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CQC finds child safeguarding in primary care ‘inconsistent’

8 July 2016

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The Care Quality Commission (CQC) is calling all primary care professionals to do more to safeguard at-risk children.

In a report, Not seen, not heard, the regulator looks at how effective health services are in providing early help to children in need, including looked-after children.

The report found that, while health professionals have improved the way they assess risk and recognise safeguarding concerns, these services are inconsistent.

The CQC is therefore urging “everyone working with children to do more to listen to and involve children in need in their care”.

After reviewing 50 reports by the CQC’s Children’s Services Inspection team, the regulator found that the risks facing a child were recognised but not shared with other services, for example between school nurses and GPs.

It says: “Practitioners frequently did not articulate their views of the risks to the child or set out what they expect from the referral – leaving the receiving team unclear of the concerns.”

While this was an issue across the system, the CQC said it was particularly prevalent in primary care.

The report found that in many cases there was no GP involvement in child protection cases, despite their “unique position of knowing the child and their family for many years”.

Meanwhile, where GPs did contribute to the safeguarding process, the CQC found that “information submitted about the child’s health was frequently too basic”.

The report lists several reasons for low GP engagement including a lack of awareness of their responsibilities in contributing to child protection cases.

Recruitment problems, including GP vacancies, were also blamed for a lack of involvement in child safeguarding.

The CQC is therefore recommending that clinical commissioning groups (CCGs) ensure designated safeguarding GPs and nurses are in place and provide sufficient resources for them to fulfil their responsibilities.

The regulator is also recommending commissioners ensure the right staff resources are available to meet challenges across the system, including skill mix, and staff development.

Professor Steve Field, the CQC’s chief inspector of general practice, said: “The number of children identified as having been abused or exploited is just the tip of the iceberg – many more are suffering in silence.

“As new risks emerge and more children are identified as being in need, it is more crucial than ever that staff across health and social care, education, the police and the justice system all work together.

“We know that with the right questions and support, services can discover the risks and harms that threaten many children, including those from parental-ill health, sexual exploitation and female genital mutilation.

“We owe it to the children. We must provide the support they deserve and the help they need to move forward with their lives.”

David Behan, the CQC’s chief executive, added: “The extent that children feel listened to significantly influences how safe and happy they feel, and it means they are more likely to achieve better outcomes in the next stage of their lives.

“Listening to and engaging children is often what identifies a good service and while most staff demonstrate passion and determination to keep children safe, the systems and the support they need are not always there and many areas are still not getting it right for children.”