Level 5 senior strategic lead doctor and nurse for children and young people in care job description

All health care staff need education, support, and leadership both locally and nationally in order to fulfil their duties in meeting the needs of both children and young people in care, and care leavers.

These role descriptions should be read in conjunction with appropriate level 3 (link to IHA section), 4 and 5 competencies. Significant expertise, knowledge and skills related to health and outcomes for children and young people in care, and care leavers is a pre-requisite for senior posts.

These posts should be separate to other safeguarding children, young people, and adult posts.

The post holder must have an enhanced disclosure check, in line with health professionals in clinical practice working with children and young people less than 18 years old. These professional posts comprise a regulated activity under the Disclosure and Barring Service (DBS) (for England and Wales), Disclosure Scotland (for Scotland) and Access Northern Ireland (for Northern Ireland).

Professionals should be of good professional standing.

This description should be read in conjunction with level 5 competencies, outlined within the document.

It should be noted that:

• the senior professional roles (level 4 senior/named and level 5 senior strategic lead/designated) are distinct roles and as such must be separate post holders to avoid potential conflict
• these roles are dedicated posts and should not be combined with responsibilities for adult or child safeguarding

The generic model job descriptions can be amended as appropriate according to national and local context.

The senior strategic role is to assist service planning and advise the commissioning ICB, Health Board or equivalent in fulfilling their responsibilities as a commissioner of services to improve the health of children and young people in care.

Any job description should be jointly agreed by the local commissioning/service planning organisation for children and young in care, the health organisation from which the doctor or nurse is employed, if different, and the relevant local authority.

The role is intended to be a strategic one, separate from any responsibilities for individual children or young who are in care. For medical professionals, the senior doctor may have a role in clinical management for children in care as the role is often incorporated as part of a full-time consultant post and based within a provider.

The post holder must have an enhanced disclosure check. These professional posts comprise a regulated activity under the Disclosure and Barring Service (DBS) (for England and Wales), Disclosure Scotland (for Scotland) and Access Northern Ireland (for Northern Ireland).

The level 5 senior strategic lead/designated doctor for children and young people in care should:

• hold consultant status or a senior post with equivalent training and experience; experience of a level 4 safeguarding/children and young people in care post and leadership is needed to fulfil the post; if not demonstrable, a period of supervision, support and training will also be required
• have undergone additional training in paediatrics and adolescent health
• have substantial clinical experience of the health needs of children and young people in care including impact of adult carer health needs
• ideally, be a locally active doctor with good knowledge of the local services available
• have proven negotiating and strategic leadership skills

The level 5 senior strategic lead/designated nurse for children and young people in care should:

• be a senior nurse or health visitor with the expectation that the post would be within the Band 8 range (the role would be subject to the usual Agenda for Change Job Evaluation process)
• have undergone training in the specific needs of children and young people and be registered on either Part 1 of the NMC register as a registered children’s nurse, or Part 3 as a specialist community public health nurse having completed a specific programme with a child and family focus
• have completed specific relevant post-registration training and be planning to, in the process of or completed higher level training e.g. at Masters level or equivalent
• have substantial clinical experience of the health needs of children and young people and the health needs of children and young people in care
• be currently practising in the field of safeguarding and children and young people in care at a senior level
• understand and be able to interpret and advise on legislation relating to children and young people
• have proven negotiating and leadership skills.

• at all times and in relation to the roles and responsibilities listed, lead and support all activities necessary to ensure that organisations across the health community meet their responsibilities for children and young people in care
• advise and support all specialist children and young people in care professionals across the health community
• be responsible to and accountable within the managerial framework of the employing organisation

The senior health professionals will work together to fulfil the following functions:

• be a member of the Corporate Parenting Board, Health and Wellbeing/Children’s Trust Board and Local Safeguarding Partnership Board or equivalents in Northern Ireland, Scotland, and Wales
• provide health advice on policy and individual cases to statutory and voluntary agencies, including the police and children’s social care
• in England, the emerging Strategic Transformation Partnerships/Integrated Care System structures may require the Level 5 senior strategic lead/designated professional’s representation at additional strategic decision-making groups supporting service design, development, and assurance

• provide advice to the service planning and commissioning organisation and to the local authority/council/health and social care trust, on questions of planning, strategy, commissioning, and the audit of quality standards including ensuring appropriate performance indicators are in place in relation to health services for children and young people in care
• work with all health care organisations to monitor performance of local health services for children and young people in care
• ensure expert health advice on children and young people in care is available to children’s social care, health care organisations, residential children’s homes, foster carers, school nurses, clinicians undertaking health assessments and other health staff
• advise colleagues in health and children’s social care on issues of medical confidentiality, consent and information sharing with specific reference to children and young people in care
• work with health service planners and commissioners to ensure there are robust arrangements to meet the health needs of children and young people in care placed outside the local area and ensure close working relationships with local authority/council/health and social care trust to achieve placement decisions which match the needs of children
• work with local service planners and commissioners to advocate on behalf of and ensure children and young person in care benefit as appropriate from the implementation of wider health policies such as in England – any qualified provider, personal health budgets
• work with commissioners and providers to gain the best outcome for the child/young person within available resources, including involvement in fostering and adoption panels according to local arrangements

