Annex A > Chapter 16 - Support and Counselling > Guidance and expert evidence on support and counselling

Guidance and expert evidence on support and counselling

Governmental guidance

334 In her paper for the Inquiry, Dr Humphrey provided a brief summary [410] of published guidance during the period of the Inquiry's Terms of Reference. She wrote:

`The 1959 Platt Report on the welfare of children in hospital led to radical changes in, among other things, access and provision for parents ...

`Over the past few years there has been an increasing consensus between government, professional and voluntary organisations on the benefits of parental participation in "family-centred" care. More recent government guidelines in this area published in 1984, [411] 1991, [412] and more recently the 1996 "Children's Charter" [413] reflect this philosophy, giving considerable attention to enabling parents to be with their children in hospital and ensuring access to information and improved contact with hospital staff to facilitate this involvement ... In contrast, there appears to be relatively little detailed advice or recommendations specifically about the provision of psychosocial support or counselling for parents of children in hospital except in the context of life-threatening illness (which is not defined) and bereavement. The 1991 report on the welfare of children and young people in hospital represents the first comprehensive set of recommendations from the Department of Health in this area since the Platt report.' [414]

1991 guidance - `The Welfare of Children and Young People in Hospital'

335 Dr Humphrey noted the terms of the guidance issued by the DoH in 1991. She wrote that this:

`... specifies that "Every children's hospital or children's division of a district general hospital must provide facilities to enable the mother and other members of the family to sustain the normal relationship to which the child is accustomed at home", such as accommodation and the use of a sitting room and kitchen, and recommends that "... hospitals collaborate with voluntary organisations helping families ... which might also be able to provide accommodation for families near regional centres in some specialties."' [415]

336 She noted that the guidelines also advised hospitals to:

`... ensure that the Hospital Travel Costs Scheme is publicised within the children's department and that a named member of staff is designated to help advise families on benefits which may be available to help with travel costs. Where a family's financial situation is particularly difficult, parents should be made aware of any assistance the hospital social worker can provide ...'

and recommended the agreement of service specifications which:

`... recognise that parents and members of the immediate family are not visitors, encourage and assist them to be with their child at all times (especially those that are most stressful, i.e. during anaesthesia, treatments, investigations and during post-operative recovery) and enable them to give continuous love, care, comfort and support for their child.' [416]

337 In respect of `life-threatening illness', the guidance:

`... encourages health authorities and hospitals to establish links with voluntary organisations active in their areas to achieve maximum co-operation in the planning and organisation of services like social work support. It also recommends that those involved in agreeing contracts should ensure that:

`all staff are sensitive to the needs of children and their families ... and are able to draw upon staff specifically trained in care and counselling;

`parents are informed in an appropriate manner, as soon as possible of their child's condition and given every opportunity to talk through their feelings;

`care is taken not to "avoid" parents whose child is dying, while at the same time recognising the need for privacy;

`where children are taken home, advice is available to parents on the help available from statutory or voluntary agencies to ensure ongoing support and counselling for as long as necessary;

`parents have the opportunity to return to the hospital to find out anything further they wish to know about any aspect of their child's illness, care or treatment.' [417]

338 In relation to the death of a child, the guidance:

`... states that it is essential that parents/carers are helped to cope with the sense of loss and grief and also given practical assistance to help them make necessary decisions. Health authorities and hospitals are advised to ensure that:

`a member of staff trained in care and counselling is designated to give families, including siblings, all the necessary support including help with the arrangement of bereavement counselling and practical issues like burial arrangements;

`the results of any post mortem investigation are conveyed in a sympathetic manner to the family...;

`the family's GP is informed as soon as possible so that, as necessary, the GP can help them cope with the medical effects of bereavement.' [418]

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Footnotes

[410] INQ 0025 0012 - 0017 ; Dr Humphrey's paper

[411] DHSS. `Hospital Accommodation for Children', Health Building Note 23, HMSO, 1984

[412] DOH. `The Welfare of Children and Young People in Hospital', HMSO, 1991

[413] DOH. `Services for Children and Young People', NHS Executive, 1996

[414] INQ 0025 0012; `Platt Report', Ministry of Health (Chairman H Platt): `Report on the Welfare of Children in Hospital', HMSO, 1959

[415] INQ 0025 0013; Dr Humphrey's paper

[416] INQ 0025 0013; Dr Humphrey's paper

[417] INQ 0025 0014; Dr Humphrey's paper

[418] INQ 0025 0014 - 0015 ; Dr Humphrey's paper