Working Together To Safeguard
Children
NHS Waltham Forest Clinical Commissioning
Group
Governing Body Training
14.01.2015
Key Roles and Responsibilities of NHS Waltham Forest
CCG Governing Body
(Section 11 of the Children Act 2004, NHS Accountability Framework 2013).
Responsibility
• To ensure that there is a clear line of accountability
for the commissioning and/or provision of services
designed to safeguard and promote the welfare of
children.
Accountability and Child Protection
• Chief Executives are responsible for
ensuring the Health contribution to Child Protection is
discharged effectively.
• Safeguarding is located in the Quality and
Governance Nurse Directorate.
The Legislative Foundation
Children Act 2004
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In response to Victoria Climbie Public Inquiry
Arrangements to ‘Safeguard and Protect Welfare’ – by ALL agencies
Duty to protect
LSCBs instead of ACPC (statutory membership held to account).
Human Rights Act 1998
• Article 2 and 3 - Right to life, Right not to be tortured or suffer
degrading treatment
• Article 8 – Right to private and family life
Domestic Violence Legislation
• Sits slightly Outside of Adult Protection as in ‘No Secrets’
• Impacts on children – risk to children must be considered
• DVHR are statutory (Safeguarding SCR - DVHR)
Sexual Offences Act 2003
• Age of consent 16 for SI (hetero and homosexual relationships)
• Children of 12 (under 13) cannot consent to SI = statutory rape
TWO KEY DOCUMENTS PUBLISHED
MARCH 2013
• Safeguarding Vulnerable
People in the Reformed
NHS
• Working Together to
Safeguard Children
Why does this matter? IMPACT
Messages from Research
• 2 children per week are killed by deliberate harm in England
• Neglect is common and a threat to health and wellbeing
• Abuse in childhood is associated with poorer physical and or mental health,
elevated delinquent behaviour and risk taking
• Severely maltreated children 11 – 17 are 6.4 times more likely to have
suicide ideation and 4.6 times more likely to self-harm that non abused peers
(18–24 years 3.9 times more likely)
• Poor parenting capacity (what is learned - attachment and empathetic
development) can creates an inter-generational abuse cycle
• Safeguarding profile changes over time.
• Children are the future!
IMPACT ON SOCIETY / SERVICES / ECONOMY IS ENORMOUS
IMPACT ON NHS SERVICES AND FUNDING?
What does good look like?
What does good look like?
& How do you know its good?
General Evidence
Cultural Evidence
• Meetings / meeting schedules attendance
• Formal reports / Annual Reports
• Audits /CQC Inspections/ Sec11
• Work-plans,
• Action plans,
• Dashboards,
• Risk registers and data etc
• 360 degree staff surveys about how
safeguarding is looking?
• Do they feel they can share and
participate?
• Ask LSCB Chair how you are doing?
• Ask the population
• Ask the child
The way it is and the way it is
perceived to be? That is the Question?
Political Hot Spots
• Cross Government – DFE and HO work-streams
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Child Sexual Abuse & Sexual Exploitation (Rotherham)
DA and DVHR
Troubled Families
Gun and Gang Crime
Female Genital Mutilation
Radicalisation (Prevent)
Neglect
• Sector Integration and Innovation
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Engagement in MASH
Call to action HV and School Nursing / Early help
LSCB and SAB engagement and development
• Can hold NHS to account (can’t direct)
• SEC 11 audits / SCR
LEADERSHIP AND VISION
Leadership, Accountability and Assurance for NHS
Organisations
• Internal assurance processes and Board accountability
• Local Safeguarding Children Boards (LSCBs)
• Safeguarding Adults Boards (SABs)
• The draft Care and Support Bill proposes putting SABs on a
stronger, statutory footing. It is intended that CCGs will become
statutory members of SABs.
• Health and Wellbeing Boards (HWBs) have overall strategic
responsibility for assessing local health and wellbeing needs in the
Joint Strategic Needs Assessment and agreeing Joint Health and
Wellbeing Strategies for each local authority area.
