Children Looked After who do not wish Parents to have Information on their Case
Scope of this chapter
Some children/young people may express a wish for their parents not to be involved in, or provided with information on, aspects of their lives, such as Looked After Reviews or health matters.
Often, decisions will be based on an assessment of the competency of the child/young person to make these decisions. There is specific guidance in some areas, discussed in more detail in this chapter.
This can be a complex area and legal advice must be sought as necessary.
Related guidance
In general, it will usually be appropriate for parents of Looked After children to be involved in, and provided with information about, aspects of their child's life. For example, attending, and being sent minutes of, Looked After Reviews, and being kept informed about any health issues. However, some children/young people may state that they do not want their parents to be involved and/or to receive information, either in relation to specific issues or in general.
If there is a legal obligation to provide or withhold information, for example a court order, then that must be complied with.
Otherwise, deciding whether to agree to such a request involves an assessment of the competence of the child/young person to make the decision, and of whether such a move would be in their best interests. These can be complex issues, and legal advice must be sought as necessary. For example, an assessment may decide that a young person is 'Gillick competent' to make the decision, but that such a decision would not be in their best interests.
If a decision is made not to involve parents or provide them with information, then a detailed record must be kept, setting out the reasons for the decision. The decision must be kept under review. The competence/mental capacity of the child/young person can fluctuate at different times and is also decision-specific. They may be competent to make a decision at some times but not others, or on some matters but not others, or it may be in their best interests for their parents to receive information in relation to some issues but not others.
In general:
- If a child/young person is competent to make the decision that information is not to be provided to their parents, would such a decision be in the best interests of the child/young person? If so, it may be appropriate for a decision to be made that information will not be shared with parents, with each case being decided on its own facts;
- This must be kept under review; it is not a one-time decision;
- The reasons for the decision must be clearly recorded as must all reviews of that decision;
- If the child/young person is assessed as not being competent to make the decision, or if they are competent but it is assessed that such a decision would not be in their best interests, then legal advice should be sought.
The first issue to be assessed is whether or not the child/young person has the legal Capacity to make the decision that information is not to be shared with their parents.
Legal Capacity can fluctuate and, for a decision to be valid, it must be made by a person who has the legal Capacity to make that decision at that time, having a clear, fully-informed understanding of what it is they are consenting to. This will include the likely outcomes which may flow from the decision being made.
Section 3 of the Mental Capacity Act 2005 says that a young person (from the age of 16) is able to make their own decision if they can do all of the following four things:
- Understand information given to them;
- Retain that information long enough to be able to make the decision;
- Weigh up the information available to make the decision; and
- Communicate their decision.
For further information, see Mental Capacity Procedure.
Children and young people below the age of 16 years may be 'Gillick Competent' to make decisions.
- The determination of a child's competence must be decision-specific and child-specific;
- Just because the child lacks competence in one context does not mean they lack it in another;
- The assessment of competence must be made on the current evidence;
- The child should be of sufficient intelligence and maturity to:
- Understand the nature and implications of the decision and the process of implementing that decision;
- Understand the implications of not pursuing the decision;
- Retain the information long enough for the decision-making process to take place;
- Weigh up the information and arrive at a decision;
- Communicate that decision.
Note: 'Gillick competence' is concerned with determining a child's capacity more generally. 'Fraser guidelines' are used specifically to decide if a child can consent to contraceptive or sexual health advice and treatment.
If the child/young person is assessed as being competent to make the decision that information about them should not be shared with parents, then the next question to consider is whether or not this decision would be in their best interests.
This must be assessed on the individual facts of each case.
If a child/young person with Capacity objects to information being disclosed to their parents, then an assessment should be made, considering their reasons and weighing the possible consequences of not sharing the information against the harm that sharing the information might cause. This is a similar exercise to the 'public interest' basis for information-sharing and breaching confidentiality.
Young people aged 16 or 17 with mental Capacity are presumed to be capable of giving (or withholding) consent to their own medical assessment/treatment, provided the consent is given voluntarily and they are appropriately informed regarding the particular intervention. If the young person is capable of giving valid consent, then it is not legally necessary to obtain consent from a person with Parental Responsibility.
GMC Guidance Confidentiality and Sharing Information provides that where a child/young person with Capacity objects to information being disclosed (e.g. to parents), health care professionals should consider the young person's reasons and weigh the possible consequences of not sharing the information against the harm that sharing the information might cause. The young person's wishes are likely to be respected unless there is an assessment that this would not be in the young person's best interests.
A child of under 16 may be Gillick Competent to give (or withhold) consent to medical assessment and treatment, i.e. they have sufficient understanding to enable them to understand fully what is involved in a proposed medical intervention.
In some cases, for example because of a mental disorder, a child's mental state may fluctuate significantly, so that on some occasions the child appears Gillick Competent in respect of a particular decision and on other occasions does not.
If the child is Gillick Competent and is able to give voluntary consent after receiving appropriate information, that consent will be valid, and additional consent by a person with parental responsibility will not be required.
GMC Guidance Confidentiality and Sharing Information provides that where a child/young person with Capacity objects to information being disclosed [eg to parents], health care professionals should consider the young person's reasons and weigh the possible consequences of not sharing the information against the harm that sharing the information might cause. The young person's wishes are likely to be respected unless there is an assessment that this would not be in the young person's best interests.
Where a child under the age of 16 lacks Capacity to consent (i.e. is not Gillick Competent), consent can be given on their behalf by any one person with Parental Responsibility. Consent given by one person with Parental Responsibility is valid, even if another person with Parental Responsibility withholds consent. (However, legal advice may be necessary in such cases).
For further information on consent, see Department of Health and Social Care Reference Guide to Consent.
GMC guidance 0–18 Years: Guidance for All Doctors provides that, where children lacking Capacity refuse to consent to information being shared with their parents, but the doctor considers it necessary in the child's best interests for the information to be shared with the parents, then it is appropriate for the doctor to disclose information to the parents (and appropriate authorities). The doctor should record their discussion and reasons for sharing the information.
GMC guidance 0–18 Years: Guidance for All Doctors provides that healthcare professionals can provide contraceptive, abortion and sexually transmitted infections (STI) advice and treatment, without parental knowledge or consent, to young people under 16 (but over 13) provided that:
- The child/young person understands all aspects of the advice and its implications;
- The healthcare professional cannot persuade the young person to tell their parents or to allow the healthcare professional to tell them;
- In relation to contraception and STIs, the young person is very likely to have sex with or without such treatment;
- Their physical or mental health is likely to suffer unless they receive such advice or treatment; and
- It is in the best interests of the young person to receive the advice and treatment without parental knowledge or consent.
Children Act 1989 Guidance and Regulations Volume 2: Care Planning, Placement and Case Review provides that in exceptional circumstances a decision may be made to exclude parents from Looked After Reviews, if their attendance would not be in the best interests of the child. A written explanation of the reasons should be given, other arrangements should be made for their involvement in the review process, and details of this should be placed on the child's case record.
A failure to involve parents in Looked After Reviews at all, therefore, should only be made in exceptional circumstances, where this would be in the best interests of the child/young person and following legal advice.
In the interests of procedural fairness, the issue of parental attendance/involvement should be considered at each review, even if the decision reached is the same.
Last Updated: May 16, 2025
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