CHAPTER 20: Hospital Discharge Procedure

Every child about whom there are child protection concerns must have clearly documented discharge-planning arrangements. These will be drawn up at a Discharge Planning Meeting. This meeting can be actual or virtual by telephone.

The Consultant or Senior Doctor will attend the meeting.  This meeting will be chaired by a Children's Social Care representative who will complete and hold a record of the Record of Discharge Plan Form.

To enable the Consultant /Senior Doctor to be present for an actual meeting, other parties will need to give notice and offer different dates/times within reason. However this must not be detrimental to the planning for the child. Meetings should be held at the hospital when ever possible.

A record of the meeting will be recorded on the Record of Discharge Plan Form.  All professionals involved will sign and retain a copy immediately following the meeting. This should be transferred electronically or by fax for a telephone discharge planning meeting. The original to be kept with Children's Social Care and a hard copy to be put in the patient's clinical notes.

Scope

This procedure applies whenever there are existing child protection concerns about an unborn baby who is admitted to the Neonatal ward, or concerns are identified following admission.

General

Social Workers needing to liaise with the Neonatal Unit should liaise with the Senior Neonatal Nurse or with the Named Nurse for Child Protection

Where a baby is admitted subject to an unborn Child Protection Plan

1. The Neonatal Unit (NU) will inform the Referral and Assessment Team or named social worker by telephone of admission. If out of hours, this will happen first thing the next working day. This will be followed with a faxed written discussion / referral as appropriate.  If urgent action is required out of hours the hospital will contact the Emergency Duty Team.
2. Within 24 hours (unless it is the weekend) Children's Social Care will inform the Nurse in Charge of the NU of the name of the allocated social worker.
3. Following this the Named Nurse for Child Protection or Senior Neonatal Nurse will provisionally agree a date for a Discharge Planning Meeting with the Consultant, social worker and social worker's manager. This should be at least 48 hours prior to discharge.
4. Within 7 days of the birth the Consultant, either directly or through the Named Nurse for Child Protection or the Senior Neonatal Nurse, will contact the allocated social worker to determine if an early Core Group meeting should be convened to update the Child Protection Plan.
5. Information sharing between the hospital and Children's Social Care will be ongoing throughout. Parents need to be made aware of this by the hospital and Social Care.
6. If the baby is ready for discharge prior to the agreed Discharge Planning Meeting, every effort will be made by the Hospital and Social Care to bring this meeting forward. If this is not possible a telephone Discharge Planning Meeting will need to occur between Social Care and the Neonatal Unit; this may involve other agencies.  If the Discharge Planning Meeting is conducted using the telephone, the Record of Discharge Plan Form will be transferred electronically or by fax between the hospital and Social Care immediately following the meeting and community health services will be sent a copy within 48 hours of the meeting.
7. If the circumstances of a Child Protection Plan change whilst the child remains in hospital it may be necessary to have a Review Discharge Planning Meeting. This should be at least 48 hours prior to discharge.

Where a baby with no existing Child Protection Plan is referred to Social Care directly from the Neonatal Unit (NU) with Child Protection concerns

1. The NU will gather information from Children's Social Care Referral and Assessment Team (see Contact Details for Referrals) as soon as concerns are noted in order to inform the Consultant's decision about making a referral to the Emergency Duty Team or Children's Social Care (depending on urgency).  Any telephone referral will be supported by a written referral within 48 hours.
2. It may be necessary to hold a Child Protection Strategy Meeting arranged by Children's Social Care at short notice. This will need to be arranged and coordinated with the Consultant with due consideration for clinical duties.
3. Ideally the Strategy Meeting should take place at the hospital.  All professionals involved will sign and retain a copy of the actions agreed at the meeting immediately following the meeting.
4. Within 48 hours the Senior Neonatal Nurse or the Named Nurse for Child Protection will contact Children's Social Care to share information in relation to clinical progress and any other significant information in regard to the child and or family. Confirmation of this information will be sent by fax to Children's Social Care.
5. If there are no concerns agreed from either agency in relation to welfare or child protection, there will be no further action from Children's Social Care - Children's Social Care will confirm this to the hospital in writing by fax.
6. If both agencies agree that there are still child protection concerns a Discharge Planning Meeting will be organised (see above).  If welfare concerns that do not meet the threshold for Social Care involvement are identified, a Common Assessment will be undertaken (see Welfare Concerns above).