Working Together is crucial to the wellbeing and safety of vulnerable people. Commissioning accountability and quality assurance for Health Providers is summarised in the 'Safeguarding Vulnerable People in the Reformed NHS Accountability and Assurance Framework' March 2013, NHS Commissioning Board - attached below. The key paragraph for Health Providers is:
3.3 Health service providers
All providers of health services are required to be registered with the Care Quality Commission (CQC) (see also section 4.5 below). In order to be registered, providers must ensure that those who use the services are safeguarded and that staff are suitably skilled and supported. This includes private healthcare providers. NHS trusts without Foundation Trust status are also accountable to the NHS Trust Development Authority (see section 4.4 below).
Health providers are required to demonstrate that they have safeguarding leadership and commitment at all levels of their organisation and that they are fully engaged and in support of local accountability and assurance structures, in particular via the LSCBs,
SABs and their commissioners. Most importantly, they must ensure a culture exists where safeguarding is everybody’s business and poor practice is identified and tackled.
All health providers are required to have effective arrangements in place to safeguard vulnerable children and adults and to assure themselves, regulators and their commissioners that these are working. These arrangements include safe recruitment, effective training of all staff, effective supervision arrangements, working in partnership with other agencies and identification of a named doctor and a named nurse (and a named midwife if the organisation provides maternity services) for safeguarding children; in the case of NHS Direct, ambulance trusts and independent providers, this should be a named professional. They should also identify a named lead for adult safeguarding.
GP practices should have a lead for safeguarding, who should work closely with named GPs and designated professionals.
Named professionals have a key role in promoting good professional practice within their organisation, supporting the local safeguarding system and processes, providing advice and expertise for fellow professionals, and ensuring safeguarding training is in place. They should work closely with their organisation’s safeguarding lead, designated professionals and the LSCB.
All providers of NHS-funded health services (NHS Foundation Trusts and public, third sector, independent sector and social enterprises,) will be licensed by Monitor (unless exempted through regulations). Where licensing is required, it will be conditional upon registration by CQC.
The perspective of children and young people
different professionals – like teachers, doctors, school nurses, health visitors, social workers and
others – and organisations working with you and your family, what they should be doing to improve
your life and to keep you safe from abuse and neglect. In Working Together, ‘children’ means anyone
who is not yet 18 years old.
This Young Person’s Guide has been written to help explain the Working Together guidance. It might be
useful to you if you have questions about help you think that you or someone you are worried about
should be getting.
The Children’s Rights Director asked children and young people what they thought
health visitors should do to help keep them safe.
• chat to parents –build up a relationship with them;
• communicate with social workers;
• call round out of the blue;
• look round the house;
• look in the fridge and cupboards.
The Children’s Rights Director asked children and young people what they thought
doctors should do to help keep them safe.
• tell people if you’re concerned;
• do more home visits to see what the home is like.
Section 11 of the Children Act 2004
Section 11 places duties on a range of organisations and individuals to ensure their functions, and any
services that they contract out to others, are discharged having regard to the need to safeguard and
promote the welfare of children.
Various other statutory duties apply to other specific organisations working with children and families
Section 11 places a duty on:
-local authorities and district councils that provide children’s and other types of services, including
children’s and adult social care services, public health, housing, sport, culture and leisure services,
licensing authorities and youth services;
-NHS organisations, including the NHS Commissioning Board and clinical commissioning groups,
NHS Trusts and NHS Foundation Trusts;
-the police, including police and crime commissioners and the chief officer of each police force in
England and the Mayor’s Office for Policing and Crime in London;
-the British Transport Police;
-the Probation Service;
-Governors/Directors of Prisons and Young Offender Institutions;
-Directors of Secure Training Centres; and
Youth Offending Teams/Services
These organisations should have in place arrangements that reflect the importance of safeguarding and
promoting the welfare of children., including:
-a culture of listening to children and taking account of their wishes and feelings, both in individual decisions
-appropriate supervision and support for staff, including undertaking safeguarding training:
-employers are responsible for ensuring that their staff are competent to carry out their responsibilities for safeguarding and promoting the welfare of children and creating an environment where staff feel able to raise concerns and feel supported in their safeguarding role;
-all professionals should have regular reviews of their own practice to ensure they improve over time.
Individual organisational responsibilities are described in detail from page 49 and include:
NHS organisations are subject to the section 11 duties set out in paragraph 4 of this chapter.
Health professionals are in a strong position to identify welfare needs or safeguarding concerns regarding individual children and, where appropriate, provide support.This includes understanding
risk factors, communicating effectively with children and families, liaising with other agencies, assessing needs and capacity, responding to those needs and contributing to multi -agency assessments and reviews.
A wide range of health professionals have a critical role to play in safeguarding and promoting the welfare of children including: GPs, primary care professionals, paediatricians, nurses , health visitors, midwives, school nurses, those working in maternity, child and adolescent mental health, adult mental health, alcohol and drug services, unscheduled and emergency care settings and secondary and tertiary care.
All staff working in healthcare settings- including those who predominantly treat adults -should
receive training to ensure they attain the competences appropriate to their role and follow the relevant professionalguidance
Within the NHS
-the NHS Commissioning Board will be responsible for ensuring that the health commissioning system as a whole is working effectively to safeguard and promote the welfare of children. It will also be accountable for the services it directly commissions. The NHS Commissioning Board will also lead and define improvement in safeguarding practice and outcomes and should also ensure that there are effective mechanisms for LSCBs and health and wellbeing boards to raise concerns about the engagement and leadership of the local NHS;
-clinical commissioning groups (CCGs) will be the major commissioners of local health services and will be responsible for safeguarding quality assurance through contractual arrangements with all provider organisations. CCGs should employ, or have in place, a contractual agreement to secure the expertise of designated professionals, i.e. designated doctors and nurses for safeguarding children and for looked after children (and designated paediatricians for unexpected deaths in childhood). In some areas there will be more than one CCG per local authority and LSCB area, and CCGs may want to consider developing ‘lead’ or ‘hosting’ arrangements for their designated professional team, or a clinical network arrangement.
Designated professionals, as clinical experts and strategic leaders, are a vital source of advice to the CCG, the NHS Commissioning Board, the local authority and the LSCB, and of advice and support to other health professionals;
-all providers of NHS funded health services including NHS Trusts, NHS Foundation Trusts and public, voluntary sector, independent sector and social enterprises should identify a named doctor and a named nurse (and a named midwife if the organisation provides maternity services) for safeguarding. In the case of NHS Direct, ambulance trusts and independent providers, this should be a named professional. GP practices should have a lead and deputy lead for safeguarding, who should work closely with named GPs.
Named professionals have a key role in promoting good professional practice within their organisation,
providing advice and expertise for fellow professionals, and ensuring safeguarding training is in place. They should work closely with their organisation’s safeguarding lead, designated professionals and
Schools and Colleges,
Early Years and Childcare,
Adult Social Care Services,
Housing Authorities, British Transport Police, Prison Service, Probation Service, Secure Estate for Children, Youth Offending Teams, UK Border Agency, Children and Family Court Advisory Support Service, Armed Services, Voluntary and private sectors, Faith Organisations