watermark
London Safeguarding Children Board: Child Protection Procedures 5th Edition London SCB Powered by tri.x Powered by tri.x
regsiter for alerts Search

4. Sharing information

Text Size: View this website with small text View this website with medium text View this website with large text View this website with high visibility


For amendment and updates see the Amendments and Archives tab above.


Contents

4.1

Introduction

 

4.1.4

Legal principles and obligations

4.2

Agency responsibilities under the Children Act 2004

4.3

Individual / agency responsibility

 

4.3.1

Confidentiality

 

4.3.6

Public interest and proportionality

 

4.3.10

Consent

 

4.3.11

What constitutes consent?

 

4.3.15

Whose consent should be sought?

 

4.3.23

When should consent be sought?

 

4.3.29

When not to seek consent

4.4

Sharing information where there are concerns about significant harm

4.5

Key questions to inform decision-making

 

4.5.2

Is there a legitimate purpose to share the information?

 

4.5.5

Does the information enable a person to be identified?

 

4.5.6

Is the information confidential?

 

4.5.8

If the information is confidential, has consent to share been obtained?

 

4.5.9

Is there a statutory duty or a court order to share information?

 

4.5.16

If consent has been refused, or there are good reasons not to seek consent to share confidential information, is there a sufficient public interest to share information?

 

4.5.20

If the decision is to share, is the right information being shared in the right way?

 

4.5.21

Have the decision and the reasons for it, been recorded?

4.6

Professional guidance

 

4.6.1

Doctors

 

4.6.5

Nurses and other health professionals

 

4.6.9

Metropolitan Police

 

4.6.15

Education professionals

4.7

Sharing information safely

 

4.7.1

Confidential information exchange

 

4.7.9

Record keeping

4.8

Information sharing glossary


4.1

Introduction

 

4.1.1

A key factor in many serious case reviews is that a good standard of practice has not been in evidence when professionals have been recording, sharing, discussing and analysing information in order to make an assessment of the needs of a child or the risks to the child. It is crucial to understand the significance of the information shared and to take appropriate action in relation to known or suspected abuse or neglect. Often it is only when information from a number of sources has been shared that it becomes clear that a child has suffered, or is likely to suffer, significant harm.

4.1.2

Early sharing of information is the key to providing effective early help where there are emerging problems. At the other end of the continuum, sharing information can be essential to put in place effective child protection services. Serious Case Reviews (SCRs) have shown how poor information sharing has contributed to the deaths or serious injuries of children. (Working Together to Safeguard Children 2015)

4.1.3

Through a common approach to assessing children's needs and improved information sharing, local authorities and their partner agencies are expected to achieve:

  • Effective communication between professionals;
  • Understanding what information should be shared, with whom and under what circumstances, and the dangers of not doing so - building confidence and trust with partners and families;
  • Better knowledge of other agencies' services;
  • Working in multi-agency / disciplinary teams, when appropriate, to deliver services;
  • Less repetition for children and their families, and an active part in the decision making process.

Fears about sharing information cannot be allowed to stand in the way of the need to promote the welfare and protect the safety of children. To ensure effective safeguarding arrangements:

  • All organisations should have arrangements in place which set out clearly the processes and the principles for sharing information between each other, with other professionals and with the LSCB; and
  • No professional should assume that someone else will pass on information which they think may be critical to keeping a child safe. If a professional has concerns about a child's welfare and believes they are suffering or likely to suffer harm, then they should share the information with local authority children's social care.


Legal principles and obligations

4.1.4

In addition to the statutory guidance following from the Children Act 2004, the key legal concepts, legislation and terminology relevant to information sharing are contained in:

These are summarised in Appendix 1: Links to relevant legislation.

For further details see the London MASH Information Sharing Guidance and related documents.

'Information sharing: Advice for practitioners providing safeguarding services to children, young people, parents and carers supports frontline practitioners, working in child or adult services', who have to make decisions about sharing personal information on a case by case basis. See the Department for Education guidance on information sharing.


