Discharge & Safety Planning Protocol for Lewisham Children & Young People

For Children and Young People who present and require a multi-agency response to address

their safeguarding and mental health needs)

July 2022

Partners to the Protocol

• Lewisham and Greenwich NHS Trust
• London Borough Lewisham, Lewisham Children’s Social Care
• South London and Maudsley NHS Foundation Trus

Purpose and Scope

The purpose of this protocol is to support multi-agency practitioners to make appropriate arrangements which support the safe and timely discharge of children and young people under 18 years of age.

The protocol is intended to ensure that all practitioners are clear about the steps to take to ensure that no child is discharged from hospital into an unsafe environment, where their health or well-being may be compromised or where further significant harm could occur.

The protocol applies to children and young people who require a multi-agency response to address their needs. A multi-agency response may be required due to:

• Serious or complex mental health needs requiring hospital admission;
• Self-harm or attempted suicide; or have expressed an intention to do either;
• Safeguarding and other welfare concerns cover situations where there is known or suspected neglect or abuse;
• Exploitation or neglect is known prior to admission, and this is recent or current, it would be expected that these children have an allocated social worker);
• The child/young person is looked after;
• Abuse, exploitation or neglect comes to light or is suspected during the hospital admission, Children subjected to Trafficking/FGM/ Modern Slavery;
• Ward Staff raise concerns about the parent/child interaction, Parent/Carer whose understanding or concern for their child is lacking. Children or young people in Police custody or due to be arrested upon discharge.
• Children or young people who have been the victim of physical or sexual assault;
• The Child/Young Person says they do not want to return home;
• This is not an exhaustive list and professionals should apply their professional judgement and consult with their named safeguarding leads if they have any concerns at all about a child/young person.

Principles

Any child or young person, who self-harms or expresses thoughts of self-harm or suicide, must be taken seriously and appropriate help and intervention, should be offered at the earliest point. Any practitioner, who is made aware that a child or young person has self-harmed, or is contemplating this or suicide, should talk with the child or young person without delay.

Most children who have been admitted with mental health needs will need on-going community care for a period of time after discharge. Follow up services for the young person’s mental health services could include, outreach sessions, liaison with local services, and outpatient therapy sessions and will be determined by the local CAMHS service following assessment.

Discharge planning is an essential part of care management in any hospital setting. It ensures that health and social care systems are proactive in supporting individuals and their families in the community. It needs to start early to anticipate problems, put appropriate support in place and agree service provision. Consideration should be given to the wider environment the child will be returning to, including siblings and other members of the household.

Children should not remain in hospital once they are well enough to leave. However, it is essential that when a child is in hospital and there are safeguarding concerns about the child, effective multi-agency planning between key professionals working with the child is undertaken before the child is discharged from hospital. Where there are safeguarding concerns, a referral must be made to Lewisham Children’s Social Care.

All agencies have a duty to share information and a joint responsibility to work together to protect children and promote their wellbeing and safety. Referrals to Lewisham Children’s Social Care must be made to MASH service who will determine the level of response by processing information through the multi-agency safeguarding hub.

Linked Policies and Procedures
The protocol should be read in conjunction with:

• The London Child Protection Procedures
• LGT Safeguarding Guideline for Paediatricians Algorithm for Safeguarding
• LGT Safeguarding Children & Young People Policy

The Full Protocol Content

Lewisham Discharge Protocol for Children and Young People - July 2022