Inquiry into children and young people on the Margins

23/08/2024

Dear Ms Williams,

We have considered the questions below as requested.

· The scale and nature of children and young people presenting in accident and emergency departments with injuries that suggest they may be the victims of child criminal exploitation, and details of any specific strategies and/or projects that health boards are involved with in this regard.

Within the Powys HB area we don’t have any A&E departments, rather a number of MIU’s. The staff in these units have access to our Safeguarding Hub for discussion around any injuries that they have concerns about and would follow the Wales Safeguarding Procedures and complete Safeguarding referrals if there is any concern that they may be related to physical abuse or exploitation. These staff also access regular Safeguarding Group Supervision, which gives them the opportunity to share experiences and learning that may include such injuries. Children already known to be at risk of exploitation are flagged on a system that staff working in MIU and across the HB can check, to assist with this decision making. We have the CSERQ tool that staff use if they have concerns around sexual exploitation of a child, but we don’t currently have an equivalent for children where there are concerns around criminal exploitation. This and the potential of the development of a training package around injuries that may be indicative of criminal exploitation would be something that we would be happy to be involved in.

We have a system where copies of the attendance of Powys children at A&E’s out of county are shared with our Safeguarding Hub, when there are concerns around the attendance. These are forwarded on to the appropriate staff within the HB to assist in the development of risk assessments and the completion of Safeguarding referrals as appropriate.

· Presentations to sexual health clinics that indicate risks of involvement in child criminal activities. Details of any specific strategies and/or projects that health boards are involved with in this regard.

From a sexual health perspective, we undertake the CSERQ on all children and young people who contact/present to this service. Any positive screening will result in a Safeguarding Referral to the LA as per our internal process. We don’t have any specific criminal exploitation screening tool or process as identified above. Sexual Health are currently linking with Safeguarding to look at how we can improve communication and information sharing between sexual health and other services regarding children who are at risk of CSE/CE.

· Presentations to any other primary health care provision in respect of child criminal exploitation and missing children, alongside any recommendations you would like to see the Committee make in this regard.

We have a system currently where GP’s and our out of hours service (Shrop Doc) are made aware of children who are on the Child Protection Register, so should these children present to their services they are aware of these concerns, which could include exploitation. The expectation is that this information would encourage a practitioner to use their professional curiosity if the child were to present with a concerning injury and make Safeguarding referrals as per the Wales Safeguarding Procedures.

This is probably an area where we could look to explore and improve further around the exploitation agenda, as not all children open to the Exploitation arena are on the child protection register.

In addition to the above, health practitioners attend exploitation strategy meetings and feedback the outcome of these meetings to our Safeguarding Admin via a proforma. The Safeguarding Team then ensure that there are alerts on clinical systems that make staff aware of the risk of any form of exploitation. This ensures that any HB staff member coming across that child is aware of this risk.

The Safeguarding Team and a member of our Sexual Health Team are active members of the Local Powys Multi-agency MACE process and involved in the development of the most recent Exploitation Strategy.

The Safeguarding Team are also represented in the Community Safety Partnership and Channel process, which may also include discussion and information sharing that is relevant to the exploitation of children in Powys.

I hope that is helpful.

Yours Sincerely

Helen Lloyd

PTHB Head of Safeguarding and Public Protection
Helen.Lloyd6@wales.nhs.uk