Symposium 15:

Developing Collaborative Policy and Practice to Tackle Child Neglect –

Sharing the Learning from a Three-year NSPCC Programme of Practice Implementation and Research

Convenor: Ruth GardnerDiscussant: Marian Brandon

Supporting and developing early responses to child neglect

in health and education services in England

Alice Haynes

3

Model of provision of early help in universal services

Aims: What are the policy guidelines? What are professionals’ perceptions? What early help are they currently providing? What are the barriers? What are the solutions and policy recommendations?Method:• Review of policy and delivery context• Discussion groups and one-to-one interviews with 41 professionals• Online survey of 852 professionals from across health and education:

o Early years practitioners, n=107o Health visitors, n=93o Midwives, n=227o School nurses, n=89o Teachers, n= 290o GPs, n=46

• Discussions groups with 18 young people 4

Aims and method

Policy and delivery context

• Statutory and non-statutory guidance gives professionals a role in providing early help, but extent to which this role is explicitly set out varies

• High levels of discontent with current health and education policy within universal services

Key findings: Perceptions of responsibilities

• All professional groups believed they and other universal services have a responsibility to be able to both identify neglect and to respond directly in some way

• Relatively high degree of variation on perceptions of responsibilities within professions

 *

Monitoring Working directly with children

Working directly with parents

Signposting to other services

Health visitors 7 6 7 7

School nurses 6 5 5 6

EY practitioners 6 5 5 7

Midwives 5 3 6 7

Teachers 7 5 4 5

GPs 5 4 6 6

*All ratings are medians

Key findings: Current provision

• Signposting families most common response across all groups• Referral to children’s social services: 75% of midwives & 47% of school nurses

would, with other groups between 29% and 35% said they would• Talk to a child: 69% of teachers, 67% of school nurses & 63% of GPs would not • Talking to a parent: 74%-90% of health professionals, compared to 66%-72% of

education professionals• Providing parents with emotional & practical support: 96% of health visitors, 79%

of EY practitioners, 67% of GPs, 66% of school nurses, 59% of midwives and 53% of teachers said they would

• Providing children with direct emotional & practical support: 87% of EY practitioners and 73% of teachers and school nurses, 53% of health visitors and 39% of GPs said they would

• Monitoring: 33% health visitors, 48% of school nurses, 63% of GPs said they would not

• Contacting other professionals: 82%-89% of health professionals, compared to 64% of education professional

Key findings: Barriers

• Workload and time pressures greatest barrier in health

• Multiagency working/information sharing greatest barriers in education -

multiagency working also rated as second biggest barrier in health

• Mixed findings on identification as a barrier

• Not all participants had received training on neglect in the past 3 years, in

particular health visitors (18%), midwives (15%) and EY practitioners (14%)

• Many professionals with specific safeguarding responsibilities had not

read their LSCB threshold document; between 20% and 50% of GPs,

teachers, midwives and health visitors

• The young participants did not tend to see universal services professionals

as well placed to provide them with support

Recommendations

• Clear role expectationsExample: Government and professional membership bodies should set out the expectations of specific universal services to provide early help for neglect to be clarified and set out in statutory, professional guidance and professional job descriptions• Relational, not transactional, public service provisionExample: Postnatal services, case continuity, home visits• Professionals who feel confident, valued and supportedExample: Training on the impact of neglect on child development, how to articulate concerns about neglect, how to convey concerns to parents/young people, how to develop relationships with parents/young people• A well-resourced workforce Example: Financial commitment to early help, recruitment of school nurses, recruitment and training of family support workers in schools and other settings