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Q&A


Dr N Vimal Tiwari, Named Safeguarding GP Herts Valleys CCG


• What attracted you to develop an interest in safeguarding children and young people?


I have a strong interest in child health and was pulled into safeguarding while working in community paediatrics. GPs, as the first point of contact for most health-related problems, may be the only professional to realise when a family or parent is running into difficulties which could place a child at risk but can find such problems very challenging.


• What does your role involve? I support GP colleagues by offering practice visits, educational seminars and sessions and advice on safeguarding issues. I meet with health colleagues regularly to discuss policy and practice and attend multi- agency forums to learn about safeguarding initiatives, achievements and concerns of other agencies such as education, the police and social care.


• What do you enjoy most about the job? Meeting many hard-working conscientious GPs who care deeply about their patients and are eager to do their best despite time constraints and resource issues. It is deeply rewarding to see major improvement in the way practices now approach their safeguarding duties.


• Are there any downsides? Child protection reviews centre on desperately tragic events involving the death or serious injury of a child which can be traumatic for all involved. Support from colleagues is vital when involved in writing reports for case reviews.


• What do you find most challenging? The few GPs who cannot accept that child maltreatment exists. They are unwilling to participate in child safeguarding activities and refuse to provide essential information for child protection purposes.


and updated. They will have regular meetings with others in the primary healthcare team and personnel from other agencies such as health visitors, school nurses, community children’s nurses and social workers to discuss any concerns about vulnerable children and families. A key focus of the role is ensuring the


practice fulfils its obligations in a variety of areas such as statutory responsibilities; contractual guidance; national/local regulatory requirements and inspection requirements in relation to information sharing and record keeping. When new staff are employed by the practice, the lead must make sure safe recruiting procedures have been followed and that the relevant vetting and barring checks have been carried out. A GP safeguarding lead will also provide


valuable advice and support to colleagues, helping them with child protection referrals and ensuring requests for child protection reports are responded to fully and promptly.


GIRFEC In Scotland under GIRFEC, the plan is for a “lead professional” to be appointed for children who need extra support – a role which can be taken on by a doctor, teachers, health visitors and social workers. The Scottish Government describes a lead professional as “someone who helps to organise support for a child and their family” and who “makes sure all the people who support a child work well together”. For doctors, this is commonly someone who holds consultant status or equivalent who has undergone higher professional training in paediatrics. However, GPs with dual qualifications in other specialties such as public health, forensic medicine or psychiatry may be able to demonstrate the required competence to undertake the role. The lead professional would help organise a “Child’s Plan” (due to be launched in 2018) detailing information about the child’s wellbeing needs and services that will provide support.


• What about the role has surprised you? Many GPs already possess a deep instinctive knowledge of the subject although they may not always be able to articulate their worries. Small changes can be enough to increase confidence and improve practice.


• What is your most memorable experience so far? The ‘light-bulb’ moment in an educational session when a GP suddenly realises that a series of apparently inexplicable events or a perplexing presentation in a consultation is related to child abuse or neglect.


• What advice would you give to a trainee GP who is interested in this field? An interest in child health is essential because a knowledge of normal child development/behaviour is required to identify variation from the expected. Curiosity about mental health and human behaviour is useful as the causes of child maltreatment remain poorly understood and under-researched.


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