Update for Trainees from Child Protection Standing Committee Meeting:
Below are notes taken from the CPSC meeting which I attended as trainee representative on 6th February.
As trainee representative I raised the following discussion points:
Ø For those trainees with a specific interest in Child Safeguarding, especially those undertaking the SPIN module, it can be difficult to get study leave from certain rotations in order to complete competencies.
Ø Committee members acknowledged this concern and the following comments were made:
o Specific safeguarding /CP training is generally only available during community paediatrics rotation
o Rotas can impact
o Protected time could potentially help
o Training can be inconsistent
o Solutions: make it a speciality, extend training so it is included as part of acute paediatrics, advertise external courses.
o Recommendation that the eBulletin be linked to the London School of Paediatrics website for wider availability and access to training opportunities.
Guidance
· Child Protection Systematic Reviews and Publications Sub Committee:
Systemic reviews (SR): Core Info is moving from Cardiff to the College and NSPCC – a new contract is being agreed. SRs completed for bruises and burns. The team are now working on fractures, and will then begin working on head injury and spinal injury.
· Safeguarding children and young people: roles and competences for health care staff – Intercollegiate Document. http://www.rcpch.ac.uk/sites/default/files/page/Safeguarding%20Children%20-%20Roles%20and%20Competences%20for%20Healthcare%20Staff%20%2002%200%20%20%20%20(3)_0.pdf
The standards, last published in 2014, should be reviewed in 2017; however funding will be needed to undertake this project. Recommendations from the committee to be considered as part of review:
o Vast number of competencies, which means it can be time consuming to complete the different levels of training which could deter people. Suggestion for case work or peer review instead of competencies.
o New version should be developed in line with the new outcomes based curriculum
o Develop a comprehensive safeguarding young people document
o Include a section on transition
o Include a section on vulnerable young adults
· RCPCH report:
o State of the Child Health Report 2017 – launched on 26th January
http://www.rcpch.ac.uk/state-of-child-health
o Shaken Baby Syndrome: English translation of Swedish Agency Systematic Review for Shaken Baby Syndrome now available
o Safeguarding bulletin: there will be a section on safeguarding in the college eBulletin after each CPSC meeting.
· The RCPCH and FFLM have produced guidance on service specification for the clinical evaluation of children and young people who may have been sexually abused, recommending that doctors undertake a minimum of 20 forensic examinations per year in order to maintain skills. Feedback following publication showed that it is not always feasible to undertake a minimum of 20 examinations, so in response the RCPCH and FFLM has developed interim guidance.
https://fflm.ac.uk/wp-content/uploads/2017/01/CSA-Examinations-Interim-Guidance-Dr-B.Butler-January-2017.pdf
The Committee acknowledged the importance of ensuring Paediatricians are made aware of training options such as the FFLM Licentiate of the Faculty of Forensic & Legal Medicine (LFFLM) – Sexual Offences Medicine (SOM) – which has replaced DFCASA.
· Guidance for doctors being asked to comment on photographs. Potential for updates to the photography section of PCO following the publication of FFLM guidance.
· Referral and management guidelines are being developed following an increase in the incidence of herpes in CYP.
· The Royal College of Radiologists’ companion (orange book) looking to be published between April and July 2017.
· The college is submitting a bid to update guidance for CYP in secure settings. There is a high incidence of babies born in secure settings, but who is responsible for their health needs?
· NHS England chaperone policy guidance http://www.rcpch.ac.uk/system/files/protected/page/Chaperone%20policy%20version4%20Dec%202017.pdf
· Guidance on Children who conceal substances (swallowers and packers) often linked to children who have been trafficked. There is adult guidance but appears to be no guidance for CYP. Home Office is seeking feedback from RCPCH on this issue. The committee are investigating if the RCPCH and FFLM should produce guidance for Emergency Departments regarding this.
· NSPCC: An educational video on child sexual abuse published on 20 February 2017 https://www.nspcc.org.uk/preventing-abuse/child-abuse-and-neglect/child-sexual-abuse/preventing-child-sexual-abuse/
· Core Info: the name of the Core Info leaflets will change. ‘Looking out for children’ is the proposed new title. The leaflets should be available for download from the NSPCC website.
· NHS safeguarding update: http://www.rcpch.ac.uk/system/files/protected/page/NHS%20England%20slides.pdf
· CQC sharing of best practice: Review of arrangements for Child Safeguarding and Healthcare for LAC in England, July 2016. http://www.rcpch.ac.uk/system/files/protected/page/CQC%20RCPCH%20presentation.pdf
Not seen, Not heard is a review of 50 local area inspections of health and social care services. It notes how services fail to adequately support CYP and also highlights examples of innovative and outstanding care. Key recommendations of the report:
1. CYP must have a voice
2. The focus must be on outcomes
3. More must be done to identify children at risk of harm
4. CYP must have access to the emotional and mental health support they need
http://www.cqc.org.uk/content/not-seen-not-heard
Coming soon: CAMHS Thematic. CQC has agreed to undertake a single agency thematic review next year and a multiagency review is planned for 2018/19.
