10.2 Resolving Professional Disagreements

SCOPE OF THIS CHAPTER

The scope of this document relates to all individuals who work as ‘professionals’ with children, young people and carers in Norfolk whether they are working in a paid or voluntary capacity in the statutory or voluntary sector.

Professional disagreements should be seen as part of ‘healthy’ professional working relationships and practitioners should be encouraged to give or receive professional challenge in a constructive and positive way. The protocol is to assist practitioners in finding a resolution when they have a professional disagreement in relation to the safeguarding of children and young people. For disputes within agencies, in house procedures should be followed. This protocol relates to the resolution of differences between agencies.

1. Introduction

Working with children and families can be difficult and complex and involves dealing with uncertainties and making important, complex decisions on the basis of incomplete information to demanding timelines in often changing, hostile and stressful circumstances.

In recognition of the many challenges around this complex work, the Norfolk Threshold Guide embeds an approach that facilitates early discussion, conversation and dialogue between professionals when there are emerging worries about children. The approach recognises that no one worker holds all the information needed to achieve a comprehensive and balanced analysis. It is only by information sharing on a multi-agency basis that a sound evidence base can be established and decisions made about ‘thresholds’ which indicate the levels of professional involvement and / or intensity of support required to meet children’s needs (NSCB 2016).

In most circumstances, there is mutual agreement between professionals working together to safeguard children and young people in Norfolk. However, when there are professional concerns or disagreements over another professional’s decisions, actions or lack of actions in relation to a referral, an enquiry or assessment / intervention, the repercussions can be extremely serious for the children and young people concerned.

Problem resolution is an integral part of professional co-operation and joint working to safeguard children and it is important to:

  • Ensure professional disputes do not put children at risk or obscure the focus on the child.
  • Ensure professional disputes between agencies are resolved in a timely, open and constructive manner.
  • Identify problem areas in working together where there is a lack of clarity and to promote resolution via amendment to protocols and procedures.

The safety of the child or children is the paramount consideration in any professional disagreement and any unresolved issues should be escalated with due consideration to the risks that might exist for the child.

There may also be occasions when concerns about professional practice may be raised in respect of an individual, or group of individuals, or where there may be concerns about the response of a professional colleague to a situation involving actual or likely harm to a child.

The first and key principle should be that it is everyone’s professional responsibility to problem solve and come to an agreed resolution at the earliest opportunity, always keeping in mind the child’s safety and welfare.

All agencies are responsible for ensuring their staff are competent and supported to escalate appropriately intra and inter-agency concerns and disagreements about a child’s wellbeing. Agencies / professionals should not be defensive if challenged and should always be prepared to review decisions and plans with an open mind and revise decisions in light of new information. Differences in status / knowledge and experience may affect individuals’ ability to challenge and all professionals should seek advice and support from the safeguarding lead in their organisations.

2. Examples of Professional Disagreement:

  • Dispute at the point of referral due to differing opinions about thresholds.
  • A professional is concerned about the action / inaction of another professional in relation to a child or family member.
  • Disagreement about decision making and a course of action to be taken for example whether there should be a Child Protection Case Conference or whether a case should be closed.
  • Dissent at / arising from a Child Protection Case Conference. (see Appendix 1)
  • Dissent arising from the implementation of a CP Plan.
  • Disagreement over information sharing.
  • Disagreement over an assessment and differences around professional analysis and joint decision making.
  • Disagreement over the provision of services.
  • An agency or professional is concerned there is drift in a case.
  • Disagreement arising over one or more professionals colluding with the parents / carers and over identification with parental issues rather than focusing on the child’s welfare.

3. Professional Resolution and Escalation Process (see Appendix 2 – Flow Chart):

The principles of Signs of Safety (SoS) should be adopted in the management of all professional disagreements. All escalations should be recorded using the SoS Template (Appendix Three) to ensure the process is transparent and robust. Each stage of the escalation process should be executed within five working days or a timescale which protects the child (whichever is less). A clear record should be kept at all stages, by all parties. In particular this must include written confirmation between the parties about an agreed outcome of the disagreement and how any outstanding issues will be pursued.

Escalation routes for individual agencies’ is outlined in Appendix Four.

Escalation can be via telephone, face to face meeting or teleconference calls

Stage One: Direct Professional to Professional Discussion.
Differences of opinion or judgement should be discussed between frontline professionals to achieve a shared understanding and agree a resolution and plan. If professionals are unable to resolve differences within time scale, the disagreement should be escalated to stage two.

Stage Two: Direct First Line Manager to First Line Manager Discussion.
If stage one fails to resolve the issue then each professional should discuss the issue with their first line manager or safeguarding supervisor/Named Nurse. The first line manager should then liaise with the other professional’s line manager in an attempt to reach a resolution. If a resolution cannot be reached, the disagreement should be escalated to stage three.

Stage Three: Senior Manager to Senior Manager Discussion.
If concerns remain unresolved at this stage a senior manager to senior manager discussion should take place to discuss the concerns and convene jointly a SoS Resolving Professional Disagreements Meeting with the practitioners and first line managers. Advice and support should also be sought from the designated safeguarding children professional within their agency.

Stage Four: Norfolk Safeguarding Children Board (NSCB) Resolution Panel chaired by the NSCB Independent Chair.

In the unlikely event that the issue is not resolved by the steps described above and/or the discussions raise significant policy issues, the matter should be referred urgently to the NSCB for resolution. This should include forwarding a written account of the dispute and what attempts have been made to resolve this. The Chair of the NSCB who will convene a resolution panel made up of senior representatives from the statutory and voluntary organisations within the NSCB.

4. Learning from Professional Disagreements and Escalation:

When the issue is resolved, any general issues should be identified and referred to the agency’s representative on the LSCB for consideration by the relevant LSCB sub-group to inform future learning.
At any stage in the process, it may be appropriate to seek expert advice to ensure resolution is informed by evidence based best practice.
It may also be useful for individuals to debrief following some disputes in order to underpin and support continuing effective working relationship.

5. Freedom to speak up (Whistle Blowing):

Staff, through fears about repercussions, may find it difficult to raise child protection concerns about colleagues or managers. Senior managers in each organisation should ensure the provision of a well-publicised ‘whistle blowing’ or ‘speak out’ procedure that provides alternative methods of reporting concerns. A leaflet should also be available to publicise the whistle blowing procedure in each partner agency.

Appendix 1 – Dissent at/arising from a Child Protection Conference
Appendix 2 – Flow Chart for Managing Escalation Process
Appendix 3 – Signs of Safety Template
Appendix 4 – Escalation Routes for Individual Agencies

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