1. Safeguarding children and vulnerable adults Public health workshop
Wendy Badger
Lead Nurse; Safeguarding Adults & Domestic Abuse
(HEFT)
In some localities, the term ‘adults at risk’ is used instead of vulnerable adults – if that is the case in your area – please change title to reflect this

2. Aim
The aim of today’s workshop is to develop your confidence, knowledge and skills to be able to deal professionally with a safeguarding issue should one arise in the course of your practice.

3. Learning objectives
Summarise the background and policy surrounding the safeguarding of children and vulnerable adults and the issues this raises for pharmacy professionals
Convey the importance of pharmacy professionals increasing their awareness of abuse, neglect and child sexual exploitation (CSE) and developing ways of working with other health professionals to promote best practice to deal with situations involving suspected abuse, neglect or CSE

4. Learning objectives continued
Highlight situations in which you are best placed to observe signs of abuse, neglect and CSE and the legal issues to consider when making a referral
Identify sources of useful information and contacts for the development of local procedures for dealing with suspected abuse, neglect or CSE observed in the pharmacy setting
Confidently make a referral to the appropriate local contacts should the need ever arise
First we'll look at how we can recognise abuse.

5. Types of child abuse
Physical, including female genital mutilation (FGM)
Sexual abuse
Emotional abuse
Neglect
Child sexual exploitation
Physical abuse also includes fabricated and induced illness, as well as female genital mutilation.
Healthcare professionals providing sexual health services should also be alert to the possibility of sexual exploitation.
While physical and sexual abuse involve deliberate harm, emotional abuse and neglect may reflect the carer’s own health or social difficulties.

6. Abuse of adults In addition, abuse in adults can be: psychological
financial
discriminatory
institutional
self-neglect
modern slavery / human trafficking
domestic abuse
Institutional – may be deliberate or through ignorance, lack of training or understanding.

7. Significant harm
Significant harm is any abuse or neglect, accident or injury attributable to lack of adequate parental care or control, that is sufficiently serious to adversely affect progress and enjoyment of life. There are no absolute criteria on which to rely when judging what constitutes significant harm. Sometimes a single violent episode may constitute significant harm but more often it is an accumulation of significant events, both acute and longstanding, which interrupt, damage or change development.

8. Serious risk of immediate harm
Where you have a reasonable belief that a child is at serious risk of immediate harm, you should act immediately to protect the interests of the child by making contact with the following:
named or designated nurse/other local authority contact
out-of-hours contact
police.

9. Information sharing
‘the amount of confidential information disclosed, and the number of people to whom it is disclosed, should be no more than is strictly necessary to meet public interest in protecting the health and well-being of a child’ ‘What do if you are worried a child is being abused’
Amend slide if other local guidance is used on information sharing.

10. Points to consider when sharing information
Can the person be identified from the information?
Is it confidential?
Do you have consent?
Do you have a statutory obligation or court order requiring you to share the information?
Is there sufficient public interest to override the above: would they or others be at risk of significant harm if you did not share?

11. Confidentiality
As a healthcare professional you have a responsibility to maintain patient confidentiality; however, you can breach this if you would be putting the victim or other vulnerable people at risk by not sharing information. Don’t let confidentiality issues put you off reporting – if you are sure you are acting in the best interests of the victim and they are at risk of significant harm, then you should be prepared to share confidential information.

12. Consent
In a case of possible child abuse, you should seek parental consent to share information, unless they are the alleged perpetrator and therefore you would be putting the child at increased risk. In the case of adults, as long as they have mental capacity they can give consent to you sharing information. If consent refused- greater risk? Best interests
Now we are moving to consider the reporting of concern.

13. Local procedures
Each clinical commissioning group (CCG) and NHS trust has a designated and/or named professional who has been trained to provide support and advice to any healthcare professional who has concerns about a child
They are your first point of contact with any concern you may have

14. Local safeguarding children contact
The Lead Nurses for Safeguarding Children within the MASH can be contacted for advice, guidance and support on
The named professional for insert name CCG /NHS Trust is:
Insert name and job title

15. Contact details -Children

16. Local safeguarding adults contact
Contact details -Adults
Local safeguarding adults contact
Sandwell (office hours) (out of hours) Birmingham (office hours) (out of hours)
The named professional for insert name CCG /NHS Trust is:
Insert name and job title

17. Recording your concerns
Listen and communicate in a way the victim can understand
Do not ask leading questions
Reassure, do not promise confidentiality
Record as much factual information as you have
Record all your concerns, actions and discussions
Time for written report may be 24/48 hours.

18. Referral
Discuss your concerns with a colleague or contact your local named nurse for advice then decide whether to refer
Seek agreement from the victim to refer or in the case of a child, their parents, unless this would put them at risk of significant harm
If referring by phone, you must provide a written report within the locally agreed time

19. In any case of suspected abuse
DO NOT:
Ignore your concerns
Attempt to investigate suspicions or allegations of abuse
Ask probing questions
Discuss your concerns with the suspected/alleged perpetrator
Assume someone else will recognise and report it

20. In summary Seek advice from your local safeguarding experts
Follow local procedures and report your concerns appropriately
Keep accurate records of your concerns and any actions you take

21. A final thought
If you ever have cause for concern, doing nothing is not an option
Never assume that someone else will recognise and report what you have seen or heard
It takes many pieces of a jigsaw before you can see the full picture

22. www.cppe.ac.uk info@cppe.ac.uk 0161 778 4000
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