This toolkit provides busy practitioners with an easily navigable resource to ensure excellence in safeguarding practice in Primary Care.
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Developments in safeguarding arrangements
Developments in Safeguarding in England
This section is relevant to England only. Named GPs and other safeguarding professionals may find the following summary helpful.
The Wood Review
In December 2015, the Department for Education (DfE) asked Alan Wood CBE to lead a review of the role and functions of the Local Safeguarding Children Boards (LSCBs) in England. As part of the review he also looked at serious case reviews and Child Death Overview Panels. The Wood Review was published along with the government response to the review. The Wood Review argued that a new system of local freedom is needed to allow local decision making and local accountability. The government plan to introduce a new statutory framework which will set out clear requirements, but give local partners the freedom to decide how they operate to improve outcomes for children.
Working Together to Safeguard Children 2018
Working Together to Safeguard Children 2018 was published in July 2018 and is the statutory framework produced by the government in response to the Wood Review. This replaces ‘Working Together to Safeguard Children 2015’. This statutory framework only applies in England.
Key implications for CCGs
- Multi-agency safeguarding arrangements
‘To achieve the best possible outcomes, children and families should receive targeted services that meet their needs in a coordinated way.’
‘The responsibility for this join-up locally rests with the three safeguarding partners who have a shared and equal duty to make arrangements to work together to safeguard and promote the welfare of all children in a local area.’
The three safeguarding partners:
- The local authority (Chief Executive)
- Clinical Commissioning Groups (CCGs) for any part of an area which falls within the local authority area (CCG Accountable Officer)
- The chief officer of police for any part of an area which falls within the local authority area (Chief Constable)
The role of the safeguarding partners:
- To set out and publish how they will work together and with any relevant agencies (as they consider appropriate) to coordinate safeguarding services. Plans should include how independent scrutiny of arrangements is to be implemented.
- Act as a strategic leadership group in supporting and engaging others.
- Implement local and national learning including from serious safeguarding incidents.
- Agree contributions with relevant agencies, including funding, accommodation, services and any resources connected with the arrangements.
- Be clear how they will assure that relevant agencies have policies and procedures in place and understand how they will share information.
- Communicate regularly with relevant agencies and others they expect to work with them.
- Agreeing clear links with other strategic partnerships (Health and Wellbeing Boards, Local Safeguarding Adult Boards, Channel Panel, Family Justice Board, MAPPA).
Organisations and agencies within a strong multi-agency system should have confidence that information is shared effectively, amongst and between them, to improve outcomes for children and their families. Safeguarding partners may require any person, organisation or agency to provide a relevant agency for the area, a reviewer or another person or organisation or agency, with specified information. This must be information which enables and assists the safeguarding partners to perform their functions to safeguard and promote the welfare of children in their area, including related local and national child safeguarding practice reviews.
The person or organisation to whom a request is made must comply with such a request and if they do not do so, the safeguarding partners may take legal action against them.
As public authorities, safeguarding partners should be aware of their own responsibilities under the relevant information law and have regard to guidance provided by the Information Commissioner’s Office when issuing and responding to requests for information.
- 29 June 2019 – safeguarding partners must have published local arrangements and had these agreed by Secretary of State for Education.
- 29 September 2019 – all new local arrangements must have been implemented.
- Child Death Reviews
Establishment of ‘Child Death Review Partners’:
- Local authority
- CCGs operating in the local authority area
Child death review partners for two or more local authority areas may combine and agree that areas may be treated as single area (should cover a child population such that partners review at least 60 deaths per year).
Role of Child Death Review Partners:
- Establish a structure and process to review all deaths of children normally resident in the local area. The purpose of child death reviews is to identify any matters relating to the death which are relevant to the welfare of children in the area or to public health and safety and to consider any necessary action.
- Agree core representation on panel or structure set up to review deaths. Must include Designated Doctor for Child Deaths.
- Funding arrangements to be agreed.
- Analyse information from all deaths reviewed.
- Publish agreed local arrangements.
- Prepare and publish reports.
- 29 June 2019 – child death review partners must have published local arrangements and notified NHS England when they have done so.
- 29 January 2020 – all outstanding child death reviews (i.e. commenced prior to 29 June 2019) must have been completed
- Child Safeguarding Practice Reviews
- A new national Child Safeguarding Practice Review Panel has been established and commenced operating on 29 June 2018.
