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SJT: Youth Consent, Gillick/Fraser & Safeguarding Steps (passthemsra.com) - Free MSRA revision


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This episode breaks down one of the most challenging MSRA SJT topics: consent, capacity and safeguarding in under-18s. You’ll learn how to sequence decisions legally (age → competence → PR → best interests), how to apply the Gillick and Fraser tests safely, when confidentiality must be broken, and how to avoid the classic exam traps. A clear walkthrough of the AGE-SAFE framework with high-yield scenario patterns every candidate must master.

0:00 Why youth consent is so complex
00:22 Ethical tension: autonomy vs safeguarding
00:55 Four legal pillars (age, competence, PR, best interests)
01:25 Under-16s: Gillick competence
01:55 16–17s: FLRA Section 8 adult-weight consent
02:40 Gillick vs MCA – key differences
03:20 Applying Fraser criteria
03:55 Confidentiality limits explained clearly
04:40 AGE-SAFE framework
05:20 Step 1: Age, urgency, PR
06:00 Step 2: Gillick assessment
06:40 Step 3: Fraser 5 test
07:20 Step 4: Encourage but don’t require parental involvement
08:00 Step 5: Document everything robustly
08:40 Mandatory safeguarding triggers
09:20 Under-13 disclosures
10:00 High-stakes refusals at 16–17
10:40 Residual court powers
11:20 Common score-killing traps
12:00 Best-interest conflicts
12:40 Disagreement between parents with PR
13:20 Rapid-fire exam patterns
14:00 Final takeaways

• Always sequence: Age → Competence → PR → Best interests
• Gillick competence = decision-specific, developmental
• FLRA (1969) Section 8 = 16–17s can consent as adults
• Fraser 5: understand advice, won’t involve parents, likely to continue sex, risk without care, best interests
• Confidentiality is not absolute — safeguarding overrides consent
• Under-13 sexual activity = automatic statutory referral
• Always encourage parental involvement but never make it a barrier to care
• Courts can override a competent minor’s refusal of life-saving care

AGE-SAFE mnemonic:
A – Age & urgency
G – Gillick test
E – Explain Fraser/PR needs
S – Safeguard & set confidentiality limits
A – Agree plan & ownership
F – Follow-up
E – Enter notes

Fraser 5 mnemonic:

  1. Understands the advice

  2. No parent involvement anticipated

  3. Likely to continue sexual activity

  4. Health risk if not treated

  5. Best interests overall

Links:
• passthemsra.com – Complete MSRA revision, notes, mocks, flashcards
• freemsra.com – Free podcasts, threads and rapid-learning guides
• msra.io – Smart MSRA Qbank with analytics

#MSRA #SJT #MedicalRevision #UKDoctors #MedEd #passthemsra #freemsra #msraio #GillickCompetence #FraserGuidelines #Safeguarding #YouthConsent

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