4.2

Agency responsibilities under Children Act 2004

 

4.2.1

The statutory guidance on s11 of the Children Act 2004 states that in order to safeguard and promote children's welfare, the agencies covered by s11 should make arrangements to ensure that:

  • All professionals in contact with children understand what to do and the most effective ways of sharing information if they believe that a child and family may require particular services in order to achieve positive outcomes;
  • All professionals in contact with children understand what to do and when to share information if they believe that a child may be a child in need, including those children who have suffered, or are likely to suffer, significant harm;
  • Appropriate agency-specific guidance is produced to complement guidance issued by central government, and such guidance and appropriate training is made available to new staff as part of their induction and ongoing training;
  • Guidance and training specifically covers the sharing of information between professions, organisations and agencies, as well as within them, and arrangements for training take into account the value of multi-agency as well as single agency training;
  • Managers in children's services are fully conversant with the legal framework and good practice guidance issued for professionals working with children.

4.2.2

The statutory guidance on s10 of the Children Act 2004 makes it clear that effective information sharing supports the duty to co-operate to improve the well-being of children.

4.2.3

Local authorities and their partner agencies should ensure that their employees:

  • Are supported in working through these issues;
  • Understand what information is and is not confidential, and the need in some circumstances to make a judgement about whether confidential information can be shared, in the public interest, without consent;
  • Understand and apply good practice in sharing information at an early stage as part of preventative work;
  • Are clear that information can normally be shared where a child is judged to have suffered, or is likely to suffer, significant harm, or that an adult is at risk of serious harm.

4.2.4

Agencies should:

  • Each appoint a senior manager, a lead information officer, responsible for decisions relating to information sharing within the agency, who can determine controversial issues;
  • Develop common documentation, systems and a joint approach to multi-disciplinary and multi-agency information sharing;
  • Encourage children and their parents to see information sharing in a positive light, as something which makes it easier for them to receive the services they need.

4.3

Individual / professional responsibility

 

Confidentiality

4.3.1

In deciding whether there is a need to share information, professionals need to consider the legal obligations including:

  • Whether the information is confidential;
  • If it is confidential, whether there is a public interest sufficient to justify sharing it.

4.3.2

Not all information is confidential. Confidential information is information of some sensitivity, which is not already lawfully in the public domain or readily available from another public source, and which has been shared in a relationship where the person giving the information understood that it would not be shared with others.

4.3.3

For example, a teacher may know that a pupil has a parent who misuses drugs. That is information of some sensitivity, but may not be confidential if it is widely known or it has been shared with the teacher in circumstances where the person understood it would be shared with others. If however it was shared with the teacher by the pupil in a counselling session it would be confidential.

4.3.4

Confidence is only breached where the sharing of confidential information is not authorised by the person who provided it or to whom it relates. If the information was provided on the understanding that it would be shared with a limited range of people or for limited purposes, then sharing in accordance with that understanding will not be a breach of confidence. Similarly, there will not be a breach of confidence where there is explicit consent to the sharing.

4.3.5

Even where sharing of confidential information is not authorised, professionals may lawfully share it if this can be justified in the public interest. Seeking consent should be the first option, if appropriate. Where consent cannot be obtained to the sharing of the information or is refused, or where seeking it is likely to undermine the prevention, detection or prosecution of a crime, the question of whether there is a sufficient public interest must be judged by the professional on the facts of each case. Therefore, where a professional has a concern about a child, a refusal of consent should not necessarily preclude the sharing of confidential information.


Public interest and proportionality

4.3.6

A public interest can arise in a wide range of circumstances e.g. to protect children or other people from harm, to promote the welfare of children or to prevent crime and disorder. There are also public interests, which in some circumstances may weigh against sharing, including the public interest in maintaining public confidence in the confidentiality of certain services. The key factor in deciding whether or not to share confidential information is proportionality (i.e. whether the proposed sharing is a proportionate response to the need to protect the public interest in question). In making the decision professionals must weigh up what might happen if the information is shared against what might happen if it is not, and make a decision based on a reasonable judgement.

4.3.7

Where there is a clear risk of significant harm to a child, or serious harm to adults, the public interest test will almost certainly be satisfied. However there will be other cases where professionals will be justified in sharing some confidential information in order to make decisions on sharing further information or taking action - the information shared should be proportionate.

