Safeguarding Children Toolkit for General Practice
Dr Vimal Tiwari, RCGP Safeguarding Children Lead
Dr Matthew Hoghton, RCGP CIRC Medical Director
Child safeguarding is a major public health issue, with tragic cases regularly attracting national media attention. Long-term costs and consequences associated with child maltreatment include increased use of health-care systems, mental and physical illnesses, substance abuse and criminal activity. Everyone working in general practice will be aware of vulnerable families where children may be subject to maltreatment but acknowledging and handling such problems can be difficult, challenging, stressful and at times overwhelming.
The recent editorial in the British Journal of General Practice has highlighted the need for policy makers and commissioners to rethink the role of general practice in child maltreatment. This role is much broader than just identifying and referring children at risk and involves utilising our position as a 'trusted ally' to actively manage maltreatment and support families. The current pressures on primary care and lack of resources exposed by the RCGP Put Patients First Campaign are likely to have significant adverse pressures on continuity of care and the broader safeguarding functions GPs perform.
This 2014 Toolkit amendment is presented as a practical guide for busy GPs and their teams grappling with the increasing complexity and pressures of general practice. Its easy access format and expanded content aims to help them navigate the vast quantity of available information and to identify material most relevant to patient care.
The Toolkit was developed in partnership with the NSPCC (the UK's major children's charity) in 2009 and has since been amended and updated to support GPs to improve outcomes for children and families by bringing together relevant guidance and information, signposting to new and existing safeguarding statutes, policy and evidence while focusing on good medical practice There is particular emphasis on the strong evidence base which support benefits of a preventative approach with early identification of adverse factors and early intervention to improve life course.
Self-contained sections offer information and direction on specific topics of key relevance to GPs and their teams, to five an overview of best practice guidance and clinical governance as well as the legal aspects of child safeguarding. The Toolkit identifies essential policy, legal and regulatory features to help practices develop, maintain and improve standards to meet professional requirements while enhancing patient safety and outcomes. The Toolkit is designed to be easily accessible by topic and to be consulted according to need or interest. Sections 1 to 5 are a useful starting point with key facts and resources for patients as well as practitioners. Sections 6 to 12 provide extended cover of newsworthy subjects such as child sexual exploitation, female genital mutilation, social media, gang abuse, trafficking and radicalisation with links throughout to useful references and websites including authoritative NSPCC materials and services.
The Tools are downloadable resources for GPs and practice teams. Some, including self-assessment audits, are adaptable for individual practice requirements. New additions are templates for case reviews, serious incident reviews and reflective exercises for use in professional and practice development and as evidence for GP appraisal and revalidation. There are also guidelines developed by external organisations to manage diagnostic dilemmas and aid decision making processes in topics such as developmental delay, domestic abuse and child sexual exploitation.
Wide stakeholder consultation and a collaborative approach including safeguarding health professionals in every jurisdiction of the UK ensured that legislation, policy and guidance relevant to all members of a general practice team was included. It is intended that this Toolkit will be beneficial to all GPs and their teams across the UK, even when legislation and policies differ between jurisdictions.
The 2014 version was written on a voluntary basis by practising GPs with editorial oversight provided by a core group from the Primary Care Safeguarding Forum, a primary care society allied to the RCGP. The emphasis is on a general practice perspective of child safeguarding, recognising that GPs see patients and families through the entire life course and acknowledging actions rarely recognised by other agencies, such as GPs active contributions to child safeguarding by identifying and responding to needs, psychological distress and social vulnerability.
Visit the Toolkit here.
Woodman J, Rafi I, de Lusignan S, Child Maltreatment: time to rethink the role of general practice. Br J Gen Pract 2014; Br J Gen Pract September 2014 64:444-445; doi:10.3399/bjgp14X681265
RCGP Campaign, click here to read more.