RCGP Safeguarding toolkit

Safeguarding roles and responsibilities in general practice

Everyone in the practice team has a responsibility for safeguarding and each member plays a crucial role. The RCGP Safeguarding Standards outline the safeguarding knowledge and capabilities for GPs and anyone working in any general practice setting in the UK.

All regulated clinical staff have safeguarding roles and responsibilities set out in guidance from relevant professional regulators (for example, General Medical Council, Nursing and Midwifery Council, General Pharmaceutical Council, Health & Care Professions Council). All staff should have their safeguarding duties and responsibilities outlined in their terms of employment.

Practice Safeguarding Lead

All practices should have a Practice Safeguarding Lead. The specifics of this role are outlined in the RCGP Safeguarding Standards document. There may also be a Deputy Safeguarding Lead (practices in England should be aware that ‘Working Together to Safeguard Children 2023: statutory guidance’ states that: "GP practices should have a lead and deputy lead for safeguarding, who should work closely with the named GP ”*). The role of the safeguarding lead is to support safeguarding within the practice, not to manage all safeguarding activity.

*Named GPs only exist in England and are GPs employed by an ICB (Integrated Care Board) to advise and support GP practice safeguarding leads (Working Together to Safeguard Children 2023: statutory guidance).

Practice managers

Practice managers play a crucial role in safeguarding in general practice by demonstrating safeguarding leadership, embedding safeguarding culture, and in particular, ensuring safe recruitment processes. The safeguarding specifics of this role are outlined in the RCGP Safeguarding Standards document.

Safeguarding Administrators

Practices should consider having a Safeguarding Administrator (practices use different terms) – this is a member of the Practice administrative team who, depending on size of practice and structure, either manages or oversees, the recording and coding of safeguarding information coming in and out of the practice. The role of safeguarding administrator does not need to be the individual’s sole role, but someone in the administrative team with the appropriate safeguarding knowledge, capabilities and responsibility. The safeguarding administrator should receive ongoing training and support for their role as set out in the RCGP Safeguarding Standards.

Safeguarding support roles

As practices evolve, and with the establishment of Primary Care Networks (PCNs) in England, there has been development of safeguarding support roles, such as safeguarding co-ordinators, within practices/PCNs. This role can be extremely varied depending on the background and experience of the individual which can range from an administrative role within a current practice structure to a safeguarding nurse employed by a number of PCNs.

The principle of the role is to support safeguarding work in primary care.

Practices/PCNs should be aware that safeguarding support roles in primary care:

• Are new, therefore caution, time and patience are needed with their development and integration.
• Are only one part of safeguarding practice and culture in primary care – safeguarding remains the responsibility of ALL staff members.
• Are an addition to current safeguarding practice and culture in primary care, not a replacement.
• Have no national standard as the role varies between practices and PCNs.
• Are recruited from a wide variety of individuals therefore experience and ability varies hugely.
• Will need significant supervision and guidance from the practice safeguarding lead and other relevant senior practice team members in line with their role, learning needs and expectations of the practice.
• Should not make any clinical or safeguarding decisions.
• Should have a clear job role with clear governance and escalation processes embedded.
• Should have the appropriate indemnity for their role.

The role can include:

• Managing the safeguarding diary of child protection and adult safeguarding conferences to support timely report completion and also to maximise GP attendance at these conferences where possible.
• Assisting GPs with preparation of safeguarding reports for safeguarding meetings and conferences e.g completing demographics and factual information such as missing vaccinations, ‘was not brought’ information, outstanding health referrals.
  • There should be robust supervision and governance structures in place within the practice regarding the preparation of reports to ensure appropriate, relevant and proportionate information is shared
  • Administrative staff should not interpret clinical information within a record for the purpose of a safeguarding report
  • The responsibility of the completion of safeguarding reports remains with GPs
• Supporting with safeguarding coding from safeguarding documents coming into the practice.
• Liaison with patients/families regarding any outstanding health issues raised through safeguarding conferences, e.g. liaising with parents to book appointments for a child’s health needs (such as vaccinations or health reviews) when a child is on a child protection plan.
• Maintain up to date registers/coding of children on child protection plans and looked after children.
• Help to support clinicians following up children and adults who are not brought to appointments. For example, by contacting them and arranging another appointment.
• Co-ordinate practice safeguarding meetings.
• Collate and maintain staff safeguarding training registers.
• Work closely with the practice safeguarding lead and practice manager.

At this current time, given the infancy of safeguarding support roles, it is generally not appropriate for individuals in these roles to attend child or adult safeguarding conferences/strategy meetings for the following reasons:

• Children and adults at risk of harm who are subject to child protection /adult safeguarding conferences are some of our most vulnerable patients. These conferences can be extremely difficult for families/adults and it is essential they are treated with respect.
• There are no ‘‘observational’ roles at a safeguarding conference. Every professional there must actively participate in the discussions and decision making.
• Professionals present need to be able to analyse, understand and interpret the information presented by all agencies as well as by the child/family/adult/carers.
• Professionals present need to be able to understand a wide range of risks involved in the situation and partake in any risk assessments.
• The professional representing primary care needs to be able to explain and interpret health information to non-health professionals, including the patient/family/carers.
• Professionals need to be able to respectfully challenge other agencies/professionals if appropriate and need to have sufficient authority to do so. They also need to be able to respond to respectful challenge towards themselves, their colleagues or their organisation.