8.1 Confidentiality, information sharing and consent are three key issues which arise in the provision of effective health care to looked after children. The main guidance summarises some important elements but should be read in conjunction with more detailed guidance issued by the Department of Health.
8.2 The Data Protection Act 1998 provides the legislative framework for matters to do with consent and information sharing. The NHS and local councils should have protocols in place which establish the framework for information sharing, both at intra and inter-agency level. Councils will have had Caldicott Guardians in place since April 2002.
8.3 A lack of protocols for inter-agency information sharing may have major implications for looked after children, as the transfer of accurate information about a child's health status and history is important in securing the right placement, and providing effective ongoing health interventions.
8.4 Obtaining consent to information sharing is therefore a vital first principle in promoting the health of looked after children. The Children Act 1989 sets out those who hold parental responsibility for a child and from whom consent needs to be sought. If children are competent to give consent for themselves, consent should be sought directly from them. The legal position regarding "competence"
differs for children aged over and under 16.
8.5 Foster carers and residential social workers who provide day-to-day care for looked after children are unlikely to hold parental responsibility. However, it is possible for whoever holds parental responsibility to give authority to someone who cares for the child on a regular basis to give consent in defined circumstances such as emergency treatment or routine treatments for coughs and colds.
8.6 It is important that consent issues are explicitly addressed in the health plan and the Placement Information Record.
8.7 The Framework for the Assessment of Children in Need and their Families (Department of Health, 2000) discusses consent and confidentiality issues at paragraphs 3.46 - 3.57.
Working Together to Safeguard Children (Department of Health, 1999) provides guidelines in cases where there are concerns that the child is or may be at risk of significant harm at paragraphs 7.2 - 7.36. Appendix 4 includes the Data Protection Registrars checklist for setting up information- sharing arrangements provided in the Integrated Children's System.
