5.8 Multi Agency Escalation Process

1. Introduction

All agencies must work together in the interests of the adult. However, at times, there may be differences of opinion on how to best manage safeguarding concerns and any identified risks.

Accountability and partnership are two of the key principles of adult safeguarding (see Principles of Adult Safeguarding).  Staff in all agencies are accountable for their professional practice and have a responsibility to challenge other practitioners if they are concerned that decisions, practice or actions (or a failure to act) mean that an adult or carer is not safe.

By following this process, practitioners will be clear how they can respectfully challenge the decisions or actions of a professional in another organisation, whilst continuing to provide the best possible service in a safe and timely way.

The adults and their wishes must remain at the centre of decision making, but they should not be caught up in any professional disagreements. Where a disagreement occurs, it should be resolved at the earliest possible stage, and the priority must be to keep the adult safe.

The resolution of disagreements must always be approached in a considerate manner, which respects and seeks to understand the views and concerns of others. Staff should be supported by their managers throughout the process.

Disagreements between practitioners working in the same organisation should be dealt with using that organisation’s own procedures and processes.

2. Aim of the Multi-Agency Escalation Process

This process provides clarity for professionals when they are unable to agree about what is in the best interests of the adult.

It should be implemented where a resolution cannot be found, and the professionals involved feel that concerns need to be escalated to ensure that the adult is safeguarded and identified risks are managed.

3. Key Principles

• Problem resolution is a key part of multi-agency working to safeguard adults.
• Professional disagreements should always be resolved through a person-centred discussion between the relevant agencies.
• Ensuring the safety of the adult or carer should always be the most important consideration in any professional disagreement, and all staff should work together to resolve differences quickly and openly.
• Every effort should be made to resolve disagreement as close to the point of origin as possible.
• Professional disagreements can be reduced by ensuring multi- agency staff are clear about their different roles and responsibilities.
• The best way of resolving difference is through open and transparent discussion. Where possible a face- to- face meeting should be held, so that the specific areas of difference can be identified and discussed.

At all stages of the escalation process actions and decisions must be:

• Shared in a timely manner and a resolution should be sought within the shortest timescale possible to ensure the adult is safeguarded.
• Recorded clearly identifying the name of the staff member/line managers/senior manager whom the discussion was held with and when. All records should be recorded and retained on the adult electronic file/agency database.

It is the responsibility of all agencies to ensure that their staff are supported to challenge and escalate appropriately when they have concerns or they disagree with another professional’s practice which they believe places, or could place, an adult at risk of harm or abuse.

To help reduce professional disagreements, multi-agency work should be based on:

• An open approach and honest relationships between partner agencies
• A belief in genuine partnership and true integrated working.
• A culture of transparency and feeling comfortable in positive challenge

4. Escalation Procedure: Steps to take

Step 1 –Initial Discussion between practitioners

This involves a discussion between the practitioners involved to see if their disagreement can be resolved.

All discussions and outcomes should be recorded on the adult’s electronic record.

Step 2 –  Discussion between Line Managers

If the disagreement is not resolved following a discussion between the practitioners involved, they should share their concerns with their line managers and appropriate action agreed. This could involve a discussion between line managers from each agency.

All discussions and agreed actions should be record on the adult’s electronic record.

Step 3 – Escalation to Safeguarding Leads or Senior Managers

If the disagreement cannot be resolved by line managers, it should be passed to the safeguarding adults lead in the organisation and or other managers to seek a resolution.

All discussions and agreed actions should be record on the adult’s electronic record.

Step 4 – Referral to the Bury Safeguarding Adults Board

In the unlikely event that the matter is not resolved at this point, it should be referred to the Safeguarding Adults Board.

The role of the Safeguarding Partnership Team and the Independent Chair is one of mediation; decision making responsibility remains with statutory agencies.

Referrals should be sent to the Safeguarding Adults Board by emailing [email protected]. The email should contain details of the disagreement and action which has already been taken to resolve it.

PLEASE NOTE – if any professional has concerns that an adult is an imminent risk of harm they should report their concerns to the Police by calling 999. A safeguarding adults referral should also be made.