VLE and SocPop Flashcards
What is every child matters?
Organise services and resources around children to ensure safety, proper development and improve well-being
What is the Local safeguarding children board?
Statutory multi agency body
Coordinate and lead child protection activities in an area
Audit and review safeguarding and welfare promoting strategies
What did Lord Laming say about doctors involved in the care of a child?
All doctors involved in care of a child about whom there are concerns about deliberate harm must provide children’s social care with a written statement of the nature and extent of concerns
Responsibility of doctor to ensure concerns are properly understood
What does Good Medical Practice (2006) say on Relationships with patients: Children and young people?
Be aware of needs and welfare of children and young people when you see patients who are parents or carers and patients who may represent a danger to children or young people
Safeguard and protect health and well-being of children and young people
Offer assistance to children and young people if you have reason to think that their rights have been abused or denied
When communicating with a child or young person you must:
Treat them with respect and listen to their views
Answer their questions to the best of your ability
Provide information in a way they can understand
What do you do if you suspect a child is at risk of abuse?
Sufficient to justify a referral
Consult with experienced colleague (Designated Nurse or Doctor for Child Protection) or line manager if in any doubt
Referral to Children’s Social Services
Who are named professionals involved in child protection in hospitals and what is their role?
Each Trust has a Named doctor, nurse and midwife to take lead on child protection matters
Responsibilities include education, support and supervision
Appropriate person to contact with any child protection matter
Who is responsible for identifying abuse and how might you do this?
All those who work with children need to be able to identify signs of abuse or neglect and know what actions to take to safeguard the child’s welfare
Knowing when a child is not developing as would be expected for their age
What effect does early intervention have on child protection?
Early intervention is vital in ensuring fewer children grow up in abusive or neglectful homes, but also to help as many children as possible reach their full potential
What is the common assessment framework?
Tool designed to aid assessment of a child’s needs where more than one practitioner is involved in meeting needs
Designed for early intervention end of spectrum of need rather than for children who are at risk of significant harm
When is a child in need of protection?
Suffering or likely to suffer significant harm which is attributable to not receiving standard of care which it would be reasonable to expect a parent to give them
What are factors likely to affect parenting capacity?
Substance misuse, domestic abuse and parental mental health concerns can greatly increase the risk of an infant being neglected
What signs can indicate neglect?
Observing interactions between mother and child and baby’s behaviour in general
A mother who does not engage with her child and a baby who is unnaturally passive
What type of attachment is most likely in children that are abused?
Disorganised attachment in 80% child abuse cases
What does significant harm indicate?
Threshold that justifies compulsory intervention in family life in best interests of children
Local authority is under a duty to make enquiries (s47)
A care order or supervision order can be made by the court
What is Section 47 (Children Act 1989)?
Enquiry initiated by local authority if a child is:
Under an Emergency Protection Order or Police Protection Order
Has or is likely to suffer significant harm
Has contravened a court order
Enables a Child protection plan to be made
Professionals/other agencies have a legal duty to cooperate and provide/share information requested regarding the child and other involved adults
What is the aim of the child protection plan?
Ensure child is safe & prevent child suffering further harm
Promote child’s health & development
Support family to safeguard the child & promote their welfare
What are child protection registers?
Contain confidential details of children who are at continuing risk of physical, emotional, sexual abuse or neglect, and for whom there is a child protection plan
What is the purpose of Serious Case Reviews?
Identify lessons about how professionals and agencies work together to safeguard and promote the welfare of children
Ensure inter-agency working is improved as a result
What is a serious case review?
Following death or serious injury where child abuse is confirmed/suspected
Child protection issues of major public concern arise
Identify system failures
Identify areas for improvement
What did the Munro Review (2011)call for?
Called for more effective inter agency working and empowering social workers with skills and confidence to act in best interests of the child
What is the most common reason for someone to contact the NSPCC, for a child to be put on the child protection register or to be made subject to a child protection plan?
Neglect
What does the United Nations convention say on rights of the child?