4.3.8

Circumstances in which sharing confidential information without consent will normally be justified in the public interest are:

  • When there is evidence that the child has suffered, or is likely to suffer, significant harm;
  • Where there is reasonable cause to believe that a child has suffered, or is likely to suffer, significant harm;
  • To prevent significant harm arising to children or serious harm to adults, including through the prevention, detection and prosecution of serious crime (serious crime means any crime which causes or is likely to cause significant harm to a child or serious harm to an adult).

4.3.9

Professionals must record the context in which the information was shared, the perceived level of risk of harm at the time, the data requested, the data shared and with whom. Agencies may have a standard form for this or ensure that there is a signed and dated entry in the case notes.


Consent

If the information is confidential, has consent to share been obtained?

4.3.10

Consent issues can be complex, and lack of clarity about them can sometimes lead professionals to incorrect assumptions that no information can be shared. Professionals in all agencies should be clear about:

  • What constitutes consent;
  • Whose consent should be sought;
  • When should consent be obtained and how;
  • When not to seek consent.


What constitutes consent?

4.3.11

Consent must be freely given and informed (i.e. the person giving consent needs to understand why information needs to be shared, who will see their information, the purpose to which it will be put and the implications of sharing that information).

4.3.12

Consent can be explicit or implicit. Obtaining explicit consent is good practice and it can be expressed either orally or in writing, although written consent is preferable since that reduces the possibility of subsequent dispute. If verbal consent has been obtained details must be recorded in case notes.

4.3.13

Implicit consent can also be valid in many circumstances. Consent can legitimately be implied if the context is such that information sharing is intrinsic to the activity, and especially if that has been explained at the outset, for example when conducting a common assessment. A further example is where a GP refers a patient to a hospital specialist and the patient agrees to the referral; in this situation the GP can assume the patient has given implied consent to share information with the hospital specialist.

4.3.14

Consent does not entitle a professional or agency to collect an unlimited range of information. The information must relate to the performance of one of the agency's functions (i.e. the agency must be acting intra-vires in seeking the information).


Whose consent should be sought?

4.3.15

Professionals may also need to consider whose consent should be sought. Where there is a duty of confidence it is owed to a person who has provided the information on the understanding it is to be kept confidential and, in the case of medical or other records, the person to whom the information relates. A young person aged 16 or 17, or a child under 16 who has the capacity to understand and make their own decisions, may give (or refuse) consent to sharing (refer to the Mental Capacity Act 2005, if required).

4.3.16

Children aged 12 or over may generally be expected to have sufficient understanding. Younger children may also have sufficient understanding. When assessing a child's understanding you should explain the issues to the child in a way that is suitable for their age, language and likely understanding. Where applicable, you should use their preferred mode of communication.

4.3.17

The following criteria should be considered in assessing whether a particular child on a particular occasion has sufficient understanding to consent, or refuse consent, to sharing of information about them:

  • Can the child understand the question being asked of them?
  • Does the child have a reasonable understanding of:
    • What information might be shared?
    • The main reason or reasons for sharing the information?
    • The implications of sharing that information, and of not sharing it?
  • Can the child:
    • Appreciate and consider the alternative courses of action open to them?
    • Weigh up one aspect of the situation against another?
    • Express a clear personal view on the matter, as distinct from repeating what someone else thinks they should do?
    • Be reasonably consistent in their view on the matter, or are they constantly changing their mind?

4.3.18 

In most cases, where a child cannot consent or where a professional judges that they are not competent to consent, a person with parental responsibility should be asked to consent on behalf of the child. Each agency should have procedures to determine who has parental responsibility for a child.

4.3.19

Where parental consent is required, the consent of one parent is sufficient. In situations where family members are in conflict professionals should talk to their agency's information lead and child protection adviser to decide whose consent should be sought. If the parents are separated, the consent of the resident parent would usually be sought. If a child is judged to be competent to give consent, then their consent or refusal to consent is the one to consider even if a parent disagrees.

4.3.20

In cases where there is conflict between the wishes of the parent and the child, particularly if the child is older or a teenager, professionals should make a decision aimed at securing the best outcome for the child. Acting in the best interests of the child, may require overriding refusal to consent by either or both the child and the parent/s.

