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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