GP Practice Liaison Leads Safeguarding - Practice Liaison Contact Details

The CCG Safeguarding Team can help you, for example, escalating cases, tackling systemic problems or helping you to address a practice issue. 

Tel: 0300 421 1540 or email:

Named/Designated Professional details can be found here.

Contact details for adjoining counties can be found here.

Gloucestershire Safeguarding Children Executive – Useful Contacts

Children in Care Health Service -   Contacts

How to make a referral/Children safeguarding process

If you are worried or concerned about anyone under 18 who you think is being abused or neglected, or that a child and their family need help and support, please contact:

The MASH 01452 42 6565  or email:

Outside of office hours (5pm-9am Mon-Fri/weekends), you should contact the Emergency Duty Team (EDT) on: 01452 614194

Professionals need to make referrals to the MASH for Children's services by completing this Multi-Agency Service Request Form (MARF).  

A  Single Consent Form is intended for use by all practitioners working with children, young people and families when they wish to share information with the County Council and its partners. The Single Consent Form (or an equivalent) will need to be completed when submitting:

  • a  Multi-Agency Service Request Form (MARF) referral
  • an Early Help Request for Service form here

Once you have contacted the MASH with a concern about a child, this is then triaged by Social Workers, if it doesn’t meet Social Care thresholds, it will be forwarded to Early Help Service.

Early help offer a wide range of information, self-help, support and services available for all aspects of family life, which everyone can access.

Glosfamilies - Family Information and Services

MASH is made up of agencies in Gloucestershire with a responsibility to protect children and vulnerable adults.  This includes;

  • Gloucestershire County Council Children Services
  • Gloucestershire County Council Education Services
  • Gloucestershire Police
  • Youth Support Service
  • Gloucestershire health community

All referrals meeting Social Care thresholds will be investigated further by the MASH and will allow agencies to share all the available and relevant information that they hold in order to make a decision as to how best to investigate and offer support.

The concept is designed to ensure a robust decision is made at the earliest stage, to help streamline the routes for referral and notifications of concern, and act as a centre for all new referrals regarding adults and children’s safeguarding.  The MASH concept supports recommendations made in numerous Serious Case Reviews about the need to improve information sharing between agencies and Lord Laming’s report ‘The Protection of Children in England. A progress report’ (HMSO, March 2009).

It is important that you make your referral as soon as you have decided that this is the best course of action.

At times we cannot understand why the referral has not been accepted by Social Care. Gloucestershire County Council have provided threshold guidance as to their assessment of referrals. See the Gloucestershire Guidance for Levels of Intervention document here.

Review your referral against this threshold document, and if you are still concerned in relation to the safety of a child, you need to escalate your concern. See the GSCB Escalation policyhere.

Please remember if you think a child or young person is at immediate risk of significant harm, contact the MASH on 01452 426565. See the GSCB leaflet for guidance on responding to concerns about a child.

Sign up for alerts:  Gloucestershire Safeguarding Children Executive (GSCE)


For anyone who comes into contact with children who have care and support needs, protecting them from abuse and neglect is a critical part of the job. Part of the role of Gloucestershire Safeguarding Children’s Board (GSCB) is to ensure people can access the training needed to do this effectively and with confidence.

Check your training requirements to fulfil your obligations set out within the SAAF (4.3.1) and by CQC. The training requirements for all health care staff are set out within the Intercollegiate Documents: Safeguarding Children and Young People: Roles and Competencies for Healthcare Staff 2019 and Adult Safeguarding: Roles and Competencies for Health Care Staff 2018.

The following table is a summary from the RCGP supplementary guide to safeguarding training requirements for all primary care staff (2019) from induction and on a three yearly basis.

Please follow the resource links below for full training information.