• External regulation and inspection– CQC and Monitor
• Locally developed peer review and assurance processes
• Effective commissioning, procurement and contract monitoring.
Safeguarding Vulnerable People in the
Reformed NHS
England, through the leadership of the Chief Nursing
Officer:
• Ensures that NHS Waltham Forest meets its specific safeguarding duties in
relation to the services that it directly commissions (e.g. primary care,
specialised services)
• Leads policy for NHS safeguarding, including defining improvement in
safeguarding practice and outcomes
• Leads, in conjunction with Regional Directors of Nursing, assurance and
peer review processes for both CCGs and directly commissioned services.
• Provides specialist safeguarding advice to the NHS
• Leads a system where there is a culture that supports staff in raising
concerns regarding safeguarding issues.
• Leads a system where there is a culture that supports staff in raising
concerns regarding safeguarding issues
Clinical Commissioning Groups
CCGs need to assure themselves that the organisations from which they
commission services have the following safeguarding arrangements in place:
• Safeguarding training for staff in order to recognise and report safeguarding
issues
• A clear line of accountability for safeguarding, properly reflected in the CCG
governance arrangements
• Arrangements to co-operate with local authorities in the operation of LSCBs,
SABs and Health and Wellbeing Boards
• Effective arrangements for information-sharing
• The expertise of designated doctors and nurses for safeguarding children and
for looked after children and a designated paediatrician for unexpected deaths
in childhood
• A safeguarding adults lead and a lead for the Mental Capacity Act, supported by
the relevant policies and training.
• Monitoring and quality assurance of all services commissioned occurs through
CQRM, SI panels, QA visits, Dash boards (KPIs).
Directly commissioned services
All providers of health services are required to be registered with the Care
Quality Commission (CQC). In order to be registered, providers must ensure
that those who use the services are safeguarded and that staff are suitably
skilled and supported. This includes private healthcare providers
Named professionals.
Named GPs
GP practices should have a lead for safeguarding, who should work closely
with named GPs and designated professionals.
The 6Cs - Strengthening Safeguarding
Practice
Incorporating compassion in
Safeguarding Practice, the
national strategy for nurses,
midwives and care staff
Compassion
Competence
Communication
Courage
Commitment
Working
Together to
Safeguard
Children is
our business
Co-commissioning in primary care
CCG will look to take back some of primary care commissioning, including
but not exclusively;
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Contract management of extended GP services
Education and training
Complaints management
Development of new services
Revising existing contracts
which will include safeguarding of children
The Voice of the Child and Vulnerable Adult /
Adult at Risk
• Securing the voice of the child young person and vulnerable adult to inform
safeguarding arrangements within Waltham Forest CCG needs accelerated progress
and must be managed as a priority area for the CCG.
• Further work is required to ensure that outcome measures and quality of
experience are included within the safeguarding performance reporting
• The CCG are co – working with the Local Authority to progress this essential facet
of CCG objectives.
The voice of the child, young person and
vulnerable adult
•Vision, strategy, leadership and capacity to
improve
•Governance, accountability and risk
management
•Quality improvement, learning and workforce
development
•Efficient/effective use of safeguarding
resources to meet current requirements and
future challenges operationally
Vision, strategy, leadership and
capacity to improve
d)Strengthen the connections between adult
safeguarding and domestic abuse by
identifying some of the organisational
developments which can support best practice
in this area.
e)Ensure that the strategic approach for
safeguarding commissioning reflects the
recently revised definition of domestic abuse
to include so called ‘honour based’ violence,
female genital mutilation and forced marriage.
Governance
National
Local
• The Francis Public Inquiry
• The Review of Winterbourne
View
• Child sex abuse scandal’s
Rochdale and Oxford
• The Investigations following
Saville
• The Death of Baby Peter and
the Munro review
• Murder of Daniel Pelka
• Rotherham inquiry
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Child KK
CTG
FT
MK
Child F