Brook Position Statement - safeguarding, confidentiality and information sharing

Based on over 45 years experience of working with young people Brook believes that the best way to protect young people from harm is to reaffirm their right to access confidential services whilst empowering and supporting professionals to make an effective assessment as to whether they are at risk of harm or exploitation.   Decisions about sharing information should be based on the degree of risk to the welfare of the client or other young people.

Brook’s position on safeguarding

Safeguarding the well-being of young people is fundamental to Brook’s aim to protect, promote and preserve young people’s sexual health.      We aim to achieve the twin goals of protecting clients from harm and ensuring that their right to confidentiality is properly upheld, in keeping with the law and good practice guidance.  

Brook believes the best way to protect young people who are sexually active is to reaffirm their right to access confidential sexual health services whilst empowering and supporting professionals to make an effective assessment as to whether they are at risk of harm or exploitation.   

Brook has robust procedures in place to safeguard the welfare of its clients and other young people in line with its commitment to enabling young people to enjoy their sexuality without harm.  The main consideration in whether to share information about a young person is the degree of risk to the welfare of the client or other young people.   Information will be shared without the consent of the young person if a professional believes that there is a serious risk of harm to the young person or other young people and the young person cannot be persuaded to agree to a referral being made to social services or other agencies.    

The presence of counsellors or advisors with counselling skills in the Brook team enables Brook to work safely and effectively with younger age groups, helping young people to avoid being pressurised into early sex, identify where they may be at risk, build their self esteem and negotiating skills and develop positive personal relationships

Brook’s position on confidentiality

Young people consistently say that confidentiality is one of their top concerns when visiting a sexual health service and that worries about confidentiality are a major deterrent to service uptake.    In a recent Brook survey 74% of under 16s said they would be less likely to visit a clinic if information had to be shared with social workers(1).  

Negative cultural attitudes to young people’s sexuality may cause young people to worry about the confidentiality of services.   We need to shift the culture to a positive, accepting one so that whilst young people value their individual confidentiality they are not deterred from using services.

The Human Rights Act and the UN Convention on the Rights of the Child both enshrine a right to privacy.   The concept of confidentiality is recognised in common law but there is a limit to this duty in that whilst there is a public interest in maintaining confidentiality there may be a countervailing public interest which favours disclosure.

Government guidance(2)  and the professional codes of practice of doctors, nurses and other health professionals place a duty on them not to disclose information about individual patients without their consent except in exceptional circumstances.    The duty of confidentiality towards young people is the same as that owed to adults.

Confidentiality at Brook means that no identifiable information about a client is passed to anyone or any agency outside Brook, including the fact of whether a person is a client, without the express permission of the client, other than in the most exceptional circumstances.  

Upholding young people’s right to confidentiality, except when they are at risk of serious harm, is a crucial factor in supporting young people’s access to high quality confidential services that can promote their sexual health and wellbeing.        It encourages the development of a relationship of trust that enables young people to talk freely and honestly about their situation which allows professionals to assess whether their clients are at risk of harm and take appropriate steps to safeguard their well-being.  

Professionals working with young people should be able to support young people to take the matter further themselves.      This is more likely to lead to a positive outcome to any investigation.   

Deterring young people from using services by requiring automatic referral of sexually active young people to social services risks losing the cooperation of young people and damages their trust in services which cannot be to their benefit.   It exposes them to increased risk of pregnancy and sexually transmitted infections with dire consequences both for individual young people and for public health generally.    Moreover, abusive or coercive relationships would be more likely to remain hidden if young people felt there were no one they could trust to listen to them and work in partnership with them to protect their safety. 

Brook therefore believes that it is vital to continue to advocate for the confidentiality of young people's services and to ensure that young people understand that they are entitled to a confidential consultation.  

Children and young people should learn about their rights to privacy and confidentiality in citizenship lessons or equivalent at school.

Brook’s position on Information sharing

The policy climate in recent years has seen an increasing emphasis on sharing information about young people in order to promote and safeguard their welfare.   The main driver has been reports highlighting failures in the child protection system, most notably the Laming Inquiry into the death of Victoria Climbie.  

Brook believes that information sharing must be done with care and sensitivity and due regard to young people’s right to privacy.  Young people’s best interests must be firmly entrenched at the heart of any decisions to share information and professionals must engage with young people to help them understand why it may be necessary to share information.    Generally, information should only be shared without the consent of the young person if there is a serious risk of harm to the young person or other young people.

References

1 Brook Wise Up! Survey, 2005
2 Best Practice Guidance For Doctors And Other Health Professionals On The Provision Of Advice And Treatment To Young People Under 16 On Contraception, Sexual And Reproductive Health, Department of Health 2004

Publication date: November 2011