1. Version Control
|Version||Date||Author and Role||Detail of Change|
|0.1||07/10/2022||Caroline Holt, Designated Nurse Safeguarding Children||Initial draft|
|0.2||01/02/2023||Caroline Holt||Draft updated with changes from team comments|
|0.3||28/04/23||Caroline Holt||Updated with wording changes and links|
|0.4||25/05/23||Caroline Holt||Final draft|
2. Approval History
|0.4||July 2023||SNEE ICB Quality Committee|
3. Next Review Date
The date this policy is due for review is July 2025
- Version Control
- Approval History
- Next Review Date
- Statement of Overarching Principles
- Equality Statement
- Cross Reference to Other Policies
- Policy Details
11.1. Goverance and responsibilities
11.2. Responsibilities of all SNEE staff
11.3. Procedural requirements
11.4. Managing allegations against staff
11.5. Information Governance
- Appendix 1: Safeguarding Children Team Contacts
- Appendix 2: Abbreviations and Definitions
5. Statement of Overarching Principles
All Policies, Procedures, Guidelines and Protocols of the Suffolk and North East Essex Integrated Care Board (ICB) are formulated to comply with the overarching requirements of legislation, policies or other standards relating to equality and diversity.
This policy sets out the statutory responsibilities of the Suffolk and North East Essex Integrated Care Board (SNEE ICB) to ensure effective safeguarding of children and young people at risk within the population they serve. This includes responsibilities for children and young adults who are placed as children in care and who are looked after by the Local Authority. This duty extends to children and young people who are cared for in placements commissioned by the ICB out of area and children with a disability, who are acknowledged as at greater of abuse than their non- disabled peers.
The legal definition of ‘children’ applies to those under 18 years of age. For the purpose of this policy the term ‘children’ applies to babies, children, and young people.
The fact that a child has reached 16 years of age, is living independently or is in further education, is a member of the armed forces, is in hospital, in Local Authority Care; or in custody in the secure estate, does not change his/her status or entitlements to services or protection.
SNEE ICB, alongside all other NHS bodies, has a statutory duty to ensure that it makes arrangements to safeguard and promote the welfare of children, young people and adults. This policy pulls together statutory guidance for safeguarding children, to incorporate a ‘think family’ approach and shared responsibility when considering safeguarding arrangements.
SNEE ICB is committed to working in partnership with both the Suffolk Safeguarding Partnership (SSP) and the Essex Safeguarding Children’s Board (ESCB) to safeguard and promote the welfare of children and young people and to have in place systems and processes to support the multi-agency policies and procedures of both the Suffolk and Essex Safeguarding Partnerships.
SNEE ICB is committed to safeguarding and promoting the welfare of children and in doing so discharging in full their duties under Section 11 of the Children Act 2004. This places a statutory duty on key people and bodies to make arrangements to safeguard and promote the welfare of children. These arrangements require all agencies to have:
- Senior management committed to the importance of safeguarding and promoting children’s welfare.
- A clear statement of the agency’s responsibilities towards children, available for all staff
- A clear line of accountability within the organisation for work on safeguarding and promoting the welfare of children.
- Service development that takes account of the need to safeguard and promote welfare, and is informed, where appropriate, by the views of children and families
- Training on safeguarding and promoting the welfare of children for all staff working with, or in contact with, children and families.
- Safe recruitment procedures in place
- Effective inter-agency working to safeguard and promote the welfare of children.
- Effective information sharing.
The SNEE ICB will ensure that service specifications, invitations to tender, service contracts and service level agreements promote dignity in care and adhere to local multi-agency safeguarding policies and procedures.
Partners are responsible for maintaining their respective organisational policies and procedures.
The purpose of this policy is to outline how the ICB fulfils their statutory duties and the approach to safeguard babies, children and young people, promoting the welfare of children.
Safeguarding is everyone’s responsibility. It is about people and organisations working together to prevent and stop both the risks and experience of abuse or neglect, while at the same time making sure that the wellbeing, views, wishes and beliefs of adults and children are actively heard and promoted within safeguarding arrangements.
All babies, children and young people have the right to live their lives free of abuse and neglect and have the right processes in place to ensure they are safeguarded and free from harm.