Taking all appropriate measures to protect the child from all forms of
physical or mental violence, injury or abuse, neglect or negligent treatment, maltreatment or exploitation, including sexual abuse, while in the care of parents, legal guardians or any other person who has care of the child
What did the NSPCC study on maltreatment show?
1/10 young adults experienced serious neglect during their childhood
What is neglect?
Persistent failure to meet a child’s basic physical and/or psychological needs, likely to result in serious impairment of child’s health or development
How can neglect occur in pregnancy?
Maternal substance abuse
What can neglect involve?
Parent or carer failing to provide adequate food, clothing and shelter Failing to protect from physical and emotional harm
Failing to ensure adequate supervision (including use of inadequate care-givers)
Failing to ensure access to appropriate medical care
Neglect of, or unresponsiveness to basic emotional needs
Why is neglect hard to define?
Effects are cumulative, can be difficult for professionals to identify point at which to make referral
Co-exists with other forms of child maltreatment. Boundaries between abuse and neglect can become blurred
Which groups of children are vulnerable and particularly at risk of neglect?
Children born prematurely Children with disabilities Infants Adolescents Children in care Runaways Asylum-seeking children
What are factors linked to neglect?
Depression
Domestic violence
Substance use
Poverty
Why are children under 1 particularly vulnerable to neglect?
Older children who are not fed properly may be able to find food from other sources but for infants, a lack of nourishment can soon become life threatening
What sort of approach is essential in dealing with neglect cases?
Effective inter agency approach
What did the NSPCC study on maltreatment show?
1/10 young adults experienced serious neglect during their childhood
What is neglect?
Persistent failure to meet a child’s basic physical and/or psychological needs, likely to result in serious impairment of child’s health or development
How can neglect occur in pregnancy?
Maternal substance abuse
What can neglect involve?
Parent or carer failing to provide adequate food, clothing and shelter Failing to protect from physical and emotional harm
Failing to ensure adequate supervision (including use of inadequate care-givers)
Failing to ensure access to appropriate medical care
Neglect of, or unresponsiveness to basic emotional needs
Why is neglect hard to define?
Effects are cumulative, can be difficult for professionals to identify point at which to make referral
Co-exists with other forms of child maltreatment. Boundaries between abuse and neglect can become blurred
Which groups of children are vulnerable and particularly at risk of neglect?
Children born prematurely Children with disabilities Infants Adolescents Children in care Runaways Asylum-seeking children
What are factors linked to neglect?
Depression
Domestic violence
Substance use
Poverty
Why are children under 1 particularly vulnerable to neglect?
Older children who are not fed properly may be able to find food from other sources but for infants, a lack of nourishment can soon become life threatening
What sort of approach is essential in dealing with neglect cases?
Effective inter agency approach
What are key elements of the Human Fertilisation andEmbryology Act 2008?
Unlawful to store or use embryos or gametes except with a license granted by HFE Authority
Requirement for appropriate counselling (includes donated gametes)
Requirement to consider welfare of child born as a result of treatment, and of any other child who may be affected by the birth
Specification of who is legally recognised as mother and father of a child created by IVF
Prohibition of preferential use of gametes or embryos that carry a gene, chromosome or mitochondrial abnormality (or of a particular sex associated with an abnormality) involving significant risk that this child would have or develop a serious physical or mental disability, serious illness, or any other serious medical condition
What does the Human Fertilisation and Embryology Act 2008 Permit embryo testing for?
Does embryo have abnormality that will reduce risk of live birth
Risk that embryo will have an abnormality that will result in a serious disability or illness
Risk of gender related abnormalities that will result in a serious disability or illness, sex selection is permitted
Is embryo tissue compatible with a sibling who has a serious medical condition which could be treated with umbilical cord blood, bone marrow or other tissue of resulting child (specifically excludes whole organs under definition of tissue)
What ethical principles and values must be considered in IVF treatment with respect to autonomy?
Right to procreate?
Right to choose future child?
Right to make choices to benefit other children?
