Child Not Brought to Appointments

Many children and adults are reliant on someone else to take them to meetings or appointments that relate to their welfare, care or health and as a result they are sometimes not taken to them. This may mean that a practitioner may record them as having ‘not attended’.

This is a safeguarding concern. Many Serious Child Safeguarding Practice Reviews (and previously, Serious Case Reviews), both nationally and regionally, have featured these ‘missed’ appointments as a precursor to serious child abuse and even child death. We ask all partners and practitioners to use “Was Not Brought” rather than “Did Not Attend” for recording or noting the non-attendance of children, young people and adults who are reliant on someone else to take them to a meeting or appointment.

The phrase “Did Not Attend” implies that the individual for whom the appointment or meeting has been arranged is responsible for not attending. There may be many reasons as to why someone doesn’t attend an appointment, however if a child or adult is reliant on someone else to make, rearrange or take them to appointments or meetings, recording or noting “Was Not Brought” is a more accurate representation of the situation. Recording or noting “Was Not Brought” enables a practitioner to consider the reasons why a child or adult was not brought to a meeting or appointment, the implications for them not having been brought, and assess the potential risks or safeguarding concerns for them, especially if there is a repeat pattern of non-attendance.

Watch this short animation for a powerful summary of the issue.

“A short video from Nottingham City ICS & Safeguarding Children Partnership”

What is the “Was Not Brought” approach?

If a child or adult doesn’t attend an appointment or meeting consider:

Are they reliant on someone else to either make and/or take them to appointments or meetings? This may be due to age, mental capacity, disability or accessibility.
What are the implications of them not attending the appointment or meeting? Are they missing needed medication or assessment, being denied the opportunity of inputting into a planned review, not being part of a discussion about their health and wellbeing.
Is this a one off, or is there is a repeat pattern?
What could be the reason for their non-attendance? Be professionally curious. Are there any other factors to consider, like coercion and control, or neglect?

Actions to Take

Record

Record or note the non-attendance as “Was Not Brought” Within the notes state:

that the child or adult was reliant on someone else to bring them to the meeting
any impact or safeguarding concern their non-attendance may have raised
if this was the first or repeat non-attendance and identify any emerging patterns
the action you have taken in response

Discuss

Discuss episodes of non-attendance with colleagues and any other relevant agencies Contact the child’s parent/carer to:

enquire why they did not come to the appointment
encourage them to rearrange, explaining the importance of the appointment and the child's wellbeing
discuss with them any barriers which may have impacted on them attending
arrange support to attend future meetings if needed

Persevere

If contact cannot be made, or if a further meeting cannot be agreed, do not discontinue the service or appointment without discussion with a senior colleague and consideration of your own agency’s attendance policies.

Escalate

Repeated patterns of a child not being brought to appointments should result in a Team Around the Family meeting to agree the best course of action. Unless there is a concern that a child is likely to suffer significant harm, a referral should not be made to the Integrated Referral Hub, until it is established the ‘Team Around the Family’ has not worked. The referral will need to show what work has been attempted, by whom, and what is expected a referral to the Integrated Referral Hub will achieve. An immediate referral should be made if it is established that urgent medical attention has not been sought or delayed.

Support and Resources

Primary Care Guidance

Guidance for children not brought to health appointments, and suggested practices for children identified as untraceable.

London Child Protection Procedures

Read the pan-London Child Protection Procedures on Neglect, which include a child not being brought to appointments.