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Safeguarding guidelines are not compulsory, clarifies NHS England

NHS England has clarified that safeguarding training guidelines released earlier this year are not compulsory, after GPs expressed concerns about their impact on the profession. 

In May, the RCGP released updated guidance on safeguarding children, which caused anxiety among GPs. 

NHS England confirmed to the BMA that the guidelines are not compulsory as long as GPs can ensure their staff are adequately trained to carry out safeguarding duties.

Writing to NHS England, BMA GP Committee chair Dr Vautrey sought clarification on the national expectations on safeguarding training. 

In his letter, Dr Vautrey referred to a letter sent by Dame Barbara Hakin, then national managing director of commissioning at the Department of Health, in 2011. In the letter, she provided reassurance to GPs about cervical cytology training, in light of primary care trusts mandating practices to undertake update training in cervical smear taking. 

Dr Vautrey wrote: 'I would be grateful, for the avoidance of doubt, if you could provide a similar level of assurance on the issue of safeguarding training, and confirm that you agree with GPC England that it is for the practice to determine that its staff have the necessary skills and competency in respect of any activity they engage in, including safeguarding, and that it can fulfil its contractual obligations even if its GPs and staff do not complete the training in the prescriptive way outlined in the intercollegiate guidance.'

The Health and Social Care Act 2008 stipulates that patients must be protected from abuse and improper treatment. However, it does not set out the exact level, content or frequency of training required to identify patients at risk of abuse and act accordingly. 

In January 2019, the Royal College of Nursing released intercollegiate guidance, which provides a 'clear framework' identifying the competencies required for all healthcare staff and the minimum training requirements to recognise child maltreatment and take effective action to improve child wellbeing.

The guidance sets out that staff should receive refresher training every three years as a minimum, tailored to the roles of individuals.  

In response to Dr Vautrey's letter, NHS England said it does 'not set out the training requirements for practice staff', and that it is for contractors to ensure their staff are adequately trained.

The letter read: 'Once again, we acknowledge the intercollegiate guidance that was developed with the input of the RCGP and practising GPs. Like any other national guidance, we recognise it is best practice that we should aspire to.

'However, the publication is guidance and not a contractual requirement. NHS England and NHS Improvement have an expectation that practices and professionals deliver safe effective care that is responsive to the needs of their patients. NHS England and NHS Improvement do not set out the training requirements for practice staff.'

It added: 'The contract obliges contractors to ensure that their staff are up to date but does not specify the detail as the needs for individual clinicians can vary. 

'Ultimately, under GP contract arrangements, it is for contractors to ensure that their staff are adequately trained. It is the responsibility of the contract holder to demonstrate that staff are appropriately trained to a level that keeps them and the public safe.'

RCGP chair Professor Helen Stokes-Lampard said: 'The guidelines give the competencies that are expected at different levels and also indicate a recommended number of learning hours for this, recognising that individuals’ learning styles and the roles they undertake vary considerably. Ideally, a mix of face-to-face meetings, informal and formal training will contribute to those hours.

'This is not a contractual requirement, but a recognised level that GPs should aim to maintain, and practices will determine how the guidelines are interpreted for their GP teams.'

The BMA previously announced that the compiling of safeguarding reports will now be paid for under the new NHS indemnity scheme for GPs in England and Wales

Readers' comments (10)

  • While we do what we can to help, the RCGP should not push what is essentially a social/police problem to doctors. It is almost impossible in a 10 min consultation dealing with their illness in this toxic climate. Strip them fully you can be accused of being a pedophile, don't strip them you can be accused of negligence not fully exposing them (GP missed chance to pick up child abuse).
    Dammed if you do dammed if you don't. It is in reality not medicine. It is not a disease that can be cured, hence doctors are struggling. No thanks to the extra responsibility being pushed to us.

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  • Interesting but presumably CCGs CAN still set these ridiculous requirements. Its already been touted through the appraisal system

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  • The new safeguarding guidance for GPs is excessive and comes across as training for training sake! What has happened to the concept of individuals identifying their learning needs and addressing them? This is still the premise of appraisal isn’t it? Everyone’s safeguarding training needs will be different and will also depend on the role of the individual. This guidance is a ‘one size to fit all’ approach to learning and training and goes against the premise of identified learning needs.

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  • Not contractual?? Maybe not, but it is "mandatory" for my colleagues and I. Not too keen to provide time to attend the safeguarding meetings tho.

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  • Realistically how much do you really know of a family in 10 min behind their closed doors when social workers and health visitors who visits them at home spending much more time has failed. We do not want the responsibility or the blame as it really is not appropriate or fair and disproportionate.

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  • I know to my cost,having had 6 CQC inspections, that the Care Quality Commission insists on all staff who interact with patients, having two annual certified updates in Safeguarding , one for children , and one for adults.
    And for Medical Staff, it should be at level 3. They will ask to see the certificates. Have them ready; you could otherwise find it very difficult to show how you have addressed their needs.

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  • and what 'competency' do we actually need to demonstrate?
    Hint : 6 hours every year is a time, not a competency, according to my primary school dictionery!

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  • Until we know what competency is needed, NONE of our GPs can be certified to having it! therefore, no GP in NHS is actually competent, despite doing hours every year of meetings and sexting, etc

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  • I see problems of spoilt children on a daily basis and have been involved in possible child safeguarding maybe once a decade.
    All this mandatory training is manifestly NOT addressing the real need. It is a demoralising waste of time.

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  • Doctors are asked to be border guards/social workers/police. Teachers to be mental health nurses/part time parent rather than to teach a subject.
    No wonder the country is in a mess. The BMA should say no. Not our job rather than exposing us to useless training and great risks to things that we can hardly do anything about.

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