Safeguarding Competencies and Training for those working within General Practice:

The GSCB deliver core safeguarding courses as well as a range of themed courses and learning events aimed at increasing knowledge on specific safeguarding topics - More information is available here 


Safeguarding Children Training Film

Was Not Brought Training Film

End FGM Campaign Animations-'The Words Don't Come'



Future SGC GP forum dates:
The Pavilion, Hatherley Lane, Cheltenham, GL51 6PN
4th March 2020  13:00 -15:00
1st July 2020 13:00 – 15:00
14th October 2020 13:00 – 15:00

Previous SGC Forum Presentations:

Competencies covered in forum - see here


Cyber bullying

Forced Marriage Partner Pack

Free webinars on best practice in speaking to trafficked children / age assessment law

Modern Slavery Training Resource

Prevent e-learning and Prevent Resources

Private Fostering Poster

All GPs need to demonstrate evidence of peer review/supervision on a regular basis for CQC.

We currently recommend that a period of time in one of the Practice meetings is allocated to discussing Safeguarding children cases.  We recommend the Practice invites Public Health Nurses (Health Visitors and School Nurses) and Midwives to these meetings. If practices have difficulty accessing these members of staff, please discuss this with Michael Richardson Deputy Director of Nursing, Gloucestershire Care Services NHS Trust:  Tel. 0300 421 8411, Mobile 07799 656490 or email .

Practices may want to consider inviting their local social worker to improve Multi Agency communication.

These meetings should be minuted by the Practice Manager with anonymised details of cases as evidence of Peer Review/supervision for CQC. Individual GPs should also record their attendance at these meetings on their portfolio for appraisals/re-validation.

Named GP for Gloucestershire CCG, Dr Katy McIntosh, is happy to offer Peer Supervision as required.  Contact email:


Looked after children in Gloucestershire have chosen to be known as ‘Children in Care’ rather than Looked after (or LAC).

Children in care and care leavers are vulnerable groups who have often experienced significant adversity in their lives which has been shown to impact long term health outcomes.

Most Children in Care in Gloucestershire live in foster placements, with some in residential placements. If a child is placed in Gloucestershire by another local authority, the responsibility for their care remains with the placing authority (and social worker).

Commissioners and providers of health services are required to cooperate with local authorities to promote and protect the health of children in care and improve their health outcomes. This can be a challenge when children often experience multiple placement moves and information is often slow to follow.

Gloucestershire Health and Care NHS Foundation Trust employ a team of specialist nurses and mental health professionals who work exclusively with these children and their carers.  You can find out more about the team here:

The Designated Doctor and Nurse in the CCG can provide support to primary care colleagues regarding local processes and practice:

CCG Designated Doctor for Safeguarding Children & LAC:  Dr Imelda Bennett

CCG Designated Nurse for Children in Care:  Pauline Edwards


The contribution of primary care teams (DfE DoH 2015)

Primary care teams have a vital role in identifying the individual health care needs of looked-after children. They often have prior knowledge of the child, of the birth parents and of carers, helping them to take a child-centred approach to health care decisions. They may also have continuing responsibility for the child when he or she returns home. 

From 1 April 2015, all patients (including children) should have a named GP at the practice with which they are registered, who is responsible for the coordination of services provided under the GP contract.

GP practices should:

  • ensure timely access to a GP or other appropriate health professional when a looked-after child requires a consultation
  • provide summaries of the health history of a child who is looked after, including information on immunisations and covering their family history where relevant and appropriate, and ensure that this information is passed promptly to health professionals undertaking health assessments
  • maintain a record of the health assessment and contribute to any necessary action within the health plan
  • make sure the GP-held clinical record for a looked-after child is maintained and updated and that health records are transferred quickly if the child registers with a new GP practice, such as when he or she moves into another CCG area, leaves care or is adopted.

Treating a patient as a temporary resident should be avoided if possible, as the medical record is not available to the treating medical practitioner. If it cannot be avoided, the treating practitioner will normally wish to talk to the child’s named GP to avoid treating the patient "blind". Temporary registration is for those who intend to be in an area for more than 24 hours but less than three months, and where there is any doubt over the potential length of stay the GP practice should opt for full registration.

Promoting the Health of Looked After Children (Statutory Guidance 2015); statutory guidance for local authorities, clinical commissioning groups and NHS England, Department for Education / Department of Health 2015

Action ACES

Adverse Childhood Experiences Study

Healthcare professionals need to be aware of the key indicators of children being sexually exploited which can include:

  • going missing for periods of time or regularly coming home late;
  • regularly missing school or education or not taking part in education;
  • appearing with unexplained gifts or new possessions;
  • associating with other young people involved in exploitation;
  • having older boyfriends or girlfriends;
  • suffering from sexually transmitted infections;
  • mood swings or changes in emotional wellbeing;
  • drug and alcohol misuse; and
  • displaying inappropriate sexualised behaviour.

