Under-18s and confidential support

What should you say first when a young person asks for confidentiality?

Most services run into difficulty in the first two minutes. A Link Worker could promise to keep everything private, the young person then discloses something that carries risk, and the Link Worker has to break the promise. The young person subsequently learns that adults say yes and then act differently, which undermines trust and hinders longer-term care and patient engagement.

Confidentiality does apply to young people. The GMC states that doctors owe children and young people the same duty of confidentiality as adults, should ask for consent before sharing, and should not delay disclosure where significant harm is at risk. The guidance is written for doctors, so check how your own policy applies it to your role. The principle transfers well though: promise only what you can keep.

For example: “Anything you tell me stays between us unless I'm worried about your safety or someone else's. If I need to share something, I'll tell you who I'm telling and why, as long as that's safe.” The sentence takes ten seconds and gives you something honest to point back to if you later need to share.

The best approach is to treat the young person’s request as neither an automatic yes nor an automatic no. Instead, perform a risk assessment and ask these three questions:

1. What support is the young person asking for? A conversation about a local youth group is a different request from help that involves a health service, a mental health referral or information passing between organisations. The wider the support, the more people see the information, and the harder it becomes to keep it from parents.
2. What does the young person understand? Check that they can describe what you would do, who would see their information and what could happen if they decline. Age informs this judgement and does not settle it. A mature 15-year-old and a distressed 17-year-old can both need more time.
   
3. Is there a safeguarding concern? Listen for anything that suggests harm, exploitation, coercion or risk to another child. If you hear a concern, the question becomes who needs to know.

The outcomes:

• Proceed when the request is modest, the young person understands it, and you hear no concern. Record the conversation and your reasoning.
• Pause when you are unsure on any of the three. Make no further promises until you have taken the case to supervision or your safeguarding lead.
• Escalate when you have a safeguarding concern. Follow your local safeguarding partnership's procedures and, where it is safe, tell the young person what happens next.

The follow up to these three questions is whether the Gillick competence the test you should apply.

The 2025 Court of Appeal ruling says it should not be the whole answer. To get technical, in Re S (Wardship: Removal to Ghana) [2025] EWCA Civ 1011, the court confirmed that the Gillick ratio is limited to whether a child under 16 can consent to medical treatment (summary by Mills & Reeve). Outside medical treatment, "Gillick competent" works as shorthand for a young person's maturity and understanding. It carries no direct legal effect.

Many teams use the term as a catch-all. Link Worker support may fall outside medical treatment, so "they're Gillick competent" cannot close the question on its own.

Four ideas sit close together but need separate handling:

• Consent: permission for a specific intervention.
• Confidentiality: what you do with the information the young person gives you.
• Parental responsibility: the legal position of the parents, which continues when a young person asks for privacy.
• Gillick competence: the test for whether a child under 16 can consent to medical treatment.

For 16 and 17-year-olds, the Family Law Reform Act 1969 lets them consent to surgical, medical and dental treatment as an adult would. It says nothing about non-medical support, so your service policy and the three questions still carry the decision.

The summary of the article so far is that legally you’re permitted to agree to an under-18’s request for confidentiality, albeit with caution. It’s that caution that requires link workers and other agents to consider when to pause confidentiality or to escalate a concern, even if it’s against a young person’s wishes. Everyone involved has a duty of care and safety takes precedence.

We have already discussed when to proceed, pause, or escalate, but this section tackles when to pause or escalate having already proceeded. The wheels are in motion, but your training and instincts tell you there is cause for concern. Below are a few example scenarios where confidentiality should be paused as a minimum:

• a young person describes harm at home or from someone with power over them
• signs that another person is controlling or exploiting them
• a risk of serious self-harm
• a relationship with a significant age gap or power imbalance
• information suggesting another child is at risk

Pausing means you stop and consult before you promise anything. Escalating means you follow your local procedure. Your local safeguarding partnership publishes the thresholds and referral routes, so use those.

This legal permission to provide confidentiality is kept on a tight leash by Section 16LA of the Children Act 2004, which came into force in England on 30th September 2026. The Department for Education also updated its statutory guidance on 10th September 2026.

The statutory guidance states that a child does not need to meet a specific statutory threshold before information can be shared. The duty covers information relevant to safeguarding and promoting a child's welfare, including concerns about early help, prevention and unmet need.

Summaries of the legislation add two more key points: sharing under the duty does not breach an obligation of confidence, and the duty does not apply where the person considers that disclosure would harm the child more than staying silent. Data protection law continues to apply, however.

For your opening conversation, this means an unqualified promise of confidentiality is harder to defend than it was a year ago. Leave room for sharing in what you say, and work on developing trust between the young person and yourself through transparency and honesty.

The duty applies to "relevant persons" named in the legislation. The statutory guidance lists local authorities, Integrated Care Boards, NHS trusts and the police among them. Working with children does not make an organisation automatically subject to the duty. A voluntary sector provider, a primary care network or a social prescribing service may or may not be covered. Ask your safeguarding lead to confirm, and ask your safeguarding partnership if the answer is unclear.

Recording matters as much as the decision. Write down what you said about confidentiality, which of the three questions you asked, what you decided, who you consulted and what you shared.

Editor's note: The Crime and Policing Act 2026 also creates a separate duty to report child sexual abuse for people in certain roles with responsibility for children, so check its commencement status and whether your role is covered. It’s also worth checking the Fraser Guidelines, which sit alongside the Gillick competency.

For commissioners: The assurance question is whether your providers can show consistent decisions, supervision and records across every Link Worker, including when a young person has asked for privacy from parents.

• Does your safeguarding policy include an under-18 confidentiality conversation, or only a general statement?
• Can every Link Worker name the safeguarding lead and the route to supervision?
• Does your recording standard capture the confidentiality explanation and the reasoning for the decision?
• Has your safeguarding lead confirmed whether the Information Sharing Duty covers your organisation?
• Does your service operate outside England? If so, the law and guidance differ in Wales, Scotland and Northern Ireland, and this article does not cover them – for all that there are strong similarities between the four nations.

A consistent record helps a team show how it reached each decision.

Whether using Access Elemental for social prescribing or Rio EPR for patient records, our solutions support recording, case chronology, controlled access to said records, and referral and outcome tracking. We even offer Rio Smart Notes as a hands-free way to record clinical conversations for the purpose of more accurate notation and quicker administration.

None of these solutions determines competence, gives legal advice, replaces your safeguarding procedures or guarantees confidentiality. Those decisions stay with your practitioners and your safeguarding lead. You are in control, but we can make the processes easier, giving you more time with the patient to engage with them and to develop that all-important bond of trust.