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Medical Treatment (including emergency treatment)

Children in care have medical needs in the same way all children do. They will also have accidents and illnesses, and therefore it is important to know what to do if a child who is in care of the Local Authority needs medical treatment of any form.

Wherever possible they should remain registered with their own doctor (GP). If this is not possible (e.g. the placement is too far from the GP surgery to make it a viable option), then the child should be registered as a temporary patient with the GP that is closest to the placement, with the expectation that the carer will complete this task.

Upon the child being placed for the first time the social worker should speak to the parent about the consent for medical treatment, and the consent that is given (or not) should be recorded on the placement plan / placement information record.

The health assessment that is completed when a child is placed for the first time and then reviewed annually should provide clear information about the overall health needs of the child. That said, there will be times when the child needs to see a GP or have treatment of some kind.  Wherever possible parents should be informed and consulted about any medical procedures.

It must be remembered that the child has the right to refuse treatment, and this must be taken into consideration.

Gillick Competence

Some children under the age of 16 can be deemed Gillick competent and are therefore able to consent to medical examination and treatment without recourse to those with parental responsibility for them. To demonstrate Gillick competence the child must show that they have sufficient maturity and intelligence to understand and appraise what is being proposed, weigh up the risks and look at alternatives.

Consideration of whether a child is Gillick competent should not be a last minute decision, but one made as part of case planning with the agreement of those involved in the care of the child. If considered Gillick competent then the child can also decide whether their parents are informed of any appointments, but again advice must be sought before agreeing to the child's request. Gillick competence is different to Fraser competence, which is specific to contraceptive advice and a child's understanding.

Emergency medical treatment

In the event of an accident a staff member or foster carer should devote their whole time to comforting and ensuring the child or young person is appropriately treated once appropriate emergency action has been taken.Consent to treatment forms are held within the placement information record.

The parents and people with parental responsibility must be notified as soon as possible for any need for treatment.

A full record must be made regarding the circumstances leading up to and including the incident.If a child is taken or admitted to hospital for treatment, the child's residential social worker or foster carer should take any medical documentation including placement information record and consent to treatment form if this is available at the locality of the incident.

A child's health plan may contain useful information for examining Health Staff.Final decisions about treatment and consent will be made by the treating physician.

Actions

StepResponsible OfficerRecord RequiredPerformance Standard
In order that a child can receive prompt treatment, a parent or a person with parental responsibility is asked to sign the medical consent section contained in placement information record prior to or shortly after the placement.Social workerComputer Placement Information record and letter of confirmationPlacement Information record 1 -48 hours before placement commences or immediately afterwards if an emergency placement
Consent to treatment form is completed within the health plan for child looked after.LAC health officerComputer28 days
At the time of the incident the person with the child must do whatever is reasonable in all the circumstances of the case to obtain the appropriate medical attention for the child.Person with the childComputerImmediately
Foster carer or staff member accompanying the child should take any relevant medical documentation if this is available at the locality of the accident or incident.Person with the childComputerPlacement Information recordHealth PlanIf readily available taken by carer accompanying the child.
Inform the parents and people with parental responsibility and the social worker of the timing of this. This may depend upon the urgency or severity of the accident or incident.  If out of hours inform the emergency duty team.Person with the child/social workerComputerFoster carers sheetResidential logAs appropriate but as soon as possible after medical treatment has been provided
Computer to be updatedSocial workerComputerimmediately
A full report regarding the circumstances leading up to and including the accident or incident should be made  and forwarded to the social workerPerson with the childComputerAs soon as possible after the accident or incident
The carer should keep  a record of all relevant information.CarerCarers logAs appropriate