Navigating intervention by Children’s Social Work Services

The provision of gender affirming healthcare has become increasingly politicised and fraught for families with transgender children in the UK. The use of puberty blockers to create ‘time to think’ for young people who wish to transition from their gender assigned at birth is entirely orthodox in most of the developed world – and is recommended by, for example, the Endocrine Society and the World Professional Association for Transgender Health. However, transgender healthcare has become a battleground of intense political debate in the UK and the supply of puberty blockers within the UK has become in fact impossible and in law illegal.

Many loving families of trans children nevertheless take the view that the best interests of their children are served by following international treatment protocols rather than UK treatment protocols, which they experience as an outlier. 

They note that the FAQ section of the Cass Review asked: “Is the Review recommending that puberty blockers should be banned?” and answered that question, “No.” It concluded the evidence base for their use was weak and recommended further clinical trials.

Nevertheless, it is our understanding that some local authority social services departments are treating the provision of puberty blockers with the consent of parents as a safeguarding issue and are opening safeguarding enquiries. 

We are told that loving families often experience these enquiries as motivated by a political stance taken by the individual social worker or local authority in respect of the choices they are making for their children rather than as a genuine safeguarding matter.

We have been asked to offer general advice to a group of families, with no previous children’s social care involvement or other reason for that involvement, who face enquiries related to the single issue of choosing to seek gender affirming healthcare which is currently not provided in the UK. 

We have also been asked to describe the various levels of safeguarding steps which may be instigated by a local authority.

We note that the 1989 Children Act places a strong emphasis on the local authority working in partnership with parents when acting in accordance with their statutory duties.

We start by considering, by way of example, the scenario of a family which genuinely fears that there is a risk that their child would act on suicidal thoughts were they not to receive gender affirming healthcare. We are told this is a not uncommon situation for families whose teenagers are aware that a denial of puberty blockers means they will never be able to ‘pass’ – and will always be identifiable as trans in a country increasingly hostile to trans people.   

A parent acting protectively on behalf of their child by taking measured steps for that child’s well-being may be well able to assert that any questioning or interference by a local authority in their parental decision making is disproportionate and unnecessary.

The UK family courts are not tasked with scrutinising reasonable decisions made by child focused parents.

In the event that a local authority chooses to press ahead with an intervention there are enquiry stages which should be utilised by the local authority in the first instance before there is any prospect of the court becoming involved. 

Where a parent holds ‘parental responsibility’ (explained below) their duty is to act in their child’s best interests and exercise considered decision-making for them. It is also for them to decide where their child’s best interests lie – not for an individual local authority or social worker – subject only to boundaries which protect children from significant harm or abuse (and a court is very unlikely to consider that a parent following eg Spanish rather than UK healthcare protocols is abusive).  

In considering whether to cooperate with a social services enquiry which, it could be argued, fails to recognise that the best interests assessment is primarily one for loving parents and families, it may help parents to know that the test for the family court is clear – separation of children from their parents via care orders is not sanctioned unless the care of the child is not what it would be reasonable to expect a parent to give. 

This is an extremely high threshold and would ordinarily only be crossed where significant harm has or is likely to occur, for example, the child has been subjected to sexual abuse, or physically harmed by way of an inflicted injury, or at is risk of emotional harm due to exposure to domestic abuse within the home or to neglect of their needs through parental substance misuse and unsafe home conditions.  

Should a social worker question your decision, you are entitled to say that you do not wish to engage with an enquiry if you consider that to be against the interests of your child, for example where it would introduce unnecessary stress and anxiety into your family, or if you are satisfied that your care is loving, thoughtful and reasonable.

By contrast to the above, parents would usually do well to engage with social workers if intended to address (often a range of) concerns which could be resolved in the short-term with immediately identifiable changes in parenting or by parents taking certain action or seeking external support. In such cases engagement and cooperation with social workers will usually help to speed up the process and draw issues to a conclusion as quickly as possible. 

Where the outcome to engagement would take your family no further, then a refusal can be viewed as reasonable and social workers should take stock and consider whether escalation would serve any purpose. 

Social work resources are stretched and responses to perceived risks should always be balanced and proportionate.

Parental Responsibility (PR) describes the rights and responsibilities you have for your child as a parent. It is a parent’s responsibility to keep their child safe, as well as to make decisions about their upbringing, such as about their education and schooling, religious practice and any medical treatment or procedure which might benefit them. 

Each person with PR, eg this could mean a mum, a dad or other primary caregiver, usually has an equal right to decide what happens in a child’s life.