- The Panel may commission and publish national reviews of serious child safeguarding cases which they consider are complex or of national importance.
- Serious child safeguarding cases are those in which:
- Abuse or neglect of a child is known or suspected and
- The child has died or been seriously harmed
- Local Authorities are required to notify the Panel of any serious incident within five working days.
- Safeguarding partners (or Local Safeguarding Children Boards where the new partnership arrangements are not yet in place) to undertake a rapid review into all serious child safeguarding cases promptly and complete this within fifteen working days of becoming aware of the incident.
- Copy of rapid review to be forwarded to the Panel, including whether partners intend to undertake a Child Safeguarding Practice Review.
- Any national child safeguarding practice reviews undertaken by the Panel are to be funded centrally. Other reviews will continue to be funded by local partnerships.
- Panel will advise regarding initiation and/or publication of Child Safeguarding Practice Reviews.
- Following establishment of local safeguarding partner arrangements - ‘grace period’ of 12 months to complete and publish any outstanding SCRs.
- Learning from SCRs must be passed on to safeguarding partners to consider follow up actions as appropriate.
So what are the challenges for CCGs going forward?
- CCG representation on new partnership arrangements? What will new arrangements look like?
- Who are ‘relevant partners’ from the health economy and how do we engage partners who may not have direct representation in new arrangements?
- How are new child death reviews to be undertaken? Funding?
- Making the most of new opportunities as an equal partner with police and local authorities.
Developments in Safeguarding in Wales
Social Services and Well-being (Wales) Act 2014
This section is relevant for practitioners working in Wales.
The Social Services and Well-being (Wales) Act 2014 came into effect in April 2016. It sets out what must and should be done to safeguard children and adults. The intention of the Act is to strengthen and build on existing practice. It is important that health professionals and workers are aware of the law, guidance and regulations that apply to their role.
Overarching Principles and Duties
The Act aims to change the way people’s care and support needs are met. The vision of care and support under the Act is one where individuals have a voice in and control over reaching the goals that matter to them and to help them achieve wellbeing.
Central to the Act is the well-being duty. People have a responsibility for their own well-being supported by their families, friends and communities. However, they may also need support from practitioners to ensure that they achieve well-being. A person exercising functions under the Act must seek to promote the well-being of people who need care and support, and carers who need support. This overarching duty applies to health organisations and their practitioners.
The Act attempts to rebalance the focus of care and support to prevention and earlier intervention, increasing preventative services within the community to minimise the escalation of needs to a critical level.
Collaboration, strong partnership working between organisations and co-production with people needing care and/or support is a key focus of the Act.
Other overarching duties when exercising functions under the Act. Practitioners have to:
- ascertain and have regard to the individual’s views, wishes and feelings (and for under 16s, those with parental responsibility, if practical and consistent with the child’s well-being);
- support them to participate in decisions and to communicate;
- promote and respect their dignity;
- have regard to the characteristics, culture and beliefs of the individual;
- supporting people to participate includes considering whether advocacy support is necessary.
For adults specifically, there is also the duty to:
- begin with the presumption that an adult is best placed to judge their own well-being and;
- to have regard to the importance of promoting their independence where possible.
- for children specifically there is also the duty to promote the upbringing of the child by the child’s family, in so far as doing so is consistent with the well-being of the child.
In the Act, protection from abuse and neglect is one of the aspects of well-being. In relation to a child, well-being also includes their physical, intellectual, emotional, social and behavioural development as well as their welfare and ensuring that they are kept safe from harm. Safeguarding is part of helping people to live life to the full, not just stopping abuse, neglect and harm.
Under the Act, you need to have regard to the following:
- United Nations Principles for Older Persons.This includes respect for older people’s dignity, beliefs, needs and privacy and for the right to make decisions about their care and the quality of their lives.
- United Nations Convention on the Rights of the Child. This includes the right to life, survival and development, and protection from violence, abuse and neglect.
- United Nations Convention on the Rights of Disabled People (UNCRDP). The code of practice for Part 2 of the Act also points out that public authorities must not act in a way that is incompatible with rights under the European Convention on Human Rights. This includes the right not to be subjected to inhuman or degrading treatment and the right to liberty and security.
