Safeguarding children ‘an afterthought’ and expertise is ‘spread too thinly’, warn paediatricians

The safety of children is under threat as doctors responsible for safeguarding feel current guidance and the NHS reforms mean resources are inadequate and expertise is spread too thinly, according to a new report by the Royal College of Paediatrics and Child Health (RCPCH). 

The RCPCH is calling for urgent action to produce national standards and make sure guidelines are robust to ensure vulnerable children don’t fall through the gaps and safeguarding is not just an ‘afterthought’.

Safeguarding in 2012: views from the frontline is based on a survey of 59 named and designated doctors. These paediatricians, known as ‘named professionals’ in NHS Trusts and ‘designated professionals’ in Primary Care Trusts, have responsibility for taking a lead on safeguarding children. Yet many feel the recent shake-up of the NHS and will limit their ability to protect children effectively.  

The report reveals that:

  • over 75% of named and designated doctors feel that their contracted time to the role is insufficient to fulfil their duties effectively
  • just one respondent felt that the role of named and designated professionals will be protected and enhanced in the new NHS
  • just 12% believe that the health reforms will stimulate innovation and improvement in safeguarding
  • only 13% of designated doctors are actively engaged with emerging health and wellbeing boards.

One doctor was expected to cover a child population of around 200,000 children without any allotted time, whilst another said they had ‘no real grasp of their role’ and ‘no specific training’ to equip them to protect some of the country’s most vulnerable children.

The RCPCH is urging Government, commissioners and healthcare professionals to act quickly to ensure that safeguarding is protected in the future.

The RCPCH wants to see:

  • the development of a NICE quality standard for safeguarding to drive service improvement
  • the Department for Education’s new statutory guidance on safeguarding (Working Together to Safeguard Children) must detail all the responsibilities and all the accountabilities of all agencies and professionals involved in the system
  • the role of name and designated doctors should always be kept separate – currently some paediatricians hold both roles in a given area, meaning their expertise is spread too thinly
  • effective networks must ensure professionals and health organisations share information and best practice with fellow experts

Dr Amanda Thomas, Child Protection Officer at the Royal College of Paediatrics and Child Health, said:

'There are clearly serious concerns amongst doctors about the future of safeguarding – in particular about their ability to fulfil their duties due to lack of time, training and resources.

'In order to protect children, it is crucial that safeguarding is not seen as an afterthought, but instead a central part of our health service.

'That’s why we want to see the Government’s forthcoming statutory guidance, Working Together to Safeguard Children, make it absolutely clear what the responsibilities and accountabilities of agencies and professionals involved in the system are and that the new safeguarding arrangements in the NHS are communicated clearly and quickly. We also want to see NICE develop a quality standard for safeguarding to drive up standards.'


View Safeguarding in 2012: views from the frontline (PDF, 112KB, 22 pages)

Notes to editors:

Named and designated professionals

Designated and named professionals have specific roles and responsibilities for safeguarding children. All Primary Care Trusts must have a designated doctor, and nurse, to take a professional and strategic lead on all aspects of the health service contribution to safeguarding children. All NHS Trusts must have a named doctor, and nurse, for safeguarding, who will provide advice and expertise for fellow professionals and promote good practice within their organisation. In some areas, the healthcare professional takes on the role of both designated and named professional.

About the RCPCH survey

In February 2012, the Royal College of Paediatrics and Child Health (RCPCH) conducted an event and survey of designated and named doctors.

59 professionals completed the survey; 29 of which were named doctors, 26 were designated doctors and 4 held both roles. This represents around a sixth of the named and designated workforce in England. Each geographical region was represented.

Full results and commentary is provided in the report.