West Hampshire Clinical Commissioning Group
North Hampshire Clinical Commissioning Group
North East Hampshire & Farnham Clinical Commissioning Group
South East Hampshire and Fareham & Gosport Clinical Commissioning Group
Hampshire Five Clinical Commissioning Groups
(CCG)
Safeguarding Strategy
2016 – 2018
West Hampshire CCG
North Hampshire CCG
North East Hampshire & Farnham CCG
South East Hampshire and Fareham & Gosport CCG
Document author: Trish Dennison updated by Kim Jones
Final version – updated 30.06.2016
Final Copy - Updated 30_06_2016
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Contents
Foreword........................................................................................................................................................ 3
Introduction............................................................................................................................................ 4
1.
What is this strategy about? ................................................................................................................... 4
Outcome of those discussions ............................................................................................................... 4
Vision for Safeguarding ....................................................................................................................... 5
2.
2.1
Why it’s important ......................................................................................................................... 5
2.2
What do we want to achieve ....................................................................................................... 1
2.3
What changes will happen in the future .................................................................................... 1
3.
Purpose.................................................................................................................................................. 1
4.
Background and context to safeguarding in Hampshire ................................................................ 1
4.1
Hampshire Health and Wellbeing Board (HWB) priorities 2013-2018 ................................. 1
4.2
Children’s and Young Peoples Plan 2015-2018...................................................................... 1
4.3
Hampshire Safeguarding Children Board priorities 2015-2016 ............................................ 1
4.4
Care Matters Board ...................................................................................................................... 2
5.
Hampshire Five CCG Responsibilities .............................................................................................. 2
6.
Safeguarding with Quality at the Heart of the Commissioning Cycle........................................... 2
7.
Assessing health needs ...................................................................................................................... 2
8.
Identify area for development in Service Provision ......................................................................... 3
9.
Procurement.......................................................................................................................................... 3
10.
Monitor and manage performance ................................................................................................ 3
11.
Safeguarding and looked after children governance structure ................................................. 3
11.1
Hampshire Five CCG’s ................................................................................................................ 4
11.2
Hampshire Safeguarding Children Board ................................................................................. 4
11.3
Hampshire Safeguarding and Looked After Children Professional Forum ....................... 4
11.4
NHS England Wessex Regional Team ..................................................................................... 4
11.5
Taking forward Safeguarding priorities across Hampshire .................................................... 4
Appendix 1 .................................................................................................................................................... 6
Appendix 2 .................................................................................................................................................. 14
Appendix 3 ..................................................................................................... Error! Bookmark not defined.
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Foreword
The Hampshire five clinical commissioning groups (CCGs) have set out in this
safeguarding strategy how they plan to ensure that all services they commission comply
with statutory safeguarding requirements. We believe that every child and young person
deserves a high quality and safe experience wherever they are cared for in NHS
commissioned services. We believe working collaboratively alongside the CCG’s
safeguarding adult, quality and children’s commissioning teams serves to protect those
most vulnerable to abuse and will ensure safeguarding is considered in all commissioned
services as well as identify where safeguarding practice can be improved to prevent and
reduce the risk of abuse and neglect.
The revised Safeguarding Vulnerable People in the NHS - Accountability and Assurance
Framework July 2015 highlights the collective responsibility across all NHS organisations
to safeguarding vulnerable people. The role of the CCGs is to gain assurance from all
commissioned services, both NHS and independent healthcare providers, to ensure
continuous improvement.
The strategy reflects our commitment in continuing to improve safeguarding practice.
We are keen to work collectively across the health economy and with partner agencies to
ensure that safeguarding developments are jointly progressed and a collaborative
approach is adopted which influences safeguarding culture and practice across
organisations to improve outcomes for children and young people.
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1. Introduction
What is this strategy about?
This strategy has been developed by the Hampshire five CCG safeguarding and looked
after children team to improve services across the local health economy in Hampshire.
This includes working in close collaboration with NHS provider and partner agencies to
ensure that safe services for children and young people are in place when they are
needed most.
How has the strategy been developed?
The safeguarding and looked after children team have developed the strategy following a
team away day to agree the key deliverables and objectives for the forthcoming year
alongside feedback and comments from a staff survey and workshop held with key
safeguarding leads, named and designated professionals across Hampshire, including
representation from:
•
•
•
•
•
•
•
•
•
•
•
•
Care UK
Fareham and Gosport CCG
Hampshire Hospital Trust
NHS England
North Hampshire CCG
North East Hampshire and Farnham CCG
Portsmouth Hospital Trust
Primary care
Solent NHS Trust
South Eastern Hampshire CCG
Southampton City Clinical Commissioning Group
Southern Health Foundation Trust
Outcome of those discussions
The discussions identified several areas where a more collaborative approach to policy
and service development is needed between the safeguarding team and local health
economy partners. Some areas identified are:
•
•
Children and young people at the centre of our discussion and decision making
Strengthening communication systems between CCGs and providers
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•
•
•
•
•
•
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Review of information systems across primary and secondary care to ensure that
vulnerable children are referred to services in a timely manner
Working together to identify what good services look like for our children in a
safeguarding system
A change in approach to manage system wide issues such as information sharing
to ensure sustained changes in practice
The need to raise the profile of looked after children across the health system
Take an innovative approach to how key messages from serious case reviews are
communicated to staff
Be able to have open, transparent, challenging conversations to ensure better
services for children are in place
Greater visibility of the designated team at all levels of NHS provider organisations
• Offer greater support to NHS providers in development of assurance processes.
