Adult support and protection: guidance for GPs and primary care teams

Triage and Adult Support and Protection - "Dos and Don'ts"

Do:

See the patient in a safe and private space with appropriate professional support

Discuss the limits to confidentiality e.g. where you know or believe that someone is at risk of harm you may have to refer on

Use specialist/trained interpreters where appropriate

Consider a triage approach that ascertains some or all of the below:

Are there any indicators that the adult is at risk of harm (from their own actions or those of others)?

Are there any indicators that they are unable to keep themselves safe?

Do they adequately self-manage their health and wellbeing e.g. their medication regime?

Are there any indicators that they are unable to protect their own property and finances?

Consider the patient's overall safety:

Are they are able to assert and defend their own rights without being unduly influenced by others (are they suggestible or easily influenced)?

Are there other aspects that indicate a vulnerability that concerns you e.g. using the internet safely, managing unsolicited telephone calls, preventing others from using their accommodation, finances or medications?

Are there any adverse events in earlier life or current adversities that are impeding their ability to make informed choices or safeguard themselves?

Are there indications that they are being or are likely to be harmed either through self-harm or self-neglect or; physically, psychologically, sexually, financially, or through their access to information and services being blocked.

Are they experiencing any of the below which is contributing to the risks in such a way that their ability to manage those risks is compromised:

• disability
• mental disorder
• illness
• physical or mental infirmity, (lack the power or ability to do something)

Are there issues which you cannot quite define? In such instances use your professional curiosity to explore them further using proactive questioning and challenge.

Don't:

Let the person leave without having formed a view about their current and ongoing safety and what actions you intend to take

Share information with anyone else other than the statutory services

Attempt to carry out an investigation or mediation e.g. contacting family etc.

Assume that you have to fully demonstrate that the legal test for action by the Council or delegated agency is met. You need only know or 'believe' that the criteria for support and protection under the legislation is met. If you know or believe that an adult is at risk of harm and may meet the legal test – you should make a referral.