1. Improving Safeguarding in the London NHS
Alan Bedford,
Safeguarding Improvement Director, NHS London
The annual conference of the
LONDON SAFEGUARDING CHILDREN BOARD
‘SAFEGUARDING LONDON'S CHILDREN’
Wednesday 9th DECEMBER 2009
Queen Elizabeth II Conference Centre
Broad Sanctuary, Westminster

2. This seminar will…..
Remind us of key Baby Peter findings from the executive summary and the CQC review of health bodies in the case
Remind us of the findings of the CQC review of safeguarding in the NHS
Describe the work of the SHA Safeguarding Improvement Team
Identify other London wide work
Gather views on key issues
Facilitate a discussion on these issues
Identify priority areas for further work

3. Selected learning from Baby P exec summary
The Need for Authoritative Child Protection practice
- Avoiding the ‘tendency to believe’
-Taking CP Plans seriously
- Getting experts to case conferences
- ‘Tight grip on intervention’
- Clarifying all key household members
- Practice that makes demands on parents
Interagency Communication (again)
- Understanding what each professional is trying to achieve
Ensuring Safeguarding awareness in universal services
- Joint teams, CAF, GP-HV communication
- Don’t assume others have perceived what you do
Lack of Challenge When Conducting Basic Inquiries

4. Baby Peter exec summary conclusions and recommendations
Lacking urgency
Lacking thoroughness
Insufficient challenge
Lacking action to reasonable inference
Not enough child focus
Thresholds too high
Expectations too low
Recommendations:
NHS/Legal/Police/SW—all to be trained in authoritative practice
And to understand the authority in their roles
Multiagency audit of interventions
Challenge low expectations of parental care
Joint local teams
Boost the CAF

5. CQC recommendations for the NHS on Baby Peter
Governance Focussed:
Trust to ensure staff are clear on safeguarding and properly trained
Trusts to ensure staff numbers are adequate eg Paeds
Establish clear systems between health and SSD
Boards to assure themselves the system works
-safeguarding supervision
-case conference attendance
-training
-declarations
These have universal application to the NHS

6. CQC Safeguarding Children NHS Review ( selected)
Findings:
Designated and named staff: time allocation variable. 30% no written brief
Many GP practices with no designated lead
Few ring fenced training budgets
% up to date with training
Access to child protection clinician not always 24 hours
Safeguarding specifications in contracts patchy
Concern about provider Trust engagement with LSCBs
Recommendations:
Boards to review arrangements for safeguarding (espec. training)
Commissioners to make certain their provider arrangements ( including GPs) are effective—especially with commissioner/provider splits

7. Safeguarding Improvement Team
The SHA (with PCT support) wanted to develop something extra to help the NHS post Baby Peter
A team made up of doctors nurses and managers from the NHS across London, offering assessment and advice to their peers
Led by the SHA Safeguarding Improvement
Going to each NHS patch (PCT plus NHS providers) for 2 days
At a time that suits the patch
This is about support rather than inspection
Briefing by top teams—meeting key leaders and practitioners-visits to service areas eg A&E, community clinics, GP surgery
Feedback given before we leave
We will adapt if there has been recent Ofsted/CQC inspection, or is about to be one
This is about focus on the NHS—so that we bring the best we can to the multidisciplinary, multiagency agenda
(We ask the LSCB chair to gives us a system wide perspective)

8. Other NHS London initiatives
Designated/named doctor and nurse fora
Recruitment and training
Leadership for Influence
Recruiting and retaining Health Visitors
Serious case reviews (SCRs) auditing
Monitoring of core standards C2
Declarations in regard to David Nicholson’s letter ( )
IT solution for real-time monitoring of children at A&E
Pilot within Haringey cluster for children subject to a child protection plan
Strategic safeguarding children guidance
Commissioning templates

9. Discussion What strikes you as the really key issues for the NHS?
- locally where you are
- London wide
- nationally
What are the high risk issues—where the NHS has a vulnerability that must be addressed?
Those of you from outside the NHS—what is your view?
Do you have recommendations for the NHS in London?
What further support may be helpful?