Sheffield Children's Hospital

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We assessed 2 quality statements under the effective key question.Patients received thorough, person-centred assessments which considered their physical, emotional and safeguarding needs.

Find out what we look at when we assess this area in our information about our new Single assessment framework.

Administrative staff took initial referrals for the service and identified any additional support requirements before a child or young person attended. This included consideration of their communication needs, such as interpreter services, and any other adjustments required to support attendance. This information was used to inform appointment planning and ensure appropriate support was available at the time of the visit.

All patients received a comprehensive assessment of their health and wellbeing needs. Assessments included a review of their medical history, sexual health, mental health and safeguarding concerns. Staff identified and documented any vulnerabilities and considered specific risk factors, including non-fatal strangulation and female genital mutilation to ensure that appropriate interventions and support could be provided. Assessments took a holistic approach and considered wider factors affecting the child or young person, including family and social history, and household composition.

Health risks associated with unprotected sexual activity were assessed and managed in accordance with national guidance. This included consideration of the need for HIV PEP and emergency contraception in line with guidance from the British Association for Sexual Health and HIV (BASHH) and the Faculty of Sexual and Reproductive Healthcare (FSRH). The service was also able to provide on-site sexually transmitted infection testing for children under 13 years of age when clinically indicated.

We reviewed a sample of patient records and found them to be detailed, clear and legible. Documentation provided a comprehensive account of assessments, clinical decision-making and care provided. However, in 1 record continuation sheets had not been signed or sequentially numbered by the consultant. This created a risk that, if documents became separated from the main record, their origin and place within the chronology of care could not be easily identified.

The service had established referral pathways to support children and young people’s wider health, safeguarding and emotional wellbeing needs. Records demonstrated that referrals were made appropriately to partner agencies and services, including children’s independent sexual violence advisers (CHISVAs), general practitioners and children’s and adolescent mental health services. Staff maintained a tracking spreadsheet to ensure referrals had been received and actioned, helping to promote continuity of care and reduce the risk of patients being lost to follow-up.

The judgement for Delivering evidence-based care and treatment is based on the latest evidence we assessed for the Effective key question.

The judgement for How staff, teams and services work together is based on the latest evidence we assessed for the Effective key question.

The judgement for Supporting people to live healthier lives is based on the latest evidence we assessed for the Effective key question.

The judgement for Monitoring and improving outcomes is based on the latest evidence we assessed for the Effective key question.

Staff received regular training in the Mental Capacity Act and demonstrated a good understanding of the complexities associated with assessing capacity and obtaining informed consent from children and young people. Patient records demonstrated that consent had been obtained and documented appropriately. Patients, or those with parental responsibility where applicable, provided written consent for all aspects of the forensic examination, including the collection of forensic samples, the use of digital photography, and the disclosure of medical records and forensic findings for use in criminal justice proceedings. Records also showed that patients were advised of their right to stop or pause the examination at any stage, and this was clearly documented on consent forms.

Staff described consent as an ongoing process rather than a single event. During forensic examinations, clinicians checked regularly with patients to confirm their continuing willingness to proceed and to ensure they remained comfortable with each stage of the examination.

Following our inspection, the service reviewed and amended its pre-examination protocol to better reflect Gillick competence guidelines.