Welcome


PCCSF is an independent professional organisation set up to
support doctors with an interest or involvement in protecting
and safeguarding children. At present, it is funded by membership subscription, run as a not-for-profit company. PCCSF is affiliated to the Alliance of Primary Care Societies from the Royal College of General Practitioners.

We welcome members from all four UK jurisdictions, representing doctors from Primary Care with an interest in
the protection and promotion of welfare of children and young people. Our membership is predominantly GPs but we welcome doctors from other specialties interested in this work.

The benefits of membership include:
· A secure email discussion group;
· A regular newsletter;
· An annual conference ( The 7th is at RCGP in 2014)

A special seminar was held in 2013 to help define the role on Named GPs for Safeguarding Children and prepare a position statement on primary care safeguarding. Membership has grown year by year from 24 in 2007 to 70 in 2014.

For details of membership contact: pccsfmembership@nhs.net

Danny Lang,
Vice Chair, PCCSF

Wednesday, 17 December 2008

Membership

We've had several enquiries about membership. The cost is reduced from now until the renewal date of 1 April 09. Email Andrew, Danny or Janice for details.

Saturday, 13 December 2008

Summary of feedback from Toolkit questionnaire


Number of respondents 8

1. What is most useful?

a.Practice advice and proformas, “specific advice tailored to a primary care setting”
b.Guidance on Read Codes
c.Guidance on recording/storage, “confidence to err on the side of too much rather than too little”.
d.Single source of references and templates
e.Glossary of terms
f.Legislation in the appendix

2. What is least useful?

a.The legislation for other principalities in the main document.
b.Difficult to find from the Home page on the RCGP website.
c.Navigation and search facilities within the Toolkit.
d.Flow chart (as this varies with each LSCB)
e.One respondent found that the sections on barriers and coding were not useful when giving presentations.
f.One respondent suggested that the questionnaire would be more useful if nurse trainer friendly and suitable for printout. Two others felt that GPs would find it too "legal".


Training Modules

1.What is most useful?

a.Ideas for exercises

2.What is least useful?

a.Not available to non RCGP members
b.Several commented that they put together bits from the modules rather than using them alone.

2.Comments

a.Some text changes needed such as Social care instead of services.
b.Legislation for different parts of the UK could be separate.
c.Should include recommendations on frequency and implementation of GP training.
d.Could publicise a standpoint on issues such as sharing information.
e.Could develop recommendations on the GP role in safeguarding.
f.Could receive feedback from children and young people.

Thursday, 11 December 2008

Minutes of the AGM 6 Dec 08

The meeting was held at the Moir Medical Centre, Long Eaton, Nottingham, NG10 1QQ
on Saturday 6 December 2008 at 1.45pm

Those present: Janice Allister (secretary); Katie Caird; Huw CharlesJones; Ian Dunn; Gill Fraser; David Jones; Danny Lang; Alison Maddocks; Dee McCormack; Charlotte Mackinnon; Jean McClune; Andrew Mowat (chairman); Dilys Noble; Sarah Thompson; Vimal Tiwari; Jo Walsh; (members). Also Anthea Mowat; Hilary Tompsett; (guests).

The meeting opened at 1.55pm.

1. Apologies:
Eileen Bamber; Judy Chen; Sue Dickson; Judith Eggleston; Claire-L Hatton; Gert M Kaiser; Kirsten Lamb; Catriona MacIver; Anna Wilson.


2. Chairman’s Report
Andrew gave a summary of the forum’s work. Members had been drawn together through the Royal College of General Practitioners’ initiatives in Child Safeguarding. The Primary Care Child Safeguarding Forum became an independent limited company on 21 December 07. It retains strong links with the College; also the Department of Health, the RCPCH, BMA, GPC and child welfare and study groups such as NSPCC, BASCPAN.

3. Election of Officers
Chairman
Andrew Mowat was unanimously elected as chairman.
Hon Secretary
Andrew proposed and David Jones seconded that Janice continue as Hon Secretary. This was carried unanimously.
Hon Treasurer
Andrew proposed and Charlotte McKinnon seconded that Danny Lang should be re-elected as Hon Treasurer. This was carried unanimously.

