Resolving professional concerns
When professionals are working together to help and protect adults with care and support needs there will inevitably be occasions when there are professional differences of opinion. No one's safety or wellbeing should however be compromised by those differences of professional opinion. This guidance must be followed to ensure this does not occur.
Constructive challenge is an important element of partnership working. Practitioners have a duty to take action to address situations where they believe the safety or wellbeing of an adult with care and support needs is being compromised by the actions or inaction of another organisation.
In seeking to resolve concerns the adoption of professionally curious approaches in relation to another organisation's practice is encouraged, as this can avoid direct confrontation and lead to a shared understanding of issues.
As such each party should see disagreements as a positive opportunity to:
- To reflect on their understanding / response, their legal duties and responsibilities
- To develop a shared understanding of issues and risks
- To consider the outcome of their response for the person in need or at risk
- To explain their decisions making and the remit of their organisation
- Improve how practitioners can work together across agencies.
Examples of case specific professional disagreements might include:
- When there is disagreement concerning a referral outcome decision
- When there is disagreement about the outcome of an assessment
- When there is disagreement about a safeguarding plan or its implementation
- When there is disagreement about an intervention to bring about the necessary changes
- When there is disagreement over the sharing of information in a particular case
This process sets out the steps to be taken by all organisations and their practitioners to resolve professional concerns and to protect the safety and wellbeing of an adult with care and support needs.
It is important that professional disagreements are resolved at Step 1 wherever possible, despite the fact that this may sometimes require challenging conversations with colleagues. This serves both to strengthen professional working relationships and to actively avoid unnecessary drift and delay in delivering positive outcomes for those in need or at risk.
Process to be followed:
This guidance offers a framework for practice.
The following steps outline how organisations should work together to resolve disagreements:
Practitioners and their organisations will need to act in a timely and proportionate way to the nature of the concern and the urgency / seriousness of the any risk. This will determine how much time should be spent at each Step of this process.
Step 1: Practitioner to practitioner
If practitioners have concerns about the practice or service responses of another organisation they should:
- Immediately discuss with their colleagues / own agency designated lead to clarify thinking and practice.
- Hold a conversation with the other party to resolve any disagreement.
- Seek to understand the alternative view and review any relevant guidance.
Is there a resolution?
(If yes)
Make sure all parties understand and agree on the actions to be taken. Make sure there is written confirmation of the actions and provide this to all relevant parties.
(If no – continue to Stage 2)
Stage 2: Manager to Manager
Practitioners must escalate their concern to their supervisor/manager. This must include a specific description of what the disagreement entails. The supervisor/manager must liaise with the individual of equal authority in the other agency about the circumstance to resolve the matter.
Is there a resolution?
(If yes)
Make sure all parties understand and agree on the actions to be taken.
Make sure there is written confirmation of the actions and provide this to all agencies.
(If no – continue to Stage 3)
Stage 3: Senior leader to Senior leader
Supervisors/managers must escalate the concerns through the line management structure to the senior operational managers / safeguarding leads within the organisation. Where organisations are Board members, their representatives will usually be the final point of escalation.
Is there a resolution?
(If yes)
Make sure all parties understand and agree on the actions to be taken.
Make sure there is written confirmation of the actions and provide this to all agencies.
Safeguarding leads or senior managers must ensure that sufficient safety measures have been put in place for the individual.
(If no)
Each organisation is responsible for recording their decisions, their rationale, their attempts to resolve concerns and any advice given/alternatives offered or suggested.
If the unresolved concerns relate the abuse, neglect or self-neglect of an individual with care and support needs[1], Continue to Stage 4.
Stage 4: Exceptional Circumstances
In the event that the unresolved concerns relate to the safeguarding of an individual with care and support needs from abuse, neglect or self-neglect[2], then senior leads will need to refer policy/practice issues of concern to the chair of Leeds Safeguarding Adults Board to determine the appropriate process for resolution: LSAB.Chair@leeds.gov.uk
Clear written records should be kept by everyone at all stages, which must include records of agreed resolutions and the proposed follow-up of any outstanding issues.
[1] As defined within Care Act 2014: Section 42(1)
[2] As defined within Care Act 2014: Section 42(1)