Appendix A: Minutes of meeting 1

Multiagency working to protect vulnerable children in the COVID era: What have we learnt? What should we do now?

Via zoom, 2 hours 27.07.21

Participants

All work clinically or in research
Sharon Dixon:.
Bryony Kendall: Named GP for safeguarding (instead of Joy Shacklock for the RCGP)
Jennifer Ginger: DPhil student at Oxford studying adoption and on the board for CoramBAAF
Catherine Pope: medical sociologist and group lead in Nuffield centre in Oxford
Chlo Mercer: grad student in education at Oxford
Yiwen Zhang: grad student in psychology at Oxford
Jenny Driscoll: child protection barrister now in academia, part of MDT at Kings College London (KCL)
Gene Feder: GP, lead for domestic violence research group at University of Bristol
Laura Kelly: social work researcher at Birmingham university
Mina Fazel: associate professor of child and adolescent psychiatry, University of Oxford
Alison Steele: Consultant Paediatrician and Officer for Child Protection RCPCH

No formal agenda – to create a space to take stock and think
Following a study by SD and CP about safeguarding during the pandemic, recognition that researchers in other fields within health and social care were doing similar work

So what? What now? What next?

Opportunities to break down silos
Opportunity to create actions for 3 students – what evidence is needed? Who from? Thinking of the group as a select committee
Opportunity for research and/or policy

Introductions – and need to pull out what each other is doing in terms of projects, especially those that are unpublished

GP work (SD)
Development of pragmatic guidance during pandemic by JS
Finding evidence that GPs were nervous (assumptions made)
Move to remote consulting a balance of losses and gains – increasingly transactional but strategies to mitigate risk, including consideration of safeguarding and vulnerability as a valid reason to conduct a face to face consultation
Access and accessibility – the digitally excluded but opportunities for flexibility and equity
Safe spaces – loss of the sanctity of the consulting room especially knowing who else was there
Space for other problems – red flags, doorhandle issues
The visual – loss of non-verbal clues but being able to see into houses we wouldn’t have previously
Connection with teams – increased isolation, loss of secondary care support but increased access to online meetings including case conferences

KCL MDT (JD)
Multi-agency Investigation of support of children safeguarding during the pandemic
7 professional groups, 67 people
Survey ended September 2020
Effect of pandemic adaptations on working relationships primarily positive: strength within partnerships “we’re all in this together” – and felt to be maintained
Safeguarding partnerships had only been in place for about 6m: most neutral about this change improving inter-agency collaboration; social care felt to still be the lead agency by default
How will ICSs impact the tri-partite arrangements?
Feeling that other agencies should be involved: education, housing, CAMHS – at strategic level if not operational
Most strongly agreed that schools were taking on more responsibilities
Remote communication: statutory processes better attended with more efficient use of time; accessibility concerns for some professionals but significantly for children and families – felt most strongly by panel lawyers supporting children
Adaptations to information sharing – high levels of support for maintaining and extending the new IS agreements, especially within health
“Professional wellbeing has plummeted” – how do we know if we are making a difference and making a meaningful impact?
Amongst it all, voice of the child less readily heard
Complexity and severity of referrals have both increased since the onset of the pandemic – what will be the impact on children, the care system, foster carers, professionals?…

LK
Similar outcomes with different methodology – spoke to core practitioners every month, including some parents
https://www.birmingham.ac.uk/schools/social-policy/social-policy-matters/news/2021/may-issue/the-child-protection-and-social-distancing-project.aspx 

Online meetings – attendance of GPs noted as a positive outcome
Partners in practice work
Hybrid conferences – children attend social care offices and professionals dial in, enabling effective engagement and ongoing support afterwards
“People adapted surprisingly well”
Digital casework deemed as less valuable than face to face, and need to move back as soon as possible
Digital intimacy – different way of being able to speak to a professional
Key message: social workers felt alone, missing opportunities for family visits, especially dealing with high-risk cases where health visitors were not attending
Families using social workers for therapeutic support which was felt to be some out of their usual
Perception gap – leaders felt things going well with multi-agency work, frontline staff felt abandoned, that they were taking risks that other professionals were not

AS
NHSE recognise that there was a mistake about redeployment of the vulnerable children’s workforce – which was addressed and reversed. There was also an inequity in areas of the country.

MF
How not to lose the gains whilst focussing on the losses
Some interesting needs to find new strategies: “what to do when you find yourself in bed with your patient?!” lots of boundary issues
Need to provide more resources to schools; location not staff – already barriers to workforce feeling the need to do more
Will look at children who feel safe at home, and safe at home

AS
Lots of schools did excellent work supporting vulnerable children
Loss of travel time vs “Team fatigue”

Juggling home and work
Universally identified as an issue
Supervision opportunities lacking
watercooler moments – bumping into other professionals
Young police felt unsupported
House prices high in London – live in small places, impact of housing – people working on their bed for 3m
Isolating staff – different local authorities using different strategies – most debate as to what could be done in the future?
Those early in their career or in an organisation have fewer network to draw on
Need to identify specific groups e.g. those with dependants at home
Changing rules e.g. do not socialise with your group outside work so that the team is resilient to being pinged
Burden on performing research at home

General practice (GF)
Challenges around remote working, especially supporting families and survivors – initial access for patient is harder, correlating in reduction of numbers of referrals
Who else is in the room?
Access – an issue pre-pandemic and harder now
Signposting for support – perception that services were closing both by patients and GPs
Personal anecdote of receiving disclosure felt would not have come about otherwise

JD
Nobody knew that Early Help was still in place – confusion about provision, how to access

Disclosures from people being seen alone
Positive maternity services
but not seeing fathers, e.g. with fathers and ICON

AS
Information from RCPCH
Wished to continue to deliver education and support as well as workplan, yet still respond to pandemic
Advice to Named Doctors – principles – how do issues affect all children and young people, as well as those known, those hidden and becoming more hidden
Impact on school closures
Impact of LAC and contact with parents; IHAs
Impact on young carers
Guidance+ created
Co-working with RCGP on working remotely
Engagement officer obtained children’s views
Rapid changes within the workforce
How to obtain real-time data in future? responding to need
Have there been more serious head injuries? And accidents? – no answers no data
Matching people with clinical and strategic experience with research experience

Where next?
CP summarised
What or who is missing?
Police, education, children and young people and families, young carers
Needing to support practitioners and researchers
Thinking laterally and innovatively
JD has some information on what schools did to keep in touch with children: food parcels, doorstep visits
What support was given to teachers? Gaps in knowledge here – would be useful to do especially going back in September 2021
RCPCH – could collect the view of CYP through engagement team
Third sector research: NSPCC, Barnardo’s etc
“community level safeguarding” – new collaborations with the 3rd sector during the pandemic

A model of supervision that can be shared? Pressures of safeguarding practitioners and this is the support that is to be provided – policy guidance
Link with research and practice looking at unmet needs

Mapping learning – power of professional kindness – and silos flourish when people are beleaguered

Ethics
Kindness

St Benedict: Be careful to be gentle, lest in removing the rust you break the whole instrument

Attempt to pull out themes…
Complexity and severity of referrals have both increased since the onset of the pandemic – what will be the impact on children, the care system, foster carers, professionals?….
How can we support each other? What do safeguarding professionals need/expect?
How not to lose the gains whilst focussing on the losses
Access and accessibility
The perception gap between what other services do and what other agencies think

So what and what next?
What would add value?

If we learnt things that promote trust between families and between professionals, how do we find out what they are and share them further?