London Safeguarding Children Professionals Network

1
London Safeguarding ChildrenProfessionals Network
NHS

• LSCB Health Representative Perspective
• A personal reflection since 1996

Briony Ladbury RN RM FPcert BA MSc
Safeguarding Children Manager Croydon
PCT Designated Nurse Child Protection
2
Starting Point 1996

• Working Together 1991 Addendum Guidance given
  to Health Authorities re Designated Named
  Professionals
• Focus on child protection
• Roles were to co-ordinate and advise Lead
  Officers on strategy and practice
• Inform senior managers of developments
• Advise ACPC on health related matters and to
  foster co-operation
• Advise provider units, and provide supervision
  training
• Named and lead professionals employed in provider
  Organisationsoften tacked on to other roles

3
First Impressions

• 3 badges ! 3 managers ! 3 budgets !
• Territorial barriers to progress
• managed by Director in HA
• Spheres of influence limited
• CP not a super-priority
• Supervised by Child Protection Manager in SSD
• Doctor / Nurse tribalism
• Adopted by ACPC
• Copious procedures policies
• Lots of custom practice

4
Millennium arrives !

• PCGs to PCTs
• By 1999 Safeguarding embedded in DoH Guidance.
• Designated and Named Roles further defined
• Prevention and early intervention (supported by
  research)
• New assessment tools promote ecological and
  holistic multi-agency care plans
• ACPC relationships often more solid and
  supportive than those with NHS senior managers
• Spheres of influence begin to expand
• Not-so scary job isolated - but opportunities
  to influence!

5
Arrival of PCTs

• Establishment of PCTs change!
• DOH letter of instruction 2002 largely ignored
  spoilt opportunity to raise the profile
• WTE Designated Nurses as standard
• Nurse-Lead Service?
• Sector Strategic Health Authorities secure an
  interest with Childrens Leads
• Team approaches improving communication,
  management and support
• NHS expertise highly valued on ACPCs
• Clinical Governance Risk Management Mechanisms
  provides a QA component to practice
• Huge work load !

6
Roots, branches mixed blessings

• Climbie Enquiry, ECM, Children Act 2004,
• DOH switches to DfES
• PCT Execs personally responsible
• CHI / CHAI / HC self audits / Star Ratings /
  raise and ? maintain the profile
• Potential spheres of influence open up (Board,
  PEC, etc)
• NSF arrangements develop safeguarding and
  child-centric practice
• Sector St HA (SWLON) provide leadership courses
  and professional support for Safeguarding
  professionals
• LCPC provides standardised procedures for London
• Children Act 2004 gives LSCB Statutory functions

7
NHS Reorganisation 2006 - Again !

• Busy time positive actions
• Opportunity to raise safeguarding as a major
  strategic and practice priority
• Opportunities to link to PBC
• Statutory status increases credibility of
  safeguarding role
• HC Standard C2 gives NHS a useful quality
  framework
• Joint Area Reviews test multi-agency practice
• Childrens Services re-defined (merge and
  integrate)
• London Safeguarding Board alignes with London St
  HA
• New opportunities for pan London Safeguarding
  Health service practice standards

8
Not so useful factors??

• DfES and SSD forge ahead
• Health Services often unheard / unseen
• Multi-agency initiatives slow to materialise
• Safeguarding slips in priority for NHS
• Assumes lower profile during NHS reorganisation
• Poor investment associated with funding
  difficulties
• Very different operational structures emerge,
• Placed in various directorates. Danger of losing
  the overarching responsibilities
• Indirect and /or reduced access to Board members
• Reduces ability to influence and change at right
  level
• Movement, retirement and recruitment difficulties
  
• Change fatigue
• A 4 C Process (Grades 6 9)
• Bad press for Safeguarding paediatricians

9
Reasons to be Cheerful

• Higher Profile with stability
• Recognition (statutory responsibilities) of
  highly qualified, experienced practitioners
• Supported professionals supported career
  structures
• Recognition of specialist competencies KSF
  profiles
• Authority with responsibility / accountability
• Reporting lines to Directors
• Strengthened multi-agency working
• Full engagement on LSCBs (performance and
  competency frameworks)
• Supported Leadership
• London St HA network for shared learning
  development

10
New improved formula

• Priority Review (DfES) 2006
• ACPCs by another name (ineffective)
• Joint Responsibility not just LA
• Health engagement flagged as a major issue
• Shaping local LSCBs as professional / equal
  partners
• Advise inform London St HA
• Support assist London Safeguarding Board
• Ensure our own performance and competencies are
  up to the job
• Grab the chance to set the priorities and do
  things differently for children and families

11
Parting Shot
Be the change that you want to see in the
world. An ounce of practice is worth more
than tons of preaching. Mohandas Gandhi