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GPs need to improve services for children at risk

Primary care has ‘inconsistent’ approach to child protection

Adrian O'Dowd

Monday, 11 July 2016

GPs must improve how they deal with children at risk of harm and try to ensure they get better at identifying and listening to them, concludes a new report from the Care Quality Commission (CQC).

The CQC has published a report Not seen, not heard looking at how effective health services are in providing early help to children in need, the health and wellbeing of looked-after children and how these services identify and protect children at risk of harm.

Although local authorities had overarching responsibility for safeguarding, the CQC said that every organisation and person who came into contact with a child had a role to play and healthcare professionals were in strong position to address children’s health and welfare needs and safeguarding concerns.

For the report, the CQC analysed 50 reports written by its children’s services inspection team from September 2013 to December 2015, and also carried out focus groups with inspectors and children and young people.

It concluded that the contribution made by primary care services to child protection cases was inconsistent, with the majority of areas needing to strengthen arrangements.

“In many cases there had been no GP contribution at all,” said the authors.

“Where GPs had been involved, the information submitted about the child’s health was frequently too basic. GPs are often in the unique position of knowing the child and their family for many years and can make significant contributions to the safeguarding process.”

The most common factors for the lack of GP engagement were:

  • lack of awareness of responsibilities in contributing to child protection cases
  • no template or guidance for encouraging and standardising GP submissions to case conferences
  • barriers that prevented GPs attending case conferences in person such as conferences being organised during surgery hours, in inconvenient locations and at late notice
  • not being kept informed by other agencies and in many areas, information sharing by other health staff with GPs was absent or ineffective.

The report says that overall, health professionals have improved the way they assess risk and recognise safeguarding concerns, but services are not consistently protecting and promoting the health and welfare of children.

More should be done by health providers, including staff in hospitals, health visitors and GPs, as well as commissioners, said the authors, to ensure that services were improving outcomes for children, strengthening the quality of information sharing and joint working.

The report contains best practice examples of effective service delivery and CQC urged health professionals and leaders to use it as a learning tool.

CQC’s chief inspector of general practice, Professor Steve Field said: “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 justice system all work together.”

CQC’s chief executive, David Behan said: “Children and young people need to be listened to and need to feel that those looking after them care about them.

“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.”

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