If your child lives with you, you will exercise a greater degree of day to day parental responsibility for them than anyone else with PR, but important decision-making for a child, such as medical treatment, should include input from all those who hold PR.

Information about how a local authority may acquire PR via a care order is explained below, but the making of a care order is highly interventionist and only warranted in circumstances where significant risk to a child is posed (as set out above) and the order will serve the welfare of the child. It is highly unlikely to be acquired in circumstances where a loving family, after careful consideration, decided to follow an international healthcare protocol rather than a UK one.

Local authorities have a duty to safeguard, protect and promote the welfare of children in their areas.  

If the local authority thinks that a child is at risk of harm or neglect and it has identified your child as being ‘in need’ then social workers should take action. The social worker who is allocated to your child should explain why the local authority thinks your child is at risk and what they would like you to do to prevent harm to your child.

Information should be provided in a language you can understand and in a format that helps you best to understand it. You may reasonably – and if you believe the intervention is badly motivated it would be wise to – ask social workers to set out their concerns in writing and for details of how their enquiry has arisen as a precondition to cooperating.

Child protection referrals may happen anonymously, but practitioners such as medical professionals providing safeguarding services for children and young people should, where practicable and safe to do so, seek consent to the sharing of information by engaging with the child and their carers and explaining why they intend to share the information and what information they will be sharing.

Information should be shared with consent, and there should be a lawful basis for the sharing of information without consent, ie to prevent serious harm to a child.  

Facts should be distinguished from opinion when a professional makes a decision to share safe-guarding information.

A referral pursuant to a political agenda would be problematic and open to challenge.

s.17 Children Act 1989  

A section 17 enquiry will be triggered if a social worker believes a child is ‘in need’. This is the threshold for a less serious intervention. 

When a child in need is identified, social workers conduct enquiries to decide what services should be provided to the child by talking to the family and professionals involved with the child.

‘Child in need assessments’ are voluntary and parents or carers can choose not to engage with the enquiry.

The focus should be on supporting the family to meet the needs of the child without beginning court proceedings or separating a child from their parents.  The best interests of the child must be the paramount consideration and, as stated above, this is generally speaking a decision for thoughtful and loving parents not for social workers.

Once a child in need enquiry has been completed and it is identified that services should be provided to the child, the social worker or their team manager should convene a Child in Need Planning Meeting within 7 working days to agree a Child in Need Plan.  

The plan should be reviewed regularly to ensure it meets the needs of the child. 

If a family has refused to engage with a child in need enquiry this may cause the local authority to have concerns that the child is at risk.  This may lead to an escalation to further child protection enquires as described below. 

It is worth reiterating that a family providing reasonable care should not become subject to an enquiry. You are entitled to weigh up how your family might benefit from engaging with a s.17 enquiry and decide that the interference may not lead to a better outcome for your child.

If the family refuses services the case will be closed unless risk is identified.  

s.47 Children Act 1989  

A section 47 enquiry will be triggered if a local authority believes a child is suffering or is likely to suffer significant harm. This is a higher threshold for a more serious intervention than under s.17. 

If social workers are worried about risk to a child, they will convene a strategy meeting to decide whether to initiate a s.47 investigation.

This meeting draws together the professionals involved with the child, such as social workers, teachers, health professionals or police officers to discuss the potential risks and consider what action ought to be taken.

Strategy meetings do not include family members, but information should be shared with the family following the meeting, unless this would place the child at more risk.

You should be provided with a copy of the s.47 assessment report.

Any s.47 assessment must be completed within 45 days from the date of a referral or in time for a Child Protection Conference.

If an Initial Child Protection Conference is required, it must be held within 15 working days of the strategy meeting.

Social workers will ask to see the child alone during a s.47 enquiry, unless it is not in their interests to do so.

Where access to a child is withheld the local authority may need to consider an application to court, but it does not mean that court action will be taken.  

Social workers should only consider court proceedings where it would derive a benefit for the child and safeguard from significant harm.

The purpose of proceedings cannot be to simply compel a meeting with the child for the purposes of probing.

If a child is considered to be at continuing risk of significant harm, an Initial Child Protection Plan may be convened to consider putting a Child Protection Plan in place. 

This is similar to the strategy meeting described above, but you will be invited to this meeting and you may bring a solicitor.  

The chair of the meeting will lead discussions about whether the child is at risk of serious harm 

If the professionals at the meeting agree that a Child Protection Plan is necessary, the plan will set out what social workers will do to promote the child’s welfare, what changes are needed to reduce the risk to the child, and what support will be offered to the family.

