A report into the death of Baby P has revealed that only half of NHS staff have the required levels of training in child protection

Posted on July 17, 2009
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A review by the health regulator, ordered by the Government after the child’s death was linked to dozens of health service failings, concludes that there are budget problems and “worryingly low” levels of training.

Only 54 per cent of NHS staff who should be trained in child protection had up-to-date training, while only 37 per cent of health trusts had a specific budget for it.

The report, by the Care Quality Commission (CQC), also shows that two thirds of GPs either do not have appropriate training, or were unaccounted for in trust child protection data.

“Immediately after the Baby P tragedy, everyone agreed that everything possible must be done to prevent a recurrence,” said Cynthia Bower, CQC chief executive.

“This must not prove to be hollow rhetoric. The NHS has got to play its part by getting these safeguarding measures in place.”

Family doctors and emergency care specialists are considered to be the front line for identifying possible abuse, with one in ten GP consultations taking place with children under the age of 14 and about three million under-16s attending A&E ever year.

But the review found that in 20 primary care trusts less than 10 per cent of GPs were up to date, while only six PCTs could say that 90 per cent or more of their GPs had adequate training.

Only 58 per cent of A&E or urgent-care staff and 42 per cent of surgeons, anaesthetists and theatre nurses who treat children had up-to-date training. In acute trusts, about one in three paediatric inpatient, day-case or outpatient staff were not up to date on child protection.

Last month the commission highlighted “systemic failings” in the NHS care given before Baby P’s death. Doctors and other health workers had contact with him 35 times in the 17 months of his life, but missed every opportunity to raise the alarm and save him, it concluded.

Today’s report also found disturbing levels of overwork for staff dealing with child welfare. Health visitors had caseloads of more than 500 children in 29 out of 152 primary care trust areas in the latest survey. Lord Laming recommended in his inquiry after Victoria Climbie’s death that a caseload should be no more than 400 children.

In addition, more than one in ten trusts did not appear to comply with the statutory requirement to carry out Criminal Records Bureau checks for all staff employed since 2002.

“There appear to be gaps in the processes covered by child protection policies,” it concluded. “We are particularly concerned with the large proportion of trusts that do not have a process for following up children who miss outpatient appointments.”

Guidance on child protection training issued by the Royal College of Paediatrics says that all healthcare staff should have basic training in child protection classified as “level one”. All those with regular contact with children and young people should have standard child protection training (level two at least).

The new report calls on trust boards to pay more attention to child protection. Almost one in three did not receive a presentation from child protection professionals during 2008. Nearly 30 trusts were not complying with child protection guidance, it said.

“In less than a year’s time, all NHS trusts will be required to register their services with us, and effective arrangements for the safeguarding and protection of children will be part of our requirements,” the report warned.

Commenting on the report, Jo Webber, deputy director of policy at the NHS Confederation, said that despite progress made by many NHS organisations, there was clearly “much more to be done”.

“Leadership is the starting point in culture change, and all boards of NHS trusts should ensure that best practice and the necessary frameworks for child safeguarding are followed,” she said.

Norman Lamb, the Liberal Democrat health spokesman, said it was “disgraceful” that some parts of the NHS were still failing to comply with basic child protection requirements, such as carrying out criminal record checks on staff.

“Ministers must look into this as a matter of urgency and hold those trusts who have failed to put proper safeguards in place to account,” he said.

http://www.timesonline.co.uk/tol/life_and_style/health/article6716169.ece

See also: Disproportionate number of children who are killed came from homes with domestic violence

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