Section 1: Multi-agency adult protection arrangements
Integrating GPs into local multi-agency networks
8. GPs have a key role to play in adult protection. They may be the first professional to see signs of potential harm, and are crucial not only in helping to protect adults, but also in helping to develop effective multi-agency responses.
Duty to co-operate
9. Multi-agency partnership is at the heart of the 2007 Act. This approach is underpinned by a statutory duty placed on a range of public bodies and office holders to co-operate with councils and with each other where harm is known or suspected. The duty to co-operate applies to:
- all councils
- Health Boards
- the Mental Welfare Commission for Scotland
- the Care Inspectorate
- Healthcare Improvement Scotland
- the Public Guardian
- chief constables of police forces
- any other public body or office holder that Scottish Ministers specify
Adult Protection Committees
10. Adult Protection Committees (APCs) help set the multi-agency strategic direction for adult protection at the local level. By providing a forum for multi-agency consideration of the ongoing implementation and delivery of adult protection, they ensure that adult protection activity is carried out effectively across all interests. A core function of the APC is to evaluate the ongoing effectiveness of multi-agency adult protection arrangements. In support of this, APCs may decide to extend their core membership beyond those required by statute to include GPs, as well as establishing sub-groups to tackle specific challenges.
11. Given the centrality of GPs in adult protection, APCs should have a GP representative as part of their core membership. Local Medical Committees and GP sub-committees represent the interests of local GPs and members of these groups may be able to fulfil this role. Where direct GP representation is not possible, APCs should ensure that, at the very least, clear lines of communication are established with local GPs. One option is for a member of the APC to function as a liaison; this is a role the Health Board representative would be well placed to fulfil. However, it is important to note that while a Health Board representative may be able to offer a link to GPs, they will not be able to represent the GP point of view.
12. Involving GPs in multi-agency arrangements for adult protection will help develop a strong understanding of the considerations and pressures that apply in adult protection cases. It will help to raise awareness of adult protection generally among GPs, so that they know how to respond when they encounter a possible adult protection case. Their involvement will allow their views to be taken into account in the development, revision and implementation of adult protection policies and procedures, as well as when agreeing strategic directions. It will also help foster a greater collaborative approach.
13. This type of collaborative approach will help to develop a shared understanding of the issues GPs must consider when interacting with the 2007 Act and carrying out adult protection activity, including respecting patient confidentiality. It should also help GPs to better understand the various processes and considerations that all professionals involved in adult protection are required to make. Involving GPs in this way will help to build mutual confidence in the processes to be followed and provide clarity on where roles and responsibilities lie.
14. This will also help to address practical difficulties in sharing information appropriately and developing strong, positive relationships between GPs and social workers. For example, local arrangements might be developed so that on referring a concern to the council, GPs are sent details of the allocated social worker and an outline of the action that will be taken within a certain timeframe.
15. APCs may decide to work with GPs and others with adult protection responsibilities to develop a quick reference guide aimed at GPs. For example, this could include local information on the referral process, similar to that summarised in the flowchart at Annex C to aid GPs when responding to a suspected case of harm. This might sit alongside contact details for local partners in the adult protection network. A quick reference guide of this sort would supplement, rather than replace, more comprehensive local policies on GP involvement in adult protection at the local level.
16. GPs should be included in multi-agency adult protection training organised by APCs. Consideration should be given to providing bespoke adult protection training to GPs. This might be delivered at GP surgeries, which would allow other members of the practice to develop an awareness of adult protection. It may also be useful to explore the possibility of developing local enhanced services and to use Health Boards' Protected Learning Time initiatives to provide adult protection training. Councils can provide advice on how Health Boards might extend multi-agency adult protection training to GPs.
17. Ensuring that GPs are a key part of the adult protection network will help develop a shared understanding of processes and practices of all involved, and hence reduce the likelihood of disputes arising. Where disputes do arise (for example, over the sharing of patient information or carrying out a medical examination under the 2007 Act) this should be dealt with through local multi-agency dispute resolution protocols. This will provide all parties with a means of raising and resolving any difficulties which arise and which cannot be addressed through other means.
Email: Susan Edmondson