Synopsis
Apply UK-nation-specific consent and capacity rules in confidential sexual-health care, distinguish Gillick competence from Fraser contraception criteria, identify exploitation or serious harm, and use the correct local safeguarding and access pathway.
- Identify age, UK nation and the exact decision. Capacity or competence is decision- and time-specific and improves with suitable communication and private discussion.
- At 16 and 17, presume ability to consent, but the legal framework for absent capacity differs: Mental Capacity Act in England and Wales, adult incapacity law in Scotland, and Northern Ireland’s distinct statutory and common-law position.
- Under 16, England, Wales and Northern Ireland use Gillick competence; Scotland uses section 2(4) of the Age of Legal Capacity (Scotland) Act 1991.
Key red flags
Sexual activity involving a child under 13 should usually be shared because the child is legally unable to consent; any decision not to share needs safeguarding-lead discussion and recorded reasons.
Force, threats, bribery, payment, substances used to obtain sex, trafficking, a position of trust or a marked age, maturity or power imbalance suggests abuse or exploitation.
The young person fears going home, the alleged source has current access, siblings may be at risk or disclosure could trigger immediate retaliation.
Pregnancy, bleeding, genital injury, severe pain, overdose, self-harm, intoxication or recent HIV exposure requires urgent clinical care alongside safeguarding.
A companion will not allow private conversation, controls devices or answers every question; this may impair voluntary decision making and safe follow-up.
The child is legally unable to consent and information should usually be shared through safeguarding routes after urgent safety assessment.
Power imbalance, position of trust, force, payment, substances, exploitation or inability to understand supports prompt protective sharing.
A parent or companion may provide support, but control, hostility, surveillance or coercion requires private assessment and a safer communication plan.
Reasoning priorities
Select the correct legal and professional framework for the particular choice.
Age alone is insufficient; record the UK nation, decision, urgency and whether capacity or competence is in doubt.
Worked reasoning
A 15-year-old requests an STI test without parental knowledge after consensual sex with a similar-age partner and reports feeling safe.
- Speak privately, explain confidentiality and limits, identify the UK nation and ask the young person to explain the proposed tests, results and follow-up.
- Assess decision-specific competence using Gillick in England, Wales or Northern Ireland, or the Scottish section 2(4) test, and address communication barriers.
- Complete a safeguarding assessment for consent, age and power difference, position of trust, substances, payment, coercion and home safety without assuming abuse from age alone.
- If competent and no protective disclosure is justified, provide confidential care, encourage a safe trusted adult, agree a secure result route and document both competence and safeguarding reasoning.