Policy briefing3rd April 2019

Disagreements in the care of critically ill children

This briefing note outlines the factors that can contribute to disagreements between parents and healthcare staff about the care and treatment of critically ill babies and young children.

Child and infant healthInfrastructure and culture

Policy briefing (PDF)

Key points

• Protracted disagreements between parents and healthcare staff about the care and treatment of babies and young children who are critically ill can have damaging effects on everyone involved.
• The reasons why disagreements develop are wide ranging, but themes include: communication issues; differing perspectives, beliefs and values
  on, for example, what kind of risks justifiably could be taken; feelings of powerlessness for both parents and staff; and delays in seeking resolution interventions.
• The wider social and cultural context is also likely to be playing a role, including the increasing place of social media in public debate, easy access to online information about medical treatments, and the severe financial pressures facing the NHS.
• There is scope for policy makers and others to do more to support the creation of healthcare environments that foster good, collaborative relationships between parents and healthcare staff. The aim should be: good communication between families and staff and an understanding of differing perspectives; appropriate involvement of parents in discussions and
  decisions about the care and treatment of their child; timely use of effective resolution interventions in cases of disagreement; and attention to the profound psychological effects that disagreements can have on families and staff.

2023 Independent review

Five years after this briefing note was published we were commissioned by the Secretary of State for Health and Social Care to conduct an independent review of disagreements in the care of critically ill children.