Safeguarding Children in Health Services

1. Safeguarding Children in Health Services Lucy Watson Director of Quality and Patient Safety Gill Munro Designated Nurse for Safeguarding Children Dr Tamsyn Nicole Designated Doctor for Safeguarding Children 22 February 2013

2. Health System 2013 aaaaaaaaaaaaaaaa

3. Key: Bodiesto beabolished Statutorybodies or functions Localarrangements The old … … and the new … National Commissioning Board:The new body that will provide ‘leadership’ for local Clinical Commissioning Groups and also commission some health services: Specialist Commissioning and Primary Care (GPs, dentists, community pharmacy & opticians). National level DepartmentofHealth NationalCommissioningBoard Regional level Strategic HealthAuthority(SHAs)(To be abolished in April 2013) Sub-nationaloffices (x 4) The NHS Reforms: The old and the new CommissioningSupport Organisation (Best West) … and areaoffices (x 50) Health & Wellbeing Boards:The new Boards bring together health and social care commissioners, councillors and a lay rep to promote joint working and tackle inequalities in people’s health and wellbeing. Role: Commissions many local services: such as social care, transport, housing and education – and as part of the new reforms, public health. Health & Wellbeing Board County/Local Authority level Local Authorities (Councils):Commissions many local services: such as social care, transport, housing and education – and as part of the new reforms, public health. Somerset Primary Care Trust (PCTs) (To be abolished inApril 2013) LocalAuthority (Council) Somerset Clinical CommissioningGroup(CCG) Public Health Clinical Commissioning Groups:The new GP-led bodies are taking over from PCTs in commissioning most health services. GP Federations (9) Locality level GP Localities:In some areas, GP Practices are working together in localities. GP Practices:Family doctors or GPs usually provide the first point of contact between a patient and the NHS. GPs work together in independent businesses called practices. GP Practices (76) Practice / local level adapted from lucy.nicholls 1 May 2012

4. Transition to the Clinical Commissioning Group • established safeguarding team across Somerset unchanged • PCT safeguarding team part of the Clinical Commissioning Group, (CCG) • strong links with safeguarding professionals across the Area Team of the NHS Commissioning Board– (Bristol, North Somerset, Somerset and South Gloucester) • opportunity to develop cross boundary practice standards • clear lines of accountability within the CCG for safeguarding and within commissioned services

5. Safeguarding Children Team – not one single provider CHAIR Somerset Clinical Commissioning Group (SCCG) Public health Director of Quality & Patient Safety (SCCG) Primary Care Designated Doctor (SCCG) Designated Nurse (SCCG) Named GP Independent Providers GP Practices (76) Health Provider Trusts Safeguarding Executive Leads Head of C&YP Services Heads of Children & Maternity Services Named Nurse Somerset Partnership NHSFT Named Doctor Taunton & Somerset Hospital NHSFT Named Doctor Somerset Partnership NHSFT Named Nurse Taunton & Somerset Hospital NHSFT Named Doctor Yeovil District Hospital NHSFT Named Nurse Yeovil District Hospital NHSFT Locality Safeguarding Nurses Named Midwife Named Midwife CAMHS Maternity Services Children Services Maternity Services Mental Health & Social Care Directorate Community Health Children Services Specialist Nurses Specialist Midwives Substance Misuse Integrated Therapies FRONTLINE PRACTITIONERS Contraception &Sexual Health Minor Injury Units 5

6. Commissioning Questions to Consider • what assurance do we have that all health services where children may be seen have sufficient knowledge and understanding to identify children at risk of harm and in need of safeguarding? • what processes are in place for the early identification of vulnerable children and young people? • is there clear clinical leadership to assess and manage the risks to individual children? • have staff received the appropriate level of training? • can we ensure that health and social care agencies jointly and effectively assess the safeguarding risks?

7. Commissioner Responsibilities • assurance of the arrangements in place for safeguarding in all Trusts • training for staff at the level commensurate with their roles – intercollegiate guidance • policies, procedures and pathways in place with clear evidence of implementation demonstrated through annual audit programme • incident reporting for safeguarding and cooperation in serious case reviews • duties to cooperate and participate in Local Safeguarding Board

8. CQC Provider Practice Standards • health providers have a safeguarding lead/named professional • policies and procedures in place to safeguard and promote the welfare of children • staff training demonstrates that staff have an understanding of their roles and responsibilities • safe working practices include recruitment and vetting procedures • good record keeping and appropriate information sharing

9. Improving Partnership Working • The quality, transition and outcome of the child’s journey is determined by how effectively organisations work together • Building effective partnerships requires • listening to each other – improving communication • understanding individual agency perspectives • using a development approach to support inter-agency working • clear roles and responsibilities • involving service users and carers • achieving long-term commitment to the process and a culture of respectful challenge

10. Protecting Children and Young PeopleHow can we do it better? • joint agency early intervention • effective pre-birth timely planning • consultation over case closure – particularly where there is recent substance misuse e.g. antenatally or new parents • listen to each other, question and challenge and finally • putting the voices of children, young people and their families at the heart of service design and delivery (2010 NICE / SCIE guidance -principles and values)