When separated parents are in conflict: keeping the child central without becoming the battleground

Kafico Ltd
Dec 8, 2025
7 min read

In my work with general practice, it’s not unusual to see parents who are separated — sometimes amicably, sometimes anything but. A pattern many of my practice customers describe is that: a child’s care or the practice themselves become a stick to beat one another with. The practice is asked to “take a view,” restrict access, validate a diagnosis narrative, or produce a letter that helps one parent “win” against the other.

If you’ve felt that pressure, you’re not alone. And it raises two linked questions:

Is this a safeguarding issue?
How do we set boundaries early, lawfully, and fairly — without escalating conflict?

This post offers a practical, child-centred way to think about those questions in the GP setting, from an information governance / data protection perspective (not as clinical direction). At the bottom you’ll find an optional SOP outline and a neutral “practice position” letter you can adapt locally.

I need to make it really clear that, I am not providing clinical, safeguarding, or medico-legal direction and this content should not be adopted or relied upon as a final policy without appropriate clinical governance.

Required clinical and medico-legal review

Before implementation, healthcare providers should ensure any process and wording are reviewed, amended as needed, and formally agreed through:

Practice partners / clinical leadership
The practice safeguarding lead(s) and local safeguarding procedures
The practice’s Medical Defence Organisation (e.g., MDU/MPS/MC) for medico-legal assurance
Local ICB / NHS safeguarding and information-sharing guidance, where applicable

Parental conflict and safeguarding: when does it cross the line?

Parental disagreement itself isn’t automatically a safeguarding referral. But persistent, intense, poorly-resolved conflict can become safeguarding-relevant, because it may lead to emotional harm or to a child’s needs being neglected.

The key test for practices is impact on the child. For example:

Is the conflict blocking necessary assessment or care?
Is there evidence of distress in the child (e.g., anxiety, sleep issues, somatic symptoms, school attendance problems)?
Is either parent using health care as a control tactic (e.g., repeated cancellations, undermining appointments, coercive contact with staff)?
Are there hints of domestic abuse, coercive control, or other risks even if not named as such?

If the answer is “yes” or “maybe,” the situation moves from “adult dispute” to a child-welfare concern that deserves careful recording and, at times, multi-agency safeguarding advice.

"poorly-resolved conflict can become safeguarding-relevant, because it may lead to emotional harm or to a child’s needs being neglected."

Records access: where practices often get stuck

One of the most common flashpoints is record access. Typical scenario:

Mum asks the practice to block dad’s access to the child’s notes. Dad has partial custody and parental responsibility. No safeguarding risk is being raised.

From a data protection / IG standpoint, the default position is:

Parents with parental responsibility usually have access to their child’s records, unless:
- the competent child refuses, or
- disclosure is not in the child’s best interests (e.g., risk of harm, coercion, safeguarding risk).

Separation or divorce doesn’t remove parental responsibility. So a practice can’t lawfully refuse access just because one parent objects, if the other parent holds PR and there’s no best-interests reason to restrict.

Where disclosure is provided, practices should redact third-party confidential information (for example, details about the other parent (not that the other parent provided about the child) that aren’t clinically necessary).

Disagreements about diagnosis or assessment

Another common scenario is disagreement over a potential diagnosis (e.g., ADHD, autism):

Mum is worried and wants assessment.
Dad disagrees and doesn’t want the child tested.

This isn’t automatically safeguarding. But can become safeguarding-relevant if the disagreement:

prevents the child from getting needed support, or
becomes part of a broader pattern of conflict that is causing distress or harm.

A safe early approach is to stay neutral, keep focus on the child’s presentation, and avoid being pulled into “proof letters.” Where disagreement blocks non-urgent care, practices usually advise parents to resolve the dispute through appropriate routes (mediation, school/SEND, family court); unless delaying care risks harm to the child.

Why a neutral “practice position” letter helps

Many practices find that an early, polite, standardised letter:

sets boundaries and reduces staff pressure,
explains PR and records rules consistently to both parents,
recentres the child,
and creates an audit trail showing the practice acted proportionately.

The important bit is tone and fairness. It shouldn’t be a scolding “warning” aimed at one parent. The safest option is a standard neutral template sent to both parents with PR (where safe).

Think: “Here’s how we work. Here’s the law. Here’s how we keep your child safe.”

A note on role boundaries (especially for DPOs)

If you’re a DPO, IG lead, or non-clinical advisor, you’ll recognise the tension here: these situations sit on the seam between information governance and clinical safeguarding judgement.

That’s why any process like the one below must be clinically owned and reviewed by safeguarding leads and an MDO before use.

Disclaimer (DPO / Non-clinical)

Status and scope of this resource

The SOP outline and draft letter below are provided as a non-clinical, information-governance–informed support resource only. They are intended to help practices consider possible boundary-setting and record-sharing approaches in situations of parental conflict.

