East and North Hertfordshire NHS Trust and NWG Network working together to improve referrals of children exploited to safeguarding teams from the acute setting.

In March 2023 the Children’s Safeguarding Team at Lister Hospital, East and North Hertfordshire NHS Trust recognised by the Children’s Safeguarding Team at Lister Hospital that front-line staff were not recognising or referring child exploitation cases that had been seen in the acute setting. This was noted by our ‘safety netting’ process of the discharge summaries screened daily.

Staff were sometimes completing information sharing forms, however, not considering the contextual safeguarding concerns and using professional curiosity to refer the child or young person to appropriate partner agencies for ongoing support. It was thought that a simple, trauma-informed flowchart or pathway would be a proactive and beneficial way for staff to recognise and respond to contextual safeguarding concerns within the Acute Trust.

Communication on the NHS Future’s Collaboration Network led to the awareness that there were no other trusts that had anything similar and therefore Hannah contacted the NWG Network (NWG) CEO, Sheila Taylor in April 2023.

At the same time, the newly resurrected NWG Health Forum members were requesting support with similar difficulties and a subgroup was formed to look at the problem and consider a screening tool to trigger full assessments.

Hannah and Sheila recognised that Hannah’s work was well underway and the tool-kit was then presented to the NWG’s health subgroup with a variety of health professionals who gave comments and positive feedback whereby all areas voiced they would find this a useful toolkit in their Trusts and areas.

The NWG encourages other health practitioners within the NWG network to consider this as a way forward. A conversation with NHS England, Kenny Gibson –Deputy Director for NHS Safeguarding took place to ascertain the next steps and his view on this piece of work, Kenny is very supportive of this work and will continue to support its development.

Between June and July, Hannah made amendments based on feedback given by health and social care professionals who had reviewed this and then presented the amended toolkit in July to the NWG health form. NWG then developed this via PDF to create a well-designed Toolkit which is now completed.

In August, Hannah and Sheila met with Kenny Gibson and he gave some clarity on how this could be maximised within the NHS, to tackle exploitation effectively whilst supporting busy staff on the front line. After some incredible and very supportive feedback on this toolkit, he explained that going digital would be the best route to ensure data could be collected and coding could be completed.

Between August and September, Hannah finalised a presentation on the Toolkit in order to present this to the Safeguarding Committee within ENHT in September to explain that allies would be required from the Integrated Care Board as part of a joint working plan.

In November 2023 it was presented to Hertfordshire’s Vulnerable Adolescent Strategic Group.

In December the Toolkit was made accessible through the NWG network and to contact Sheila if they would like this toolkit sent to them for use within their agencies alongside feeding back to us with how useful they think it will be for them.

January 2024 it was then presented to Hertfordshire’s Learning and Development subgroup.

Since then 14 areas (including an Ambulance Service) have been given the Toolkit to make amendments to suit their local external agencies e.g. equivalent to East and North Hertfordshire’s HALO. Some of the specialities include Adolescent link in the CED, SG nurses, DA leads, named nurses, maternity & clinical support and modern slavery teams.

Ongoing plans:

At the end of March, the NWG aim to send a survey to those who have requested specified questions to inform if the toolkit is being considered or has been implemented, is it effective, consider if users require any amendments to be made, etc. These will then be sent out again 3 months later to look at data collection and ongoing feedback.

The NWG and their independent evaluator will hopefully be able to carry out some qualitative evaluations with hospitals who are really keen to utilise this and to continue to watch the progress.

Eventually, we aim to roll this out with ambulance and GP services also.