4.3.21

The need to renew consent should be reviewed and the person who gave consent should be kept informed of circumstances in which the data is shared, wherever this is appropriate.

4.3.22

If there is a significant change in the use to which the information will be put to that which has previously been explained, or in the relationship between the agency and the individual, consent should be sought again. Individuals have the right to withdraw consent after they have given it, although in practice this is rarely exercised.


When should consent be obtained and how?

4.3.23

There are many situations in which a professional can share information legally without obtaining consent from a child or his carer. These are not limited to situations where there is an imminent danger or risk of harm to a child. Frequently, when an assessment of the risk factors affecting a child or family is being undertaken, information will be shared without consent (relying upon statutory powers and duties) when consultation has taken place with a line manager or designated safeguarding professional.

4.3.24

A number of examples of statutory powers and duties to share information are set out in Information Sharing: Further Guidance on Legal Issues (National Archives 2008). The guidance also describes the broad powers and duties which clearly can only be fulfilled if information is obtained about children and their families or about the entire population in an area.

4.3.25

It is good practice for all professionals to obtain consent before sharing information, even when there is no legal requirement.

4.3.26

Consent will almost always be needed at the stage where services are offered unless there are very serious child protection concerns where there is a statutory duty to intervene. In most cases telling a child and/or their family when information about them has been shared or seeking their consent to do so, develops their trust in the professional / agency. This may be particularly important with older children (e.g. for Connexions personal advisers).

4.3.27

Agencies should provide an information leaflet and obtain written consent in the form of a standard consent letter.

4.3.28

When a professional seeks consent for information to be shared, the following information should be provided as a minimum:

  • What information has been or will be collected;
  • The purposes for which it will be used;
  • Who the information might be shared with;
  • The purposes for which the agencies which receive the information might use it (including detection of crime).


When not to seek consent

4.3.29

See section 4.4 below; all sharing of sensitive information, with or without consent, should be recorded including details of the risk of harm. In addition, if a professional shares information without seeking consent, this should be clearly recorded, including the reasons for not seeking consent.


4.4

Sharing information where there are concerns about significant harm

 

4.4.1

Professionals who work with, or have contact with children, parents or adults in contact with children should always share information with LA children's social care where they have reasonable cause to suspect that a child may have suffered, or is likely to suffer, significant harm.

4.4.2

While, in general, professionals should seek to discuss any concerns with the family and, where possible, seek their agreement to making referrals to children's social care, there will be some circumstances where professional should not seek consent e.g. where to do so would:

  • Place a child at increased risk of significant harm;
  • Place an adult at risk of serious harm;
  • Prejudice the prevention or detection of a serious crime;
  • Lead to unjustified delay in making enquiries about allegations of significant harm.

4.4.3

In some situations there may be a concern that a child may have suffered, or is likely to suffer, significant harm or of causing serious harm to others, but professionals may be unsure whether what has given rise to concern constitutes 'a reasonable cause to believe'. In these situations, the concern must not be ignored.

4.4.4

Professionals should always talk to their agency's designated safeguarding children professional and, if necessary and where they have one, a Caldicott Guardian - who will have expertise in information sharing issues, though not related to child protection. The child's interests must be the overriding consideration in making any decisions whether or not to seek consent.

4.4.5

Significant harm to children can arise from a number of circumstances, it is not restricted to cases of deliberate abuse or gross neglect. A baby who is severely failing to thrive for no known reason could be suffering significant harm but equally could have an undiagnosed medical condition. If the parents refuse consent to further medical investigation or an assessment, professionals are still justified in sharing information for the purposes of helping ensure that the causes of the failure to thrive are correctly identified.

4.4.6

Similarly, serious harm to adults is not restricted to cases of extreme physical violence. The cumulative effect of repeated abuse or threatening behaviour or the theft of a car for joyriding may well constitute a risk of serious harm. A professional is likely to be justified to share information without consent for the purposes of identifying a child for whom preventative interventions in relation to such behaviour are appropriate.


4.5

Key questions to inform decision-making

 

4.5.1

In deciding whether or not to share information professionals should use eight key questions: (see DfE Information Sharing website (updated 2015) for all tools.)