Practitioners should also be aware that many children and young people who are victims of sexual exploitation do not recognise themselves as such.

The screening tool and Gloucestershire's multi-agency protocol for safeguarding children at risk of CSE can be accessed here.

Safe Teen Relationship Education and Empowerment Team (STREET)

STREET Gloucestershire, named by local young people, is a new service providing support for 13-19 year olds who are affected by teen relationship abuse or have been affected by domestic abuse within their family.

Evidence showed that 16 to 19 year olds were experiencing the highest rates of domestic abuse of any age group. However, there is a growing awareness that young people under 16 are experiencing abuse in their relationships. New research has shown that young people aged 13 to 15 reported experiencing some form of relationship abuse at the same level as those aged 16 and above.

Gloucestershire County Council is working with West Mercia Women’s Aid (WMWA) who are partnering with Gloucestershire Domestic Abuse Support Service (GDASS) to provide a single, integrated service for the county’s young people.  Based at the GDASS office in Gloucester, the service will work with young people across the county and will also partner with schools, youth organisations, statutory children’s services, police and health services to make sure that young people have swift and easy access to the specialist support they need.

STREET Gloucestershire will be delivering both one-to-one and group support using evidence-based programmes that focus on an understanding of healthy relationships, and the promotion of self-esteem and resilience.  Targeted support will also be available to young people who may be displaying harmful behaviour in their own close relationships with partners or family members.

How do I refer to STREET Gloucestershire?

Anyone concerned about a young person who has been affected by domestic abuse, or by abuse in a teen relationship, can make a referral by filling in this referral form and sending this to the following secure email address:

Anyone referring to the service is asked to make sure that the young person and, if under 16 years old; their parent/guardian has consented to the referral.  The service will take a ‘no wrong door’ approach, and referrals that come through other means will also be picked up. A completed referral, sent to the email address above, will guarantee contact with the young person and their family within 10 working days. 


For further information please contact: or call the information line on 01452 726 584.


Honour based violence, Forced marriage and Female genital mutilation

The monitoring form (please see resource link below) is for Honour based violence, forced Marriage and Female Genital Mutilation. No action is taken on receipt of these forms, because they are not referral forms. Should staff identify any concerns they should report formally to the police (particularly when considering mandatory reporting of FGM), or refer, where appropriate, to support services or social care. The monitoring form can be completed and sent to to assist in data collection to understand the prevalence of these issues in the county. Honour Based Violence, Forced Marriage and Female Genital Mutilation MONITORING FORM

Please also see the Home Office Forced Marriage Partner Pack.

These short animated films have been developed to create awareness around the health and physiological consequences of FGM and cut through much of the inaccurate and misleading information circulating in the public sphere about FGM.

End FGM Campaign Animations-'The Words Don't Come'


Please follow the link above to the Gloucestershire Domestic Abuse and Sexual Violence (DASV) Autumn 2019 briefing.

Gloucestershire Anti-Slavery Partnership (GASP)

Please follow the links below for Gloucestershire's Anti-slavery Partnership (GASP) resources;

The Home Office have also provided Criminal Exploitation of Children and Vulnerable Adults guidance aimed at frontline staff who work with children, young people and potentially vulnerable adults


Every Child Protected Against Trafficking (ECPAT)

Serious Case Reviews are mandatory processes and GP contribution to them as part of information gathering is essential. For further guidance, please visit the GMC website.

Serious Case Reviews:

Serious Case Reviews are mandatory processes and GP contribution to them as part of information gathering is essential. For further guidance, please visit the GMC website.

Local Child Safeguarding Practice Reviews:
"Working Together to Safeguard Children" (2018) recommend that  the Safeguarding Partners (GSCE) should maintain a local learning and improvement framework which is shared across local organisations who work with children and families.

