Practice learning and development

This section provides suggestions on activities that help to develop whole organisation excellence in safeguarding children.

GPs and their practice staff are encouraged to access local multi-agency training as this provides an excellent opportunity to understand the roles of other professionals and organisations, as well as ensure that colleagues appreciate the roles and responsibilities of those working in general practice. These will be found on the local safeguarding partnership website.

The Intercollegiate Document: Safeguarding Children: Roles and Competencies for Healthcare Staff helps to ensure that GPs and practice staff are clear on their safeguarding children roles and expected competences. The guide outlines expected ‘levels’ and learning outcomes that can be matched to job roles in general practice. Evidence of achievement of learning outcomes at the appropriate level can help to support revalidation.

The RCN has also produced Getting it Right for Children and Young People, a self assessment tool for general practice nurses and other first contact settings providing care for children and young people that refers to the safeguarding role of the practice nurse and the required core competences to work with children and young people.

Case examples that can be used for practice discussion

These examples of cases can be used as a starting point for practice discussion and learning. There is also a suggested template for structuring discussions with an accompanying example [PDF].

  1. An expectant mother has disclosed using small amounts of cannabis.She says that it helps her to relax.
  2. A six-week old infant attends the practice for a routine development check, accompanied by his mother. On examination, you notice a small bruise on the baby’s back.
  3. A young mother, who you have been treating for depression, shares that her new boyfriend is finding the behaviour of her toddler son irritating. You are aware that she is reluctant to allow the health visitor to call.
  4. Your pharmacist flags up that a repeat prescription for a 14-year old, who is being treated for epilepsy, has not been collected.
  5. A receptionist notices a frazzled parent hit their three-year old in the waiting room. The child is inconsolable.
  6. A 15-year old, who attends a local private school, attends for hormonal contraception. She spends much of the consultation texting and is reluctant to share details of her partner.
  7. A child, who like his parents, has a mild learning disability, attends with a urinary tract infection. You notice that he has lost some weight and appears slightly grubby.
  8. A mother discusses her concerns that her 8-year old child has a rare auto-immune disease. You notice that she is one of your ‘frequent attenders’ and that previous referrals to the paediatrician have failed to identify the reasons why the child is missing so much schooling.
  9. As you arrive to do a home visit to a newly delivered mother you see a number of people hanging around outside. There are some empty cider cans on the windowsill and the house smells strongly of tobacco smoke. The baby is being given a bottle-feed by mother’s younger sibling.
  10. One of the administrative staff who has been scanning letters onto the system discovers that a child has missed two appointments with the hospital specialist, who has written to you saying they will be discharged from their clinic list.
  11. A 42-year old lady discloses that she found her husband watching ‘child pornography’ on his computer and she doesn’t know what to do.
  12. On summarising a new patient record, an admin member of staff flags up that there are MARAC (Multi-Agency Risk Assessment Conference) notifications in the record.
  13. A 12-year old boy attends with his mother – he has disclosed to her an incident of sexual abuse which happened some years earlier – this was perpetrated by another child (of the same age) in the wider family.
  14. One of the receptionist flags up that a child has been registered with the practice but there appears to be no other family members registered at the practice.
  15. A mother discloses that her partner has hit her and thrown her across the table. Her young children were in bed at the time. The mother does not want you to tell anyone and says her children are unaware of the incident.