By Ben Clover
Nursing Times
“Significant and worrying gaps” in the way some NHS walk-in centres operate risks child abuse going undetected, a study has warned.
The report into adherence to procedures designed to identify vulnerable children presenting at walk-in centres was prepared for NHS London and released under the Freedom of Information Act.
It said there was “ample evidence” that families in which deliberate abuse or neglect was a feature sought services where mistreatment was less likely to be recognised or reported.
The strategic health authority asked staff about training and procedures at the capital’s 40 walk-in centres, defined as “standalone units independent of hospital trusts or A&Es, employing their own staff to see patients who may or may not be registered with a GP”.
The results suggested just under a third of London’s walk-in centres did not have “protocols in place to help with the identification of the most vulnerable groups of children and young people”.
It added: “There are significant and worrying gaps with regards to children in the following circumstances: exposure to domestic violence, sexual activity or exploitation of a minor, children who have run away from home or from care and children who are missing from education.”
The research said 84% of centres had systems for sharing information with other bodies but “several” had no mechanism to identify attendees subject to a child protection plan or “to monitor frequent attendances by a child to the service”.
According to the document, a “considerable number” of units had no effective transfer procedure for potentially vulnerable children who needed to be redirected to another service for child protection examination. In such circumstances the child should be accompanied or taken in an ambulance and should “never be allowed to make their own way or be transferred by a private taxi arrangement”.
The Association of Directors of Children’s Services said it was “vitally important” walk-in centres were connected to the wider child protection system. Past president Matt Dunkley said: “Commissioners [and] providers should reassure themselves that these elements are in place to prevent vulnerable children from slipping through the net.”
NHS London said in a statement that while the report “highlights variable understanding and attitudes with regard to child protection”, the data could not be relied on absolutely because in many instances “staff completing the surveys weren’t always clear about the questions being asked”.
It added that nursing directors at primary care trust clusters had been reminded of best practice and designated professionals “were asked to formulate and manage action plans”. It added: “There have been no safeguarding serious incidents relating to walk-in centres.”