Gillick competency

An important safeguarding consideration is whether a child is able to make their own informed decisions about their own welfare and to understand the implications of those decisions.

This is known as 'Gillick Competency' after the case which set a legal precedent around a child's competency to make decisions about their own medical treatment without parental consent.

Although the ability to make decisions and consent to medical treatment (including counselling) is still linked to the child's age, it is recognised that competence in children varies and a child under 16 could consent to treatment providing they could demonstrate ‘sufficient understanding to make informed decisions’.  

Although Gillick competency is mainly applied to decisions about medical treatment, practitioners can use it in other contexts, for example if a young person requests confidential help for substance misuse or other therapeutic support. However, it does not relate to giving consent for sexual activity.  

The 'Fraser guidelines' apply specifically to situations where children request advice and treatment about contraception or sexual health. They add an additional requirement that before any advice is given, a practitioner should be confident that it is ‘in the best interests of the child’ and that their physical or mental health will suffer if they do not receive the advice/treatment.

We would always want to encourage a child to talk to their parents and carers about decisions they are making (unless it would increase risk to do so). It is also important to remember that child protection is paramount, and you must follow your reporting procedures in order to safeguard a child, even if it goes against their wishes to do so. Seek advice in any situation where a child doesn’t want you to pass on their information to parents and carers or other agencies.