SAFEGUARDING CHILDREN: RESPONSIBILITIES AND GOVERANCE FRAMEWORK

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1 Context SAFEGUARDING CHILDREN: RESPONSIBILITIES AND GOVERANCE FRAMEWORK Safeguarding children is everyone s responsibility. Safeguarding and promoting the welfare of children is defined as: protecting children from maltreatment; preventing impairment of children s health or development; ensuring that children are growing up in circumstances consistent with the provision of safe and effective care; and undertaking that role so as to enable those children to have optimum life chances and to enter adulthood successfully. NHS Portsmouth Clinical Commissioning Group commits to fulfill its duties regarding Children s Safeguarding; further the CCG will be an active partner on local safeguarding arrangements, ensuring children in the City have consistent, safe and effective care. Statutory Duties, Legislation and Guidance Section 11 of the Children Act 2004 places a duty on key persons and bodies to make arrangements to ensure that in discharging their functions, they have regard to the need to safeguard and promote the welfare of children. Section 11 identifies a range of agencies to which this duty applies, including NHS bodies. The supporting guidance Working Together to Safeguard Children (March 2010) explains that this Section 11 duty means that these bodies must make arrangements to ensure two things. Firstly, that their functions are discharged having regard to the need to safeguard and promote the welfare of children, and secondly, that the services they contract out to others are provided having regard to that need. At an organisational or strategic level, this means having: senior management commitment 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; staff training on safeguarding and promoting the welfare of children for all staff working with or (depending on the agency s primary functions) in contact with children and families; safe recruitment procedures in place; clear processes in place to manage allegations against members of staff effective inter-agency working to safeguard and promote the welfare of children; and effective information sharing. In June 2012 revised Working Together to Safeguard Children guidance has been published and is currently out to national consultation. This revised guidance has been updated to include specific duties relating to NHS Clinical Commissioning Groups. Page 1 of 7

2 Purpose of this Framework This Framework sets out NHS Portsmouth Clinical Commissioning Group s arrangements for fulfilling its duty to have regard to the need to safeguard and promote the welfare of children. It is recognised that this Framework has been developed utilising current guidance as it applies to Primary Care Trusts, the NHS legal entity most closely aligned to the future role and function of the CCG. PCTs will end as entities by April 2013, with CCGs establishing as part of the new NHS structure from that date. The recently published consultation on revisions to Working Together to Safeguard Children (June 2012) includes specific guidance for CCGs. This Framework has taken account of the proposed revisions and the CCG will review the Framework once the national consultation has been completed. For the purposes of this Framework, reference to PCT duties in current national guidance is taken as indication of the most likely expectations of CCGs with regard to children s safeguarding. Roles and Responsibilities: Local Authority (Portsmouth City Council) Section 10 of the Children Act 2004 places a duty on each children s service authority to make arrangements to promote co-operation between itself and relevant partner agencies (including the NHS, police, probation, housing etc.) to improve the wellbeing of children in their area. This includes a responsibility to establish a Local Safeguarding Children Board (LSCB) involving key partners. Portsmouth City Council has established the Portsmouth Safeguarding Children Board (PSCB), with an independent Chair. This Board has been in operation for a number of years. Portsmouth City Primary Care Trust has been a member of this LSCB and NHS Portsmouth CCG has joined as a member during 2011, ahead of its establishment in April NHS Portsmouth CCG CCGs need to demonstrate that they are meeting their responsibilities to safeguard and promote the welfare of children in accordance with the Children Act (2004). In addition they need to demonstrate they are supporting and complying with Local Safeguarding Children Board procedures. These responsibilities are set out in Annex A, with details of the local arrangements NHS Portsmouth CCG will put in place in order to fulfill these responsibilities. Governance Arrangements in NHS Portsmouth CCG Safeguarding arrangements are an integral part of the CCG s Quality and Integrated Risk Management Framework and, as such, will be managed in accordance with the Frameworks and their supporting policies. The CCG will be expected to have a clear line of accountability within the organisation for working on safeguarding. As such ultimate accountability for Children s safeguarding will be with the CCG s Clinical Leader (the Accountable Officer). In order to ensure the duties related to this accountability are discharged and to secure significant executive level management and leadership, the CCG s will be responsible for ensuring the CCG has the correct procedures and capacity in place and that the CCG is fulfilling in full any partnership duties. In doing so, the COO will work closely with the CCG Executive member who holds the Quality & Safeguarding role. Table 1 outlines the roles and responsibilities of these 3 key members of the CCG s Governing Body. Page 2 of 7