Treasurers’ report
I. Danny circulated copies of a summary of the Accounts.
II. He nominated Potter Baker, of Launceston, as accountants. This was agreed, after the meeting was assured that the expected charges were reasonable for this size of company.
III. Direct debit mandates would cost a further £250 and more per item in administration. The meeting agreed that this could be considered when membership grew.
IV. The question of company or charity status was raised. Again when membership increases, this will be reviewed, but it was felt that the expenses and administration involved were not merited yet.
V. It was agreed that the annual subscription should remain at £80, and the subscription renewal date will be 1 April 09.
VI. The website did not have ongoing costs as it has a blog basis. The only charge was the registration with eNom.

4. President or Patron
It was very much hoped by the meeting, in view of Andrew’s recent invitation as PCCSF representative to Buckingham Palace, to engage a member of the Royal Family as patron.
It was felt that other prominent figures might have a conflict of interests. It would be essential to maintain the General Practice foundation. It was left to the executive committee to sort out.

5. Executive Committee
I. Ian Dunn was unanimously elected as Meetings’ Co-ordinator.
II. David Jones, Dee McCormack, Charlotte McKinnon and Vimal Tiwari offered to serve on the Exec in addition to the elected officers. It was also agreed that other members would be welcome to put themselves forward for this.
III. Alison Maddocks offered to help Danny do a PCCSF presentation for the 2009 BASCPAN conference.
IV. Andrew thanked all who contributed so much.

6. Date of the next meeting
This will be decided by the exec.

The meeting closed at 2.22pm.

Janice Allister, 11 Dec 08.

Wednesday, 12 November 2008

Baby P interim notes

Baby P: summary
Born
Died 3.8.2007 Haringey
Mother born 1981
Mother’s Boyfriend born 1976
Other adults Jason Owen, born 1972 [lodger]
Angela Godfrey, mother’s friend
Other children Runaway [age 15] [Owen’s girlfriend?]
GP Dr Jerome Iqwueke
Paediatricians Dr Heather Mackinnon, Whittington Hospital
Dr Sabah Al-Zayyat, St Anne’s Hospital
Police DC Angela Slade
Social Services MariaWard [field worker]
Gillie Christou [manager]
Background
Injuries
 Eight broken ribs and a broken back, with another area of bleeding around the spine at neck
level.
 Numerous bruises, cuts and abrasions, including a deep tear to his left ear lobe, which had
been pulled away from his head.
 Severe lacerations to the top of his head, including a large gouge which could have been
caused by a dog bite.
 Blackened finger- and toenails, with several nails missing; the middle finger of his right hand
was without a nail and its tip was also missing, as if it had been sliced off.
 A tear to his frenulumwhich had partially healed.
 One of his front teeth had also been knocked out and was found in his colon. He had
swallowed it.
 Lacerations/tears to scalp consistent with dog bites
Chronology dates
 September 2006: Mum tells GP “child bruises easily”
 October 2006: Mum explains to GP baby had fallen down stairs previous day
 11 December 2006: GP notices more bruising which mother could not explain
o immediately referred to Paediatrician [Dr Mackinnon,Whittington Hospital]
o Social Services notified [?by whom]
o Child on Protection Register [Neglect, Physical Abuse]
 16 December 2006: Released into care of Angela Godfrey
 19 December: Mother & partner arrested & bailed
o CPS decided no reasonable prospect of successful prosecution
o [Police closed investigation into abuse 2 August 2007]
 January 2007: Returned to family home by Social Services
 Case Conferences
o Paediatrician unable to attend but “made report available”
o says she “would not have supported return to family home”
o Mother “working well” with Social Services
o illusion fabricated that Mother living alone
o Mother completed parenting course
 Feb-April 2007: Boyfriend frequently left in charge
o injuries coincided with his increasing involvement in household
 April 2007: Taken to Hospital “unexplained cuts & bruises”
 June 2007: Taken to Hospital “unexplained cuts & bruises”
 25 July 2007: Telephoned GP to ask help “getting Social Services off her back”
 26 July 2007: Saw GP, noticed child “withdrawn”
 1 August 2007: Saw Paediatrician [Dr Sabah Al-Zayyat, St Anne’s Hospital]
o child development clinic
o child not examined because “cranky and miserable”
o with her for an hour
 2 August 2007 Police announced they were closing investigation
 3 August 2007 Mother called 999
o Baby P “blue, cold and stiff”
o Formally pronounced dead at North Middlesex Hospital shortly after midday
PCCSF will await outcome of the National Inquiry announced today/
AJM11 Nov 2008

Friday, 24 October 2008

AGM 1.45pm 6 Dec 08 at the Conference

Our AGM will be after lunch at the Conference. Looking forward to seeing you there!

