The benefits of multidisciplinary safeguarding meetings

VULNERABLE CHILDREN

GPs are in a prime position to identify vulnerable children. Treating whole families over long periods of time, we are rewarded with valuable insights into the difficulties that some children face. However, we only see the lives of children in 10-minute snapshots and must recognise that the influences on a child’s wellbeing are many and varied. This problem is compounded by the fact that we rarely see into the homes of young families, with domiciliary visits being largely reserved for frail older people and those with multiple morbidities. We must therefore draw on the wider healthcare team to obtain as full a picture as possible of a child’s life if we are to recognise those in need.

To address this need the Wyre Forest clinical commissioning group (CCG) has commissioned a Safeguarding Children Local Enhanced Service (LES). Practices are funded to hold regular multidisciplinary safeguarding meetings.

BACKGROUND

INITIATION OF THE ENHANCED SERVICE

The doctors of one Wyre Forest practice were aware that allied health professionals held valuable information regarding children and their families but there was no robust mechanism by which this could be shared. Thus, the local school nurse and representatives from the health visiting team were invited to attend regular meetings at the surgery. Positive feedback from those attending these initial meetings prompted the decision to encourage other practices to adopt the same approach. This additional work was subsequently formally incentivised through a new enhanced service. The LES was originally commissioned by the CCG in July 2012.

SAFEGUARDING MEETINGS

To satisfy the requirements of the LES, practices must hold meetings on at least six occasions throughout the year. The attendees should include a GP, a health visitor, and a school nurse. The team is supported by a member of the practice administration staff who is responsible for compiling the agenda and documenting the discussions. The minutes that are generated are made available to the practice clinical team. An alert is added to the computer-held record of any child who is discussed, so if they subsequently attend the practice the consulting clinician is signposted to refer to the minutes for further details. LESs came to an end in April 2014; the meetings, however, have continued as part of a service specification within the standard NHS contract.

During the enhanced service’s first operational year, eight of the 12 practices enlisted. All but one managed to hold sufficient meetings and were awarded payments. In its second year, 11 out of the 12 practices were participating in the LES.

FEEDBACK FROM PROFESSIONALS

In order to determine whether the meetings were felt to be beneficial, a web-based survey (Appendix 1) was sent out to the managers of the 11 participating practices. They were asked to forward it to those staff members who attended the meetings. It was also sent to the 17 health visitors and six school nurses working within the Wyre Forest. Twenty-four responses were received: 42% of these came from GPs, 25% from health visitors, and 25% from school nurses. All responders stated that they found the meetings useful. The main rationale for their positive responses were that the meeting provided a forum to share concerns and to pool relevant information from different professionals. All responders felt that the meetings had improved communication between members of the multidisciplinary team and 83% reported an improvement in professional relationships. In terms of problems encountered, 39% reported difficulty in arranging for all relevant professionals to be available to attend and 8.7% had encountered difficulty with writing and distributing the minutes.