regardless of whether the GP holds any information at the time of notification, the LP will ensure that a copy of the completed assessment and plan is sent to the GP with whom the child is registered;
• The LP is responsible for coordinating the EHA and TAF meetings. The LP will as standard, send an invitation to attend or contribute to any TAF meetings taking place. The GP has a responsibility to cooperate with the Early Help and Team Around the Family process, and will be expected to ensure that all relevant information is shared at all stages of professional intervention and involvement;
• Regardless of whether the GP holds any information at the time of the TAF meeting, the LP will ensure that a copy of the meeting minutes are sent to the GP with whom the child is registered.

5. Child in Need

All referrals into the Multi-Agency Safeguarding Hub (MASH) are screened the by Doncaster Children's Services, and a decision made in respect to the level of support required for a child at that specific time. If a decision is made to initiate a Children and Families Assessment under Child in Need (CIN), Section 17 of the Children Act 2004, the Children's Services Area Team Manager will agree and assign a Social Worker (SW) to coordinate and direct the assessment and on-going plan.

Once a decision is made to progress a Children and Families Assessment and Child in Need Plan, the process to engage GP service will be as follows:

• The SW will make contact with the child and family; there is an expectation that this will be a face to face contact. During this contact the SW will obtain and clarify the GP details for the child, family and significant others. It is important that the GP details of all those that are significant within the child's life are sought, this may involve a number of GP practices;
• During the initial face to face contact with child and family, the SW will obtain written consent that will allow all relevant information to be shared between all surrounding services and professionals that are required to ensure a comprehensive assessment and plan;
• Following the initial contact and with written consent, the SW will send a standard letter to each GP service that has been put forward by the child and family. This letter will inform the GP of the child's current social care status, a copy of the completed consent form will be sent with each letter;
• The GP will see a return slip at the bottom of the letter. This slip is an acknowledgment of receipt of the letter and declaration of any information to be shared. The GP will return the completed slip to the SW. The GP is not expected to offer specific information on the return letter and is advised to await further contact from the SW. If the GP feels there is significant information to be shared that is seen to impact on the safety and wellbeing of the child, the GP must be proactive and make immediate contact with the assigned SW or their Team manager;
• If the return slip sent by the GP declares that the GP does hold information in respect to the child or family members, the SW will initiate telephone communication with the most appropriate person given by the GP on the completed slip;
• Regardless of whether the GP holds any information at the time of notification, the SW will ensure a copy of the completed assessment and plan is sent to the GP with whom the child is registered;
• The SW is responsible for coordinating the Children and Families Assessment and CIN meetings, the SW will as standard, send an invitation to attend or contribute to any CIN meetings taking place. The GP has a responsibility to cooperate with the Children and Families Assessment and CIN process, and will be expected to ensure that all relevant information is shared at all stages of professional intervention and involvement;
• Regardless of whether the GP holds any information at the time of the CIN meeting, the SW will ensure a copy of the meeting minutes are sent to the GP with whom the child is registered.

6. Step Down from Child in Need (CIN) to Team Around the Family (TAF)

When the CIN plan is coming to an end and the SW is looking to a TAF for continued support, it is important that appropriate information is passed to the assigned Lead Professional. The LP will be expected to continue liaison with identified professionals and services as required in the procedures above.

Appendices

Click here to view Appendix 1: Letter to inform GP of an Early Help Assessment (EHA) and Team around the Child/Family (TAC/F)