Appendix B: Minutes of meeting 2

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

Via zoom, 28.09.21

Participants

Sharon Dixon: GP, Nuffield Dept of Primary Care health sciences, University of Oxford
Bryony Kendall: Named GP for safeguarding Liverpool
Joy Shacklock: RCGP safeguarding lead, Named GP for safeguarding Harrogate
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
Jenny Driscoll: child protection barrister now in academia, part of MDT at Kings College London (KCL)
Yiwen Zhang: grad student in psychology at Oxford
Jane Birchenough: safeguarding lead at Rose Hill Primary School, Oxford
Harry Ferguson: Professor social work, University of Birmingham
Tracey Taylor: Thames Valley Police child protection unit
John Simmonds: director of policy for Coram BAAF
Chloe Mercer: grad student in education at Oxford
Alison Steele: Consultant Paediatrician and Officer for Child Protection RCPCH

Gene Feder: GP, lead for domestic violence research group at University of Bristol – apologies

Introduction from Sharon
• Learning from her own work, looking for evidence in only general practice, let alone health
• Safeguarding is multi-agency in essence so make sharing learning multi-agency too

JD: how communication between agencies changed during the pandemic
JB: 17% children supported by CPP or TAF
JS: developing toolkits and policy
HF: monthly interviews of 48 practitioners of experience of protecting children during the pandemic, practice focussed, April to December 2020
JG: research on adoptive parents who also have birth children

Voice of young people
Capturing through NSPCC and RCGP book group

Professional-client encounters
Pros and cons in all of the research, challenges between individuals we care for
Between silos and within silos
Positive issues with digital ability to rapidly arrange meetings
Including parents and carers – family time of children being taken into care being restricted due to the pandemic – long term implications
Police taking statements over the phone, with 50% presence in the station

Impact on professional well-being
Less explored
Perception gap – between frontline workers and senior Mx
Role of agency decision maker (ADM) – e.g. if adoption is long term plan – reviewing all evidence provided – judge described this person as “naïve and simplistic”, lack of corridor conversations for clarifications affecting competence and confidence
Challenges of access to informal peer support: water cooler moments
Risk of death due to going to work new for most
Retention of staff becoming a real problem for the future – risk is rising as we hold more uncertainty

Uncertainty about hearing VOTC
What have I missed and what have I not seen?
Compounding of inequalities including digital
Different rules for assessment by frontline practitioners e.g. social worker and police (wearing PPE) and usually in the garden

Organisational and governmental guidelines
Interpretations differed e.g. PPE wearing
Systemic risk and regulatory framework – moral injury from (Ofsted) inspections continuing and perception of blame culture

Physicality of how children communicate
When the child runs off on zoom does someone follow them with a camera? Capturing their physical nature not just their actual voice
Impact of friendships – and lack of social interactions missing school

Vulnerable children and schools
LA stated key-worker and vulnerable – so who should be invited in to school?
Impact of food poverty
Digital inequalities – “families of 12 using 1 phone to access google classrooms”; donated chromebooks not accompanied with internet access
Decision to clap eyes on every child in the school – “decisions made on the doorstep”
Uncertainty of vulnerability – in educational context and in medical context
Feelings and fears of parents
Schools feeling beleaguered

Themes arising from DA work
Safety: who is off screen? How much of the story are we getting?
Police taking statements – “as far as we know people are on their own” – appointments made in advance for adults
Interactions between people present

Those families just about coping before the pandemic and it pushed them over the edge
People (GPs) became keener to learn how to deal with issues – more engaged with safeguarding education
SW role broadened as often the only people going into homes “social work had a good pandemic, children’s social work emerged stronger due to innovation and energise, responding to the challenge, finding a voice”
“The politics of affirmation is messy and dirty” – admittedly complicated

Review of research
What we could we do with what we are hearing?

When things get tough, people become more silo-ed

Looked for policies across and between agencies in the pandemic

Little crossed barriers, evidence presented in silos

Policing in the pandemic published April 2021 https://www.justiceinspectorates.gov.uk/hmicfrs/publications/the-police-response-to-the-coronavirus-pandemic-during-2020/

General practice – information overload –which would explain reinforcing staying in silos

The expectation is there: everyone has responsibility but no-one has complete control, and there aren’t resources in place to support early identification: need for a realistic conversation: “we can’t do what we want to do to protect children”

10 years of austerity has had a significant impact – and no easy solution

Families under stress and in distress (bereavement, parental conflict, school) – system based on trust and confidence
Safeguarding system is risk-averse and compliant, with an investigative approach – with many examples of where professionals get it wrong and someone dies

Information sharing
• ongoing issue
• high support for a formalised pre-agreement for all agencies from strategic leads
• need for shared understanding of what agencies hold
• especially with children people want access to parental records – when their Hx of trauma is brought up this can be re-traumatising – GPs can share with IRO rather than the whole CP conference
• usually considered as a failure to share, especially at a lower level

Moral injury
Practitioners working at capacity
Especially not being able to contact other professionals (“the SW has not shared the history with me”)
Who is responsible for the risk and who is going to do something? The risks were not shared equally amongst agencies
Working in isolation

The challenges of the interface is often around IS between agencies
Positively progressing the learning

The intercollegiate documents are due to be revised – what do we want health staff to know and focus on? Especially around information sharing.

Who is consistently familiar and working with the families?

Ability to identify your own stress and that within the organisation

Layers of organisations able to use their voice

People not aware how different agencies were responding to guidance

From schools: focus on positivity – how use in work?

Brighton and Sussex – quality circle

Multi-agency working with courts, health and LA

Discuss one topic at a time – “everybody has to agree that they will listen to, agree, acknowledge and reflect on what is brought”

No criticism

Promotes an open-ness

Reflective supervision

Schwartz rounds?

Being and doing: bearing witness but needing witness protection – the people who hold the families – who will hold them? And how is this hard-wired into training for juniors?

‘Resilience has been weaponised’

What should we hang on to and what should we jettison?

HF: this conversation itself has been hugely important “I’ve never been in a meeting with three GPs in the room”. Recognise the restrictions of covid.

AS: recognition of good practice by staff during pandemic. Digital enabling of staff for multi-agency working. Listening is a core skill.

JD: efforts of schools made is some ways strengthened relationships between schools and families. How we build on these? Issues for children with their families and remote access for contact. Early help was hard to access, making it hard to build trust.

BK: intersectionality, multi-agency working, framing safeguarding as public health, compassionate leadership including boundaries, honest conversations, give people hope for recruitment and retention

JS: reflected on a judge who moved from being a decision maker regarding children coming into care, to facilitating a discussion, using the court in problem-solving to help parental addiction – giving the parents a chance to be listened to

JSH: are we setting people up to fail during safeguarding training? The resources are just not present. Relationship building between professionals and with families

Concrete deliverable: report will be on https://www.gtc.ox.ac.uk/academic/health-care/sheila-kitzinger-programme/

The intersectionality of inequality