Conference 6 Dec 2008 - free for PCCSF members!

It's at Long Eaton Surgery
Nottingham
NG10 1JX
9:30-4pm
We hope you’ll come to our inaugural Conference. As part of our discussions, we'll be debating, with representatives from medical and statutory bodies, current issues in Safeguarding, particularly the scanning, storage and retention of Case Conference minutes. And we’ll be looking at the RCGP/NSPCC Toolkit, and seeing how it might be improved.
Cost:
PCCSF Members FREE
Non-Members £40
For people wishing to join, we are offering a special half-year membership rate of £50, and free admission to the Conference.
Please register using the following form:



Safeguarding Children Conference 2008
Saturday 6th December 2008
Long Eaton Surgery
Nottingham
NG10 1JX
9:30-4pm
Registration Form
Name…………………………………………………………
Address………………………………………………………
…………………………………………………………………
………………………………………..Postcode……………
Job title……………………………………………………….
I wish to attend the Safeguarding Children Conference 2008
and I am [please tick]
A member of PCCSF
I wish to Join PCCSF ( £50 for membership to April 09 plus
Conference fee…Cheque enclosed
I enclose a cheque for £40 for Conference only
[Make cheques payable to “Primary Care Child Safeguarding Forum]
Send to Dr Danny Lang
Treasurer PCCSF
7 Galleon Court
Charlestown
St Austell
Cornwall PL25 3NQ
Closing date Friday 21st November 2008

Tuesday, 12 August 2008

CAMHS Review 2008 - Summary of interim report

The DoH has commissioned a review of CAMHS services in England. Having consulted widely, an interim report has been published, which merely acknowledges the fact of critical feedback ,and signposts focus areas for the final analysis, expectd in the Autumn 2008.

Making the whole system work more effectively – the CAMHS Review is considering how leadership and accountability can be clarified and articulated so that children, young people, parents and professionals all understand who is responsible for what, when children need help.

Monitoring and evaluation – the Review suggests that the current focus of monitoring and evaluation on process improvements needs to shift towards the difference being made and outcomes.

Vulnerable children – the Review recognises that in some areas of the country there is still a lack of access to and provision of services for vulnerable children and is looking at ways to better meet their needs.

Workforce development – the Review suggests that approaches to improving mental health and well-being should be a specific aspect of training for the whole children’s workforce.

Resources – current dependence on short-term funding has a negative impact on financial planning and the long term viability of good programmes, workforce stability and recruitment. The Review will explore how this might be improved.

Cultural Change and Implementation – the Review will explore how to improve everybody’s understanding of what can be done to meet a child’s mental health and psychological needs and disseminate good practice.

The review is aimed at ensuring that the educational and psychological needs of all children and young people with mental health problems, or those at risk of developing them, are being met.

Andrew Mowat

Friday, 1 August 2008

Inspector's Report on Safeguarding Arrangements

Safeguarding children: the third joint chief inspectors’ report on arrangements to safeguard children
Published 8th July 2008

Assesses arrangements in 4 key areas:
  • overall effectiveness of systems
  • wider safeguarding role of public services
  • targeting vulnerable groups
  • response to child protection concerns

Overall effectiveness of systems

  • LSCB statutory partners [Connexions, CAFCASS, YOS] not yet involved everywhere
  • few LSCBs have prioritised specific vulnerable groups
    o looked-after children
    o privately fostered children
    o asylum seekers
    o children in mental health settings
    o children in secure and out of area placements
  • cannot show impact of their work
  • joint commissioning is underdeveloped
  • services constrained by time-limited funding
  • MAPPA arrangements are variable
  • variable updating of CRB checks
  • variable checking of staff in post prior to requirement for CRB

