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4.8.2 Consent for Medical Treatment

Contents

  1. Key Points
  2. Children and Young People Under 16 Years Who are Accommodated
  3. Children and Young People Under 16 Years who are Subject to a Care Order or Interim Care Order
  4. Young People Over 16 Years
  5. Emergency Treatment


1. Key Points

  1. For all children/young people under 16, either accommodated or in compulsory care, good practice dictates that permission should be sought from the parents/those with parental responsibility.
  2. The Placement Plan requires details of who has the authority to give consent to medical treatment including dental treatment, emergency medical examinations and treatment (including anaesthetics), regular medical examinations required by law for looked after children/young people and routine medical treatment including immunisation.

    The form requires discussion with parents to consider whether parents agree or object to particular immunisations or other specific medical treatments. This provides important information which must be considered in the issue of consent for medical, surgical or psychiatric treatment.
  1. Different procedures apply to (a) children and young people under 16 years who are accommodated under Section 20 of the Children Act 1989; - (b) children and young people under 16 years who are subject to a Care Order or Interim Care Order, and (c) young people over 16 years.
  2. In cases of emergency the Doctor will make a judgement based on the needs of the child/young person.


2. Children and Young People Under 16 Years Who are Accommodated

  1. The Placement Plan must be consulted for specific details (see Key Point 2).
  2. The child or young person must be consulted regarding the treatment.

    NHS guidance recognises the principle that where a child/young person under 16 achieves a sufficient understanding of what is proposed, the child/young person may consent to a doctor or health professional making an examination and giving treatment (in accordance with the Gillick principle). The Doctor or professional must be satisfied that any such child/young person has sufficient understanding of what is involved and the treatment proposed.

    If the child/young person under 16 refuses treatment, parents or those with Parental Responsibility may consent on behalf of the child. Legal advice should be sought.
  1. Parental consent should be sought for medical, surgical or psychiatric treatment. The parents must be contacted and the requirement for the child/young person to receive the treatment be explained.
  2. Parents must have a face to face discussion with the Medical Practitioner responsible for administering the treatment. Access to transport to the hospital or other venue of treatment, if required, will be provided by the Designated Social Worker/ Family Support Practitioner by giving bus tokens or transporting parents.
  3. If the parent is unable/unwilling to give consent or where they cannot be contacted, a distinction must be made between urgent but non-life threatening treatment and non-urgent behaviour.
    1. Urgent

    Section 3(S) Children Act 1989, provides that a person who does not have Parental Responsibility for a particular child/young person but who has care of the child/young person may do whatever is reasonable in all circumstances of the case for purpose of safeguarding or promoting the child/young person's welfare.

    Life threatening usual implies an emergency situation and in those circumstances a doctor can treat without consent.

    1. Non Urgent

    For non-urgent treatment of a child/young person where parents are unwilling to give consent, the Local Authority should apply for leave to make application for a Specific Issues Order under Section 8, Children Act 1989. Legal advice must be sought following discussion with the Service Manager.


3. Children and Young People Under 16 Years who are Subject to a Care Order or Interim Care Order

  1. The child or young person must be consulted regarding the treatment.

    NHS guidance recognises the principle that where a child/young person under 16 achieves a sufficient understanding of what is proposed, the child/young person may consent to a doctor or health professional making an examination and giving treatment (in accordance with the Gillick principle). The doctor or professional must be satisfied that any such child/young person has sufficient understanding of what is involved and the treatment proposed.

    If the child/young person under 16 refuses treatment, parents or those with Parental Responsibility may consent on behalf of the child. Legal advice should be sought.
  1. Good practice dictates that parental consent should be sought for all medical, surgical or psychiatric treatment. The Placement Plan should be consulted.
  2. Where a parent is unable/unwilling or where it is inappropriate to involve the parent (i.e. where contact has been terminated) permission for medical treatment must be sought from the Area Manager.
  3. A consent form must be signed and this may only be done by the person who has been given an explanation of the procedure. This applies to:
    • All surgical operations
    • Medical and dental treatment that requires an anaesthetic
    • Contraception.
  4. The signing of the form may be delegated to a Family Support/ LAC Team Manager, Advanced Social Work Practitioner, Home Manager, Social Worker, Foster Carer in consultation with the Area Manager.
  5. Permission for the following must be obtained from the Director of Children, Families and Schools:
    • Abortions
    • Caesarean Section (Planned)
  6. Copy of the permission to sign the consent form must be shown to the medical practitioner.


4. Young People Over 16 Years

  1. A young person aged 16 years gains the legal right to give informed consent to surgical, medical and dental treatment. A young person aged 16 years who has a mental illness, learning disability or psychiatric disturbance will be subject to the same mental health provisions and safeguards as an adult. A psychiatrist opinion may be required.
  2. Consent may be given on behalf of a young person who has reached 16. In controversial cases discussion should take place with the Service Manager, in order that a decision regarding treatment may be taken in the best interests of the young person. It may be necessary to seek legal advice. The young person's wishes and feelings should clearly be taken into account.


5. Emergency Treatment

If a child/young person is in need of emergency treatment, the doctor will make a judgement based on the needs of the child.

End