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Lack of specialist child protection in health settings places children in care at risk

A lack of specialist child protection roles within health settings reveal a system struggling to deliver a reliable service for vulnerable children and young people, the Royal College of Paediatrics and Child Health has warned.
Rising demand and workforce shortages are leading to vacancies in vulnerable children and families lead roles across the UK, the RCPCH has said.
Officer for Child Protection at the RCPCH Alison Steele said the findings reveal a system struggling to deliver a reliable service for vulnerable children and young people. "In many parts of the UK, vital child protection roles simply don’t exist. Even where they do, they are too often vacant or filled by clinicians who have neither the time nor the support to deliver the duties of the role. The reality is we don’t have enough suitably trained paediatricians to fill all the vulnerable children posts. We are storing up significant future problems with our failure to adequately resource the specialty."
Looked after children are among the most vulnerable people in society and Named Doctors provide a vital role in coordinating and delivering care. Yet the RCPCH study found 45% of Trusts in England did not have a filled or vacant Named Doctor for Looked After Children role.
The study also found:
- 36% of Trusts don’t have a filled or vacant post for children with special educational needs and disability, despite government guidance stating that all Trusts in England should either have the role in place or explain why it has not been advertised or appointed in their area.
- 23% of Trusts surveyed stated that they did not have access to a Designated Doctor for Child Deaths, even though government guidance states that every Clinical Commissioning Group in England should appoint a Designated Doctor for Child Deaths.
- In the most recent survey from RCPCH, demand for paediatric consultants outstripped supply by 21%.
- Most child protection roles are filled by community paediatricians, a sub-speciality that is under-resourced by 25%.
- The most recent RCPCH census showed the proportion of consultants in community paediatrics positions declined from 18.5% of the workforce to 17.4% in 2017.
"The non-existence of lead roles for looked after children, child deaths and special educational needs and disability increases the likelihood of clinicians being asked to fulfil duties for which they haven’t received the relevant training and places an already vulnerable group at greater risk," warned the RCPCH report.
The RCPCH calls for lead roles to exist without exception and guidance should be developed for roles in all UK nations.
The need for additional lead roles in areas where none currently exist should be reviewed, the report adds. Holders of lead roles should also have the necessary experience, support and training.
The report concludes that more paediatricians need to be recruited and trained.
Workforce census: Focus on vulnerable children and families paediatric workforce (2020)

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