Safeguarding children with complex medical needs who travel outside of the local authority or abroad

If you are the safeguarding leading for your organisation, please ensure that you disseminate and implement this policy throughout your organisation as per the following instructions. 

Health (CCGs, LTHT & LCH):

  • Ensure staff are made aware of the guidance via your internal communication channels
  • Make the Local Protocol available via your own websites with a link across to this page
  • Ensure this protocol is incorporated into training at the appropriate level and for the appropriate staff.

All other partner agencies, organisations and clusters:

  • Ensure staff are made aware of the guidance via your internal communication channels
  • Make the Local Protocol available via your own websites with a link across to this page.

When the above has been completed please update your Organisational Safeguarding Assessment to provide assurance to the Policy and Procedures Sub Group that this local protocol has been disseminated and implemented.


Introduction

What is this guidance? This guidance provides all agencies with a clearly defined procedure, addressing the management of situations where parents wish to take children with complex medical needs out of the local authority area either to another local authority area or abroad, either temporarily or permanently and where it is considered that this may place the child at significant risk.

Why do we need this guidance? This guidance provides all agencies with clear instructions about how to manage situations, when travelling to another local authority area / abroad may put a child at significant risk, and where safeguarding concerns may or may not pre-exist.

What is the purpose of this guidance? All agencies need to understand their responsibilities in the management of situations where parents wish to take children with complex medical needs to another local authority area / abroad, and where this may place the child at significant risk.

Who is this guidance aimed at? This guidance is aimed at practitioners working with families whereby there is a child or children with complex needs, either regularly or occasionally, and there is an intention to travel to another local authority area or abroad. These practitioners will come from a wide range of agencies both statutory and non-statutory.

When reading this guidance practitioners should also be mindful that children with complex needs may also travel abroad in relation to undergoing Female Genital Mutilation (FGM), and where this is known or suspected the FGM pathway should be followed.

The key contact for comments about this policy is: LSCP.Info@leeds.gov.uk 

Definitions 

When this guidance speaks of children with complex medical needs there is no agreed definition among policymakers or practitioners. This term, however, includes children who have a disability, children with special educational needs and children with ‘life-limiting’ or ‘life-threatening’ conditions.

Responsibilities 

All agencies must work in accordance with the Leeds Safeguarding Multi-Agency Policies and Procedures, and local guidelines, in relation to any safeguarding concerns they have. 

The LSCP takes responsibility for this guidance and approves its use.  

When information about the intention of the family with child/ren with complex medical needs to travel to another local authority area or abroad is brought to the attention of any particular competent agency it is the responsibility of that agency to identify and inform the lead clinician for the child. The lead clinician must then assess the risk involved.

Risk Assessments 

All agencies involved in a child’s care must consider the implications of any forthcoming travel and discuss this with the family and other key practitioners. A risk assessment for the proposed journey must be made and clearly documented in the child’s records, stating the views and wishes of the family. The Safeguarding Children with Complex Medical Needs who Travel Outside of the Local Authority or Abroad – Risk Assessment Template (available on request from LSCP.Info@leeds.gov.uk ) can be used to aid conversations, identify and record risk.

If the outcome of the risk assessment clearly identifies that there is a significant risk of harm to the child/ren as a result of the proposed journey abroad, and the family are choosing not to make appropriate plans for travel with the child/ren in line with the health professionals advice, then immediate contact with the Front Door Safeguarding Hub must be made to Children Social Work Services indicating that the journey places the child/ren at the risk of significant harm. The practitioner should reference this guidance when contacting Children Social Work Services.

If the child/ren has an allocated Social Worker they should be contacted and a strategy discussion / meeting should be held. The practitioner should reference this guidance when contacting the Social Worker.

Should a practitioner become aware that a child/ren with complex needs has travelled to another local authority area or abroad and a risk assessment has not been undertaken, the risk assessment should be taken retrospectively. If the outcome of the risk assessment is that there are risks for the child/ren to travel immediate contact with the Front Door Safeguarding Hub must be made to Children Social Work Services indicating that the journey places the child/ren at the risk of significant harm. The practitioner should reference this guidance when contacting Children Social Work Services and identify the risks based on the retrospective risk assessment.

Safeguarding Children with Complex Medical Needs who Travel Outside of the Local Authority or Abroad – Workflow Process  

If you are working with a family with child/ren who have complex health needs who wish to travel to another local authority area or abroad with the child/ren, either temporarily or permanently then you must undertake the following steps:

a) All practitioners involved in the management of the complex needs of the child/ren must consider the implications of the forthcoming travel and discuss the same with the family and other key practitioners, by phone or a meeting. These discussions should be reflected in the child’s records.

b) A risk assessment of the proposed journey is made in conjunction with the child’s clinician (or appropriate health care professional) which demonstrates consideration to the following:

  • Length of time out of area / the country
  • Area / country that is to be visited and availability of appropriate health care services should they be required
  • Preparation by the family in relation to the journey – this should include their understanding of how to access health care; the need for health insurance; equipment / medication needed for the duration of the journey and any additional feeding supplies
  • Mode of transport and how the child is going to be managed during the journey
  • Prior arrangement with the local health care in their destination
  • Families understanding of risk and views.

The decision making involved in the risk assessment must be clearly documented.

Where the outcome of the risk assessment does not identify any risk to the safety and welfare of the child/ren, no further action is required.

Where the outcome of the risk assessment clearly identifies that there is a significant risk of harm posed to the child/ren with the proposed journey, and the family are choosing not to make appropriate plans for travel with the child/ren, in line with the health professionals advice, the practitioner carrying out the risk assessment MUST; immediately contact Children Social Care Services indicating that the journey places the child/ren at risk of significant harm, identifying what the risks to the child is and any previous actions taken i.e. liaison with other practitioners and an over view of the risk assessment. The practitioner should reference this guidance when contacting Children Social Work Services.

If the child/ren has an allocated Social Worker they should be contacted and a strategy discussion / meeting should be held. The practitioner should reference this guidance when contacting the Social Worker.

Should a practitioner become aware that a child/ren with complex needs has travelled abroad and a risk assessment has not been undertaken, the risk assessment should be taken retrospectively. If the outcome of the risk assessment is that there are risks for the child/ren to travel abroad immediate contact with the Front Door Safeguarding Hub must be made to Children Social Work Services indicating that the journey places the child/ren at the risk of significant harm. The practitioner should reference this guidance when contacting Children Social Work Services and identify the risks based on the retrospective risk assessment.

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