Child Protection: Removal at Birth - Interagency Procedures

Publication: 12/11/2001  
Next review: 01/01/2023  
Standard Operating Procedure
CURRENT 
ID: 596 
Approved By: LTHT Trustwide Safeguarding Children Steering Group 
Copyright© Leeds Teaching Hospitals NHS Trust 2020  

 

This Standard Operating Procedure is intended for use by healthcare professionals within Leeds unless otherwise stated.
For healthcare professionals in other trusts, please ensure that you consult relevant local and national guidance.

Standard Operating Procedure for Removal at Birth
Interagency Procedure

Aims

  • To inform staff of the actions to be taken when Children’s Social Work Services (CSWS) have determined a baby is to be removed at birth due to the risk of significant harm
  • This procedure details roles and responsibilities of professionals involved to ensure everyone is working to a consistent and safe standard of practice
  • What actions to take if no birth alert has been received and CSWS advise a baby is expected or required to be removed at birth

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Background and indications for standard operating procedure/protocol

A pre-birth assessment or a Child and Family Assessment should be completed by CSWS when a decision to remove a baby has been made. CSWS should provide an agreed Birth Alert (see appendix 1) in order to share safeguarding information in a consistent manner with LTHT clinicians, referencing key details of the case the outcome of the assessment and a safe, detailed plan for LTHT to follow in the post-natal period.

Best practice indicates Birth Alerts should be completed by 34 weeks gestation. However, sometimes this does not happen if there has been a lack of engagement from the family or if the assessment was started at a late gestation in pregnancy. CSWS are required to share any necessary information with the LTHT Children and Midwifery Safeguarding Team as soon as practically possible (and before the EDD) on the Birth Alert proforma when this is identified.

Please see below the essential information that should be provided on the Birth Alert when a baby is expected to be removed:

  • Who made the referral to CSWS
  • What were the presenting concerns for the referral to be made
  • What assessment has been undertaken by CSWS
  • The outcome of the assessment
  • The required specific actions and recommendations for LTHT maternity staff including if baby is being removed immediately following delivery from delivery suite or from the postnatal ward.
  • Particular reference should include who is or is not allowed contact with the baby and if any agreed persons are required to be supervised.
    NB this is the responsibility of CSWS to arrange and should not be undertaken by LTHT staff
  • Any Court orders being applied for following delivery or if a voluntary agreement has been reached, should be clearly documented.
  • Any relevant background information about the immediate and extended family or known associates including any risk to the baby or staff safety should be included
  • For high risk cases it is recommended that a face to face meeting is undertaken between CSWS, Named or Deputy Named Midwife for Safeguarding, the allocated social worker and social work team manager

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Procedure method (step by step)

