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Child Safeguarding Protocol. In EMIS Web Jez McCole, GP, Gleadless Medical Centre, Sheffield @ jezmccole. The Problem. Lack of awareness of Safeguarding issues Common to most busy surgeries What is already in the busy record? What was the point of coding it?
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Child Safeguarding Protocol In EMIS Web Jez McCole, GP, Gleadless Medical Centre, Sheffield @jezmccole
The Problem Lack of awareness of Safeguarding issues • Common to most busy surgeries • What is already in the busy record? • What was the point of coding it? • Coding is more than just about QOF • Bringing the electronic medical record to life • Highlighted during our Three Minute Surgery
Theme 2 - Everything is ok This theme demonstrated how professionals didn’t recognise the safeguarding issues or vulnerabilities that existed. There were 2 main reasons for this: 1. Normal for Community. In 3 cases professionals felt that the children were one of a ‘number of children like this’ in the community: ‘There are lots of other families like this in their practice area so this family would not have stood out. This is of concern… because of the clear level of risk that there was in this family.’ (2011) 2. Misplaced Optimism. There was evidence (in 8 cases) of professionals working with an overoptimistic view of the situation. The most common reason was that they didn’t question, recognise, know or collate the family history or vulnerabilities that exist. ‘Assessments failed to consider the historical information regarding this couple. Agencies failed to consider the multiple risk factors’ (2011)
Theme 3 - Assessment, Assessment, Assessment This highlights the importance of assessment and the difficulties that arise when this isn’t thoroughly completed. • An Assessment Mindset is seeing every encounter with a family as an opportunity to re-evaluate the situation. The lack of this was an issue in 6 cases. • Silo Thinking. In 6 casesprofessionals viewed situations in isolation, were task focused and ‘episodic’. This also highlighted where professionals didn’t consider the possible impact of the parents mental health on their parenting. • Downgrading of risk (4 recent cases). In these professionals closed cases when there was no evidence of any new information to inform this decision. • Recognition of risk by universal services. 3 cases highlighted that although universal services had contact with a family, they didn’t recognise the circumstances the children were living in. • Communication and information sharing was an issue in 10 reviews.
Three Minute Surgery N = 40+
Our Aims When any record is loaded • To present the Child Protection Status of the patient • To inform the user about Safeguarding procedures
Protocol Ingredients • A coded record • Concepts • Connectors • Protocol Alerts (‘Zap box’)
A (well) Coded Record Agree your codes Used on the record of the child • [13Iv] Child is the subject of a Child Protection Plan • [13Iw] Child has been removed from a plan [13IO] • [13IS] Child is a Child in Need • [13IT] Child is no longer a Child in Need Used on the record of a parent/guardian • [13Iy] Family member subject of a Child Protection Plan • [13Iz] Family member removed from a Child Protection Plan
THE CONCEPTS • The engines of the protocol • Interrogate the record • Change the direction of flow based on what they find • Written in the Concept Manager
Build the Protocol Starts as a blank canvas
Concept & Alert Alert No Longer on a Plan Concept
Program the trigger Update Record Thank you
Examples of other Gleadless Protocols & Reports • Label printing • Helicobacter eradication • eGFR African ethnicity adjuster • Metformin & Low eGFR warning • Arrhythmia check • Amiodarone Safety • QRISK checker • Folic Acid prescribing by risk factors • Diabetes reports • DMARD max med review 3months preventer • Diabetes Hypoglycaemia Risk • Driving on Hypoglycaemics • District nurse case load management Protocols • Mental Health Care Planner • Cannabis Support Alert