  1. Is there a legitimate purpose to share the information?
  2. Does the information enable a person to be identified?
  3. Is the information confidential?
  4. If the information is confidential, has consent to share been obtained?
  5. Is there a statutory duty or court order to share the information?
  6. If consent has been refused, or there are good reasons not to seek consent to share confidential information, is there a sufficient public interest to share information?
  7. If the decision is to share, is the right information being shared in the right way?
  8. Have the decision and the reasons for it, been recorded?


Q1  Is there a legitimate purpose to share the information?

4.5.2

A professional requested to, or wishing to, share information about a child, must have a good reason or legitimate purpose to share the information.

4.5.3

For professionals who work for a statutory service such as education, social care, health or youth justice, or for a private or third sector agency and are contracted by one of the statutory agencies to provide services on their behalf, the sharing of information must be within the functions or powers of that statutory body.


Establishing the legality of information sharing

4.5.4

In order to comply with the law relating to confidentiality, data protection and human rights professionals should establish a legitimate purpose for sharing information. They can do so using the following questions:

  • Is there a legal basis for sharing / obtaining the information?  (Such as a duty or a power e.g. s47 of the Children Act 1989);
  • Was the information obtained under a specific statutory power or duty which limits what can be done with it and who the information can be shared with?
  • Is it personal or sensitive person information to which the Data Protection Act 1998 applies? (Information about individual identifiable children almost invariably will be one or the other);
  • Why is the information being shared or requested?
  • Can either party, requesting or sharing the information, show a sufficient 'need to know'?
  • Is the request proportionate to the purpose for which disclosure is sought?
  • Will the request involve secondary disclosure? (Disclosure by the person to whom data has been disclosed to another agency or person e.g. if a GP provides data to a school and the school passes it to LA children's social care);
  • Is consent needed from the child or someone who can give consent on their behalf before the information can be shared?
  • If consent is needed, has the necessary consent been obtained?
  • If consent cannot realistically be obtained or sought is there another justification for disclosure without consent e.g. to protect the interests of the child?
  • Is the justification of sufficient weight to override the duty of confidence? (See Information sharing glossary);
  • Is there another way to achieve the objective with less impact on confidentiality (e.g. would anonymous data suffice)?


Q2  Does the information enable a person to be identified?

4.5.5

In most cases the information covered by these procedures will be about a named child. It may also identify others, such as a parent or carer. If the information is anonymised, it can lawfully be shared as long as the purpose is legitimate. If the information allows a child and others to be identified, it is subject to data protection law and professionals must follow these procedures and where appropriate take legal advice in deciding whether or not to share the information.


Q3  Is the information confidential?

4.5.6

There are three different types of confidential relationship:

  • A formal confidential relationship, as between a doctor and patient, social worker and client or counsellor and client. In these relationships all information shared, whether or not directly relevant to the medical, social care or personal matter which is the main reason for the relationship, should be treated as confidential;
  • An informal confidential relationship (e.g. between a teacher and a pupil). A pupil may tell a teacher a whole range of information some of which is not confidential, but may also ask the teacher to treat some specific information as confidential. Then, for the purposes of the confidential information only, the teacher and pupil will have a formal confidential relationship;
  • A relationship where the person may not specifically request that some information is kept confidential when they discuss their own problems or pass on information about others, but may assume that personal information will be treated as confidential. In these situations professionals should check whether or not the information is confidential and under what circumstances information may or may not be shared with others.

4.5.7

Public bodies which hold information of a private or sensitive nature about individuals for the purposes of carrying out their functions (e.g. LA children's social care) may also owe a duty of confidentiality, as people have provided information on the understanding that it will be used for those purposes. In some cases the body may have a statutory obligation to maintain confidentiality, for example in relation to the case files of looked after children.


Q4  If the information is confidential, has consent to share been obtained?

4.5.8

See section 4.3.10 - 4.3.29 (above).


Q5  Is there a statutory duty or a court order to share information?

4.5.9

In some situations professionals are required by law to share information, for example, in the NHS where a person has a specific disease about which environmental health services must be notified. There will also be times when a court will make an order for certain information or case files to be brought before the court.