2. Vision for Safeguarding
We want all children and young people, to be able to access safe health services at any
point in time when they are in need of support.
2.1 Why it’s important
The Hampshire joint health and wellbeing strategy (2013-2018) and joint strategic needs
assessment (2013) state that children and young people under the age of 20 make up
nearly one quarter of the population. There are approximately 309,462 children and
young people aged 0-19 years in Hampshire, which is around 23% of the total population
(2011 Office for National Statistics mid-year population estimated). It is important that
everyone is able to grow up in a safe, healthy environment and most children in
Hampshire grow up to lead successful lives as adults but there are some who do not. In
particular, children from poorer backgrounds often do not achieve the success of others.
Variations in socioeconomic and family circumstances lead to the variations in outcomes
seen in Hampshire’s children and young people. There were 29,000 children and young
people aged 0-15 living in poverty in Hampshire in 2011, which was 11.8% of all children
in this age group. This compares to 21.7% for England. Havant and Gosport had the
highest proportion of children living in poverty in 2011 (20% and 18% respectively).
•
Obesity prevalence is very variable across Hampshire and mirrors the map of
deprivation and childhood poverty.
•
Children from areas of deprivation experience disproportionately higher levels of
oral disease, with 21.7% of 5 year olds having some dental decay against a
national average of 30.9% (2007/08 survey). However 5 year olds in Havant had
dental decay levels of 34.6% - much higher, followed by Rushmoor (30.9%).
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•
Disabled children and their families constitute one of the most vulnerable groups
in Hampshire. Defining and measuring the landscape of childhood disability is
challenging due to the lack of an agreed definition across health, education and
social care domains, with no single definition being complete. Despite this
ambiguity, there is consensus amongst paediatricians, social services managers
and educationalists that the population of children accessing services is
increasing, as is the complexity of physical disability and complex health need.
Hampshire joint strategic needs assessments (2013) makes recommendations to:
•
Address the impact of poverty on the achievement and life chances of children
and young people.
•
Look to support children and young people’s physical, spiritual, social, emotional
and mental health, promoting healthy lifestyles and reduce inequalities in
outcomes.
•
Look to address the needs of disabled children and their families
One in five people in Hampshire are children
One in eight children under 18 years are growing up in
poverty
Increasing numbers of children have complex health and
social care needs
There has been a steady increase in the number of children who have been referred for
assessment to children services department, an increase in children on protection plans
and an increase in looked after children:
•
•
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43% increase in assessments
51% increase in Child Protection Plans
17.3% increase in looked after children
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2.2 What do we want to achieve
We will work together with NHS England, NHS and Independent health providers, partner agencies, Hampshire County Council,
HSCB, Care Matters Board to ensure that there are high quality safe services that meet the needs of children and young people,
especially those who are experiencing abuse and neglect.
2.3 What changes will happen in the future
What we want to change
Action we will take
How we will measure success
That all children and young people are to be Require all assessment tools used across Evidence
via
provider
included in all care planning processes.
health organisations to include the organisations audit of individual
perspective of the child
children’s records and patient
feedback processes the voice of
the child is recorded.
Greater
communication
between
the Share team work plan and priorities with Clear understanding amongst NHS
safeguarding and looked after children team, key leads
and Independent health providers
NHS and Independent health care providers
Set up regular meetings between of shared outcomes
designated and named professionals
Co design a good system of information sharing Stakeholder workshop to be held to Audit effectiveness of policy
across the local health community
develop and implement policy
Work with key stakeholders to identify what good Co-design future service developments Representation
recorded
and
services look like for children and young people
such as policies and service pathways
evidenced in policy development
and service redesign in final
documentation and minutes of
meetings
The requirement to promote the health of looked Provide training where applicable and Evidence will be shared at clinical
after children to be embedded throughout all monitoring of standards. Produce local quality review meetings on a
NHS Organisations
guidance and information for practitioners quarterly
basis
indicating
compliance rate above 80%
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Timely training events to cascade key messages Utilise webinars as key learning events
to be offered to NHS providers and frontline staff Work with safeguarding leads in provider
organisations to host learning events
Have open, transparent and challenging Team to develop coaching and mentoring
conversations that support practice and quality skills
assurance processes
Designated team to spend more time with Designated team to work alongside named
frontline staff in provider organisations
safeguarding leads to identify opportunities
to attend relevant meetings
Develop an organisational culture of appreciative Identify opportunities to use examples of
learning and growth.