Part 7 of the Act (sections 126-142) deals with safeguarding and is underpinned by the overarching duties of the Act. It reiterates that safeguarding is everyone’s business and that practitioners in all agencies need to recognise and act when they identify children and adults at risk. It also confirms that safeguarding is much broader than protection from abuse, neglect or harm and how to help people to keep themselves safe should be something that is always considered.
Other parts of the Act link to the duty to protect people from abuse and neglect, and to protect children from harm are:
- Part 2 links prevention, information and advice to safeguarding;
- Part 3 links assessment to safeguarding;
- Part 4 links meeting needs to safeguarding;
- Part 6, Section 78 says that a local authority looking after any child must safeguard and promote the child’s well-being;
- Part 9 says that a local authority must make arrangements to promote co-operation between itself and partners with a view to protecting adults with needs for care and support, or children, who are experiencing, or are at risk of, abuse or neglect;
- Part 10 says that local authorities must arrange, where necessary, for an independent advocate to support and represent an individual in safeguarding processes.
Children and Young People Under 18
There is a new definition of a ‘Child at Risk’. The old term of ‘Child in Need’ as under section 17 of the Children Act 1989 is removed.
There is a new duty for relevant partners of a local authority to report children at risk (Section 130). If a partner has reasonable cause to suspect a child is at risk, it must inform the local authority of that fact. Again, the decision to act does not require actual abuse or neglect to have taken place.
When a child has been reported under Section 130 of the Act, the local authority shall make enquiries to enable them to decide whether they should act to safeguard or promote the child’s welfare under section 47 of the Children Act 1989.
This means that practitioners will still need to use the Children Act 1989 section 47 and the All Wales Child Protection Procedures in the same way as they do now when responding to child protection referrals.
Developments in Safeguarding in Scotland
This section is relevant for practitioners working in Scotland.
The key guidance for anyone working with children in Scotland is the National Guidance for Child Protection in Scotland (Scottish Government, 2014).
The national approach to improving outcomes for children and young people in Scotland is ‘Getting it right for every child (GIRFEC)’ (Scottish Government 2015). GIRFEC is based on children’s rights and its principles reflect the United Nations Convention on the Rights of the Child (UNCRC). It provides a framework for those working with children and their families to provide the right support at the right time.
- Its principles help shape all policy, practice and legislation that affects children and their families.
- It provides a consistent way for people to support and work with all children and young people in Scotland.
- It aims to improve outcomes for children and make sure that agencies work together to take action when a child is at risk or needs support.
- Is underpinned by prevention, recognising that: early intervention and partnership working is the best protection, that child wellbeing and protection is a collective responsibility
The Children and Young People (Scotland) Act 2014
The Children and Young People (Scotland) Act 2014 was passed by the Scottish Parliament in March 2014. This legislation is a key part of the Scottish Government's strategy for making Scotland the best place in the world for children to grow up. By facilitating a shift in public services towards the early years of a child's life, and towards early intervention whenever a family or young person needs help, the legislation encourages preventative measures, rather than crises' responses.
Underpinned by the Scottish Government's commitment to the United Nations Convention on the Rights of the Child 1989 ( UNCRC), and the national approach, GIRFEC, the 2014 Act also establishes a new legal framework within which services are to work together in support of children, young people and families.
The Children and Young People (Scotland) Act:
- Part 3 of the Act places requirements on local authorities and health boards to prepare ‘children’s services plans' for each local authority area, reporting on this each year.
- Establishes a 'Child’s Plan' (Part 5) for every child that is deemed to need one, to be prepared by the health board for pre-school children and the local authority for school-aged children.
- Establishes a 'Named Person'(Part 4) for every child up to age 18, to be provided by the health board for pre-school children and the local authority for school-aged children.
- Places a definition of 'wellbeing' on a statutory footing, referring to the SHANARRI indicators.
- Makes looked after children a priority for a host of publicly funded bodies by naming them as Corporate Parents, tackling issues important to looked after children and young people, such as poverty, early school leaving, poor health and exclusion.
The Children and Young People (Information Sharing) (Scotland) Bill
Organisations must handle, store, process and share personal information in line with existing laws and guidance. People working with children, young people and their families must work in partnership with them when considering and sharing information necessary to promote, support or safeguard a child or young person's wellbeing.