· JTAI – multi-agency reviews with Ofsted, HMI Constabulary, HMI Probation, HMI Prisons, and Ministry of Justice. These are individual programmes and involve a deep dive into 6 areas of which 2 are considered examples of ‘good practice’. The results of the first JTAI which looked at child sexual exploitation are captured in the summary report Time to Listen. Current JTAI is on domestic violence and the next will be on neglect. A consultation is currently underway to decide the focus of the review on neglect; comments are welcomed. The following one after neglect will be on sexual abuse in familiar relationships.
https://www.gov.uk/government/publications/joint-inspections-of-child-sexual-exploitation-and-missing-children-february-to-august-2016
· Children in humanitarian crisis: Education and training event last year developed web based guidance and signposting on how to support the health needs of migrants.
The college identified the following pieces of work it could undertake to support children in humanitarian crises:
1. Conduct a systematic review of the research and evidence into age-assessment guidance and develop subsequent paediatric guidance
2. Review web-based guidance
3. Develop a research plan to investigate the health needs of refugee children
The Executive Committee (EC) of the College decided to take forward options 2 and 3. The first option was not chosen because it is not necessarily the role of paediatricians and it would be costly to undertake (estimated cost £150,000). To support 2 and 3, the College is preparing a bid to the NIHR who put out a call for research on health interventions for migrant health and wellbeing
· FGM section planned for purple book.
· FGM examinations for asylum seeking children guidance: The committee agreed that guidance should be produced to support Paediatricians undertaking medical assessment of children who have experienced FGM.
· Children & Social Work Bill: The Bill is wide-ranging and will update and amend child protection and social work legislation. It is currently awaiting a date for report stage in the House of Commons.
Education & Training
· FGM courses: Recent courses in London, Edinburgh and Cardiff, run by Deborah Hodes and Sarah Creighton were very well received. Additional funding has been secured for two more courses; one in London and one in Liverpool.
RCPCH London 09/05/2017
Liverpool 27/11/2017
· Fabricated or Induced Illness course: new course should take place before July 2017.
· Requests for Looked After Children (LAC) course. Currently there is level 3 e-learning in place but resources are stretched to provide face to face training.
· Child Protection Response and Recognition Course (CPRR) – see ALSG website. The CPRR and Child Protection Working Group are seeking volunteer doctors and nurses with expertise and experience in child safeguarding to join the working group.
· https://www.baspcan.org.uk/events/ Click on link for upcoming Child Safeguarding Events.
· NSPCC conference. How safe are our children? 21-22nd June 2017. https://www.nspcc.org.uk/what-you-can-do/events/how-safe-conference-2017/?&gclid=CjwKEAjwz9HHBRDbopLGh-afzB4SJABY52oFCJSNXSJBQf-q8jNw1XZBjQRlj3hzJk-xDrPWVyUgJRoCTDvw_wcB&gclsrc=aw.ds
Other things of interest:
· Neena Modi on Victoria Derbyshire https://twitter.com/VictoriaLIVE/status/828543223576424448
· Article in the Guardian on Child Poverty https://www.theguardian.com/society/2017/feb/02/we-need-a-renewed-effort-to-tackle-child-poverty
· IICSA report now available: https://www.iicsa.org.uk/ https://www.gov.uk/government/collections/independent-panel-inquiry-into-child-sexual-abuse
· Including voice of CYP in CPSC:
The CYP Engagement Team ensures that CYP are at the centre of the work of College. They oversee a virtual network for CYP and parent carers (called Us) and one for workers (called the Engagement Collaborative). The network facilitates the collection of a range of voices: universal, targeted or specialist voices which help the College understand their needs. Different techniques are used to acquire CYP perspectives e.g. consultations, roadshows, school visits, virtual networks, visiting waiting rooms.
Key themes identified as important for CYP (so far): communication, mental health, poverty, PSHE, local knowledge and signposting for specific services, single point of contact and technology.
What the CYP team can offer to support specific projects:
o &Us educators
o Set challenge days (e.g. project capsule)
o innovators (e.g. work over a longer period with a group to come up with cost- effective solutions to common issues)
o road shows (visit schools)
o academy (offer back to CYP e.g. national accreditation) What the CYP team can offer CPSC:
o Individual level – including the voice of CYP in the work of the committee
o Operational level – community voice, e.g. set up a challenge day by bringing CYP together
Curriculum review update:
· Moving from competency based outcome based.
· Table of 11 generic learning outcomes. Each section has sub section of syllabus items. Divided into syllabus for Level 1, 2 and 3 trainees.
· Framework of knowledge based capabilities (essential and desirable)
· Syllabus items are governed by RCPCH; updated each year as a result of input from CSAC committees etc.
The draft curriculum has been agreed in principal by the core group. It has an outcomes based framework aimed at developing capabilities and applicable skills and knowledge. Capabilities are defined as either essential or non-essential. The syllabus will be governed by the RCPCH meaning it will be easier to amend to ensure it remains fluid and up-to-date.
A draft has been shared with the GMC and positive feedback has been received so far. It has also been presented to trainees who also shared positive feedback.
The approval application date is 27 July and a decision is expected in October 2017.
The syllabus does consider the intercollegiate document but it does not map directly across.
Are trainees aware of the new syllabus? If anyone has any feedback/ suggestions for improvement with regards to safeguarding please email me at
Finally…
Child Protection systematic review and publication sub-committee is looking to recruit appraisers. Work is currently being done on fracture and head/spinal trauma, then plan to do retinal haemorrhages. Much of this will be available on PCO. Anyone interested in becoming an appraiser please contact Rosa Nieto.