Maintenance is necessary to ensure that policies and procedures are kept up to date. Managers should review policies and procedures and any changes, updates and implementation should be signed for. Managers will be responsible for providing the staff with updates and changes as they occur.

Confidentiality is very important in any organization. With regard to the health of the children it is important that staff keep all information confidential. The child’s health may only be discussed amongst people who need to and are authorised to do so. All staff must sign a letter of agreement regarding confidentiality.

HIV/AIDS According to the law of the country, the Human Resource department of the organisation must have an HIV/AIDS policy in place which covers issues relating to staff members who might be or who might become HIV positive.

Occupational Safety/Discipline which includes the non-compliance with prescribed working procedures and failure to wear personal protective clothing or equipment when necessary e.g. wearing gloves when working with body fluids; the negligent use of medication and the intentional and negligent release of harmful viruses or bacteria into the work environment by not following procedures. These actions could result in a formal disciplinary procedure as set out by the Human Resources department.

Important elements in understanding policy and proceduresDecide on elements to include in your policies and procedures and draw up a map of different stakeholders and their area of involvement in the different stages of the project cycle.

Who are these stakeholders?  

1. Staff working directly with children
2. Staff working indirectly with children
3. Senior management
4. Trustees
5. Children
6. Children’s families and people significant to them
7. Volunteers and interns 
8. Partner organisations

Policies should be built on the following seven elements

1. Personnel recruitment
2. Education and Training  
3. Management Structure  
4. Behaviour Protocol  
5. Communication about Children  
6. Reporting and Reaction Protocol 
7. Ramifications of Misconduct

They should be based on six important cornerstones

1. A child rights-based approach
2. Consultation
3. Ownership
4. Confidentiality
5. Transparency
6. Sensitivity

In developing policies using the above elements and corner stones an important question to ask before implementing the policy is: Why do we want this policy? 

Each policy should have clear and understandable procedures indicating how to carry out the policy. (Child Protection Policies and Procedures Toolkit: How to Create a Child-safe Organisation Jackson & Wernham 2005)

Areas that need policies within Paediatric Palliative Care will include:

• The Safety of Children          
• Bereavement Care            
• Admission
• Access to Information          
• Referrals                          
• Visitors
• Media
• General Child Care            
• Confidentiality
• Uniform Standard of Care    
• Volunteers                        
• Rights of the Child
• Death of a Child                  
• Child Protection
• Discipline

Examples of child protection policies can be found on the following websites:

www.childhope.org.uk  

www.savethechildren.org  

www.tearfund.org 

www.worldvision.org