4.5.10

These situations are relatively unusual and where they apply professionals will know or be told about them. In such situations professionals must share the information, even if it is confidential and consent has not been given. Wherever possible, professionals should inform the individual concerned that the information is being shared, why, and with whom.


Disclosure for the purposes of court proceedings

4.5.11

There will be occasions when it is necessary for the police to seek information held on other agency databases / files in order for the Crown Prosecution Service to use the information for prosecution in a criminal trial. There will also be occasions when legal representative for defendants in criminal trials will seek access to such information in a trial.

4.5.12

At these times, consideration must be given with legal advisors to the question of public interest immunity, a series of legal rules intended to protect the confidential nature of information held on files as a result of confidential relationships between individuals and public services.

4.5.13

Separate protocols exist both for the above purpose and in the situation where LA children's social care need to present information held on police files in the pursuit of civil care proceedings brought to protect children. These protocols are agreed between the Metropolitan Police Service and the judiciary and the police service and the Association of London Directors of Social of Children's Services (ALDCS).

4.5.14

Where an agency and its legal advisor do not believe the protocols to be appropriate that agency will need to consider legal advice about its responsibilities to share information to protect children weighed against its responsibilities to uphold the principles of public interest immunity in respect of information held.

4.5.15

See also the Protocol on the Exchange of Information in the Investigation and Prosecution of Child Abuse Cases (2003), developed by CPS, ACPO, LGA, ADSS; endorsed by HO, DfES and Welsh Assembly, and Protocol and good practice model ("2013 Protocol"): Disclosure of information in cases of alleged child abuse and linked criminal and care directions hearings at: the CPS website.


Q6  If consent has been refused, or there are good reasons not to seek consent to share confidential information, is there a sufficient public interest to share information?

4.5.16

If consent is refused, professionals should apply the public interest test. That is, considering whether the public interest in maintaining confidence in confidentiality is outweighed by the public interest in protecting a child at risk of significant harm or serious harm to an adult. There will be cases where sharing some information without consent is necessary to enable professionals to reach an informed decision about whether further information should be shared or action should be taken.

4.5.17

In deciding whether the public interest justifies disclosing confidential information without consent, professionals should be able to seek advice from a line manager or a designated safeguarding children professional whose role is to support professionals in these circumstances. If professionals are working in the NHS or a local authority the Caldicott Guardian may be helpful. Advice can also be sought from professional bodies, for example the General Medical Council or the Nursing and Midwifery Council.

4.5.18

If the concern is about possible abuse or neglect, all organisations working with children will have a named person who undertakes a lead role for child protection, so consulting this person may also be helpful.

4.5.19

If professionals decide to share confidential information without consent, this should be explained to the child or their parent, unless to do so would put the child at risk of harm.


Q7  If the decision is to share, is the right information being shared in the right way?

4.5.20

If the decision is to share, professionals should share information in a proper way. This means:

  • Share the information which is necessary for the purpose for which it is being shared;
  • Share the information with the person or people who need to know;
  • Check that the information is accurate and up-to-date;
  • Share it in a secure way;
  • Establish with the recipient whether they intend to pass it on to other people, and
  • Ensure they understand the limits of any consent which has been given;
  • Inform the person to whom the information relates, and, if different, any other person who provided the information, if professionals have not already and it is safe to do so.


Q8  Have the decision and the reasons for it, been recorded?

4.5.21

Professionals should record all decisions whether or not to share information and why. If the decision is to share, the record should include what information was shared and with whom.


4.6

Professional guidance

 


Doctors

4.6.1

Protecting children and young people: The responsibilities of all doctors (September 2012) sets out the good practice and standards for doctors.

4.6.2

The General Medical Council guidance entitled Confidentiality: Protecting and Providing Information (2009) emphasises the importance in most circumstances of obtaining a patient's consent to the disclosure of personal information but makes clear that information may be released without consent to third parties (e.g. statutory agencies such as LA children's social care and police) in exceptional circumstances if a failure to disclose information may expose the patient, or others, to risk of death or serious harm.

4.6.3

The General Medical Council has confirmed that its guidance refers to information about third parties who are of direct relevance to child protection (e.g. adults who may pose a risk to a child, or children who may be the subject of abuse).