3 Table 1: CCG Governing Body: Roles Clinical Leader ( Accountable Officer ) Ultimate accountability for Responsibility for ensuring ensuring the CCG the CCG has in place discharges in full its duties procedures and capacity to in relation to Children s fulfill it safeguarding duties Safeguarding Ensures Board level scrutiny of safeguarding Ensures CCG participation in Local Children s Safeguarding Board Ensures arrangements are in place to assure the CCG that all providers and contractors to the CCG are fulfilling their safeguarding duties CCG Executive (Quality & Safeguarding) Ensures clinical overview and influence over all CCG safeguarding processes Represents the CCG at Local Children s Safeguarding Board Provides very senior and clinical leadership for the CCG and acts as local champion and advocate for children s safeguarding in CCG business and, in particular, in primary care Reports to the CCG Governing Body on all aspects of Children s Safeguarding Portsmouth Safeguarding Children Board The CCG will be a key member of the established Portsmouth Safeguarding Children Board. The CCG joined the PSCB during 2011 whilst the CCG was operating in shadow running mode, recognising the importance of the PSCB to the CCG post-authorisation in April The CCG is represented on the PSCB by the CCG Executive member (a GP) who holds the Quality & Safeguarding portfolio. The CCG s will act as a deputy. NHS National Commissioning Board The revised Working Together to Safeguard Children guidance (June 2012, currently out for consultation) describes the role as the National Commissioning Board (NCB) as being responsible for ensuring the health commissioning system as a whole is working effectively to safeguard and promote the welfare of children. As such Portsmouth CCG fully expects to be reporting to the local regional office of the NCB on local arrangements for discharging its duties regarding safeguarding. Conclusion NHS Portsmouth CCG expects and wants to fulfill the responsibilities and duties placed upon it regarding Children s Safeguarding. Whilst national guidance clarifying these duties with regards to CCGs has not yet been published at time of writing, the CCG has set out in this Framework how it will set in place arrangements to discharge children s safeguarding duties placed on the NHS; the CCG will review this Framework on publication of national guidance (expected in 2012). The CCG will set these arrangements in place prior to its establishment in April 2013, recognising the importance of having clear arrangements in place during this period of transition. Innes Richens (Designate) May 2012 Page 3 of 7

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5 Appendix A: NHS Portsmouth CCG s Responsibilities and Arrangements for Children s Safeguarding Responsibility Local Arrangements Lead 1 A clear line of accountability within the organisation for work on safeguarding and promoting the welfare of children and senior management commitment to the importance of safeguarding 1.1 It should be clear who has overall responsibility for the agency s contribution to safeguarding and promoting the welfare of children. 1.2 It should be clear what lines of accountability are up through the organisation to the person with ultimate accountability for children s welfare (including staff training and development). The Clinical Leader ( Accountable Officer ) will have overall responsibility for Children s Safeguarding. The Clinical Leader ( Accountable Officer ) will ensure his/her responsibilities for safeguarding are delivered via the delegation of key functions to: - a CCG Executive member of the Governing Body and; - the of the CCG Clinical Leader Clinical Leader 1.3 Responsibilities on children s safeguarding and welfare will be encompassed in job descriptions 1.4 The CCG should employ, or have in place a contractual agreement to secure the expertise of, designated professionals, i.e. designated doctors and nurses for safeguarding children and for looked after children (and designated paediatricians for unexpected deaths in childhood) (Working Together revised 2012 All staff directly employed or contracted to deliver CCG functions will account for children s safeguarding via their direct line management to the CCG s who, in turn, reports to the Clinical Leader ( Accountable Officer ) Safeguarding will be included in staff induction describing how staff should exercise vigilance to help mitigate against the risk that children using CCG services might be suffering from abuse. The CCG will maintain the routine publication of a statement of CCG s responsibilities regarding Safeguarding made available to all staff via payslips. All CCG job descriptions will include clear duties regarding Children s Safeguarding The CCG will secure a designated doctor and designated nurse before April 2013 (subject to publication of national guidance during 2012). Existing arrangements for designated paediatrician input to unexpected deaths in childhood will be maintained. Page 5 of 7