good practice in meetings, training events
Improve outcomes for those children that have Use consistent data to identify where
been identified as living in areas where increased more
targeted work needs to be
safeguarding issues have been identified
undertaken*
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Evaluations will evidence change
in practice
Repeat the staff survey in April
2016
Attendance at key meetings,
measure progress in repeat staff
survey April 2016
Staff survey will measure change
is perception
Influence service provision through
CCGs quality team and children
commissioning team
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3. Purpose
This strategy outlines the framework for ensuring that safeguarding is included in all
aspects of the Hampshire five CCG’s commissioning responsibilities.
The CCG safeguarding and looked after children’s team will work collaboratively with
NHS England Wessex Area Team, Hampshire County Council Hampshire Safeguarding
Children Board (HSCB), Care Matters Board, partner agencies NHS and Independent
healthcare providers to consult with and ensure that the voice of service users and
frontline staff are taken into account in the development of services and policies.
4. Background and context to safeguarding in Hampshire
The strategic priorities and work plans of other agencies and organisations have a
great influence on the key issues in Hampshire and the direction of travel for NHS
Commissioners and providers and include the following priorities across Hampshire.
4.1 Hampshire Health and Wellbeing Board (HWB) priorities 2013-2018
We want all our children and young people in Hampshire to thrive and achieve their full
potential. To help them achieve this we want them to feel safe and be physically and
emotionally healthy.
4.2 Children’s and Young Peoples Plan 2015-2018
The revised plan will be available in autumn 2015. The consultation with key
stakeholders has identified that mental health is seen as a very important issue, there is
strong support for early intervention and for improving children’s awareness of risks,
including bullying, online risks and the risk of child sexual exploitation.
4.3 Hampshire Safeguarding Children Board priorities 2015-2016
•
To ensure that there is a co-ordinated multiagency understanding of, and
response to the complex issues of neglect and parenting
•
Board partners provide a ‘child first and family focused approach when
considering the impact of substance misuse, mental ill health and domestic abuse
in adults
•
To have a co-ordinated multi-agency approach and response to key safeguarding
issues, including; missing, exploited and trafficked children and young people,
high risk adolescents, radicalisation and the PREVENT agenda
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•
Quality assurance, measuring impact and embedding learning.
4.4 Care Matters Board
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Addressing the 5 areas identified in the Hampshire Pledge for Children in Care
and Care Leavers
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Under “Your Health” in the Pledge. Improving public health outcomes of dental,
immunisation, emotional health and wellbeing, smoking cessation and meeting the
health needs of those children in care placed outside Hampshire County Council
•
Improving the quality of statutory health assessments for children in care
•
Improving the health pathway for those young people leaving care.
5. Hampshire Five CCG Responsibilities
The CCGs have responsibility for ensuring effective safeguarding practice by holding
providers to account for the delivery of contractual obligations against safeguarding
standards. The CCGs also take responsibility for working closely with providers to ensure
processes are in place to drive continual improvement including the adoption and sharing
of information. This includes working closely with NHS England and all safeguarding
partners to advise, support the development of quality assurance processes and
continually improve safeguarding practice across Hampshire
Each provider and member practice of the CCG’s remains accountable for the quality of
services within their own organisation. Individual CCG members’/staff have a
responsibility to report incidents and respond in an open and transparent way in order to
support improvements in our service. Safeguarding remains Everybody’s Business.
6. Safeguarding with Quality at the Heart of the Commissioning Cycle
Safeguarding is intrinsically linked to providing high quality care and therefore central to
the whole commissioning cycle including our commissioning and contracting decisions
for prospective services. Safeguarding forms part of the NHS standard contract (service
condition 32) and commissioners will need to agree with their providers through local
negotiation, what contract monitoring processes are used to demonstrate compliance
with safeguarding duties.
7. Assessing health needs
The safeguarding and looked after children team can help undertake health needs
assessment through:
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•
•
•
•
Collation and analysis of existing information being collected through safeguarding
in quality schedules with providers
Draw on patient experience information from Children/Young person stakeholder
events held by the patient engagement and children’s commissioning team
Review of national policy and guidance to ensure ‘ must do’s’ are considered
Help to set specific safeguarding indicators to measure progress.
8. Identify area for development in Service Provision
The safeguarding and looked after children team can help identify gaps in service
provision by:
•
Collating data from a variety of sources such as complaints, clinical quality visits,
Inspection reports, serious incident reports and others stakeholder’s feedback and
patient / staff survey results
9. Procurement
The safeguarding and looked after children team can help monitor and manage
performance through
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•
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Development of safeguarding standards in new service specifications.
