Gillick Competency and Fraser Guidelines

When is Gillick Competency considered?

When a person under 16 wishes to receive treatment or advice without their parents/carers consent, knowledge, or in disagreement with their wishes.

When a young person wishes to refuse treatment

How is Gillick Competency assessed?

The person’s age, maturity, and mental capacity

Their understanding of the issue and what it involves, including advantages, disadvantages, and potential long-term impact

How well they understand any advice or information they have been given

Their understanding of any alternative options, if available

Their ability to explain a rationale around their reasoning and decision making

When can Gillick Competency be overruled?

When a young persons refusal treatment may lead to their death or severe permanent harm

When do Fraser Guidelines apply?

Specifically around advice and treatment about contraception and sexual health with those under 16

What should be satisfied regarding Fraser Guidelines?

The young person cannot be persuaded to inform their parents or carers

The young person understands the advice being given

The young person’s physical or mental health or both are likely to suffer unless they receive the advice or treatment

It is in the young persons best interest to receive the advice, treatment, or both, without the parent’s consent

The young person is very likely to continue having sex without or without contraceptive treatment

What age should sex be reported no matter what?

13 years old

When are there child protection concerns with the Fraser Guidelines?

Underage sex is a possible indicator of child sexual exploitation

Children who have been groomed may not realise they are being abused

Sexual activity with a child under 13 should always result in a child protection referral

If a young person repeatedly presents about STIs or terminations of pregnancy this may indicate child sexual abuse or exploitation