The NHS Experience: The Snakes and Ladders Guide for Patients and Professionals.

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    The NHS experience: The “Snakes and Ladders” guide for patients and professionals

    Solutions need to acknowledge that complexity, and require further thinking and action at a local, national and international level. As such, we would encourage professionals working with children to embrace their role as advocates, because investing in children and helping them to achieve their potential pay dividends for their future and for our society. Human and Animal Rights and Informed Consent. This article does not contain any studies with human or animal subjects performed by any of the authors. Skip to main content Skip to sections.

    Advertisement Hide. Download PDF. Challenges and Solutions for the Safety of Children in the Community. Part of the following topical collections: Topical Collection on Patient Safety. Introduction Child safety In order to explore the area of child safety in our community, let us examine how this term is understood and its scope. Based on the discussion above, we wish to propose our own definition of child safety in the community: Child Safety is the right of the child or young person to be protected from physical , psychological or social harm through environmental modification , health , education and social system vigilance and the promotion of resilience through education , family and carer nurture , peer support , and professional and community advocacy.

    Prenatal and early years Domestic violence or intimate partner violence. Domestic violence or intimate partner violence IPV [ 11 ] can have a significant impact on child and maternal health outcomes [ 12 ]. During pregnancy, frequency of IPV increases [ 13 ], becoming a major child safety issue. A National Institute for Health and Care Excellence NICE meta-analysis [ 11 ] found that universal screening is generally acceptable to clients when used sensitively, with more success when self-administered and addressing other short- and long-term safety concerns.

    Efficacy of screening requires clear institutional support, training, effective protocols and access to onsite referral systems. Unfortunately, increased screening does not necessarily lead to increased referrals [ 11 ], perhaps because of lack of supporting structures for onward referrals. Even if she was referred, there is insufficient evidence to say this would have been successful [ 14 ].

    Maternal mental health.

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    However, as stated before, effectiveness of screening is only as valuable as the system within which it sits. There have been reports of inconsistent use of EPND-S perhaps reflecting the limited time and resources available to professionals, to use this tool [ 21 ]. Alcohol misuse. Contact with social services.

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    There were good times as witnessed by the second social worker and difficult times later, when Lucy had to care for her mother with little support. This highlights the challenge of assessing children in a snapshot of time. However, when she did require intervention, later on, it was no longer available to her.

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    Laming raised this in his extensive review of child protection practice [ 30 ]. He was concerned that thresholds are a way of restricting resources and have no statutory basis—they are often set too high and cases can be missed. Dealing with did not attends DNAs. Unfortunately, due to her non-attendance, she was discharged from the system. DNAs can signal a safety concern and there needs to be systems in place to evaluate possible safeguarding concerns [ 31 ]. This could involve re-connecting with the patient and their general practitioner.

    This provides a useful shift in understanding, from the child safety perspective, in acknowledging the parental role. Age 18 transition. Table 1 Summary of child safety interventions. Child safety and the 3 R approach Child safety is the right of the child or young person to be protected from physical , psychological or social harm through environmental modification , health , education and social system vigilance and the promotion of resilience through education , family and carer nurture , peer support and professional and community advocacy.

    Relationships between professionals Improving communication within teams and enhancing interdisciplinary relationships within the community to improve outcomes for a child. Team communication. Recent information sharing guidance [ 38 ] suggests we should facilitate exchange of information which might impact on child safety.

    The paediatrician in the community. Protocols and check lists. It is the human factor, the user themselves, that enhances the efficacy of a protocol. Space to think. Holistic methods of assessment.

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