6 Responsibility Local Arrangements Lead guidance) Via these arrangements, the CCG will continue to ensure arrangements are in place to commission a health needs assessment and health plan for any child looked after by the Local Authority where this is required by the Local Authority. 1.6 All NHS trusts (except Ambulance Trusts, NHS Direct Sites and NHS Walk-in Centres) designate a named doctor and a named nurse for safeguarding children who provides advice and expertise for fellow professionals and other agencies and promotes good professional practice within the Trust for safeguarding and promoting the welfare of children. The CCG will expect all providers and contractors to the CCG to have these arrangements in place. This will be specified contractually. The CCG will seek assurances routinely from all providers/contractors, via its designated nurse and doctor roles, that such arrangements are in place. 2 Service Development 2.1 Ensure a culture of listening to and engaging in dialogue with children and taking account of their wishes and feelings both in individual decisions and the establishment or development and improvement of services (Working Together revised 2012 guidance) The CCG will continue to involve service users and their families in the review and development of its services. Multiple methods will be used dependent on the service under review including one-off consultations, ongoing user groups, gaining feedback through different digital media. 3 Staff Training and continued professional development 3.1 Ensuring that their staff and those in services contracted by the CCG are trained and competent to be alert to potential indicators of abuse and neglect in children, know how to act on their concerns and fulfill their responsibilities in line with LSCB procedures. 4 Safer recruitment and vetting procedures 4.1 All agencies have in place safe recruitment practices for all staff, including agency staff, students and volunteers working with children. Where a criminal record review on employment is mandatory, these are undertaken routinely. The CCG will have clear HR policies in place setting out the CCG s expectation of staff with regards to Children s Safeguarding. The CCG will include Children s Safeguarding routinely in staff learning and development programmes, including a focus on recognising and reporting safeguarding issues. The CCG will adhere to best recruitment practice as outlined in its policy (insert recruitment policy name here). The CCG will have a clear process for managing any Page 6 of 7

7 Responsibility Local Arrangements Lead allegations made against its staff and will assure itself that all contractors and providers have allegation management arrangements in place. 5 Effective Inter-agency working 5.1 CCG required member of Local Children s Safeguarding Board 5.2 Ensuring that all health agencies with whom they have commissioning arrangements are linked into the relevant Local Safeguarding Children Board(s), and that there is appropriate representation at an appropriate level of seniority. 6 Information Sharing Effective arrangements for safeguarding and promoting the welfare of children should include having in place agreed systems, standards and protocols for sharing information about a child and their family within each agency and between agencies. The CCG will ensure representation at the Portsmouth Safeguarding Children Board (PSCB) by the CCG Executive member with responsibility for Quality & Safeguarding; the will act as deputy. The CCG will, through its contracts and provider relationship management arrangements, assure itself that local providers of NHS care are fulfilling their duties with regards to safeguarding and promoting children s welfare. For GP practices, the CCG will maintain the requirement for each practice to identify a Safeguarding lead whose responsibilities include ensuring involvement in local safeguarding arrangements and the practice is remaining fully compliant with safeguarding policy. The CCG will collaborate in development of information sharing agreements between local organisations that promote safeguarding or children s welfare. The absence of a shared information agreement will not constitute a barrier to sharing if, via local arrangements and professional judgment, sharing would help a practitioner deliver services to a child. CCG Executive (Quality & Safeguarding) CCG Executive (Quality & Safeguarding) Page 7 of 7