• work with other professionals taking a strategic overview of the service to ensure robust clinical governance of local NHS services for children and young people in care
• work with commissioners to ensure quality assurance and best value of placements including processes of audit, follow up, and review
• contribute to local children and young people’s strategies to ensure there is a system in place to check the implementation and monitoring of individual health plans
• advise and input into the development of practice guidance and policies for all health staff and ensure that performance against these is appropriately audited
• work with organisations across the health community to ensure that appropriate training is in place to enable health care staff to fulfil their roles and responsibilities for children and young people in care

• work with other professionals to agree team responsibilities
• work closely with other level 5 senior strategic lead/designated children and young person in care professionals locally
• liaise with, advise, and support children and young people in care specialist health staff across the health community
• maintain regular contact with the local health care team undertaking health assessments on children and young people in care
• liaise with health boards, children’s social care and other service planning and commissioning organisations over health assessments and health plans for out of area placements
• liaise with the health board/authority child protection and safeguarding lead
• complete and present annual report as outlined in statutory guidance

• provide advice to all organisations across the health community on the implementation of an effective system of audit, training, and supervision
• provide advice on monitoring of elements of contracts, service level agreements and commissioned services to ensure the quality of provision for children and young people in care. KPIs and data collection for national returns are included but there should also be interpretation and presentation of data to health systems senior management
• undertake an analysis of the range of health neglect and need for health care for local children and young people in care. Evaluate the extent to which children and young people in care ’s views inform the design and delivery of the local health care services for them
• use the above to influence local service planning and commissioning decisions; contribute to local JSNA
• provide advice to the chief executive of the employing health care organisation (either directly or via identified structures or level 5 senior strategic lead/designated personnel such as the medical director, nurse director or children’s lead) about their responsibilities to ensure that performance indicators in relation to children and young people in care are met, and that there are adequate resources for level 4 senior/named and level 5 senior strategic/designated professionals to carry out their roles effectively

• advise ICBs and Health Boards on training needs and the delivery of training for all health care staff across the health community including those GPs, paediatricians and nurses undertaking health assessments and developing plans for children and young people in care
• participate (as appropriate) in local undergraduate and postgraduate paediatric training to ensure health, including mental health, of children and young people in care is addressed
• play an active part in the planning and delivery of multidisciplinary and multi-agency training for all health care professionals

• provide advice including case-focused support and supervision for health care staff at all levels within organisations across the health community that deliver health care services to children and young people in care
• produce a supervision strategy for the health community which provides direction and options for supervision models, as appropriate to need

• provide supervision for children and young person in care level 4 senior/named specialist professionals across the health community, or ensure they are receiving appropriate supervision from elsewhere
• Personal development
• attend relevant regional and national continuing professional development activities in order to maintain knowledge and skills; this includes meeting professional organisation requirements as well as receiving specific training that relates to specialist activities
• receive supervision from outside the employing organisation (this should be funded by the employing organisation and be provided by someone with relevant expertise)

• attend relevant regional and national continuing professional development activities in order to maintain knowledge and skills; this includes meeting professional organisation requirements as well as receiving specific training that relates to specialist activities
• receive supervision from outside the employing organisation (this should be funded by the employing organisation and be provided by someone with relevant expertise)

• receive annual appraisal; appraisal should be undertaken by someone of appropriate seniority with relevant understanding such as a board level director with responsibility for children and young people in care , medical or nurse director and/or via an equivalent arrangement as agreed locally; when appraisal is delivered within a health provider, opinion and feedback related to the senior strategic lead should be obtained from a system leader colleague and incorporated; for nurses, midwives, health visitors and relevant health staff, reference should be made to the NHS Knowledge and Skills Framework; this may require input from another level 5 senior strategic lead/designated professional from the same discipline from another locality

• senior strategic professionals should be performance managed in relation to their strategic functions by a board level director who has executive responsibility for children and/or safeguarding as part of their portfolio of responsibilities. This may be the employing health organisation if different from the NHS ICB/Health Board, public health lead for children in the local authority/council/health and social care trust and the corporate parenting board
• be accountable to the chief executive of their employing body

• should have the authority to carry out all the above duties on behalf of the employing body and be supported in so doing by the organisation and by colleagues

• professional roles should be explicitly defined in job descriptions, and sufficient time and funding should be allowed to fulfil specialist responsibilities effectively
• the time required to undertake the tasks in this job description will depend on the size and needs of the children and young person in care population, the number of staff, the number of health care organisations covered by the role, and the level of development of local structures, process, and functions
• the employing body should supply dedicated and effective secretarial support
• given the stressful nature of the work, the employing body must ensure that focused supervision and support is provided; organisations should put in place formal arrangements which may include other level 5 senior strategic lead/designated doctors or nurses from other trusts/employing organisations to provide supervision/peer review for each other

The data below are a minimum guide to the resources required for the roles. These have not been updated from the last edition.