NHS trusts across England are failing to comply with child protection requirements such as staff training and working with local safeguarding children boards, the Care Quality Commission said today.
In a report into NHS arrangements for safeguarding children, the regulator recommended that all trusts conduct urgent reviews of their performance in this area.
There was a “worrying” lack of compliance among trusts in training – only 54% of all healthcare staff were up to date – while a lack of clarity over roles existed even among doctors with designated child protection responsibilities.
Review ordered in wake of Baby Peter
Former health secretary Alan Johnson ordered the review on 1 December 2008 following a public outcry over the death of baby Peter in Haringey, north London, sparked by the trial of those responsible.
The second serious case review into the boy’s death, published in May, was critical of responses from health professionals who came into contact with the child including health visitors, nurses, GPs and a specialist doctor.
In the same month, a CQC report on the four trusts involved in Peter’s case found issues that contributed to the failure to protect him, including poor communication between staff, under-staffing and the failure of health practitioners to attend child protection conferences, had not been fully overcome in three of the trusts.
The CQC’s national review said it was “particularly concerned” that half of primary care trusts and 32% of acute trusts did not have a process for following up children who missed outpatient appointments. This was despite a 2008 report from the Confidential Enquiry into Maternal and Child Health, Why Children Die, raising this as a significant factor in safeguarding.
The importance of training had also been highlighted in previous reviews, but just 37% of trusts had a dedicated budget to provide this, the CQC found.
One in ten trusts lack reporting system
Although the report concluded that most trusts had the right people and systems in place for safeguarding children, more than one in ten trusts did not have a reporting system to flag child protection concerns.
One in four trusts said that their chief executive or board lead never met with the chair of the local safeguarding children board to review progress and identify issues for development, while a third said that such meetings happened “occasionally”.
NHS Confederation: culture change needed
The NHS Confederation said the report showed that despite progress in the NHS, there was “much more that can be done” to improve child protection.
Deputy policy director Jo Webber said: “Central to the improvement of child safeguarding is the creation of a culture that empowers staff to put the safety of children at the heart of what they do.
“Leadership is the starting point in culture change and all boards of NHS trusts should ensure that best practice and the necessary frameworks for child safeguarding are followed.
Serious case review
In the days prior to baby Peter’s death, a GP and a paediatric doctor both had concerns about his appearance but failed to alert others. Peter was found dead in his cot on 3 August 2007 with a broken spine.
The SCR described relationships between health visitors and GPs in Haringey as “exceptionally distant”.