Policy for the Discharge and transfer of children and young people ...
Policy for the Discharge and transfer of children and young people ...
Policy for the Discharge and transfer of children and young people ...
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
Appendix 5. Self <strong>Discharge</strong> PathwayIf a parent chooses to take <strong>the</strong> discharge <strong>of</strong> <strong>the</strong>ir child against medical advice, staff shoulddiscuss this with <strong>the</strong> parents, establishing <strong>the</strong>ir reasons <strong>and</strong> explaining <strong>the</strong> risks this could haveon <strong>the</strong>ir child’s health.All discussion should be clearly documented in <strong>the</strong> child’s health record.If <strong>the</strong> parent still requests discharge, <strong>the</strong> appropriate doctor must be contacted immediately inorder to review <strong>the</strong> child <strong>and</strong> fur<strong>the</strong>r in<strong>for</strong>m <strong>and</strong> explain any associated risks to <strong>the</strong> parent.If <strong>the</strong>se interventions fail to deter <strong>the</strong> parent, <strong>the</strong> impact on <strong>the</strong> child’s welfare must be assessedby nursing <strong>and</strong> medical staff, <strong>and</strong> safeguarding procedures should be followed if leaving <strong>the</strong>hospital would place <strong>the</strong> child at significant risk <strong>of</strong> harm.Safeguarding procedures should also be followed if <strong>the</strong> child is subject to a protection plan or isa child in Care.If <strong>the</strong> child is removed against medical advice, <strong>and</strong> <strong>the</strong>re are significant safeguarding concerns,<strong>the</strong> Trust security department should be contacted to assist, <strong>and</strong> an immediate referral toChildren’s Social Care must be made.Staff should not place <strong>the</strong>mselves at risk in trying to prevent <strong>the</strong> parent leaving with <strong>the</strong> child.If <strong>the</strong>re are no safeguarding concerns, <strong>and</strong> <strong>the</strong> child will not be at significant risk <strong>of</strong> harmfollowing discharge, <strong>the</strong> parent should be asked to sign a ‘<strong>Discharge</strong> Against Medical Advice’<strong>for</strong>m.If <strong>the</strong> parent refuses to sign, this must be fully documented in <strong>the</strong> child’s health record.The parent should be advised to contact <strong>the</strong>ir G.P. practice <strong>for</strong> ongoing care.If possible normal discharge procedures should be followed with regard to giving advice,arranging <strong>for</strong> medication etc.Whenever clinically indicated, appropriate outpatient follow-up arrangements should still be<strong>of</strong>fered/made when a child/parent discharges against medical adviceA <strong>young</strong> person assessed as having capacity to underst<strong>and</strong> <strong>the</strong> consequences <strong>of</strong> taking <strong>the</strong>irown discharge against medical advice may wish to take <strong>the</strong>ir own discharge. In this case staffshould try to dissuade <strong>the</strong> patient from doing so.If this is unsuccessful <strong>the</strong> <strong>young</strong> person’s parents must be notified <strong>and</strong> <strong>the</strong> patient should beasked to sign a ‘<strong>Discharge</strong> Against Medical Advice’ <strong>for</strong>m. They should be advised that o<strong>the</strong>rrelevant pr<strong>of</strong>essionals (e.g. G.P., Social Worker, School Nurse) will be in<strong>for</strong>med <strong>of</strong> <strong>the</strong>irdecision.Without exception, <strong>the</strong> child’s GP <strong>and</strong> Health Visitor/School Nurse <strong>and</strong> any o<strong>the</strong>r keypr<strong>of</strong>essionals involved in <strong>the</strong> child’s care must be in<strong>for</strong>med at <strong>the</strong> earliest opportunity, preferablywithin 24 hours, that <strong>the</strong> child has left/been removed from <strong>the</strong> ward.If a parent expresses that <strong>the</strong>y wish to discharge <strong>the</strong>ir child due to a complaint or concern aboutcare, every ef<strong>for</strong>t must be made to address <strong>and</strong> resolve <strong>the</strong> complaint/concern with reference to<strong>the</strong> Trust Complaints’ <strong>Policy</strong>, to enable care to continue<strong>Policy</strong> <strong>for</strong> <strong>the</strong> discharge <strong>and</strong> <strong>transfer</strong> <strong>of</strong> <strong>children</strong> <strong>and</strong> <strong>young</strong> <strong>people</strong> from child healthPage 22 <strong>of</strong> 38