Competencies

It is important to note that:

• each level will have many professionals and staff, and their job title and role will be different across different specialities and in different areas of the UK,
• it is acknowledged that a range of knowledge, skills and competencies will be needed across the workforce with different levels of experience and expertise across the levels,
• the levels themselves describe a ‘complete’ set of expectations but acknowledge clinicians will be working towards more detailed levels of knowledge and will need to be up to date with emerging themes and refresh knowledge and skills across their career,
• within level 3 there will be a cyclical refresh of knowledge and new skills, and competence related to emerging themes and areas of work. Specific levels of expertise may differ slightly e.g. a higher level of expertise for plastic surgeons regarding inflicted burns, maternity & gynaecology clinicians regarding FGM,
• those with specific safeguarding duties are expected to have higher levels of competence.

Explanation of competencies

Maintaining safeguarding competencies is expected of every health care staff worker involved in the care of any child or young person, or the care of adults who are parents/carers. All health care staff who deliver either a clinical service to under 18 year olds, or mental health and substance misuse services to adults who are parents/carers for children under 18 years old, should demonstrate level 3 competence. Health care staff who deliver specialist services, such as child protection assessment medicals or statutory health assessments for children and young people in care, need more clinical expertise, and specific knowledge and skills .(described in level 3 competencies).

All health care providers delivering services, including mental health services, to under 18 year olds will be expected to have staff fulfilling level 4 (senior, experienced staff) and level 5 (strategic leadership) roles.

There will be a range of learning needs for health care workers, and therefore, training and resources should be appropriate for individual service requirements, whilst providing the basic knowledge and skills to meet the competencies.  Level 1, 2 and 3 training should build on knowledge and skills. Therefore, staff trained and up to date at level 3 should also be assumed competent at levels 1 and 2; level 2 competent staff should be classed as also competent at level 1.

New starters to a health provider or service need to receive induction training in local policies and procedures as well as generic knowledge around safeguarding and children and young people in care. Level 1 and 2 competencies are expected to be covered in mandatory training programmes. A yearly update is recommended. This update can be obtained from a range of opportunities and should be based on adult learning principles. This could be delivered as whole lifetime (adult, child, young person) training and include transitional and contextual safeguarding.

All health care staff who deliver a clinical service to children and young people are expected to have level 2 competencies so that they can respond to vulnerable children and young people by seeking advice and/or escalating concerns appropriately.

All health care staff who deliver a clinical service to children and young people are expected to have level 3 competencies if they are working predominantly with children and young people. All the health care staff involved in the care of children and young people are expected to build on the core competencies gained in level 2 and become advocates for safeguarding children and children in care.

It is recommended that level 3, 4 and 5 competencies and learning related to safeguarding children and young people, and children and young people in care are discussed at annual appraisal. Where there are defined job roles, e.g. clinicians undertaking child protection assessment medicals, and health assessments for children in care these roles should be reviewed specifically in appraisal or equivalent and include involvement in peer review.  Clinicians at senior levels, e.g. levels 4 and 5 professionals, will require more expansive review in relation to expert knowledge, leadership skills, governance and outcomes.

Learning and mandatory training should have an individualised approach for the clinician to meet the needs of their job role, evolving evidence-base, national drivers and needs of local population. At senior strategic level roles this needs to identify and address national drivers, enquiries and Government/NHS plans and legislation as well, standardising and improving quality across health providers.

Every revalidation cycle (3 – 5 years) should consider competence in safeguarding children and young people and children and young people in care, including all areas of experience, skills, and knowledge, with a relevant multi-agency working approach, and reflection across a range of adult learning activities.

These recommendations about competence and keeping up to date, also apply to National Health Service (NHS) funded private provision. All children and young people are entitled to equal protection under the UN Convention on the Rights of the Child (UNCRC); therefore, Integrated Care Boards (ICBs) and Health Boards have a duty to ensure NHS service specifications reflect this. It is the authors’ professional view that any private provider should consider and work to the same standards for the benefit of children and young people.

Important information about data

The data relating to time required for activities and time per population has not been updated. This was not in the remit of the review process. It should be acknowledged that it would be very difficult to accurately data capture time spent in these multifaceted leadership roles. The principles of responsibility and accountability are not restricted to outcome data and model job roles cannot be too prescriptive. Statutory duties must be met. Each health system area of practice must have senior leadership in place as safeguarding children and young people and children and young people in care are integral in general population health needs. Considering a public health approach and long-term planning every intervention for these cohorts of children and young people are also influencing what happens to the adult population of the future and cannot be quantified.