This Bill was introduced in June 2017. It aims to bring clarity and consistency to sharing information for the named person service and child’s plan.
The Bill's objective is to give families, practitioners and the wider public greater confidence in how the safeguards to information sharing will operate in relation to the named person service and provision of a child’s plan, for example human rights, data protection and confidentiality.
The Bill responds to a Supreme Court ruling in 2016. The Supreme Court found that providing a named person for every child to promote and safeguard their wellbeing was ‘unquestionably legitimate and benign’. It ruled that changes are required to the information sharing provisions in Part 4 of the Act to make those provisions compatible with Article 8 of the European Convention of Human Rights.
Information sharing: code of practice
The Bill requires Scottish Ministers to issue a code of practice that will apply when sharing information by or with the named person service and in relation to a child’s plan.
The code will require the services that support children and young people and their families, such as the NHS, local authorities and the third sector, to follow the code helping them to ensure that relevant safeguards are considered and applied when sharing information in relation to the named person service and child’s plan.
Child Protection Improvement Programme (CPIP)
In February 2016, the Scottish Government announced it would be undertaking a Child Protection Improvement Programme (CPIP). The core objective was to identify where recommendations for sustainable improvement could be made, building upon the observable improvements in practice that have already taken place in recent years and seeking to further embed Scotland's unique approach to child wellbeing: GIRFEC.
The CPIP report sets out a number of actions, including:
- taking action to tackle and prevent child neglect taking action to tackle and prevent child sexual exploitation
- working with partners to implement the children's actions outlined in the Human Trafficking and Exploitation Strategy, which is being overseen by the Child Trafficking Strategy Group
- supporting children affected by parental substance misuse
- working with partners to keep children safe online
Human Trafficking and Exploitation (Scotland) Act
Human Trafficking and Exploitation (Scotland) Act was introduced in October 2015. The Act introduced a range of provisions, including a new single offence of trafficking for all forms of exploitation for both adults and children and those who seek to exploit others.
The Act also increases the maximum penalty for offenders to life imprisonment, commits ministers to publishing and updating a human trafficking strategy, and places a duty on ministers to ensure there is a guardian service available for both child victims and children who are at risk of and vulnerable to becoming victims.
In October 2016, the Scottish Government launched a consultation on Scotland’s first Human Trafficking and Exploitation Strategy. The consultation set out the Scottish Government’s plans to tackle trafficking. A guide to what the Act does and a small number of case studies to illustrate some of the facets of trafficking and exploitation in Scotland were also published.
Limitation (Childhood Abuse) (Scotland) Bill
The Limitation (Childhood Abuse) (Scotland) Bill was introduced by the Scottish Government in November 2016. It will remove the three-year time limit on bringing civil cases to court, also known as a time-bar, and remove the limitation period for actions of damages in respect of personal injuries resulting from childhood abuse.
Child Death Review System
In 2014 the Scottish Government accepted the recommendation of the Child Death Reviews Working Group that Scotland should introduce a national Child Death Review System. Recommendations include:
- Systematically review each death in a multi-agency forum. Any local learning would be implemented amongst relevant professionals and services. These reviews should be timely, appropriate and sensitive to the needs of bereaved families.
- Collate a uniform data-set relevant to each child death for national analysis to inform national multi-agency learning and aid the development of national policy and
- Identify factors which may reduce preventable childhood deaths.
National Guidance for Child Protection Committees for Conducting a Significant Case Review
Introduced in 2015 and replaces previous guidance (2007). Significant Case Review is a multi-agency process for establishing the facts of, and learning lessons from, a situation where a child has died or been significantly harmed. Significant Case Reviews should be seen in the context of a culture of continuous improvement and should focus on learning and reflection on day-to-day practices, and the systems within which those practices operate. Wherever possible, staff should be involved in reviews and should get feedback when the review is finished.
All reviews are now shared with the Care Inspectorate The primary role for the Care Inspectorate is to support continual improvement in the quality of services for children and young people, including child protection services. They will conduct a biennial review of all SCRs completed in Scotland, reporting nationally on the key learning points for the benefit of relevant services across Scotland and the Scottish Government.