Dr Martin Weatherhead Named Doctor for Childrens Safeguarding Sunderland TPCT Clinical Director Coun PowerPoint PPT Presentation

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Title: Dr Martin Weatherhead Named Doctor for Childrens Safeguarding Sunderland TPCT Clinical Director Coun


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Dr Martin WeatherheadNamed Doctor for
Childrens SafeguardingSunderland TPCTClinical
Director Counted4 CICGP Principal
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The Protection of Children in England A Progress
report. Lord Laming, March 2009
  • Rec 34 ...statutory duty of all GP Providers
    to comply with child protection legislation and
    to ensure all GPs have the necessary skills and
    training to carry out their duties.
  • Rec 20 All drug and alcohol services should
    have well understood referral processes which
    prioritise the protection and well being of
    children. These should include automatic referral
    where domestic violence, drug or alcohol abuse
    may put a child at risk of abuse or neglect

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Childrens Act 2004

There is a statutory duty placed on key persons
or agencies to make arrangements to ensure that
in discharging their functions they have regard
to the need to safeguard and promote the welfare
of children GMC,RCGP,BMA---SAFEGUARDING IS CORE
WORK
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  • Hayley (aged 25 years) presents to her GP. She is
    pregnant, her LMP suggests gestation is 5-6
    months but her periods have never been regular
    in part because of her known drug and alcohol
    misuse.
  • The GP knows the family well, Hayley has 3 sons
    who are looked after and her relationship with
    the boys father, George, who also misuses drugs
    and alcohol has been violent.
  • Hayley tells the GP that Childrens Services know
    about the pregnancy.

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  • Questions
  • What action should the GP take?
  • Who should the GP contact?

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Issues for Primary Care
  • History/exam dont forget standard medical
    treatment/assessment and drug and alcohol history
    (including smoking).
  • ICE why late presentation?
  • Refer
  • Ante Natal Clinic
  • Community Drug Team (if not in treatment)
  • Social Services (if appropriate) When?
    Consent? How?
  • What to include in a referral? (and to whom)
  • paternal behaviour (Serious Case Review
    evidence)
  • positive and negative
  • core GP obligation
  • to Childrens Services - proforma
  • Who co-ordinates the response? Information
    gathering in the early stages especially.
  • should be clear in LSCB guidance (all GPs should
    not only know where they are (QoF) but understand
    the content and their use as a reference)
  • How does the Primary Care Team communicate in a
    fragmenting world? (Childrens Centres non
    co-location with GPs)

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  • Questions
  • What contribution can the DAT make?
  • What concerns will there be for the parents and
    the unborn baby in relation to drug and alcohol
    misuse?

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Issues for DAT
  • Information sharing protocols / models of care
  • Support the parent optimise treatment (Hidden
    Harm)
  • Destabilisation v. Ideal opportunity, turn over
    a new leaf. Detox role
  • (Want to detox Why? prolonged neonatal stay.
    Detox in pregnancy (alcohol))
  • Support the obstetric team
  • An alternative view to Childrens Services
  • Support the Primary Health Care Team
  • Testing why? Role of testing
  • Multi-agency approach

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What is safeguarding?
  • The term safeguarding has not been defined in law
    (except via statutory guidance)
  • Safeguarding has two elements
  • protecting children from maltreatment
  • preventing impairment of childrens health or
    development

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Who is responsible for safeguarding?
  • The practice team, however, is not responsible
    for making a diagnosis of child abuse and
    neglect rather to share concerns appropriately
    and refer onto the relevant agency responsible
    for carrying out an assessment and, as
    appropriate, arranging medical examinations to
    help determine whether or not child abuse has
    occurred.

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  • it is important to stress that we must not
    stereotype families or adults who do have health
    problems, such as mental health or substance
    misuse, although it is crucial that a holistic
    approach is taken with families so that the needs
    of children are assessed when treating patients
    with mental health problems or addictions
  • Toolkit,p.10

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Learning from Serious Case Reviews
  • Correspondence - record date of receipt
  • Who is accompanying the child recording of
    information, noting interaction
  • Unusual symptoms refer for paed assessment.
    Discuss with paed consultant
  • Strip baby for physical examination (esp. unusual
    symptoms)
  • Significance of bruising in non-mobile babies
    referral for assessment

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  • Referrals to hospital send letter (fax system),
    include relevant medical and social information,
    including is child on CPR (or has been?)
  • Under 16s contraception
  • explicit reference to competence in records
  • Follow Sunderland LSCB Sexually active under 18s
    policy
  • New patient checks review records is child on
    CPR? Consider contacting previous GP/ liaison
    with HV or SNS
  • Leaving practice any unaddressed safeguarding
    issues consider contacting as above
  • Considering the risks from other family members
    (e.g. impact of paternal factors)

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Toolkit Content
  • Introduction
  • Template for Policy Procedures
  • Skeleton into which the practice incorporates its
    LSCB guidance
  • Legal Guidance Framework
  • All 7 UK jurisdictions
  • Audit Tool
  • Training Modules

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Summary
  • The Toolkit is
  • A system for helping practices develop policy
    procedures individualised to need
  • A training tool
  • An audit facility
  • Web launched January 2008
  • Free to anyone
  • Training modules free to members

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Areas of Debate
A - FII B - considering your own/staff
safety C - role of practice lead professional
(very inclusive) D - flow chart p.19 E - it does
not supercede LCSB guidance F - storage of child
protection conference minutes G - sexual activity
lt13

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Summary
  • Links between drug and alcohol misuse, mental
    health issues, violence and criminal behaviour
  • The intergenerational cycles of misuse
  • The long-term nature of intervention and support
    required to break the cycle
  • The need for a transparent, tightly coordinated,
    multidisciplinary and interagency care plan
    involving and engaging parents, children and the
    wider family
  • The need for professionals to feel confident and
    supported in managing the issues
  • The Safeguarding dimension

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