The James Paget University Hospitals NHS Foundation Trust is committed to ensuring that it has in place systems to safeguard the welfare of children. This includes working in partnership with other relevant organisations to ensure we provide care that is safe and proactively identifying children and young people who are at risk.
Some of the measures we have in place to ensure this include:
- For further information please select one of the Disclosure & Barring Service (formerly CRB) checks for staff in accordance with statutory employment regulations.
- Child protection policies and systems which work in partnership with our key local stakeholders. These are systematically reviewed to ensure they meet national guidance and recommendations resulting from child protection cases. This is part of the Trust's commitment to ensure continuous improvement in its processes to protect children and young people.
- Processes to follow up missed outpatient appointments which include flagging up where there are specific concerns about the safety and welfare of vulnerable children and young people.
- Child protection training for new and current staff in line with national guidance.
- Named professionals with clear roles and responsibilities for supporting the safeguarding agenda.
- Board level executive leadership for safeguarding is provided by the Director of Nursing who reports directly to the board on any concerns within the Trust. A programme of audit to provide assurance around safeguarding processes is also in place and regular reports are reviewed within the Trust's governance committee structures.
- Safeguarding procedures within Accident and Emergency are clearly set out within the Trust's safeguarding policy and further enhanced with department specific guidance.
Children Act 1989
The key elements from the Children Act 1989 are:
- The overriding purpose of the Act is to promote and safeguard the welfare of children
- Parents have responsibilities; children have rights
- Children are best cared for in their own homes
- All staff dealing with children have a responsibility towards children who may have been abused
- Concerns must be shared with colleagues and other agencies when confronted with possible abuse
Two sections of the Act have specific meaning.
Section 17 enquires (child in need)
A child is in need if:
- He / she is unlikely to achieve and maintain, or to have an opportunity of achieving or maintaining, a reasonable standard of health or development without the provision of services by the local authority (LA)
- Health or development is to be significantly impaired, or further impaired without the provision of such services
- He / she is disabled
Section 47 enquires (child protection)
- Where there is reasonable cause to suspect that a child is suffering or is likely to suffer significant harm
- This can include harm or likelihood of harm which is attributable to a lack of adequate parental care or control
- They depend on adults for their basic needs
- They believe what adults tell them
- They believe what is happening to them happens to other children
- They do not have a voice in society
- They are not always listened to by adults
- They cannot always express concerns
- They may have learning disabilities
Children looked after by the Local Authority (Looked After Children - LAC) may be more vulnerable
On average, every week in England and Wales at least one child is killed at the hands of another person
(Home Office 2011)
The term "child abuse" is used to describe a range of ways in which people, usually adults, harm children although other children can also harm children.
A child is anyone under the age of 18
Often the adult is a person who is known and trusted by the child.
Child abuse can take place in the home, at school, ANYWHERE where children spend time.
The framework is used by all children's services to assess a child's needs. It is often shown as a triangle or pyramid (see below) to highlight the key areas, which are the child's development, parents/carers and their environment. Notice how the child's welfare is at the centre.
When assessing a child using the Framework for the assessment of children in need and their families it is important that if the child needs help that they are referred to the correct people. A child can either be an information sharing case or in need of child protection.
The four main types of child abuse are listed below.
- Other abuses are Child Sexual Exploitation (CSE), Domestic abuse and Female Genital Mutilation (FGM)
Physical abuse may involve:
- Hitting or Shaking
- Burning or scalding
- Or otherwise causing physical harm to a child
Emotional abuse is the persistent emotional maltreatment of a child such as to cause severe and persistent adverse effects on the child’s emotional development. It may involve conveying to children that they are worthless or unloved, inadequate, or valued only insofar as they meet the needs of another person. (Working Together to Safeguard Children 2013)
Sexual abuse involves forcing or enticing a child or young person to take part in sexual activities, not necessarily involving a high level of violence, whether or not a child is aware of what is happening. The activities may involve physical contact and non-penetrative
Neglect is the persistent failure to meet a child’s basic physical and / or psychological needs, likely to result in the serious impairment of the child’s health or development. Neglect may occur during pregnancy as a result of maternal substance abuse.
Once a child is born, neglect may involve a parent or carer failing to:
- Provide adequate food,
- Clothing and shelter,
- Ensure adequate supervision (including the use of inadequate care-givers),
- Ensure access to appropriate medical care or treatment
Child Sexual Exploitation (CSE)
Sexual exploitation of children and young people under 18 involves exploitative situations, contexts and relationships where young people (or a third person or persons) receive ‘something’ (e.g. food, accommodation, drugs, alcohol, cigarettes, affection, gifts, money) as a result of them performing, and/or another or others performing on them, sexual activities.
Child sexual exploitation can occur through the use of technology without the child’s immediate recognition; for example being persuaded to post sexual images on the Internet/mobile phones without immediate payment or gain.
In all cases, those exploiting the child/young person have power over them by virtue of their age, gender, intellect, physical strength and/or economic or other resources. Violence, coercion and intimidation are common, involvement in exploitative relationships being characterised in the main by the child or young person’s limited availability of choice resulting from their social/economic and/or emotional vulnerability.
(National Working Group for Sexually Exploited Children and Young People 2008)
Domestic violence and abuse is ‘any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members regardless of gender or sexuality.
Female Genital Mutilation (FGM)
FGM (sometimes referred to as female circumcision) refers to procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons. The practice is illegal in the UK.
The legal situation
FGM is practiced in some cultures but it is illegal in the UK. It is also illegal to arrange for a child to be taken abroad for FGM. If caught, offenders face a large fine and a prison sentence of up to 14 years.
The Trust’s Safeguarding Leads are responsible for acting as a source of information and support for staff, patients and visitors when they have concerns about safeguarding children. There is a JPUH Safeguarding Children Strategy and related policies and guidelines and Safeguarding Team internal webpage where information can be found about how to make a referral.
If a referral is needed this will go to either the Norfolk or Suffolk MASH (Multi-Agency Safeguarding Hub). The MASH is made up of professionals from Social Care, Police and Health who will collectively decide what the next steps may be.
If you witness or hear about abuse:
- It's everyone's responsibility to report it
- Healthcare workers have a duty to report abuse if suspected
- Ensure the person is safe. If there is an immediate threat contact emergency services on 101 or 999
- Report concerns to the person in charge
- Refer concerns to relevant MASH – Norfolk patient - 0344 800 8020
Suffolk patient - 0808 800 4005
For general advice, or if you are unsure who to call in the hospital, please contact: Eleanor Elder or Lynn Manning on 01493 452523 or 453964.