Development of quality schedules and possible CQUIN schemes
Evaluation of potential provider bids.
10. Monitor and manage performance
The safeguarding and looked after children team can help monitor and manage
performance through:
•
•
•
Regular monitoring of quality schedules and CQUIN schemes within contracts
Attendance as appropriate at clinical quality review meetings
Clinical visits to providers
• Triangulation and analysis of all available data including section 11 audit, serious
incidents, serious case reviews, multi-agency case reviews, attendance at
provider safeguarding committees, professional meetings, patient experience and
complaints.
11. Safeguarding and looked after children governance structure
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11.1
Hampshire Five CCG’s
The Hampshire five clinical commissioning groups will each retain individual
accountability in discharging their statutory safeguarding and looked after children duties
within their internal governance structures.
11.2
Hampshire Safeguarding Children Board
Integral to the HSCB constitution is the agreed nominated membership of CCGs, NHS
Providers and expert advice form the designated professional team. The formation of the
HSCB health sub group with executive representation from Hampshire five CCGs NHS
Provider Trusts, Designated professional team and NHS acts as the hub of co-ordination
and activity of the local health community.
11.3
Hampshire Safeguarding and Looked After Children Professional
Forum
The Designated Professionals across Hampshire host these meetings quarterly on a
rotational basis. It is open to all safeguarding leads and teams in NHS and Independent
provider organisations. The aim of the forum is to disseminate key information both on a
national and local basis and provide an opportunity for peer review and appreciative
learning.
11.4
NHS England Wessex Regional Team
NHS England’s ensures that the health commissioning system as a whole is working
effectively to safeguarding adults and children. NHS England need to provide support
and advice to the designated and specialist professionals and to be able to access the
widest possible expertise to support improving practice across the NHS system. NHS
England Wessex sub region team hosts the safeguarding network for designated
professionals and named GPs. The role of the safeguarding network includes:
•
Underpinning system accountability through peer review-based assurance and
other sources of intelligence to identify local improvement priorities
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Identifying and sharing best practice across the local health system
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Leading and driving improvement in safeguarding practice across the local NHS
system, working closely with the Local Safeguarding Children Boards
•
Considering in details the health implications and learning from inspection and
local incidents including serious case reviews, safeguarding adult reviews,
individual management reviews, and developing local action plans as appropriate.
11.5
Taking forward Safeguarding priorities across Hampshire
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•
Information sharing: Co design a good systems of information sharing across
the local health community
•
Ensuring the child/ young person is at the centre of decision making:
Children and young people included in all care planning. All assessment to include
the perspective of the child
•
Learning and development opportunities Timely training events to cascade key
messages to be offered to NHS and independent providers and frontline staff. We
will utilise webinars as key learning events and work with safeguarding leads in
provider organisations to host learning events
•
Shape the culture of learning: We will use appreciative learning to highlight
examples of good practice where children have been effectively safeguarded
•
Hold each other to account. Be able to have open, transparent conversations
challenging conversations that support practice and quality assurance processes
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Appendix 1
The following guidance, documents, reports and legislation will also govern how services
should be provide, managed and monitored:
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The Children Act 1989 and 2004.
HM Government 2007. Statutory guidance on making arrangements to safeguard and
promote the welfare of children under section 11 of the Children Act 2004. Updated
March 2007. London: Department for Education and Skills.
Working
together
to
Safeguard
Children
(DoE
2015)
http://www.workingtogetheronline.co.uk/index.html
When to suspect child maltreatment NICE 2009.
Protecting Children and Young People: the responsibilities of all doctors. (GMC,
2012)
Intercollegiate Safeguarding Children and Young People: Roles and competencies for
healthcare staff (2014)
Promoting the health and wellbeing of looked after children (2015)
Intercollegiate Looked after children: Knowledge, skill and competences of healthcare
staff (2015)
Who Pays? Determining responsibility for payments to providers (2013)
Public Health Guidance (PH28)-Promoting the quality of life of looked after children
and young people. NICE (2010)
Quality standard (31) for the health and wellbeing of looked after children and young
people. NICE 2013
Information Sharing Guidance (DoE 2015).
Data Protection Act 1998.
The Functions of Clinical Commissioning Groups (DH, 2012)
Human Rights Act 1998 Care Quality Commission Essential Standards for Quality
and Safety
Safeguarding Vulnerable Groups Act 2006
Equality Act 2010
Safeguarding Vulnerable people in the Reformed NHS Accountability and Assurance
Framework ( NHS England, 2015)
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Appendix 2 – Governance, assurance and oversight of safeguarding across health in Hampshire
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Appendix 3 – Hampshire 5 CCG’s Governance structure
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