In terms of wider safeguarding role of public services

  • shared understanding of safeguarding lacking
  • lack of common approach across secure establishments
  • children still express concern for safety in care settings both secure and fostering
  • uncertain continuity funding preventive services [e.g. sex education]
  • dedicated programmes have failed to reduce rate of teen pregnancy
  • still significant substance misuse in offenders, substance misuse work not joined up on release
  • shortage of suitable mental health hospital beds
  • limited access to secure mental health beds
  • continuing lack of provision for learning difficulties and disability
  • 20% of LSCBs unable to demonstrate impact of strategies to deal with Domestic Violence
  • Probation response to children who offend, with background of DV, inadequate in 50%
  • significant variation in knowledge/understanding of DV in CAFCASS workers

Targeting Vulnerable Groups

  • 10% of children’s homes and fostering services inadequate in keeping children safe
  • children have limited say or choice in placement
  • educational attainment unacceptably lower for looked-after children
  • lack of continuity of social workers causes adverse effects in care plans
  • looked after children in custody have less contact with social worker than required
  • prison social workers doing well but uncertain funding
  • no agency has sole responsibility for children who go missing
  • processes for identifying young carers are underdeveloped
  • continuing concern about length of time children in court custody before secure placement
  • YOT assessments “lack rigour” and not informed by home visits
  • concerns remain about adequacy of health services for children who offend
  • treatment for young sexual offenders is limited
  • access/sustaining education is inconsistent
  • needs of children with learning difficulties who offend not well identified
  • restraint techniques still variable: previous report recommendations not implemented
  • inappropriate disciplinary/security measures applied: routine strip-searching etc
  • children in secure settings at distance from home less well monitored
  • concerns lack of priority given to children’s safeguarding by some NHS Trust and PCT boards
  • concerns extent health staff training
  • Concerns maintaining skills treating children by specialists [surgeons/anaesthetists]
  • access to specialist therapies [respite, speech/language/equipment, ADHD/Autism] limited
  • inadequate arrangements protection/care of children in airport holding facilities
  • some authorities provide less care to looked-after asylum seekers than others
  • continuing concern re effect on children’s wellbeing of detention in immigration removal centres
  • failure to address needs relating to ethnicity
  • no overall inspection of how children of armed forces personnel overseas kept safe

Response to child protection concerns

  • concerns that staff [in NHS, CAFCASS, YOT] have not received basic or intermediate child protection training
  • access to training is limited for schools, youth services, childrens homes, GPs, prison staff, YOT staff, nurses and hospital specialists
  • threshold for external investigation in response to allegation about use of force in prisons
  • lack of rigour & avoidable serious delay of serious case review
  • referral thresholds still not well understood by referring agencies
  • thresholds sometimes raised in response to workload, staff shortage and resources
  • identification of children at risk in criminal justice system poor
  • lines of accountability unclear
  • difficulties persist in parts of the NHS about sharing sensitive information


Recommendations

The Safeguarding Framework

All agencies
1. All agencies that have a statutory duty to cooperate (local authorities, district councils, police, primary care trusts, NHS trusts, Connexions, probation service, youth offending service, Children and Family Court Advisory Support Service, secure training centres and prisons) should ensure that they are fully compliant in respect of statutory membership of Local Safeguarding Children Boards by 1 September 2008.

Government
2. The Department for Children, Schools and Families, the Home Office and the Ministry of Justice should clarify the roles, functions and responsibilities of agencies contributing to multi-agency public protection arrangements (MAPPA) and ensure that relevant agencies meet them fully.

Local Safeguarding Children Boards
3. Local Safeguarding Children Boards should ensure that robust quality assurance processes are in place to monitor compliance by relevant agencies within their area with requirements to support safe recruitment practices. These processes should include regular audits of vetting practice and random sampling of compliance with checks with the Criminal Records Bureau.

The wider safeguarding role of public services

Government
4. The Department for Children, Schools and Families, the Department of Health and the Ministry of Justice should increase and better target child and adolescent mental health services in order to improve access to these services for children and young people with learning difficulties and/or disabilities and those who are in the criminal justice system.

