Baby_P

Baby “P” Following the conviction of two men and a woman for causing, or allowing the death of “Baby P”, the Secretary of State for children, schools and families, Ed Balls, instructed Ofsted, along with the Healthcare Commission and the Chief Inspector of the Metropolitan police, to carry out an urgent review of services to children and young people in the London borough of Haringey. They were instructed to pay strict attention to safeguarding, and how to prevent any further occurrences. In a press statement given on 1 December 2008, Mr Balls said: ‘The whole nation has been shocked and moved by the tragic and horrific death of Baby P. All of us find it impossible to comprehend how adults could commit such terrible acts of evil against this little boy. And the public is angry that nobody stepped in to prevent this tragedy from happening. ‘I want to say very clearly at the outset: social workers, police officers, GPs, health professionals, all the people who work to keep children safe, do a very difficult job, often in really challenging circumstances – all around the country and in particular in Haringey. ‘They make difficult judgements every day that help to keep children safe – and many of them are unsung heroes. ‘But they must also be accountable for their decisions. And where things go badly wrong, people are right to want to know why and what will be done about it. In the case of Baby P, things did go tragically wrong.’ Following the conviction of the three for causing or allowing Peter’s death there was a national outcry over standards at the social services department and its leadership. The court case highlighted many areas of concern from visits by social workers to leadership decisions. As a consequence of the joint area review, both the leader of Haringey Council and the lead member for children’s services announced their resignations The Council sacked the Director of children’s services without compensation. The Healthcare Commission conducted investigations into the provision of health and social care with regard to Baby P. As part of this function “interventions’” were undertaken. Intervention’s considered: • The action taken by the trusts in response to recommendations from the original serious case review. • Safeguarding practices within the trusts. • The way in which each trust works with other agencies involved with the safeguarding of children. • Further work that the trusts individually need to undertake to improve safeguarding practices. The common themes that arose from the investigations were • Lack of communication. • Shortage of staff. • Lack of training. • Absence of child protection supervision. • Lack of awareness of child protection procedures. • Inadequate governance. Rather than cover all the aspects that arose from the investigations I have chosen the one I consider to be the most important. That is the issue of communication. Communication. Or a severe lack of it are key to this case and whilst there were other factors as have been mentioned such as lack of training and staff shortages it was a severe lack of communication between, not only inter agency but also between personnel on the same team. The following are instances of different departments and different trusts and the way that they dealt with the issue of communication in relation to children’s services. The Whittington Hospital NHS Trust Staff reported that the presence of on-site social workers from Islington social services department has had a significant impact on improving communications between health and social care staff, allowing frequent discussions of new referrals as well as ongoing cases. In contrast, staff reported that the communication with Haringey social services is not as effective, primarily as a result of social workers not being based on-site. A joint review, with a doctor and a social worker working as a team and making joint decisions, is an excellent model of practice that should be instilled as normal working practice. Paediatric services managed by Great Ormond Street at North Middlesex University Hospital NHS Trust Staff disclosed that problems with communication between health and social care professionals remain an ongoing issue. While there are some social workers based in the trust, they also carry out community workloads and therefore only have limited attendance at the hospital. The attendance of healthcare professionals at child protection case conferences remains poor. This is largely attributed to the timing and location of conferences, with doctors, in particular, being unable to attend off-site conferences due to their clinical commitments. It reported that feedback from case conferences is inconsistent and, when minutes from the conferences are circulated, they are usually not received until the date of the next case conference for that child. At this time, no specific audit has been undertaken to determine the scale of this problem. An area of serious concern highlighted by all trusts and social services teams was the communication following the submission of child protection referrals to social services. Some staff that were under the impression that it was sufficient to send a referral to social services by fax, and that a follow-up call from the referrer was not necessary. Both the local and pan-London procedures say that, while a follow-up call by the referrer is seen as best practice, a discussion between the social worker and referrer is essential – this is causing confusion among staff. However, it appears that healthcare professionals believe that it is the responsibility of social service staff to initiate this communication, and that after they send a referral letter they have relinquished responsibility. There appears to be a lack of effective links between named and designated professionals for child protection within the area and the surrounding boroughs, through which they can discuss issues and share best practice. Although the midwifery service has strong, evidence-based governance systems, it seems to be separated from the rest of the children’s services at the hospital and in the wider health community. This has the potential risk of isolating professionals from safeguarding processes. The trust has identified this risk and has responded by ensuring that the named midwife has the support of an experienced midwife who has worked for many years in the area of safeguarding children. Some good practices, in terms of communication, were also noted. For example, North Middlesex University Hospital NHS Trust has made provision for the electronic recording of child protection register alerts on their patient administration system since April 2005. These alerts include children on the registers of both Enfield and Haringey boroughs. In October 2005, the trust also implemented an alert for unborn children. The trust has modified the system since its implementation. It now includes the named key worker within the patient administration system screen shot, and has changed the child protection register status to ‘Haringey Child Protection Plan’ or ‘Enfield Child Protection Plan’, to enable identification of borough and to reflect the change from 'Register' to ‘Child Protection Plan’. Another positive development was the automatic referral notification system. This automatically informs all members of the trust’s safeguarding team by email whenever a referral to social services is sent. Following the resulting investigations and various court cases following the tragic death of baby p a telephone poll was carried out by the LGA (local government association) in March 2009. Two in five people say their opinion of child social workers has got worse since the tragic case of Baby P The survey also reveals that nearly four in five would support more resources being given to local authority children's social services. Just over half would recommend social work as a career for a family member or friend, compared to just 39 per cent of people who would recommend social work as a career for their own child. The LGA said the findings reinforced the fears of council leaders that the fallout from the Baby P case will lead to a decline in respect for child social workers, an increase in departures from the profession and difficulty in attracting new candidates. This could increase the chances of child abuse being missed. Margaret Eaton, chairman of the Local Government Association, said: "There are real difficulties for councils in recruiting and retaining high calibre child social worker staff. We must look to the future and recruit and retain staff so that they can protect the most vulnerable children in society. "There should be a long-term commitment by all those who support social workers to prove to people that we now need them more than ever if we are to protect children from abuse at the hands of dangerous individuals." References A:- CQC Review of the involvement and action taken by health bodies in relation to the case of Baby P B:- The Guardian newspaper 1st Dec 2008 C:- Health and Social Care (Community Health and Standards) Act 2003.