Child Protection Case Conferences

There are a large number of people who may be invited to attend a child protection case conference:

• Independent Reviewing Officer (IRO) - the IRO chairs the meeting
• Parents, carers and their representatives
• The child or children – depending on age and situation
• Social worker
• Family support workers
• Legal representatives for family and or social care
• Health representatives, for example, GP, health visitor, midwife, school nurse, paediatrics, mental health
• Education
• Police or Probation
• Substance misuse workers and youth justice workers
• Young carers suppport worker

Every person in attendance has an important active role to play. The conference provides a forum for professionals from all agencies involved with the family to meet and discuss concerns about the care of an unborn baby, infant, child or children based on information gathered in the course of the child protection investigation.

The child protection case conference (CPCC) will focus on the child's circumstances, what they mean for the child's lived experience, what parental/carer behaviours are causing harm or likely to lead to harm, whether the parents understand this and what needs to change.

If it is decided that harm has occurred, or there is a risk of harm, the conference will determine whether the parents or carers have capacity to prevent future harm and to meet the child’s emotional, physical and developmental needs. If a decision is made to make the child subject to a child protection plan (or equivalent in Northern Ireland, Scotland or Wales), then this will state the category of maltreatment and decisions on what needs to happen, to secure agreed outcomes for the child and family.

In summary the plan should reflect:

• Factors that need to change to achieve the outcomes;
• Assessed needs/risks and priorities of the plan;
• Key people involved, agreed tasks and responsibilities;
• Timescales for action;
• Support and resources required to take the plan forward and a process for monitoring of the plan.

The aim of a child protection plan is to improve the child's daily life and address the impact of adverse parent/carer behaviours (or other risks) on the child's development and needs as well to ensure their long-term well-being.

If a child becomes subject to a child protection plan, a core group is established, and this will meet regularly to monitor the plan. Review child protection conferences will be arranged (initially after three months, and then a further six months) until a decision can be made that the child can be removed from a plan, normally with a 'step-down' to continued support through a Child in Need plan. If serious risk remains, the local authority may instigate family court proceedings, and the child becomes 'looked after' (see section on Looked After Children).

GPs will receive case conference meeting notes with details of decisions made. A child protection plan may require GPs and practice staff to undertake specific actions (e.g. to ensure immunisations as per schedule). Concerns about compliance with any health care plans should be communicated to the child's social worker at the earliest opportunity, as this may be an important sign of increasing risk to the child.

RCGP advice on the processing and storing of safeguarding information, such as meeting notes and reports from case conferences, can be found in Section 3. This guidance includes advice on coding.

GP Attendance at Case Conferences

GPs should attend the conference if at all possible. However, like all statutory agencies, primary care has increasing demands on it and less and less resources to meet those demands. The ability for practices to attend case conferences depends on many factors such as staffing, clinical demands, locality and proximity to where the case conferences are held, and how much advance warning practices are given about the case conference.

The GMC (General Medical Council) in their guidance 'Protecting Children and Young People' states:

• If you are asked to take part in child protection procedures, you must cooperate fully. This should include going to child protection conferences, strategy meetings and case reviews to provide information and give your opinion. You may be able to make a contribution, even if you have no specific concerns (for example, general practitioners are sometimes able to share unique insights into a child's or young person's family).
• If meetings are called at short notice or at inconvenient times, you should still try to go. If this is not possible, you must try to provide relevant information about the child or young person and their family to the meeting, either through a telephone or video conference, in a written report of by discussing the information with another professional (for example, the health visitor), so they can give an oral report at the meeting.

Practice child safeguarding policies and procedures (refer to Section 3 of the toolkit) should set out processes for ensuring that requests for case conference reports and attendance are handled in a timely and effective way.

Here are a few suggestions to help practices manage case conference attendances and timely report writing:

• The date for the next child protection conference should always be in the case conference minutes that practices should receive – practices can put that date into the practice diary as soon as they receive the minutes, set up a reminder for when the report is due and if possible rota the most appropriate GP to attend.
• Having a dedicated safeguarding administrator who can manage the case conference minutes, make the diary entries and set up reminders for when the report is due.
• Offer to hold the conference in surgery premises so you can attend, even if it isn't for the whole conference.
• Liaising with social services to enable the practice to be invited to all strategy discussions which should result in the GP receiving the minutes from the strategy meeting and the date of any subsequent initial child protection conference. This will allow for more time for the GP to complete the report for the conference.