All staff have a role in raising awareness of safeguarding concerns and connecting with the ICB’s Safeguarding team for advice when required.
See Appendix 3 for the Safeguarding teams contact details.
This Safeguarding Children Policy illustrates the requirements and compliance with legislative duties to safeguard children and should be read in conjunction with:
- Children Act (1989; 2004)
- Working Together to Safeguard Children, (HM Government 2018)
- Safeguarding children, young people and adults at risk in the NHS Safeguarding accountability and assurance framework (2022)
- The ICB policy: Managing Safeguarding Allegations Against Staff Policy and Procedures
- Promoting the Health and wellbeing of Looked after Children (DH 2015)
- Mental Capacity Act (2005)
- Female Genital Mutilation Act (2003) (updated by the Serious Crime Act 2015)
- Sexual Offences Act (2003)
- Modern Slavery Act (2015)
- Domestic abuse legislation (2014; 2015)
- Safeguarding Children: roles and competencies for Healthcare Staff: 2019.
- Serious Violence Duty (2022)
- Looked After Children. Knowledge, skills and competencies of health care staff. Intercollegiate Role Framework Document (2015)
- Child Death Review Statutory Guidance (2018)
Safeguarding is also underpinned by the Human Rights Act 1998.
Managers are responsible for ensuring that practice reflects the standards within this policy and that staff are given adequate resources and support to comply with them.
8. Equality Statement
This Policy will operate alongside the ICBs Equal Opportunities, Diversity at Work Policy, and Equality Delivery System. The ICB’s vision is to have in place a sustainable people driven service system of care which is best of class, and values based on hope inspiring environments and embracing diversity. The ICB will ensure that all staff, volunteers, service users and visitors are treated with dignity and respect, and no individual is treated differently on the grounds of their marital status, maternity, race, gender, gender reassignment, disability, age, religious belief or their sexual orientation.
The ICB assures staff, volunteers and people entitled to our services are treated fairly, equally ICB will challenge discriminatory attitudes and provide rules and standards of behaviour.
The ICB will monitor the use of this Policy, and will ensure that the policy is implemented fairly, and will take action if it appears that it is has a disproportionate effect.
This policy applies to all employees of the ICB, including fixed term employees and seconded when working within the ICB and whilst on ICB business.
10. Cross Reference to Other Policies
- Dealing with concerns around conduct policy
- Safeguarding Adults at Risk Policy
- Equality and Diversity Policy
- Whistleblowing Policy
- Complaints Policy
- Patient Engagement Strategy
- Integrated Risk Management Framework
- Serious Incident (SI) Management Policy
- Information Sharing Policy
- Managing Investigations Policy
- Disclosure and Barring Service Policy
11. Policy Details
11.1. Governance and Responsibilities
Safeguarding Children, Young People and Adults at risk NHS: Safeguarding and Accountability and Assurance framework. (NHS England and NHS Improvement 2022) sets out clearly the roles, duties and responsibilities of all organisations.
Working Together to Safeguard Children (2018) set out the responsibilities of all organisations with regard to safeguarding children and provides statutory guidance for all health organisations.
The Chief Officer (CO); has overall responsibility for the strategic and operational management of the SNEE ICB and is responsible for ensuring that the health contribution to safeguarding children is discharged effectively across the whole health economy through commissioning arrangements.
Chief Nurse: responsibilities
Is the overall lead for Safeguarding in the ICB.
Reports to the CO and the ICB on issues in relation to changes in strategic direction, significant developments, learning from serious incidents or identified risks in relation to safeguarding children.
Is responsible for the execution of all safeguarding responsibilities on behalf of the CO and the ICB Board.
Promotes the safeguarding children within commissioning arrangements to meet identified quality standards through quality scrutiny processes.
Monitor the progress of recommendations and outcomes from Serious Untoward Incidents, Individual Management Reviews, Serious Case Reviews and Domestic Homicide Reviews.
Oversee the performance management of the Designated Professionals.
Commission safeguarding annual reports on behalf of the ICB Board.
Ensure providers and contracted services are aware of their responsibilities in relation to reporting safeguarding incidents.
ICB Board: responsibilities
Maintain a continued awareness of current safeguarding issues and ICB responsibilities/accountability.