Reviews should be conducted regularly, not only on those cases which meet statutory requirements but also on other cases which can provide valuable lessons about how organisations are working together to safeguard and promote the welfare of children.

The different types of review include:

  • Serious Case Review - where abuse or neglect is believed to be a factor (statutory requirement)
  • Child Death Review - a review of all child deaths up to the age of 18 (statutory requirement)
  • Review of a child protection incident which falls below the threshold for an SCR; and
  • Review or audit of practice in one or more agencies.

The Working Together guidance states that a Serious Case Review should always be carried out where abuse or neglect is known or suspected and either the child has died (including suspected suicide) or if a child has been seriously harmed and there are concerns about how agencies have worked together. The Serious Case Review sub group of the local GSCE considers all new cases and make a recommendation as to whether a SCR is required to the Chair of the GSCE. Reports should be completed and published between 2 to 6 months after decision to initiate a review.  Final reports of SCRs findings should be published on the GSCE's website for a minimum of 12 months. The reports should provide a sound analysis of what happened in the case, and why, and what needs to happen in order to reduce the risk of recurrence; be written in plain English and in a way that can be easily understood by professionals and the public alike; and be suitable for publication without needing to be amended or redacted.

Lessons from previous serious case reviews can be found on the Gloucestershire Safeguarding Children Executive's website. 

Please see also  'Sharing the Lessons and Reducing the Risk'

Child Death:
The Child Death Review process is designed to help provide the appropriate support to families and schools, to gain information about why and how children die. More information can be found on the Gloucestershire Safeguarding Children Board's website, here.



Child Death:

The Child Death Review process is designed to help provide the appropriate support to families and schools, to gain information about why and how children die. More information can be found on the Gloucestershire Safeguarding Children Board's website, here.

Prevent is part of the Government’s counter-terrorism strategy that aims to stop people becoming terrorists.  It is a multi-agency approach to safeguard people at risk of radicalisation.

Prevent E-learning can be accessed here. This offers an introduction to the Prevent duty and explains how it aims to safeguard vulnerable people from being radicalised to supporting terrorism or becoming terrorists themselves. The training addresses all forms of terrorism and non-violent extremism, including far-right wing and Islamist extremism threatening the UK. It has been developed by HM Government following consultation with a range of individuals and organisations.

For more information please see resources listed below:

A child with complex medical needs can be roughly defined as a child who has 2 or more specialities involved and is under 1 or more tertiary hospitals. The role of the WellChild Nurse Care Coordinator is multifaceted; they will be the nominated clinical key worker from health to coordinate the child’s care. They will support at times of transition such as from hospital to home and from children’s to adult services. They will be a central point for communication, communicating changes in circumstances to multiple health, social and educational service providers.  The WellChild Nurse: Care Coordinator will act on behalf of children/young people and their families in an advocacy capacity as required. They will liaise and with professionals within and outside of Gloucestershire to coordinate care and improve the experience for the child/young person and their family

Referral criteria:

  • Prolonged inpatient care at level 3/4;Tertiary care managed by 2 or more specialist teams; Tertiary care managed by 1  specialist team but with health complications
  • YP condition is complex to manage – organ transplant, complex multisystem condition, acquired brain injury, significantly life limiting
  • No clear overriding diagnosis for which accounts for all the medical conditions and/or ongoing conflict around the assessment or care plan for condition
  • Requires a central point of communication to guide and support a family through transition points e.g. From hospital to home or between services
  • Child/YP not engaging with education and/or no discernible consistent understanding of YP educational needs
  • Social concerns such as housing, economic situation or parental capacity to manage condition
Referral form and contact details are on the Gloucestershire Care Services website:

When a person or a group of people use the internet, mobile phones, online games or any other kind of digital technology to threaten, tease, upset or humiliate someone else this is a form of bullying. It is not acceptable and should not be happening.


