Policy responses and statements
- Name of organisation:
- Scottish Executive Health Department
- Name of policy document:
- Joint Inspection of Services for Children and Inspection of Social Work Services: Joint Inspections Bill and protocol progress
- Deadline for response:
- Response sent to Scottish Executive on 19/01/06 (no specific deadline stated)
Background: The Scottish Executive has written to the College as a follow-up to their letter of 26 October 2005, as they wish to update RCPE on the progress of the legislation and the associated documents.
The Bill has just finished the second stage review by the Education Committee and will proceed to the third stage, currently planned for the 19th January 2006. The Education Committee’s report following its evidence review in the Bill’s first stage meeting can be found here.
Following the extensive and helpful input to the process and the provision of evidence to the Education Committee, the Bill and the protocol have been revised. The Bill as amended can be found here.
The Bill has been amended to reference the protocol. The protocol is now solely for the joint inspection of child protection services and will be tested after the first four inspections.
The Executive enclosed the revised protocol and stated that any comments would be welcomed.
COMMENTS ON
SCOTTISH EXECUTIVE HEALTH DEPARTMENT
JOINT INSPECTION OF SERVICES FOR CHILDREN AND INSPECTION OF SOCIAL WORK SERVICES: JOINT INSPECTIONS BILL AND PROTOCOL PROGRESS
The Royal College of Physicians of Edinburgh is pleased to respond to the Scottish Executive on its request for comments on the Joint Inspection of Services for Children and Inspection of Social Work Services: Joint Inspections Bill and protocol progress.
Summary
The College welcomes the revision in the draft protocol, particularly the inclusion of legal safeguards for accessing health information and providing Parliamentary scrutiny and consultation for the protocols.
In using the principle of implied consent for access to records, the process will be much more acceptable to patients and health professionals. It will still be important to evaluate the views of the patients and carers about the acceptability of the process, and on the particular point that non health professionals may be accessing health records.
The College continues to prefer the restriction of access to health professionals whenever possible. This would allow better interpretation and understanding of what is written, and allow fair comparison with other practice.
It is important that health professionals understand the implications of the new regulations, particularly given the speed of development
Specific comments are offered as follows:
Implementing confidentiality requirements
Confidentiality statements will need to be changed before inspections can begin. This would have to be done in a clear manner, describing the records it potentially applies to, the process of being sent a leaflet in advance by Her Majesty’s Inspectorate of Education (HMIE), and the process of opt-out. Many teenagers access adult services, and these services are all potentially included. It is not clear if the statement refers only to inspection of child protection or children’s services.
For the leaflet sent out by inspection teams to those involved with an inspection, clarity will be needed about who receives this. Will this go to young people over 12 only? Does the family constitute all members or the person with parental responsibility? The legal position on who is competent to give or withhold consent to access to health information will need to be closely adhered to. HMIE may need to discuss this with relevant practitioners. The holder of a health record eg hospital or GP may need evidence that the relevant persons have been notified.
The leaflet will need to clearly indicate that non health professionals may be involved in the process, including the police, and that confidentiality may be broken for the purposes of criminal investigation. This will also need to describe the records which may be accessed, as above. Implied consent should still be informed consent.
On sending the leaflet to those involved in an inspection, patients may request partial access to records only, and thought may be needed as to whether this can be accommodated where practicable.
Implied Consent
If it is considered in the best interests of the child to proceed without implied consent, will there be notification to the persons concerned that this will occur? Also, the holder of the record or health professional may need evidence of the justification in taking this decision. From the wording given it appears that this decision would be taken where there is some risk to the individual child rather than for the more general purpose of completeness of the inspection.
Resource Implications
In a recent multi-agency audit in child protection in Fife, cases were tracked and this was done by allowing senior professionals from within their own relevant agency to extract the information required under strict guidelines. This approach has been successful and there was not evidence of bias in the results achieved in this way. This model may have provided an alternative, sustainable means of achieving the type of investigation which is desired. However the College understands that the time taken to achieve such a detailed audit was considerable and exceeded the time expected. The timescales in the protocol appear optimistic. It may therefore be more cost effective for at least one of the inspectors to be a health professional.
Copies of this response are available from:
Lesley Lockhart,
Royal College of Physicians of Edinburgh,
9 Queen Street,
Edinburgh,
EH2 1JQ.
Tel: 0131 225 7324 ext 608
Fax: 0131 220 3939
[19 January 2006] |
