Resolving Professional Difference of Opinion and Escalation

Safeguarding children and promoting their welfare is a responsibility shared by all  organisations who work with children and families and often requires a multi-agency collaborative approach. This includes appropriate information sharing and working to multi-agency agreed decisions/plans. Occasionally situations arise when practitioners within one organisation may believe or consider that the actions, inactions or decisions of another do not adequately safeguard a child. Learning from local and national Serious Case Reviews/Child Safeguarding Practice Reviews has highlighted the need for a clear escalation policy that all practitioners can feel confident to use.

At no time must a difference of opinion detract from ensuring that the child is safeguarded. The child's welfare and safety must remain paramount throughout and it is recognised that practitioners on either side of the discussion may  feel they are acting in the child's best interest. Differences of opinion, and effective challenge are welcome as these healthy discussions can lead to a more robust solution.

Practitioners in all agencies, including schools, have a duty to act proactively and assertively to ensure that a child's welfare is the paramount consideration. The Local Safeguarding Partners recognise that good practice will sometimes include constructive challenge between practitioners. This difference of opinion could become evident in day-to-day practice or discussion, or during multi-professional meetings. Therefore, when a professional has a difference of opinion to that of another professional on the grounds of the child's welfare they should work with the same professional  to first seek to understand the rationale for the decision. If concern still exists for the child's safety and wellbeing after an initial discussion, the practitioner concerned should constructively challenge the practice using this policy. 

This policy provides all practitioners working with children and families, including Designated Safeguarding Leads and managers with the means to raise concerns they have about decisions made by other practitioners or agencies by:

• Holding solution focussed discussions to avoid a situation or resolve a difference of opinion at the earliest opportunity;
• Ensuring a resolution between agencies is found quickly and openly;
• Identifying problem areas in working together where there is a lack of clarity and promote resolution via amendments to multi-agency protocols and procedures.

It is critical that organisations and senior leaders encourage practitioners to hold constructive discussions with their colleagues to find the best solution for the child(ren), and to escalate if it has  not been possible to reach an agreement on this. Opportunities for reflective supervision are critical to enable practitioners to have the space to talk through any differences of opinion, and to feel supported to be able to escalate confidently.

Examples of potential areas where partnership colleagues may have a difference of opinion include, but are not limited to: 

• A referral is not considered to meet the threshold for assessment or involvement by Children's Services;
• Children's Services ask the referrer to gather further information before a referral is progressed;
• There is a difference of opinion as to whether the child protection procedures should be invoked;
• There is a difference of opinion between Children's Services and the Police as to whether or not investigations/enquiries should progress under a single or joint agency basis;
• There are different views over the sharing of information and/or provision or services;
• There is a difference of opinion over the outcome of any assessment and whether the appropriate action plan is in place to safeguard and promote the welfare of the child;
• There is a difference of opinion over the roles and responsibilities of the different organisations involved;
• There are concerns relating to the action or lack of action in progressing plans;
• There is a difference of opinion over a decision by any agency working with the child to close the case and cease involvement with the family.

Most differences of opinion can be resolved through discussion and negotiation. The practitioners involved should attempt to resolve differences through discussion and find a solution for the child within one working day. If they are unable to do so, the practitioner(s) must report them to their line manager / team manager. This is recognised as day-to-day practice to enable a coordinated and consistent multi-agency response to find a solution.

In cases where a concern is ongoing, or progress is slow, it may be useful to instigate a professionals meeting to understand the risks and the lived experience of the child. Most issues or concerns can be resolved through discussion by the relevant line managers / team manager. This contact should take place within twenty-four hours. The purpose of this contact is to review the available information and to resolve the concern. It may be helpful to consider the involvement of the designated or named professional at this stage.

Any action agreed should be recorded and shared with relevant practitioners and managers and saved on the child's file held by each involved agency.

Where it is not possible to resolve the matter at frontline / team manager level, the professionals involved are expected to seek solutions at the next managerial level or appropriate safeguarding lead, between the service/organisations concerned and within 24 hours. This is a regular occurrence and should be seen as standard practice to support resolutions for the child.

The issue must then be considered at that management level, with direct communication taking place with the designated professional or named professional for safeguarding within the individual agency that raised the matter.

Any action agreed should be fed back immediately to the relevant practitioners involved, and the detail of the escalation and agreements reached should be recorded on the child's file held by each involved agency. The details should also be shared with the Safeguarding Children Partnership Business Manager as evidence of escalation.

On the rare occasion that the difference of opinion cannot be resolved at stage two, the matter must be referred to a senior manager with responsibility for safeguarding who will consider the matter with an equivalent level of management within the concerned agency within 24 hours.

The purpose of escalating the issue to this level is to reach a position where differing professional opinions are thoroughly considered and any gaps in communication are addressed. The aim is to facilitate a constructive dialogue that clarifies the matter. Ultimately a consensus or agreement must be reached among the agencies involved, prioritising the best interests of the child over any professional disagreements or deadlock.

Any agreed actions should be communicated immediately to the relevant practitioners involved, and the details of the escalation and agreements reached must be recorded on the child's file maintained by each involved agency. The details should also be shared with the Safeguarding Children Partnership Business Manager as evidence of the escalation process.

In the unlikely event that the difference of opinion remains unresolved, the matter must be referred to the departmental head with lead responsibility for safeguarding in both/all involved agencies, who will report the matter to the relevant local Statutory Safeguarding Children Partners.

They will also instigate a meeting of senior managers with operational responsibility for the case within a maximum of 48 hours. You may wish to consider an independent facilitator. The purpose of this meeting is to review the issues at hand and provide a final opportunity for the involved agencies to ensure that there is a full understanding of the issues before a decision is finalised. The Chair of this meeting will then report on issues arising from this process to the Case Review Subgroup of the local Multi-Agency Safeguarding Children Partnership.

In all cases where it has not been possible to resolve differences and/or where there may be lessons to be learned for future practice, consideration should be given to holding a multi-agency case review.

At any stage of the process, any action agreed should be fed back immediately to the professionals involved, and the difference of opinion and agreements reached, should be saved in the agency's case management system in accordance with their agency internal procedures.

All differences of opinion over appropriate intervention or support for a child should be resolved in a timely way so that the welfare of the child remains paramount. However, if a child is thought to be at risk of immediate harm the designated safeguarding lead/line manager in your agency should be informed immediately. 

If the professional feels the child is at risk of imminent harm they should use their professional judgement and if appropriate dial 999 and ask for Police assistance.

Additionally, if the process highlights gaps in policies and procedures these must be brought to the attention of the Local Statutory Safeguarding Children Partners and referred to the Berkshire Child Protection Policy and Procedures Sub Group.