When children/young people (YP) are not brought to appointments or staff are unable to access them in the home for a planned home visit (non-access visit), this can raise safeguarding concerns or child protection concerns.
Therefore, within ASPH children and YP non attendances or non-access visits are not treated the same as adults and these procedures have been developed to reflect this. It is important to bear in mind that children do not fail to attend appointments but that their parents or carers may not bring them to an appointment. This can occur for various reasons; however parents and carers have a responsibility to ensure all children and YP receive health care. Unfortunately not all parents have the capacity to facilitate this.
A missed health appointment for a child or young person on its own may be of no concern or it may be very significant. Each non-attendance or non-access visit should be reviewed on an individual basis and the need for further action based after assessing the risk. Each practitioner is accountable for the decisions they make and the consequences of those decisions. If there are safeguarding concerns, staff should discuss with their line manager or a member of the safeguarding team (see appendix 1).
All staff have a duty to safeguard children by recognising abuse and referring onwards as required (Working Together 2018) and have key responsibilities as set out in in the ASPH Safeguarding Children Policy. Additionally the Care Quality Commission has reiterated the need for there to be robust processes in place to follow up children who fail to present for health appointments. (CQC Safeguarding Children 2009). Lack of formal process in following up children’s non-attendance was highlighted as an important factor in safeguarding in the report Why Children Die. (Confidential Enquiry into Maternal and Child Health, 2008). Retrospective analysis of Serious Case Reviews (SCR’s) has repeatedly identified parental non-engagement or dis-engagement with professionals as a factor which places children at increased risk. Non-attendance at health appointments has also been highlighted in local SCR’s and in children who have been abused.
All staff at ASPH have a duty to promote and safeguard the welfare of children and young people (Working Together 2018).
This policy applies to all staff working at Ashford and St. Peter’s NHS trust that see children and YP under the age of 18 years. It must be followed by all temporary staff including those on temporary or honorary contracts, secondments and agency staff.
The policy applies to any child/children under the age of 18 years of age who is not brought and therefore does not attend (DNA) at any clinic at Ashford and St Peter’s Hospitals (ASPH) or any of their satellite clinics. The policy also applies to those children who are not seen at pre-arranged visits at home or elsewhere in the community; no-access (NA) visits.
|Compiled by:||Dr Clare Hill, Named Doctor Safeguarding Children|
|Ratified by:||Safeguarding Committee|
|Date Ratified:||January 2019|
|Date Issued:||January 2019|
|Review Date:||January 2022|
|Target Audience:||All Health Professionals|
|Contact name:||Dr Clare Hill, Named Doctor Safeguarding Children|
- Ashford and St Peters NHS Trust Children’s Safeguarding board Policy
- The Children Act 1989 and 2004
- Confidential Enquiry into Maternal and Child Health, 2008
- CQC Safeguarding Children 2009
- Working Together to Safeguard Children 2018
- Surrey Safeguarding Board procedures
- NICE clinical guideline 89 When to suspect child maltreatment