Adoption process for patient records

Blank chronology form

Body Maps - Documentation of Injuries and Tabling of Concerns:

Case conference template - under review

Child Sexual Exploitation Screening Tool

Delegation of Authority

Early Help Request for Support Form

Honour Based Violence, Forced Marriage and Female Genital Mutilation MONITORING FORM

ICD Competencies (Learning Logs) are under the Training Section

Midwife GP Patient Summary Record Request

Multi-Agency Service Request Form (MARF)

STREET (Safe Teen Relationship Education and Empowerment Team)

Young person new patient registration form

BMA SG Children toolkit

CQC registration

Criminal Exploitation of Children and Vulnerable Adults - County Lines Guidance

Escalation flowchart

GMC safeguarding Ethical Guidance for Child Protection

Levels of Intervention Guidance June 2019

Levels of Intervention Windscreen

Lone Patient and Routine Enquiries about Domestic Abuse protocol

Missing Children Protocol (Revised April 2018)

Non accidental injuries in non-mobile infants and children

Promoting the Health of Looked After Children (Statutory Guidance 2015)

Protecting Children and Young People The responsibilities of all doctors - GMC

Recognising and Responding to Domestic Abuse (2017)

RCGP toolkits

Safeguarding Children and Young People: Roles and Competencies for Healthcare Staff updated January 2019

Safeguarding Children, Young People and Adults at Risk in the NHS: Safeguarding Accountability and Assurance Framework (SAAF) August 2019 NHSE / NHSI

Safeguarding Children and Young people  A toolkit for General Practice – RCGP

Was not brought policy

Working Together to Safeguard Children (2018)


The coding and documentation of safeguarding information on a patient’s record is as important as the coding and documentation of any other significant medical issue such as cancer, diabetes, depression or learning disability for example.

Safeguarding information needs to be immediately obvious on a patient’s notes to all health practitioners* who may access those medical notes for the purposes of direct patient care.

Suffering abuse or neglect is as threatening to the health and well-being of a patient as other major medical conditions are and therefore should be treated in the same manner. By coding and documenting this in the same way as we do other medical conditions, we highlight patients who are vulnerable and who are at risk which enables us to offer appropriate support.

When coding and recording any safeguarding information, good questins to ask yourself are:

  1. Would someone who doesn’t know this family, e.g. a locum, be instantly aware from first glance at the notes/Summary Care Record that there are safeguarding concerns for this child/family/adult?
  2. Would a member of the administrative team who is printing out a complete set of this patient’s notes for an insurance company be instantly aware that there is sensitive safeguarding information that needs to be redacted?
    1. E.g. Child Protection Conference Reports or MARAC information – these DO NOT BELONG TO PRIMARY CARE and therefore primary care do not have authorisation to share these notes with anyone.
    2. This also applies to safeguarding information held in consultation notes or 3rd party references.
  3. If this patient moved practice, would the new primary care team be able to instantly identify from the summary that there are safeguarding concerns?

If your answer is ‘no’ to any of these questions then you may need to rethink how that information is currently recorded.


The following groups of people need appropriate codes added to their notes as Major Active Problems:

A child (born or unborn) on a Child Protection plan
A short note should also be added as to what category they are on a plan for i.e. Emotional Abuse, Sexual Abuse, Physical Abuse, and Neglect. If the child is not yet born, something should be added to the mother’s notes and then added to the child’s once born.

When a child is taken off a Child Protection Plan the appropriate code needs to be added as a Major Active Problem.

It is often the case that all siblings in the family are also on the same Child Protection Plan so will have this information coded on their notes. However, if the siblings are not on a Child Protection Plan they also need appropriate codes on their notes as a Major Active Problem also.

A short note should be added as to who the sibling is that is on a Child Protection Plan (name, D.O.B) and what category they are on a plan for.

Parents/Step-parents of children on a Child Protection Plan
Parents/Step-parents or any other adult living in that household also need a code on their notes as a Major Active Problem.

Again, a short note should be added with the name of the children and the DOBs and what category they are on a plan for.

Child Protection Case Conference invitations and reports
Child Protection Case Conference invitations and reports should generally be scanned into ALL the notes of the family/household members – there will be some exceptions to this which need to be judged on a case by case basis.

Recording family groups/relationships
It is very important that where possible family/household members are linked on the Medical Records. This aids practitioners to be able to see ‘the child behind the adult’ and ‘the adult behind the child’.

Child in Need
Any child who is classed as a ‘child in need’ also needs appropriate coding as a Major Active Problem.

