The CQC issued a call to healthcare staff and leaders to do more to identify and listen to children at risk of harm in the Not seen, not heard report released on Friday.
It found that more must be done by health providers, including staff in hospitals, health visitors and GPs, to ensure that services are improving outcomes for children, strengthening the quality of information sharing and joint working, the report said.
The contribution to child protection cases by primary care was particularly ‘inconsistent’, the report claimed, with the majority of areas needing to make improvements. It added that ‘in many cases there had been no GP contribution at all’.
This is despite GPs often being in the unique position of knowing the child and their family over many years, allowing them to ‘make significant contributions to the safeguarding process’.
The report found that common factors leading to lack of GP involvement include lack of awareness of responsibilities in contributing to child protection, a lack of confidence, absence of guidance and barriers to attending case conferences in person.
It recommended that GPs should be supported to better contribute to child protection meetings and case conferences. This could include changing the times to occur outside of surgery hours or using technology for GPs to engage remotely.
GPs should contribute to case conferences even if they cannot attend, it added, by providing comprehensive reports that have been discussed with the social worker or conference chair ahead of the conference date.
Inspectors found ‘too often’ that the voice of the child was not being heard, the report said. It found that 63% of children and young people felt they were not involved in decisions about their own care.
It called for all healthcare providers to engage children in their care planning to help them take ownership of their treatment and care.
Risks to children are not always obvious and require ‘a continuous professional curiosity’ about the child and their circumstances, it said.
Support for children
GPC deputy chairman Dr Richard Vautrey said: ‘I think the CQC need to also recommend increased investment into general practice so we can recruit more GPs and staff to be able to do these things.
‘Hard-working GPs and practices do their level best to safeguard their children and vulnerable adults at all stages, and will respond to requests for information appropriately
‘But attending often long case conferences some distance away from the practice means they are no longer able provide appointments to other patients at a time when many need the urgent attention of their GP.
‘It is always going to be a difficult issue. Until we've got more resources and GPs in place it’s going to be difficult to prioritise attending case conferences above providing urgent care to others within the practice.’
CQC chief inspector of general practice, Professor Steve Field said: ‘The number of children identified as having been abused or exploited is just the tip of the iceberg – many more are suffering in silence.
‘As new risks emerge and more children are identified as being in need, it is more crucial than ever that staff across health and social care, education, the police and the justice system all work together.
‘We know that with the right questions and support, services can discover the risks and harms that threaten many children, including those from parental-ill health, sexual exploitation and female genital mutilation.
‘We owe it to the children. We must provide the support they deserve and the help they need to move forward with their lives.’