The child’s name will be added to the Child Protection Register, also known as the ‘at risk’ register.

You should be provided with a copy of the Child Protection Plan.

Given that such plans are usually formulated on the input of a number of professionals, against a backdrop of wider ranging concerns, escalation to this stage is unlikely to occur for a child focused family seeking internationally recognised treatment for their child.

Where the local authority does not consider it immediately necessary to make an application to court, but still has concerns regarding the child’s safety, a pre-proceedings process may commence.

You will be sent a letter setting out the social worker’s concerns and inviting you to attend a meeting with a solicitor to discuss what needs to change to prevent the matter going to court. 

Social workers will be trying to establish that you are willing to work with them to address concerns. 

Again, this further escalation is unlikely to be appropriate where it is clear that the single issue causing concern is the provision of treatment, for example to prevent self-harm by a child and on an issue where expert medical opinion differs internationally. 

Any person with parental responsibility has an automatic entitlement to legal aid when they receive a letter inviting them to a pre-proceedings meeting. 

As a very last resort, the local authority can apply to the court for a care order for a child if they assert that there are reasonable grounds for believing that a child was suffering, or at risk of suffering, significant harm and that this was as a result of either the care that they were receiving, or were likely to receive if the order was not granted.

There must be sufficient reasons to justify making a care or supervision order.  The harm must be set out clearly in a list of allegations known as the ‘threshold criteria’. If the court finds that the threshold is not crossed, a care order cannot be made. 

The provision of puberty blocking treatment is unlikely in itself to cross threshold given the complexity and nuances for the families involved and in the absence of medical consensus.

If a care order is granted it allows social workers to share parental responsibility with others who hold parental responsibility.  

An ‘interim’ order will be made in the first instance pending the final decision of the court, usually after a period of assessment of any carers.  A parenting assessment would not alone resolve the issue of whether blocking puberty is in a child’s interests.  

The local authority may ask the court to approve the removal of a child from their parents’ care to be placed with another carer (who may be a family member), or with foster carers or in a residential placement.  The local authority would have to consider what evidence they are able to present to justify the sharing of parental responsibility and even more so, the proportionality of separating a child from their parents or carers.

A care order cannot be made for a child past their 17th birthday and will expire once a child reaches the age of 18. 

Any person with parental responsibility has an automatic entitlement to legal aid where they are a respondent in care proceedings for a care or supervision order. 

A court may make a supervision order if the threshold criteria set out above are met, but circumstances do not require the local authority to share parental responsibility.

The bar is set as high for a supervision order as it is for a care order in terms of establishing facts which cross threshold and the above advice therefore applies. 

A supervision order places a duty on social workers to ‘advise, assist and befriend’ the child.  

It may require a child to live in a specified place, engage in certain activities and report to a particular place at a set time. 

A supervision order can last for up to one year and may be extended yearly to a total of three years.

A supervision order will expire once a child reaches the age of 18.

As described above, you may choose not to engage with social workers if you feel that their request for an enquiry is unfounded, but you should be mindful of their duty to assess whether a child is in need or at risk.

If you feel social workers have acted unfairly in their approach to your family, you may choose to utilise the local authority’s internal complaints procedure to scrutinise their action.

If you feel that an unjustified referral has been made to children’s social workers, you may choose to seek disclosure of the information held in respect of the family by making a Subject Access Request for records.

If you feel a professional has unfairly referred you to Children’s Social Work Services, you should consider pursuing the reason for the referral via their organisation’s management structure.

We also understand that, in egregious cases of misuse by Children’s Social Work Services of their statutory safeguarding powers to advance a political agenda, Good Law Project (which asked us to prepare this advice) may be willing to assist families to challenge that misuse.

For initial advice regarding social services involvement or for assistance at an Initial Child Protection Conference you may be entitled to legal aid known as ‘legal help’ depending on your financial means.

A financial assessment referred to as a ‘means assessment’ will look at all your finances, including your savings, assets and income.

If you’re on Universal Credit, or a few other specific benefits, you might be ‘passported’ but your savings will be looked at.  You will, for example, need to provide three months of bank statements, a letter confirming which benefits you claim and proof of your rent or mortgage payments. 

Legal aid for advice in relation to pre-proceedings meetings or for representation on a care or supervision order application is not means tested. In other words, you have an absolute entitlement to legal aid as a person who holds parental responsibility.