2.4.7 Care Pathway for Section 47 Child Protection Medicals |
SCOPE OF THIS CHAPTER
From Thursday 29th May 2008 section 47 daytime medical assessments will be carried out at the North Middlesex University Hospital Paediatric Assessment Centre, North Middlesex University Hospital NHS Trust, Sterling Way, Edmonton, London, N18 1QX instead of St. Ann's Child Development Centre.
(Directions: The Paediatric Assessment Centre is situated next to the 'Walk in Centre' entrance near A&E. Entry to the centre is gained via a ramp).
This chapter was updated to reflect current arrangements in February 2011.
Contents
1. Booking Appointments
Appointments can be made between 9am and 5pm Monday to Friday
(excluding bank holidays) by calling:
Claudia Cupidon,
Child Protection Administrator,
North Middlesex Hospital
Tel: 0208 887 2493
Fax: 0208 887 2712
2. Clinics
Section 47 paediatric medical assessments take place in a dedicated Child Protection clinic with sessions held as outlined below, excluding bank holidays:
Monday 1.30pm - 4.30pm,
Tuesday 1.30pm - 4.30pm
Wednesday 9.30am - 12.30pm
Thursday 9.30am - 12.30pm
Friday 1.30pm - 4.30pm.
New cases are seen at these sessions. 2 children are booked in at each session. Occasionally 3 children may be seen if they are from the same family but this will be at the discretion of the doctor on call as he/she may be on the acute on call rota at North Middlesex University Hospital. It is usually not possible to see more than 3 children at any session.
The slots on Friday afternoon are kept free for urgent cases. Non-urgent cases are not seen on Friday afternoon.
2.1 Referrals received between 4-5pm:
Doctor on call to contact the Paediatric Registrar at either North Middlesex University Hospital or The Whittington Hospital and hand over the case personally.
2.2 Out of Hours:
There is no change in the provision of the out of hours service. Any appointments out of hours need to be arranged via the North Middlesex Hospital via A&E or by contacting the Paediatric Registrar on call.
3. Paediatric Clinical Care Pathway for Paediatric Opinion when there is an Allegation/Suspicion of Physical Abuse, Emotional Abuse and/or Neglect
4. Consent
The issue of consent for paediatric assessments or medical treatment is addressed in paragraphs 7.9.7 to 7.9.15 of the London Child Protection Procedures - 4th edition (April 2011). The following outlines who can give consent for a paediatric assessment:
- A child of sufficient age and understanding (Gillick competent or Frazer ruling competent);
- Any person with parental responsibility, providing they have the capacity to do so;
- The local authority when the child is the subject of a care order (and by definition this includes an interim care order) - even so the guidance is clear that although the local authority has the power to determine the extent to which a parent or a person who has parental responsibility for the child may meet his parental responsibility for him this power may not be exercised unless the local authority is satisfied that it is necessary to do so in order to safeguard or promote the child’s welfare. Thus the parent should be informed and where possible their consent should be secured, even when the child is the subject of a care order. To fail to inform the parent and where possible to ask for consent when a parent is contactable is poor practice. To go against parental wishes and go ahead with a paediatric assessment should only be done with very good reason authorised in writing by the Head of Service in Children’s Social Care;
- The local authority when the child is accommodated under s20 of the Children Act 1989, and the parent/s have abandoned the child or are physically or mentally unable to give such authority;
- The fact that a child is accommodated under s20 of the Children Act 1989, by itself does not give Children’s Social Care the authority to give consent to a medical examination;
- The High Court when the child is a ward of court;
- A direction attached in family proceedings to an emergency protection order, an interim care order or a child assessment order overrides the need to ask for consent.
5.Sexual Abuse Medical Examinations
There is no change in the provision of sexual abuse medical examinations.
If the assault has occurred within the past 72 hours for any child under age 13 years or within 7 days if the child is over 13 years of age:
Social Worker or police to make an urgent referral to Haven Clinic Whitechapel 0207 247 4787 or Paddington 0207 886 1101.
If the assault occurred more than 72 hours ago for any child under age 13 years or more than 7 days in a child over 13 years of age:
Social Worker to contact the St. Ann's Child Development Centre Child Protection Administrator on 0208 442 5441. The On Call Doctor will discuss the case with the social worker. An appointment will be arranged with Dr. Hodes, Consultant Paediatrician at University College Hospital clinic.
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