Detailed step-by step description of procedure

  1. Following the outcome of the assessment undertaken by CSWS, the allocated children’s social worker should email a completed Birth Alert to the Children’s & Midwifery Safeguarding Team on leedsth-tr.SafeguardingChildren@nhs.net
    This should be completed by 34 weeks gestation.
    The Birth Alert should also be emailed by the allocated social to the woman’s case loading midwife in the community and
    Leeds Community Healthcare on lchsafeguardingteam@nhs.net.
  2. If removal is planned from Delivery Suite or there are other complicating or high risk factors and Police Powers of Protection (PPP) or an Emergency Protection Order (EPO) are required, a face to face meeting should take place between the Named/Deputy Named Midwife for Safeguarding at LTHT, the allocated social worker and social work team manager by 34 weeks or before birth. It may not be appropriate for the parents to attend this meeting but their wishes should always be considered in the plan. If this is not possible due to imminent delivery the allocated social worker should contact the Children’s & Midwifery Safeguarding Team at LTHT on 0113 3923937and discuss the details over the telephone. This should be followed up by a Birth Alert to the above email address.
  3. Once the Birth Alert is received by the Children’s & Midwifery Safeguarding Team, the Birth Alert will be reviewed to ensure the plan for removal from LTHT is safe and robust. The Birth Alert may be returned to CSWS for further clarification and final agreement by the social worker and the Children and Midwifery Safeguarding Team.
  4. The final agreed or interim draft Birth Alert should be uploaded to the woman’s K2 record in the attachments section, by the Children’s and Midwifery Safeguarding Team. A note will also be placed in the K2 safeguarding wizard that the Birth Alert has been uploaded and any amendment requested from CSWS
  5. If new information is received from CSWS that requires the agreed Birth Alert to be amended the Children’s & Midwifery Safeguarding Team will make any amendments to the plan, upload to K2 and document in the K2 safeguarding wizard. This will be done by clinical staff out of hours.
  6. If the baby is expected to require admission to the Neonatal Unit, the Birth Alert should be shared by the Children’s & Midwifery Safeguarding Team via email with the Neonatal Unit Matron and Neonatal Team Leaders on shift that day. Neonatal staff have access to the K2 to verify additional information regarding the woman and baby.
  7. If a birth alert regarding a removal at birth has not been received by 34 weeks as expected, the Children’s & Midwifery Safeguarding Team will contact the allocated social worker directly. If no response is received, this will be escalated to the social workers team manager in line with the LSCP Professional Concerns Resolution process.
  8. When the woman presents to the Maternity Assessment Centre (MAC) in labour, the midwife should check the information documented in the woman’s K2 Safeguarding Wizard. The MAC midwife should contact the allocated social worker named on the Birth Alert confirming admission and labour. If the admission is out of office hours, Emergency Duty Team (EDT) should be notified on 0113 535 0600.
  9. The MAC midwife should verbally handover the Birth Alert information to the Delivery Suite Midwife on transfer, and the NNU if the baby is likely to be admitted due to the clinical needs.
  10. Once the baby has been delivered the midwife on delivery suite should contact the allocated social worker or EDT as above at the earliest possible time.
  11. There are 2 pathways for removal of the baby following delivery, either from Delivery Suite or the Postnatal Ward (See Appendix 2 & Appendix 3).
  12. Check the birth alert for maternal consent of a voluntary agreement under Section 20 of the Children’s Act for removal. If the woman retracts her consent please contact the allocated social worker or EDT for further advice.
  13. If maternal consent has not been gained under section 20, the baby will be removed under Police Powers of Protection (PPP) (which does not require a court order and is valid for 72 hours) and will usually happen from delivery suite.
  14. The baby may also be removed under an Emergency Protection Order (EPO) which requires the Police or CSWS to apply to the courts (this can only be done in working hours and lasts up to eight days).
  15. The Police & CSWS will arrive with relevant paperwork. Please ask the staff for ID and have sight of the official paperwork. The midwife should document on the baby’s PPM+ record and a copy of the official paperwork should be taken to upload to the baby’s PPM+ record. The woman’s K2 safeguarding wizard should also be updated.
  16. Consideration should be made for the woman to be discharged home if clinically well when the baby is being removed from Delivery Suite.
  17. If supervised contact is required during delivery and/or the postnatal period there may be a period of time, if the admission is out of hours, that staff in the hospital may be required to facilitate supervision until CSWS arrive on the ward. CSWS are aware that hospital staff cannot supervise contact out of this scenario. This should be explicitly documented in the Birth Alert.
  18. The Delivery Suite midwife should handover all safeguarding information to the midwife for those women and babies transferred to the postnatal ward.
  19. If the baby is being removed under an Emergency Protection Order (EPO) or a Interim Care Order (ICO) the social workers are required to apply for a date and time in court which is usually the next working day. The woman may want to attend this court hearing. Once the court order is granted by the judge the allocated social worker will arrive on the ward to remove the baby. This will usually occur from the postnatal ward.
  20. Always ensure you ask for ID and request sight of any court order before allowing any access to the baby to be removed. A baby should never be allowed to leave the delivery suite/ward without the Police/social worker’s professional ID and a valid and in date Court Order. The midwife should document on the baby’s PPM+ record and a copy of the official paperwork should be taken to upload to the baby’s PPM+ record. The woman’s K2 safeguarding wizard should also be updated.
  21. Any attempt to take the baby from hospital must be reported to the police, CSWS & hospital security in line with the LTHT Child Abduction Policy 2018. Update K2 safeguarding wizard and baby’s PPM+ record.

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Appendix 2

Provenance

Record: 596
Objective:
Clinical condition:

n/a

Target patient group: Neo-nates where there is a planned removal
Target professional group(s): Secondary Care Doctors
Secondary Care Nurses
Allied Health Professionals
Midwives
Health Visitors
Adapted from:

Evidence base

There is currently no evidence base for this procedure. This has been written taking into account normal local practices and procedures and general guidance within the West Yorkshire Consortium Inter Agency Safeguarding and Child Protection Procedures. See web page below. https://westyorkscb.proceduresonline.com/chapters/p_pre_birth.html.

Approved By

LTHT Trustwide Safeguarding Children Steering Group

Document history

LHP version 6.0

Related information

Not supplied

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