Find information about sexual health and safeguarding below, or visit the safeguarding section of the MPFT website for more safeguarding information.
The Sexual Offences Act 2003 dictates that the age of consent in the UK is 16 years old. This law is in place to protect children from abuse or exploitation, not to prosecute under 16s engaging in mutually consenting sexual activity. To further protect children the act also deems children under the age of 13 unable to give consent to any form of sexual activity under any circumstances.
As a result, sexual health services across Staffordshire, Stoke-on-Trent, Shropshire, Telford and Wrekin are available to all aged 13 upwards. Where a child under 16 is seeking sexual health services an assessment will be carried out utilising the framework laid out by the Fraser guidelines.
Fraser guidelines relate specifically to contraception and sexual health. To be deemed Fraser competent the professional must be satisfied that:
1. The young person has sufficient maturity and intelligence to understand the nature and implications of the proposed treatment
2. They will not tell their parents or allow the doctor to do so
3. They are very likely to begin or continue having sexual intercourse with or without contraceptive treatment
4. Their physical or mental health is likely to suffer unless they received the advice or treatment
5. The advice or treatment is in the young person’s best interests.
Fraser guidelines originally related only to contraceptive advice and treatment, following a case in 2006, they now apply to decisions about treatment for sexually transmitted infections and termination of pregnancy.
Health professionals will encourage the young person to inform their parent(s) or get permission to do so on their behalf, but if this permission is not given they will still give advice and treatment. If the conditions are not all met, however, or there is reason to believe that the child is under pressure to give consent or is being exploited, there would be grounds to break confidentiality.
Where a concern for the safety or wellbeing of an under 18 is identified, appropriate action will be taken by the professional identifying the concern, in accordance with the Midlands Partnership NHS Foundation Trust Safeguarding Children Policy in line with the Children’s Act of 1989. Practitioners will inform the young person that they will be passing on their information and explain their concerns wherever it is safe and appropriate to do so.
Find more information on safeguarding on the Midlands Partnership NHS Foundation Trust website here.
Those aged 16 and over have a general right to independence, choice and self-determination including control over information about themselves. However, practitioners should always be cognisant of the fact that the law defines a child as any person under the age of 18; meaning that those over the age of consent should be treated as children and afforded the protection of child safeguarding processes wherever it is deemed to be in their best interest or for their protection.
All those aged 18 and over are assumed to be competent to give consent unless a reason to believe otherwise is identified. Where there are doubts regarding a person’s mental capacity a two stage functional test as defined within the Mental Capacity Act 2005 will be carried out by the practitioner identifying the concerns; and the results documented within the patient’s records.
The two stage functionality test consists of:
Stage 1: Is there an impairment of, or disturbance in the functioning of a person’s mind or brain? If so, is the impairment or disturbance sufficient that the person lacks the capacity to make a particular decision?
If the answer to stage 1 is no, the service user should be deemed competent. If yes stage 2 should be considered.
Stage 2: Can the person-
- understand information provided
- Retain that information
- balance or weigh that information as part of the decision-making process
- communicate their decision (by verbal, written, using sign language or any other means).
Where a service user is unable to satisfy any one or more of the criteria within stage 2 they will be regarded as lacking mental capacity to make the decision, our practitioners will carry out separate assessments for each service or treatment the service user requests.
In the context of sharing the information of adults, consent will be obtained prior to sharing information; however where concerns regarding an adult are deemed to be an emergency or are life-threatening situations, relevant information may be shared with appropriate agencies or emergency services without consent.
This includes situations whereby public interest served outweighs the public interest served by protecting confidentiality for example, where a serious crime may be prevented. Information can be shared lawfully within the parameters of the Data Protection Act 2018 and the General Data Protection Regulation (GDPR).
All safeguarding decisions made within sexual health services are underpinned by the six key principles of safeguarding laid out within The Care Act 2014:
- Empowerment: People being supported and encouraged to make decisions with informed consent
- Prevention: It is better to take action before harm occurs
- Proportionality: The least intrusive response appropriate to the risk presented
- Protection: Support and representation for those in greatest need
- Partnership: Local solutions through services working together (including working with local communities)
- Accountability: Accountability and transparency in safeguarding practice
Modern Day Slavery
Click here to find Midlands Partnership NHS Foundation Trust’s MDS statement.
Shropshire and Telford Risk Assessment Questions
Our teams in Shropshire and Telford would like to ensure all local healthcare professionals are aware of the Risk Assessment Questions asked to under 18s at their service. This information is being shared so that, if necessary, you can discuss the questions asked and young people are aware of the nature of the questions asked by the team when they visit the service.