Maintain a knowledge base through mandatory training, reviewing reports, newsletters and updates.
Promote the welfare of children and adults with care and support needs in both personal and ICB activity and comply with all organisational and local Safeguarding Partnership multi agency policies and procedures.
Consider the requirement of safeguarding in all activities both professionally and personally, in particular through contracting and performance monitoring.
Designated Nurses and Doctors for Safeguarding Children: responsibilities
Are identified within the health economy as clinical leads with statutory roles and responsibilities for safeguarding children. Are appropriately trained and given sufficient time to carry out their duties effectively.
Take a strategic, professional advisory lead on all aspects of the health service contribution to safeguarding across the ICB, which includes all providers.
Advise on the planning and delivery of an organisational programme of safeguarding training which includes the Mental Capacity Act and Prevent.
Provide clinical advice on the development and monitoring of the safeguarding aspects of ICB contracts.
Provide supervision, advice and support to the Named professionals and safeguarding leads in provider organisations.
Provide expert professional advice on matters relating to safeguarding to other professionals, the ICB, Local Authorities, the Local Safeguarding Boards and associated sub-committees and partner agencies.
Advise on serious incidents or individual management reviews which arise as part of the Rapid Reviews, Child Safeguarding Practice Reviews, and monitor specific health implementation and outcomes of agreed actions.
Advise on the development of organisational and multi-agency strategy, policy procedures audits and projects relating to safeguarding children and adults.
Attend the local safeguarding Partnerships Board and relevant Sub-committees in a professional advisory capacity for the ICB and communicate positively ICB values and strategic vision to stakeholders and partners as appropriate.
Alert the ICB to situations which compromise organisational ability to discharge safeguarding responsibilities.
To challenge decisions in multi-agency arena, where children or adults with care and support needs are believed to remain at risk via escalation processes outlined in local procedures.
Are responsible for planning and undertaking quality assurance processes to include visits to care settings and review of investigations and outcomes following serious incidents.
Produce an Annual Report on Safeguarding.
Designated Nurse and Doctor Looked After Children: responsibilities
Provide specialist knowledge in all aspects relating to looked after children across the Suffolk and North East Essex health economy.
Provide strategic and clinical leadership to the service and to the Specialist Children in Care (CIC) Health Teams, ensuring that the ICB fulfils its statutory duties for Looked after Children and care leavers.
Work closely with health providers and the commissioners of the services to ensure processes are in place for the effective delivery of statutory health assessment reviews to an acceptable quality standard. Have oversight of the performance of commissioned CIC health providers.
Work closely with SNEE Young People’s Social Care Services to promote an integrated care approach in the best interests of Looked after Children and care leavers.
Ensure the Corporate Parenting Board is aware of the health needs of their looked after population and the effectiveness of the services commissioned to provide this support via the Corporate Parenting Board meetings.
Promote integrated working with Child and Adolescent Mental Health (CAMHS) Looked after Children teams to advance emotional health and well-being outcomes for children in care.
Engage with public health colleagues to ensure that service development is evidence based and that Looked after Children and care leavers are considered across the health economy.
Report to and provide specialist knowledge to commissioners.
Work in partnership with Designated and Named safeguarding colleagues to ensure Looked after Children and care leavers are safeguarded.
Provide specialist knowledge advice and leadership to the ICB in all aspects relating to Looked after Children and care leavers.
Designated Paediatrician for Unexpected Child Deaths: responsibilities
Undertakes lead responsibility for medical responses to unexpected deaths of children which occur within an identified area as outlined in Ch5 Working Together to Safeguard Children 2018.
Work with the Police and Children’s Social Care to co-ordinate responses to unexpected child deaths.
In partnership with the Police and Children’s Social Care, undertake appropriate investigations and enquiries and evaluate the reasons and circumstances of the death in agreement with the Coroner.
Liaise with those who have on-going responsibility for other family members providing support to the bereaved family, and where appropriate referring on to specialist bereavement services following the death.
Maintaining contact at regular intervals with family members and professionals who have on-going responsibilities for family members, to keep them up to date with information about the child’s death.
Act as clinical medical advisor as a member of the Child Death Overview Panel.
Quality Assurance Team Managers: responsibilities
Work in close partnership with the ICB Safeguarding Children Leads.
