GP mythbuster 33: Safeguarding children

Page last updated: 25 April 2024
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GP practices play an important role in safeguarding children and young people from abuse and neglect.

Safeguarding children and young people should be integrated into existing practice systems and processes for delivering general practice. This includes what we expect to see on our inspections. It relates to key line of enquiry S1: how do systems, processes and practices keep people safe and safeguarded from abuse?

Statutory guidance

The Department for Education published the updated version of Working together to safeguard children in July 2018. This is statutory guidance which helps professionals understand what they need to do, and what they can expect of one another, to safeguard children. It focuses on core legal requirements and makes it clear what individuals and organisations should do to keep children safe. Safeguarding children is defined as:

  • protecting children from maltreatment
  • preventing impairment of children’s health or development
  • ensuring that children grow up in circumstances consistent with the provision of safe and effective care
  • taking action to enable all children to have the best outcomes.

Competence and training

All healthcare staff must be competent to recognise abuse, clearly understand their responsibilities and take effective action appropriate to their role. GPs and managers have a responsibility to ensure that all practice staff have the knowledge and skills to be able to meet this requirement.

When we inspect we need to see that GPs and all other practice staff can demonstrate their competence in safeguarding children and young people at risk.

Each practice should have a designated lead for safeguarding children and young people. This key role in the practice:

  • promotes good practice
  • provides advice and support for fellow staff
  • makes sure that fellow staff are suitably trained in safeguarding.

We need to see evidence that:

  • the practice gives sufficient priority to safeguarding children
  • staff take a proactive approach to safeguarding and focus on prevention and early identification
  • staff take steps to protect children and young people where there are known risks, respond appropriately to any signs or allegations of abuse, and work effectively with other organisations to implement protection plans
  • there is active and appropriate engagement in local safeguarding procedures and effective work with other relevant organisations.

Intercollegiate guidance

The Royal Colleges give clear guidance about the appropriate competencies and levels of training in safeguarding children or child protection for different members of staff. The Royal College of Nursing published updated intercollegiate guidance Safeguarding Children and Young People: Roles and Competencies for Healthcare Staff in January 2019.

Competency framework

The competency framework set out in the intercollegiate guidance identifies levels of competency ranging from level one to five (and board level). It also gives examples of which groups of staff fall within them.

  • Level 1: All staff including non-clinical managers and staff working in healthcare services.
  • Level 2: Minimum level required for non-clinical and clinical staff who, within their role, have contact (however small) with children and young people, parents/carers or adults who may pose a risk to children.
  • Level 3: All clinical staff working with:
    • children, young people and/or
    • their parents/carers
    • and/or any adult who could pose a risk to children
      who could
    • potentially contribute to assessing, planning, intervening and/or
    • evaluating the needs of a child or young person and/or parenting capacity.

This is regardless of whether there have been previously identified child protection/safeguarding concerns or not). 

This includes practice nurses.

  • Level 4: Named professionals
  • Level 5: Designated professionals

This updated intercollegiate guidance changes the level of competency indicated for practice nurses. We acknowledge that practice nurses will not immediately be able to achieve this competency but would expect to see that they were working towards level 3.

Notifying CQC of safeguarding incidents

Not all referrals the practice makes to the local authority need to be notified to CQC. Practices are only required to notify CQC of safeguarding incidents where the allegation of abuse is linked to their provision of care.

In our Safeguarding Handbook we clarify when we expect statutory notifications of abuse. See Appendix 10.

Inspector's handbook: Safeguarding (February 2018)

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