Adult safeguarding

Human rights law

UK policy and practice on safeguarding of adults has its basis in human rights law and is informed by the European Convention on Human Rights (ECHR), principally:

• Article 2: The right to life
• Article 3: The prohibition of torture
• Article 5: The right to liberty
• Article 8: The right to respect for private and family life, home and correspondence (the right to self-determination)
• Article 14: The prohibition of discrimination.

A more comprehensive description of the implications of the ECHR can be found here.

The law surrounding safeguarding of adults had as its starting point the 'No Secrets' guidance published by the Department of Health in 2000. 'No Secrets' was superseded by the Care Act 2014 which introduced mandatory requirements in relation to adult safeguarding including duties and definitions which are consistent with the EHCR. The Act itself does not define 'the adult at risk', but instead states that safeguarding duties apply to any adult who:

• has the need for care and support, and
• is experiencing, or is at risk of, abuse or neglect, and
• as a result of their needs is unable to protect themselves from the risk of or experiencing abuse.

See also the Social Care Institute for Excellence website for The Care Act: Safeguarding Adults.

As part of raising safeguarding concerns in vulnerable individuals, the capacity of the patient involved should be clear and may need to be formally assessed (see Adults without Capacity).

Every person should be treated with dignity and respect and should be empowered to make choices (where they are able to) themselves. Where a competent person refuses care (which is their right), they must be made fully aware of the risks associated, however, the duty of care extends to considering where others may be at risk and what action is needed to protect them. A more detailed examination of Consent, Capacity and Confidentiality can be found on this website.

There are other factors that may make healthcare providers concerned about an adult safeguarding issue, particularly if a patient lacks capacity. These include recurrent attendances, multiple failures to attend, and the reactions of those with the patient. If abuse is suspected a safeguarding referral should be made promptly. It is vital that any action taken is clearly and comprehensively documented.

Information sharing

Where there are safeguarding concerns, staff have a duty to share information. Where ever possible, information should be shared with consent, though a person’s right to confidentiality is not absolute and may be over ridden in the interests of public safety or a police investigation. This is dealt with in more detail in the section of these web pages dedicated to Confidentiality.

The following links detail the General Medical Council (GMC) position and resources on the duties of a doctor relating to adult safeguarding:

• GMC and older adult safeguarding
• GMC adult safeguarding resources
• GMC and Confidentiality in handling patient information

You may also find it useful to refer to the resources in our Educational Resources section. 

Other useful sources of information

The NHS England Safeguarding team webpages provide additional excellent links and contacts with additional pages on topics not covered in these web pages, e.g. modern slavery.