Must maintain a continued awareness of safeguarding issues and ICB responsibilities/accountability, and maintain a knowledge base by reviewing reports, newsletters and attending training/development sessions.
Monitor that all commissioned services have robust policies and procedures embedded to safeguard and promote the welfare of children.
Inform the ICB safeguarding lead of any deficits in health services which may impact on inter-agency working, and potentially put vulnerable people at risk.
Employees (including contracted staff): responsibilities
Comply with the two safeguarding Partnerships policies procedures and guidance on safeguarding children.
Attend safeguarding training at the appropriate level to their role as outlined in the Intercollegiate Documents: ‘Safeguarding Children and Young People: Roles and Competencies for Health Care Staff’ (2019) and ‘Looked After Children: Knowledge, Skills and Competences of Health Care Staff’ (2015) and maintain a level of knowledge and skills appropriate to their role.
Protect children at risk by recognising and responding to abuse and neglect and know what action to take to make appropriate referrals, (see procedural requirements below for referral process)
Access safeguarding advice and supervision at the appropriate level for their role as outlined in the Intercollegiate Document: – Safeguarding Roles and Competencies for Health Care Staff (2019)
Take part in surveys audits and evaluations regarding safeguarding as appropriate.
Take immediate and appropriate action regarding allegations against people who work with children as outlined in the ICB Raising Concerns (Whistleblowing) policy.
Comply with safe recruitment of staff in line with the ICB HR processes.
11.2 Responsibilities of all SNEE staff
Staff members employed, contracted or volunteers who do or do not directly deliver services to individuals, in circumstances where they identify a concern around the safety and welfare of a child or young person, are expected to ensure that they act in accordance with the Suffolk Safeguarding Partnership and the Essex Safeguarding Board procedures in recognising and responding to abuse of children.
For definitions and types of abuse please see:
- Spotting the signs of child abuse | NSPCC
- Working Together to Safeguard Children 2018 (publishing.service.gov.uk)
- Suffolk Safeguarding Partnership
- Essex Safeguarding Children Board
The needs of most children and families are straight forward and the majority of these can be met by some kind of universal provision. The needs of other children and families can be more complex and may require the intervention by multiple agencies to provide support.
Providing early help is more effective in promoting the welfare of children and young people, providing support as soon as a problem emerges rather than reacting later. The effectiveness of early intervention is underpinned by professional responsibility, ensuring that, if a family does not meet the thresholds for specific services, action is taken to prevent lower-level needs escalating.
Children’s presenting needs should be determined by a robust risk assessment which should inform the proportionate service response. In Suffolk and North East Essex this is achieved through completion of the on-line form and referral to the local Children’s Services from where the risks are assessed and the referrer informed of outcome.
11.3 Procedural Requirements
What to do if you are worried about the safety of a child or young person.
If at any time, a member of staff feels that a child needs urgent medical assistance, they have a duty to call for an ambulance or arrange for a doctor to see the person at the earliest opportunity.
If at the time, staff have reason to believe the child is in immediate and serious risk of harm or that a crime has been committed the police must be called.
If anyone believes that a child or young person may be suffering, or may be at risk of suffering significant harm, they should always refer their concerns to their local Children’s Social Care and/or the Police.
The SSP provides detail of the processes to follow when there are safeguarding concerns regarding the safety of a child (processes are therefore not replicated here in detail).
Procedures can be accessed on the SSP website.
Advice can also be sought from SNEE Designated Nurses Safeguarding Children Teams (see Appendix 1).
North East Essex
The Southend, Essex and Thurrock (SET) Safeguarding and Child Protection Procedures provide detail of the processes to follow when there are safeguarding concerns regarding the safety of a child (processes are therefore not replicated here in detail). The SET Procedures can be accessed on the ESCB website.
Contact numbers and the link for the ‘Request for Support Portal’ for advice and reporting concerns to Children’s Social Care can also be located on the Essex Safeguarding Children Board website.
Advice can also be sought from SNEE Designated Nurses Safeguarding Children Teams (see Appendix 1).
11.4 Managing allegations against staff
ICB staff should always act in such a manner as to safeguard and promote the interests of individual patients and clients – all allegations of child abuse by ICB staff must be taken seriously.
