Sharing concerns with families

Good practice for professionals sharing the news

“I think that conveying difficult news to parents is just as much of an art form as doing an operation and it’s just as important to be self-critical.” Professor Sir David Hall

Valuing the child

  • All children are unique. It’s vital that professionals see the child first and their condition second.
  • Use the child’s name at all times.
  • Keep discussions about the child positive and avoid making predictions.
  • Whenever possible, keep the child with the parents when sharing the findings and diagnosis.
  • If it’s not appropriate for the child to be present, remember to communicate in a way that shows respect for the child.
  • When sharing the news of additional needs identified in an older child, consider whether the child should be present.
“Parents need to be treated with dignity as individuals who have the right to respect and not as stereotypes.”

Respect parents and families

  • Support and empower parents.
  • Treat all parents’ concerns seriously.
  • Listen to parents and share information sensitively and honestly.
  • Use plain and understandable language and give explanations to build parents’ confidence.
  • Acknowledge and respect cultural difference.
  • Give opportunities to ask questions and check parents’ understanding of their situation.
  • Avoid giving negative non-verbal messages before sharing concerns with parents.


  • Allow time for individual and team preparation before specific consultations
  • Families and their circumstances vary enormously. Professional teams need to share their knowledge of the family so that they can share the news sensitively and effectively.

Who should be present?

  • Evidence shows that parents, wherever possible, prefer to hear the news together and always in private.
  • It may be appropriate for another family member or friend to be there in support of one or both parents.
  • If it’s unavoidable that a parent is alone, a member of the team should support the parent during and after sharing the news.
  • When an unaccompanied parent has heard the news alone, arrange to inform the other parent and close family members as soon as possible.
  • Keep the number of staff involved to a minimum: ideally the person responsible for sharing the news and one other team member known to the family.
  • If you need an interpreter, choose carefully. Do not expect a family member to act as interpreter.

Tuning in to the parents: effective communication

  • Parents’ reactions vary enormously and cannot be predicted.
  • Professionals need to be well prepared and confident to share the news, whilst flexible enough to respond to parents’ needs.
  • Make time and space for parents to reflect on the news and meet again with a member of the team if they wish.

Next steps: practical help and information

  • Make a record of the initial discussion available to parents and their GP. This could in writing or in audio, but always in the parents’ first language.
  • Provide contact details at the initial meeting and encourage parents to ask further questions as they arise.
  • Arrange an early follow-up appointment at the end of the initial meeting.
  • Provide written information at an early stage about: the child’s condition, statutory and voluntary services, practical and emotional support
  • Offer support to parents to enable them to share the news with other family members and friends.
  • Make parents aware of their right to seek other professional opinions.
  • Establish contact between hospital-based and community services.
“They (parents) want, and have a right to, full information about the services and benefits available… conveyed in a manner which recognises their lack of familiarity with systems and procedures that are complex and potentially daunting.” Anne Leonard

Support for professionals

  • Acknowledge and address personal and professional development needs.
  • Ensure staff have training, clinical supervision and continuous professional development.
  • Promote inter-professional practice, mutual support and sharing good practice.
  • Give opportunities for de-briefing for all team members following meetings with parents.
  • Identify, acknowledge and seek to address inequalities between professionals and parents.
  • Promote an ethos of continuous quality improvement and auditing of practice.
“I think we should be teaching that every child is an individual… a baby is a baby… I think we ought to develop a common attitude: that’s my baby and I’m proud of him, no matter what.” Alan Counsell, teacher, advisor, counsellor and a disabled person

See also How Information is Shared Matters from Disability Matters

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