What ethical principles and values must be considered in IVF treatment with respect to duty of care?
Minimising harm
Balancing benefits and burdens
Harm/benefit to who? Future child, parents, existing children
What counts as a harm? physical harm, psychological harm
What ethical principles and values must be considered in IVF treatment with respect to societal values?
Fair use of resources (principle of justice): Impact on IVF and PIGD funding (setting limits/criteria)
Limits on individual autonomy: Harm to other individuals (selection for abnormal genes), Discrimination (effect on societal attitudes to specific groups, perception of disability), Respect for persons/human life
What is PIGD?
Pre implantation genetic diagnosis
What values do people hold with regard to technology and reproduction?
Complex and multi-faceted
Informed by personal circumstances and experiences
Broader cultural and social ideas
What is Spinal Muscular Atrophy?
After CF, SMA is most common potentially fatal autosomal recessive inherited condition in UK population
Neuromuscular condition affecting anterior horn cells in spinal cord
Leads to generalised and severe muscle atrophy
Divided into three clinical ‘types’ (Types I-III) each with different prognoses and ages of onset
Carrier frequency between 1 in 40 and 1 in 60 in general population
Two carrier parents have a 25% chance of having a child with SMA, a 50% chance of a child who is an asymptomatic carrier and a 25% chance of a child who is neither affected nor a carrier
What Genetic Testing is Available for SMA?
Adult Carrier Status Testing (over 18s)
Prenatal Genetic Testing (for families known to be at risk)
Pre-Implantation Genetic Diagnosis (for families known to be at risk)
SMA not currently screened for in routine antenatal screening, although there have been calls for this to be introduced
What are differences between Prenatal Testing and Pre-Implantation Genetic Diagnosis?
Prenatal testing: genetic testing of foetus in established pregnancy. Using Chorionic Villus Sampling (CVS) or amniocentesis between 10 and 15 weeks of pregnancy (depending on what is being tested for)
Pre-Implantation Genetic Diagnosis: alternative to prenatal testing. Genetic testing done at embryonic stage. Embryos created using IVF techniques and those identified as free of a particular condition are transferred to mother’s uterus for gestation
What are advantages and disadvantages of reproductive technologies?
Offer parents greater control over reproductive outcomes
Bring up dilemmas and areas where values of clinician and patients may clash (or patient(s) may be conflicted themselves)
What are the legal definitions of a child?
UN Convention on rights of the child: A child is
What are children’s rights?
Right to life, survival and development
Protection rights:(e.g protection from violence, kidnapping, child labour)
Participatory rights: when adults are making decisions that affect children, children have the right to say what they think should happen and have their opinions taken into account
What are children’s interests?
UNCRC: best interests of children must be primary concern in making decisions that may affect them
Children Act: In any decision made by Court (and by implication others with decision making responsibility) in relation to a child; welfare of child should be paramount concern
GMC 0-18 years: Guidance for all doctors. Assessment of best interests will include what is clinically indicated in a particular case
What does the GMC say should be considered with regards to children’s interests?
Assessment of best interests will include what is clinically indicated
Views of child or young person including previously expressed preferences
Views of parents
Views of others close to child or young person
Cultural, religious or other beliefs and values of child or parents
Views of other healthcare professionals involved in providing care
to child or young person, and other professionals who have an interest in their welfare
Which choice, if there is more than one, will least restrict child or
young person’s future options
Describe how the emphasis of children’s rights and interests changes into adulthood
Protection and participation in children
Becomes self determination and autonomous decision making in adults
What does the mental capacity act say on people aged over 16?
Person assumed to have capacity and therefore can consent (need to demonstrate lack of capacity to treat without the person’s consent)
Parental responsibility still in place if aged 16 or 17 therefore a parent can consent
What is Gillick competency?
For a particular decision, a young person must:
Show maturity and understand problem, implications, risks and benefits, consequences, alternative options, implications on family
Able to retain information, weigh pros and cons, communicate a reasoned decision about what their wishes are