Concerns may not be solely in connection with what happens in the working environment. The actions of an individual in their personal life may indicate that their behaviour could be a risk of harm to children they work with e.g., perpetrators of domestic violence, neglect of their own children.
This procedure applies when an allegation or suspicion arises during a member of staff’s work, with his or her own children, with other children living outside the family and historical allegations.
This procedure outlines how, as an organisation, SNEE ICB will effectively fulfil its legal duties and statutory responsibilities with regard to managing safeguarding allegations against staff.
In accordance with Working Together 2018, this section of the policy relates to a staff member who may have:
- Behaved in a way that has harmed a child or may have harmed a child.
- Possibly committed a criminal offence against or related to a child.
- Behaved towards a child or children in a way that indicates he or she would pose a risk of harm to children This may be in their professional or personal life.
- Behaved or may have behaved in a way that indicates they may not be suitable to work with children.
The ICB has a duty to notify the Local Authority Designated Officer (LADO) of all allegations of child abuse which are made against their employees or that are brought to their attention by whatever means.
Working Together to Safeguard Children refers to local authorities having a designated officer, or a team of designated officers involved in the management and oversight of allegations against people that work with children.
For details of the role of the LADO, managing allegations of abuse by people who work with children and the referral process.
Any member of staff who becomes aware about an allegation of concern in relation to safeguarding children by an employee of SNEE ICB, must report it to their own line manager and at the same time inform the Designated Nurse Safeguarding Children. Advice can also be sought from the Designated Professionals team if unsure of what action to take.
The line manager must take advice from a senior member of the Human Resources Department and all allegations should be reported immediately to the Named Senior Officer for SNEE ICB (Director of Nursing) at the earliest opportunity (the recipient of the allegation must not try to unilaterally determine the validity of the allegation) and the person who is the subject of the allegation should not be informed until advice has been sought from either the line manager, the Named Senior Officer, or the Designated Professionals team: this is important in terms of future investigations.
The Named Senior Officer, or deputy, informs the Local Authority Designated Officer (LADO) within one working day of allegation being made, regardless of the nature of allegations and who receives the allegation. This must include situations where the worker resigns.
Compromise agreements are not acceptable in such circumstances and may put others at risk in the future. The Named Senior Officer works collaboratively with other agencies contributing to a strategy meeting and taking appropriate action as agreed.
Consideration is given in regard to Disciplinary Procedures e.g. suspension, referral to Disclosure and Barring Service (DBS). Employees must be aware that abuse is a serious matter that can lead to a criminal conviction. Where applicable the organisation’s Disciplinary Policy will be implemented.
If concerns arise about a member of staff’s behaviour towards any vulnerable individual, Social Care and/or Police must inform the organisation in order to assess whether there may be implications for children or adults at risk with whom the person has contact at work.
11.5 Information Governance
The SNEE ICB has a duty to ensure that effective information sharing takes place to safeguard children and vulnerable adults. The SSP and ESCB have inter-agency sharing agreements which the SNEE ICB, as Board members are signed up to.
Even where you do not have consent to share confidential information, you may lawfully share it if this can be justified in the public interest.
If there are concerns that a child may be at risk of significant harm the information should be shared without delay.
The main legal framework relating to the protection of personal information is set out in the document: Information sharing: advice for practitioners (publishing.service.gov.uk).
These documents provide information on the pieces of legislation which may provide statutory agencies and those acting on their behalf with statutory powers to share information.
Managers are to ensure their staff are sighted on these documents when making decisions about sharing personal information on a case-by-case basis, whether they are working in the public, private or voluntary sectors or providing services to children, young people, adults and/or families.
Where information is shared there should be clear documentation setting out why information was shared to ensure there is an audit trail for the decision-making process to share that information.
Seek advice if you are not sure what to do at any stage and ensure the outcome of any discussion is recorded.
You can contact the SNEE Safeguarding Team via email to discuss your concern.
Monitoring and Review
The policy and procedure will be reviewed every three years and in accordance with the following as required:
- Legislative changes
- Good practice guidance
- Case law
- Significant incidents reported
- New vulnerabilities identified
- Changes to organisational infrastructure
- Changes in practice