child becomes competent to consent to treatment: it depends both on the child and on the seriousness and complexity of the treatment being proposed.35 ‘Competence’ is not a simple attribute that a child either possesses or does not possess: much will depend on their relationship and trust between doctors, other health professionals and the child and their family or carer. Children can be helped to develop competence by being involved from an early age in decisions about their care. If a child under 16 is competent to consent for himself or herself to a particular intervention, it is still good practice to involve the family in decision making, unless the child specifically requests that this should not happen and cannot be persuaded 35 Gillick competency and Fraser Guidelines. 38 otherwise. As with older children, a request for confidentiality must be respected unless the child is suffering or likely to suffer significant harm without disclosure. 39 Annex D: Some terms used in this guidance Designated professional: CCGs are required to have access to the expertise of a designated doctor and nurse for looked-after children, whose role is to assist commissioners in fulfilling their responsibilities to improve the health of looked-after children. The Royal Colleges’ intercollegiate framework includes model job descriptions. Designated teacher: all maintained schools and academies are required to have a designated teacher for looked-after children. Their role is to act as a source of advice and expertise and to champion the needs of looked-after children within the school as well as work with the local authority that looks after the child to ensure his or her personal education plan (PEP) is developed and implemented. Distant placement: Regulation 11(5) of the Care Planning