Safeguarding children

All NHS Service and Commissioned Services have a key role to play in safeguarding and promoting the welfare of unborn babies, children and young people. This is a statutory duty under Section 11 of the Children Act 2004 and in accordance with Government guidance Working Together to Safeguard Children 2018. 

The safety and welfare of children is of paramount importance to the Joined Up Care Derbyshire as an integrated care system. Joined Up Care Derbyshire recognises that safeguarding is a shared responsibility, requiring effective joint working between agencies and professionals and recognises the different roles and expertise amongst health staff. 

Protecting children and young people from the risk of abuse and neglect is not something that any individual or Organisation can achieve on their own. Safeguarding is about working in partnership with other agencies so that together we can identify risks, share information and do whatever we can do to reduce the risk of harm to children and young people. 

To ensure that the Integrated Care System plays an active role in contributing to the effective safeguarding of children we do the following: 

• Have an Accountable Chief Executive and Executive Lead for safeguarding who ensure that safeguarding is at the forefront of service planning.
• Employ a Designated Nurse and Doctor for Safeguarding Children. These roles take a professional and strategic lead on all aspects of the health service contribution.
• Play an active role in the Safeguarding Children Partnership arrangements working with partner agencies such as Local Authority and the Police to ensure that local priorities for safeguarding children are met.
• Regularly meet with Health Providers that the Integrated Care Board (ICB) commissions to ensure that they have effective arrangements for safeguarding children, young people and families.
• Provide safeguarding children training for ICB staff and independent contractors. 
• Policy guidance has been developed to ensure best practice is maintained across the Integrated Care System.   

All staff who come into contact with children and young people including staff working primarily with adults who have dependent children have a minimum responsibility to recognise what constitutes child maltreatment and know how to act when they have concerns about the welfare of a child or young person. 

Abuse can happen to a child at any age, from pre-birth up to the age of 18 years. It can happen in all walks of life; to children from any ethnic and cultural background and to children with or without disabilities. Abuse, harm and maltreatment can be deliberate or unintentional. 

Safeguarding children is defined in national guidance 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 life chances  

Physical Abuse

A form of abuse which may involve hitting, shaking, throwing, poisoning, burning, scalding, drowning, suffocating or otherwise causing physical harm to a child. Physical harm may also be caused when a parent or carer fabricates the symptoms of, or deliberately induces, illness in a child. (Definition provided by Working Together 2018) 

Neglect

The persistent failure to meet a child’s basic physical and/or psychological needs, likely to result in the serious impairment of the child’s health or development. Neglect may occur during pregnancy as a result of maternal substance abuse. Once a child is born, neglect may involve a parent or carer failing to: 

• provide adequate food, clothing and shelter (including exclusion from home or abandonment);
• protect a child from physical and emotional harm or danger;
• ensure adequate supervision (including the use of inadequate care-givers); or
• ensure access to appropriate medical care or treatment.  

 It may also include neglect of, or unresponsiveness to, a child’s basic emotional needs. (Definition provided by Working Together 2018) 

Sexual Abuse

Involves forcing or enticing a child or young person to take part in sexual activities, not necessarily involving a high level of violence, whether or not the child is aware of what is happening. 

The activities may involve physical contact, including assault by penetration (for example, rape or oral sex) or non-penetrative acts such as masturbation, kissing, rubbing and touching outside of clothing. They may also include non-contact activities, such as involving children in looking at, or in the production of, sexual images, watching sexual activities, encouraging children to behave in sexually inappropriate ways, or grooming a child in preparation for abuse (including via the internet). 

Sexual abuse is not solely perpetrated by adult males. Women can also commit acts of sexual abuse, as can other children. (Definition provided by Working Together 2018) 

Emotional Abuse

The persistent emotional maltreatment of a child such as to cause severe and persistent adverse effects on the child’s emotional development. 

It may involve conveying to a child that they are worthless or unloved, inadequate, or valued only insofar as they meet the needs of another person. It may include not giving the child opportunities to express their views, deliberately silencing them or ‘making fun’ of what they say or how they communicate. 

It may feature age or developmentally inappropriate expectations being imposed on children. These may include interactions that are beyond a child’s developmental capability, as well as overprotection and limitation of exploration and learning, or preventing the child participating in normal social interaction.

It may involve seeing or hearing the ill-treatment of another. It may involve serious bullying (including cyber bullying), causing children frequently to feel frightened or in danger, or the exploitation or corruption of children. 

Some level of emotional abuse is involved in all types of maltreatment of a child, though it may occur alone. (Definition provided by Working Together 2018)

New processes

The Children and Social Work Act (2017) requires two significant changes in local arrangements for safeguarding children.  

The first is to move responsibility for ensuring reviews are carried out when a child dies from the Local Safeguarding Children Boards to the local authority and clinical commissioning group (called the Child Death Review Partners).  

The second is to require three statutory safeguarding partners – local authorities, chief officers of police, and clinical commissioning groups – to make arrangements to work together with relevant agencies to safeguard and protect the welfare of children in the area.   

In Derby city and Derbyshire we have taken the opportunity to review our current structures and implement changes to support more effective arrangements in the future.   

Derby City Council, Derbyshire County Council and NHS Derby and Derbyshire Clinical Commissioning Group (now superseded by NHS Derby and Derbyshire Integrated Care Board) have reviewed and updated their responsibilities to put in place arrangements to review the death of a child and these are called the Child Death Overview Panel Arrangements. 

The multi-agency safeguarding arrangements for city and county are now governed by one joint partnership, called the Derby and Derbyshire Safeguarding Children Partnership, which will support and challenge partners across both areas to work effectively together.

Implementation plans are in place to support the delivery of both these changes.

The

and explain the changes and new arrangements.