At all times, the doctor’s role should be focused on protecting and promoting health and wellbeing, and taking prompt action to prevent that from being threatened or compromised.
If, during the duration of the solitary confinement, doctors become concerned about the health and wellbeing of the child or young person, or identify a deterioration in their health, they should report their concerns to those responsible for reviewing the solitary confinement decision.This should prompt consideration of whether solitary confinement should be maintained.
Respect for confidentiality should never be seen as an insuperable barrier to raising concerns, but wherever possible, the patient’s consent should be sought before information is reported to the relevant person.
Doctors also have a more general duty to raise concerns about conditions which put patient safety at risk, or about practices which are abusive or negligent.
All organisations should have clear mechanisms in place for reporting concerns, and in the first instance, doctors should speak to the governor in charge of the establishment. Where this is not practicable, doctors may need to contact the relevant area manager, or a senior colleague within their Trust.
In the event that those concerns are not addressed, doctors may wish to consider going beyond reporting their concerns to a wider disclosure.
The key question for doctors is whether their responsibility to protect and promote the health of patients can best be discharged by pursuing their concerns. These decisions can be very difficult for doctors and are often best taken through discussion with colleagues or relevant medical defence bodies.
Need more help?
If you are thinking about raising a concern read our guidance on raising concerns
BMA members can contact our employment advisors for advice on these issues by phoning 0300 123 1233 or by email