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Kent - Resolving Professional Disagreements and the Escalation of Professional Concerns

Contents

  1. Key Principles
  2. Escalation of Professional Concerns
  3. Referral Stage
  4. At Outcome of Section 47 Enquiry
  5. Arising from Child Protection Conference
  6. About Implementation of Protection Plan
  7. If Professional Differences Remain


1. Key Principles

The key principles are:

  • Practitioners must avoid professional disputes that put children at risk or obscure the focus of the child;
  • Disagreements within and between agencies must be resolved quickly and openly;
  • Potential problem areas in working together should be identified and resolution promoted via amendment to protocols and procedures;
  • The safety of individual children and focus on children are the paramount considerations in any professional disagreement and any unresolved issues should be escalated with due consideration to the risks that might exist for the child;
  • Effective working together depends on an open approach and honest relationships between agencies;
  • Effective working together depends on resolving disagreements to the satisfaction of workers and agencies and a belief in a genuine partnership;
  • Professional disagreements are reduced by clarity about roles and responsibilities and airing and sharing problems in networking forums.


2. Escalation of Professional Concerns

The Kent Safeguarding Children Board is clear that there must be respectful challenge whenever a professional or agency has a concern about the action or inaction of another. Similarly agencies/professionals should not be defensive if challenged. Practitioners and managers should always be prepared to review decisions and plans with an open mind.

Good practice involves professionals sharing difficulties and dilemmas and an expectation that there will be constructive challenge between them in their day to day work.

Problem resolution is an integral part of professional cooperation and joint working to safeguard children.

Professional disagreement is only dysfunctional if not resolved in a constructive and timely fashion.

At no time must professional disagreement detract from ensuring the child is safeguarded. The child's welfare and safety must remain paramount throughout.

The aim should be to resolve difficulties at practitioner level between agencies; if necessary with the involvement of their managers, engaging in open discussion with colleagues in other agencies. Attempts at resolution must be within a time frame which clearly protects the child or children; for example, differences of opinion concerning the possible non-accidental injury of an infant/young child must be resolved immediately.

It should be recognised that differences in status and/or experience may affect the confidence of some practitioners to pursue this unsupported.

A clear record should be kept at all stages, by all parties. In particular this must include written confirmation between the parties about an agreed outcome of the disagreement and how any outstanding issues will be pursued.


3. Referral Stage

Disagreements over the handling of concerns reported to Specialist Children’s Services typically occur when:

  • The referral is not considered to satisfy eligibility criteria for assessment;
  • Informal advice is sought and a social worker has concluded that a referral is required;
  • Specialist Children’s Services conclude that further information should be sought by the referrer before the referral is progressed;
  • Professional opinion about level of risk;
  • Professional disagreement about decisions and actions;
  • Specialist Children’s Services believe that a Child and Family  Assessment can be started without invoking child protection procedures (see the Child Protection (Section 47) Enquiries Procedure in this manual);
  • Specialist Children’s Services consider that child protection procedures must be invoked;
  • Specialist Children’s Services and Police Public Protection Unit place different interpretations on the need for a Section 47 Enquiry / criminal investigation.

If the professionals are unable to resolve differences through discussion and/or meeting within a time scale, which is acceptable to both of them, their disagreement must be addressed by more experienced / more senior staff.

With respect to most day to day difficulties this will require a Specialist Children’s Services first line manager liaising with her/his equivalent in the relevant agency, e.g:

  • A detective sergeant in the Police Public Protection Unit;
  • A senior health visitor / nurse / GP;
  • Designated teacher.

If agreement cannot be reached following discussions between the above ‘first line’ managers (who should normally seek advice from designated / named / lead officer / child protection advisers) the issue must be referred without delay through the line management to the equivalent of service manager / detective inspector / head teacher or other designated professional.

Alternatively, and more commonly in health services, input may be sought directly from designated doctor or nurse in preference to use of line management.

Records of discussions must be maintained by all the agencies involved.


4. At Outcome of Section 47 Enquiry

If Specialist Children’s Services has concluded a s.47 enquiry and decided not to convene a Child Protection Conference, those professionals and agencies most involved with the child and family and those who took part in the s.47 enquiry, have the right to request a conference be convened on the basis of serious concerns that a child’s welfare may not be adequately safeguarded without one.

The team/group manager that chaired the strategy discussion considers whether an initial child protection conference is required.  If the decision is still disputed the case will be considered by the Service Manager. On receipt of any such request  an immediate Strategy Discussion should be convened to agree any interim support and protection required.

In the unlikely event that the outcome of these alternate steps fail to satisfy the concerned agency, the issue should be put as a matter of urgency to the Performance and Quality Assurance Manager  to reach a decision and determine what further responses (if any) are a justifiable and proportionate response. 

If concerns remain the case can be referred to the KSCB Serious Case Review Sub Group.


5. Arising from Child Protection Conference

If the chair of a conference is unable to achieve a consensus on making a child subject to a Child Protection Plan, s/he will make a decision and note any dissenting views.

The agency or individual who dissents from the chair’s decision must determine whether s/he wishes to further challenge the result. In the unlikely event that the dissenting professional believes the decision reached by the chair places a child at (further) risk of Significant Harm, s/he should formally raise the matter with the Chair and her/his agency’s designated doctor / nurse / teacher.

If that designated doctor / teacher / nurse concurs with the concerns of the professional, s/he should immediately alert the designated safeguarding manager in the local authority.

In the light of the representations made, the Performance and Quality Assurance Manager must determine whether to uphold the decision reached by the conference chair or require that a review conference be brought forward or an initial conference be reconvened. 

In the unlikely event that the outcome of these alternate steps fail to satisfy the concerned professional, the issue should be put as a matter of urgency to the KSCB Serious Case Review Sub Group who can determine what further responses (if any) are a justifiable and proportionate response.


6. About Implementation of Protection Plan

Concern or disagreement may arise over another professional’s decisions, actions or lack of actions in the implementation of the Child Protection Plan, including core group meetings.

The line managers of the professionals involved should first address these concerns.

If agreement cannot be reached following discussions between the above ‘first line’ managers, the issue must be referred without delay through the line management to the equivalent of service manager / detective inspector / head teacher or other designated professional.

Alternatively, and more commonly in health services, input may be sought directly from designated doctor or nurse in preference to use of line management.


7. If Professional Differences Remain

If professional disagreements remain unresolved, the matter must be referred to the heads of service for each agency involved. In the unlikely event that the issue is not resolved by the steps described above and/or the discussions raise significant policy issues, it may be helpful to convene the KSCB Serious Case Review Sub Group which has the brief to consider policy and practice or serious cases.

End