Looked After Children
The following groups of people need codes added to their notes as Major Active Problems:

  • Children who are Looked After/ Child in Care / Fostered.
  • Parents/carers who have had their child removed from them or their child is being looked after / child in care / fostered.
  • Siblings of the child who is being looked after / child in care / fostered but they themselves are not looked after.
  • Adults who are the Foster Parents.
  • Other children/adults in the household where the Looked After Child resides.

In each of the above situations a short note should be added with the code to give details of name, DOB of child who has been looked after / fostered.

When a child is no longer Looked After, the appropriate code needs to be added to their notes (this can happen when either the child is returned to their parents or the child turns 18 years old).

‘Was not brought’
It is important to make the distinction between ‘Did Not Attend (DNA)’ and ‘Was not brought’. Generally, children, and indeed many adults with care and support needs, need to be brought to health appointments by their caregivers (the exception to this would be teenagers who may have made the appointment themselves). Therefore, they cannot ‘not attend’ an appointment and should be coded as ‘not brought’ rather than ‘did not attend’.

This changes how we action any follow up from these missed appointments. Not being brought to an appointment can be a sign of neglect or that the family/caregivers are struggling in some way. Each practice should have a policy of how these missed appointments are actioned.

See current list of codes below

Computer Coding for Safeguarding Children (Read Codes)

Governance codes for child protection and shotgun certs for CQC

If the parents of a child are married when the child is born, or if they’ve jointly adopted a child, both have parental responsibility.  They both keep parental responsibility if they later divorce.

An unmarried father can only get legal responsibility for his child in 1 of 3 ways: 

  • jointly registering the birth of the child with the mother (from 1 December 2003)
  • getting a parental responsibility agreement with the mother
  • getting a parental responsibility order from a court

For Children in Care, parental responsibility remains with the natural parents not the Foster Carers, unless there is a Court Order where parents and Social Care have joint parental responsibility.  For Children in Care who attend your Practice, Foster Carers should provide a “Delegation of Authority” form.

We would recommend the Delegation of Authority form is scanned into your computer systems as it will provide consent for future contacts with the child.

A series of documents to be used in managing allegations can be found via the GSCB website here.

   These documents should be used when someone is alleged to have: 

  • Behaved in a way that has harmed or may have harmed a child
  • Possibly committed a criminal offence against, or related to, a child
Behaved towards a child or children in a way that indicates s/he is unsuitable to work with children or in a way indicates s/he would pose a risk of harm if working regularly or closely with children

In response to Sir Robert Francis' Freedom to Speak Up report and his recommendation to review primary care separately, NHS England has published specific guidance for colleagues in general practice, optometry, community pharmacies and dental practices. This follows a consultation with staff working in primary care. As of 1 April 2016, primary care staff can raise concerns directly with NHS England. The guidance sets out who can raise a concern, the process for raising a concern, how the concern will be investigated and what will be done with the findings of the investigation.

Please see the full document here.

Tips for safer recruitment:

  • Advertisements - adverts should include reference to your work place commitment to safeguarding and Criminal Records Bureau (CRB) checks. (Disclosure and Barring Service (DBS) checks).
  • Interviewing - Practice Safer Recruitment techniques. Training is now available through the NSPCC.
  •  References - If the job involves working with children, get references prior to interview for shortlisted candidates and ensure concerns are discussed. Don't accept photocopies or undated references.
  • CRBs now DBS - all staff who start a new job or have a break in service of more than 3 months, who are working or volunteering with children, should have a DBS if they are in a regulated activity.
  • The new Disclosure and Barring Service came into force in 2012. Updates on progress can be found here.
  • Child Protection Policy - ensure your work place has a robust CP policy, which should be reviewed annually. All staff should know what to do if they have a concern and be familiar with the South West Child Protection Procedures.

Newsletter - January 2020

MAPPA Gloucestershire Contact Details:

MAPPA Coordinator

Detective Inspector Simon Goodenough

Kirsty Ridge, MAPPA Administrator
Tel: 01452 753180

Referrals to be sent  

For further information, please visit        

Identifying and Referring MAPPA Offenders

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