4.6.4

It states: 'If a professional believes a patient to be a victim of neglect or physical, sexual or emotional abuse and that the patient cannot give or withhold consent to disclosure, the professional must give information promptly to an appropriate responsible person or statutory agency, where the professional believes that the disclosure is in the patient's best interests. If, for any reason, a professional believes that disclosure of information is not in the best interests of an abused or neglected patient, the professional should discuss the issues with an experienced colleague. If the professional decides not to disclose information, the professional must be prepared to justify their decision.'


Nurses and other health professionals

4.6.5

What to do if you're worried a child is being abused: Advice for practitioners March 2015: Guidance for senior nurses, health visitors, midwives and their managers should be followed.

4.6.6

The Nursing and Midwifery Council has produced a code of professional conduct which contains the advice that disclosure of information may occur:

  • With the consent of the patient or client;
  • Without the consent of the patient or client when the disclosure is required by law or by order of a court;
  • Without the consent of the patient or client when the disclosure is considered to be necessary in the public interest (public interest is defined to include child protection).

4.6.7

The Health Professionals Council, which governs therapies and professions allied to medicine, has produced a statement on confidentiality and individual professional bodies produce their own, essentially similar guidance.

4.6.8

When in doubt, health professionals should consult their agency's designated safeguarding children professional/s (i.e. the named professional for safeguarding children who may in turn seek advice from the designated doctor or nurse and / or the Caldicott Guardian or solicitor of the Trust).


Metropolitan Police

4.6.9

The police are lawfully able to supply information to relevant third parties for defined categories of request, as follows:

  • A child protection referral is made in relation to an enquiry under s47 Children Act 1989 (e.g. during a strategy meeting / discussion);
  • Information is requested as part of an inter-agency risk management meeting set up under the Criminal Justice and Court Services Act 2000 or the Sex Offenders Act 1997;
  • LA children's social care is carrying out an assessment in order to inform a decision as to the justification for a s47 enquiry or otherwise;
  • LA children's social care is carrying out a 'child in need' assessment under s17 Children Act 1989 and written consent from the subject/s has been obtained or the need to safeguard a child overrides the duty of confidence;
  • The request relates to a child subject of a child protection plan;
  • LA children's social care is faced with the immediate need to place a child with a family member or friend in an emergency and has obtained the necessary consents.

See also the Protocol on the Exchange of Information in the Investigation and Prosecution of Child Abuse Cases (2003), developed by CPS, ACPO, LGA, ADSS; endorsed by HO, DfES and Welsh Assembly, and Protocol and good practice model ("2013 Protocol"): Disclosure of information in cases of alleged child abuse and linked criminal and care directions hearings at: the CPS website.

4.6.10

Any request for information that does not fall within these categories will be declined.

4.6.11

Where there is doubt, the police officer will consult the police legal services or the data protection unit.

4.6.12

Information will be provided by the police on the strict understanding that it is confidential in nature, will only be used for the purposes of a child protection or child in need assessment and that it may not be passed on to any third party without the express permission of the police.

4.6.13

Outside of the context of a s47 enquiry or criminal investigation, completion of 'information request forms', processed in accordance with police standards, will usually be required (see Child Protection Inquiry – Information Request Form 87B).

4.6.14

In urgent cases, information shared as part of a s47 enquiry may be provided verbally prior to being confirmed in writing on form 87B (see Child Protection Inquiry – Information Request Form 87B).


Education professionals

4.6.15

Education professionals have a professional responsibility to share information with other professionals in order to protect children, particularly with investigative agencies such as, the police and LA children's social care. This responsibility applies to teaching staff and other school-based staff, including PCT school nurses, as well as those working for LA education.

4.6.16

Section 27 Children Act 1989 also imposes a duty on local education authorities to assist LA children's social care in the exercise of its functions (e.g. child protection), if requested to do so and if it is not prejudicial to the discharge of their own function.

4.6.17

The Education Act 2002 introduced additional duties on local education authorities, governing bodies and teaching staff to share information that may be relevant to child protection with LA children's social care.


4.7

Sharing information safely

 

Confidential information exchange

4.7.1

The professional requesting information about a child and their family from another agency and the professional in that agency who provides it must record the event contemporaneously and date it, in accordance with their own agency procedures. Both professionals must also record the reason for request and the level of risk of harm in play at time of request.