Government, agencies providing services to children and young people and relevant inspectorates
5. All government departments, agencies and relevant inspectorates should specifi cally include the impact of domestic violence on children and young people within their risk assessments for planning, delivering, evaluating or inspecting safeguarding services.

Safeguarding groups of vulnerable children

Local authorities
6. Local authorities should make adequate provision of safe, sustainable and supported accommodation and stop the use of bed and breakfast accommodation for care leavers and young people both at risk of custodial remand or returning to communities from custodial settings.

Government
7. The Department for Children, Schools and Families and the Home Office should monitor at a national level the incidence of children missing from home.
8. The Department for Children, Schools and Families and the Youth Justice Board* should provide guidance to staff working in custodial and residential settings on the behaviour management of children and young people. Such guidance should include a model behaviour management strategy and emphasise that restraint should only be used as a last resort and should not be used solely to gain compliance. The guidance should make clear that methods of restraint should not rely on pain compliance.
9. The Department for Children, Schools and Families and the Youth Justice Board should issue a requirement that all incidences when restraint is used in custodial settings and which result in an injury to a young person are notified to, and monitored and publicly reported by, the Local Safeguarding Children Board.
10. The Department for Children, Schools and Families and the Youth Justice Board should issue a requirement that all incidents of strip-searching of young people in custodial settings are risk-assessed and recorded and that this data should be monitored by prison safeguarding committees. The Youth Justice Board should monitor the aggregated data nationally across the secure estate.
11. The Department for Children, Schools and Families and the Ministry of Justice/Youth Justice Board should provide long-term funding for social work input into youth offender institutions.
12. The Department for Children, Schools and Families, Department of Health and the Youth Justice Board should make the necessary provision to ensure that all children who display, or are convicted of, sexually harmful behaviours are assessed and that their needs for treatment are met.
13. The Department for Children, Schools and Families, the Department of Health and the Ministry of Justice/ Youth Justice Board should ensure continuity in the provision of mainstream services, particularly health and education, when young people return from a secure setting into the community.
14. The UK Border Agency should ensure that children are detained only in exceptional circumstances and for no more than a few days. The individual welfare needs of children should be taken into account, and that process documented, in any decision to detain and throughout the detention process.
15. The Department for Children, Schools and Families should issue guidance to local councils to ensure that children whose detention continues for more than seven days are subject to an independent welfare assessment of their health, welfare, educational and developmental needs and have an individual care plan. The welfare assessment and care plan should inform weekly reviews of the continued detention of children.

Child protection

Government and Local Safeguarding Children Boards
16. The Department for Children, Schools and Families and Local Safeguarding Children Boards should ensure greater consistency in decision-making about when a serious case review should be commissioned.

Government and Inspectorates
17. Ofsted should report annually on the outcome of evaluations of serious case reviews.
18. The Department for Children, Schools and Families should ensure that the national dissemination of biennial reports on the lessons learned is timely.

Government
19. The Department for Children, Schools and Families and the Youth Justice Board should ensure that the assessment tools used within the youth offending service and secure settings are robust in addressing the safeguarding needs of children and young people.
20. The Department for Children, Schools and Families, the Department of Health, the Home Office and the Ministry of Justice should ensure that information-sharing arrangements between healthcare professionals and other professionals providing services for children are in place and monitored to ensure informed and coordinated service provision.
21. The Department for Children, Schools and Families, supported by other relevant government departments, should provide an annual update of progress made on the recommendations in this report.

All agencies providing services to children and young people
22. All agencies that have a statutory duty to cooperate (local authority children’s services, district councils, police, primary care trusts, NHS trusts, Connexions, probation, Youth Offending Service, Cafcass, secure training centres and prisons) should clarify the chain of accountability and responsibilities for child protection from the front line through to their most senior level.

Full report can be downloaded from:
http://www.safeguardingchildren.org.uk/

Andrew Mowat
July 2008

Saturday, 12 July 2008

Conference - 1 October

We are holding a joint day conference in Bournemouth with other RCGP societies the day before the main RCGP conference.

We are working on the details, but the theme will be co-morbidity.

Sorry - this RCGP societies day has now been cancelled so our day conference will not happen then, but we are still planning a day further ahead. Watch here for details.

For more information please e-mail me: janice@pccsf.co.uk