Safeguarding thresholds, parental-responsibility disputes, and best-interests decisions are context-specific and must be determined by clinicians using professional judgement, the child’s circumstances, and local multi-agency pathways.

Nothing here replaces or overrides clinician judgement, statutory safeguarding duties, GMC guidance, local children’s services/MASH thresholds, or MDO advice.

Managing Emerging Parental Conflict / Use of GP Practice in Disputes

1. Purpose

To help the practice:

keep the child’s welfare central,
remain neutral in disputes,
manage record access lawfully,
identify when conflict may be causing emotional harm or blocking care,
protect staff from being drawn into adversarial dynamics.

2. Scope

Applies wherever:

parents/guardians are separated or in conflict, and
the practice is receiving contradictory requests, disputes about diagnosis/treatment, or pressure to restrict access.

3. Trigger criteria

Start this SOP when any pattern of the following is present (usually at least 2+ events, unless severe):

Contradictory clinical requests escalating or blocking care.
Requests for letters or notes to support one parent against the other.
Attempts to prevent lawful record access without a best-interests/safeguarding rationale.
Coercive, hostile, or manipulative behaviour toward staff.
Any sign of impact on the child (distress, missed care, school issues, health deterioration).

4. Roles & responsibilities

All staff: identify triggers, remain neutral, record accurately, alert safeguarding lead.
Safeguarding lead/GP: oversees disclosure decisions, disputes, escalation, and letter issuance.
Practice manager: supports boundaries, comms policy, staff safety.

5. Procedure

Step 1 — Neutral handling

Acknowledge request.
Do not agree immediately to take sides, mediate, write partisan letters, or block PR-based access.
Use a standard line: “We focus on the child’s health needs. We can’t arbitrate parental disputes. We’ll review and respond in line with policy.”

Step 2 — Verify PR and child capacity

Confirm PR status if unclear.
Clinician considers child’s capacity and wishes, where appropriate.

Step 3 — Clinical disagreement

If non-urgent, advise parents to resolve externally (mediation / legal routes) before proceeding.
If delay risks harm, safeguarding lead considers best-interests action and/or seeks paeds/legal/MDO advice.

Step 4 — Records access

Default: provide PR-holder access unless competent child refuses or disclosure is not in best interests.
Redact third-party information.
If any hint of risk (DA/coercion/abduction), pause and seek safeguarding/MDO advice.

Step 5 — Documentation

Record neutrally in the child’s notes:
nature of disagreement,
what each parent said,
decisions/rationale (PR, capacity, best interests),
observed impact,
whether standard letter issued and to whom.

Step 6 — Standard practice-position letter

Send to both parents with PR (unless unsafe).
File in record.

Step 7 — Safeguarding escalation

Escalate when conflict:

blocks essential care,
is clearly distressing/harming the child,
involves abuse/neglect indicators,
or cumulatively raises concern.
Use early help / MASH advice / referral as locally appropriate.

Step 8 — Staff safety

Follow zero-tolerance policy for abusive behaviour.

Review

Safeguarding lead reviews cases quarterly.
SOP reviewed annually or after significant incident.

Template Letter: Neutral Practice Position for Separated / Conflicting Parents

(Send to both parents with PR unless there is a documented best-interests/safety reason not to.)

Dear [Parent/Carer name],

We are writing to both parents/carers with parental responsibility to clarify the practice’s position where there are differing parental views about a child’s healthcare.

Our role and approach

Our duty is to provide healthcare based on [Child’s name]’s needs and best interests. We are not able to mediate or take sides in parental disputes. Any clinical decisions we make will be based on the child’s health presentation and relevant professional guidance.

Parental responsibility and involvement

Where both parents hold parental responsibility, we will aim to involve both appropriately in significant health decisions, unless doing so would not be in the child’s best interests or the child is competent and chooses otherwise.

Access to medical records

Parents with parental responsibility are usually entitled to access their child’s medical record. Access may be limited only where:

the child or young person has capacity and does not consent to sharing; or
in our clinical judgement, sharing would not be in the child’s best interests.

When records are shared, any third-party information (for example details about another parent) will be removed where appropriate.

Disagreements about assessment or treatment

If there is disagreement about non-urgent assessment or treatment, we will usually ask that this is resolved between parents through appropriate routes (for example mediation or legal advice) before proceeding. If we believe delay is likely to be harmful to the child, we will act in the child’s best interests and may seek advice from safeguarding professionals.

Communication with the practice

To ensure we can focus on your child’s care:

please avoid asking staff to pass messages or arguments between parents;
please keep requests focused on clinical matters;
abusive or threatening communication towards staff is not acceptable and will be managed under our practice policy.

The child’s wellbeing

Ongoing high conflict between parents can affect children’s wellbeing. If we become concerned that conflict is impacting [Child’s name]’s health, development, or access to care, we may seek safeguarding advice or involve other services in line with our duties.

If you have questions about this letter or wish to discuss your child’s health needs, please contact the practice to arrange an appropriate appointment.