4.7.2

The recording must indicate if the consent of the subject child or their parent/s was sought and obtained, sought and refused or not sought.

4.7.3

If information was provided without consent, the reason/s for doing so must be made clear and the record must also indicate whether the subject child or their parent/s was subsequently informed of the information transfer.

4.7.4

Unless they are already known, a telephone call received from a professional seeking information must be verified before information is divulged, by calling their agency back.

4.7.5

A record of any information given or received by 'phone or in person must be made, as well as reasons for not informing at time or subsequently, alongside details of the risk of harm as in Section 4.7.1, Confidential information exchange above.

4.7.6

Transmission of personal and sensitive information by fax should only happen when unavoidable. The number / address to which it is being sent should be checked very carefully (preferably by a colleague) and reassurance provided and recorded about the security of its handling by the other agency.

4.7.7

All faxes containing confidential information should have a cover sheet which contains a confidentiality statement (e.g. 'This fax is confidential and is intended only for the person to whom it is addressed'). Faxes should be sent to 'Safe Haven' fax machines. If there is any doubt about being able to ensure confidentiality agreement should be reached by both parties that the recipient will stand by the fax machine and provide confirmation to the sender that the fax has been received.

4.7.8

Confidential information should only be sent by secure electronic systems and not by internet e-mail. E-mails containing confidential information should have a confidentiality warning (e.g. 'This e-mail is confidential and is intended for the person to whom it is addressed').


Record keeping

4.7.9

Professionals in all agencies must ensure that in the child (or adult who is a parent)'s file, they:

  • Record all requests for information, who is making the request and the purpose for which the information is sought;
  • Keep a detailed log of information disclosed identifying the person to whom it has been provided and the purpose;
  • Record the date a piece of information was created or recorded and whether it comprises fact, opinion, hypothesis or a mixture of these together with the identity of the person recording the information and the risk which has prompted the disclosure;
  • In situations where written consent to disclosure has been obtained, record this and file the written consent with the record;
  • In situations where consent to disclosure is needed, if written consent has not been obtained, record clearly the basis on which consent to disclosure has been obtained and ensure that this is readily accessible to everyone who might be asked to share that data including any relevant legal or data protection issues;
  • In situations where consent to disclosure is needed, if consent has been refused or not sought, record clearly the refusal and / or the reasons for proceeding without consent. Ensure that this is readily accessible to everyone who might be asked to share that data including any relevant legal or data protection issues.

4.8

Information sharing glossary

 

Term

Definition

Anonymised information

Information from which a person cannot be identified by the recipient.

Confidential information

Information not normally in the public domain or readily available from another source, it should have a degree of sensitivity and value and be subject to a duty of confidence.

Consent

Agreement freely given to an action based on knowledge and understanding of what is involved and its likely consequences. All consent must be informed. The person to whom the information relates should understand why particular information needs to be shared, who will use it and how, and what might happen as a result of sharing or not sharing the information.

Explicit consent

Consent given orally or in writing.

Implied consent

Where the person has been informed about the information to be shared, the purpose for sharing and that they have the right to object and their agreement to sharing has been signalled by their behaviour rather than orally or in writing.

Lead information officer

A senior manager in each agency, responsible for decisions relating to information sharing within the agency, who can determine controversial issues.

Personal data

Information about any identified or identifiable living individual and includes their name, address and telephone number as well as any reports or records.

Proportionality

The key factor in deciding whether or not to share confidential information without consent is proportionality: i.e. is the information professionals wish to, or are asked to share, a balanced response to the need to safeguard a child or another person, or to prevent or detect a serious crime.

Public interest

The interests of the community as a whole, or a group within the community or individuals.

Public interest test

The process a professional should use to decide whether to share confidential information without consent. It requires consideration of the competing public interests e.g. the public interest in protecting children, promoting their welfare or preventing crime and disorder and the public interest in maintaining public confidence in the confidentiality of public services, and to balance the risks of not sharing against the risk of sharing.

Secondary disclosure

Disclosure by the person to whom data has been disclosed to another agency or person e.g. if a GP provides data to a school and the school passes it to LA children's social care.