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CQC slams NHS ‘lack of understanding’ over Rotherham child abuse

The Care Quality Commission (CQC) has concluded that there is “still a lack of understanding” about the roles and responsibilities of health services in Rotherham in protecting children and young people from abuse and neglect. 

The regulator stated that there is a “surprising” lack of awareness, particularly with regards to Child Sexual Exploitation (CSE), despite the publication of Alexis Jay’s inquiry last August and subsequent scrutiny. 

Rotherham CCG has just 20 days to draw up an action plan on the review’s recommendations, which include working with GPs to ensure they understand local child protection processes and their responsibilities therein. 

Sue McMillan, CQC’s deputy chief inspector, said: “We’re disappointed that despite the intense scrutiny on child protection in Rotherham and the help packages that have been made available, services with a key role in child safeguarding are unclear about their responsibilities. While progress has been made, it is too slow and more is required. 

“This is unacceptable and we will check progress against our recommendations. These agencies need respond quickly to this report to ensure that no child is let down by the services designed to protect them.”

The regulator’s dedicated child safeguarding team assessed acute and community healthcare services in February, and the review focused on the experiences of and outcomes for children and young people using a range of methods. It also included examining the performance of health providers including Rotherham, Doncaster and South Humber NHS Foundation Trust and the Rotherham NHS Foundation Trust, as well as Rotherham CCG and NHS England’s local area teams. 

It was found that children who are brought into the care of Rotherham social services were not receiving timely initial health assessments (IHA) and when they did take place, they were not always effective and not always followed up.  

Additionally, Rotherham’s contraceptive and sexual health services “do not understand their roles or responsibilities in relation to safeguarding and in particular, CSE”.  And there have been cases with young people receiving inpatient mental health services who have been discharged back to Rotherham without local mental health services knowing. “This is unacceptable and puts vulnerable children at serious risk of harm,” noted the regulator. 

CQC has recommended both trusts, NHS England and the CCG should ensure that pharmacists, doctors and nurses in Rotherham Walk-in Centre are aware of their role in referring young people for screening for sexually transmitted infections or in raising safeguarding concerns. 

The CCG and Rotherham NHS Foundation Trust should also make sure children or young people who attend the emergency department should have their previous attendances considered as part of the safeguarding assessment. 

Responding to the report, Sue Cassin, chief nurse of NHS Rotherham CCG, said: “Since the visit five months ago we have put in place a number of improvements as part of a multi-agency action plan that was developed by all partners across Rotherham. 

“[An] example of the work that has already taken place includes all frontline health professionals having received safeguarding training and how to spot the signs of CSE. This has been supplemented with ‘spot the symptoms’ pocket guide, which was launched early this year. Rotherham’s Multi-Agency Safeguarding team became operational in April this year with a strong health presence, which is already improving communication across all partners. Also, we have developed a looked after children health passport in conjunction with children to ensure they have input into planning of their healthcare.” 

Dr Deb Wildgoose, interim director for children’s and community services at Rotherham, Doncaster & South Humber NHS Foundation Trust (RDaSH), added that the trust has carried out refresher safeguarding training and CSE training for more than 500 frontline staff across the trust so that they better understand the needs of young people who may be vulnerable to CSE. 

“This is part of our ongoing training programme,” she said. “We are aware of the areas that require development and, as the report says, we have a significant improvement plan that we are already implementing. We are aware that there are areas of our work that require urgent attention, and we are working hard to put in place changes and developments to improve our service as quickly as possible.” 

Louise Barnett, CEO at Rotherham NHS Foundation Trust, which the CQC has rated as requires improvement, after criticising staff levels and the lack of ‘robust’ systems in place to manage risk, said the rating “reflected the challenges” that the trust faced. 

She added that whilst all services covered by the inspection would be addressed in the improvement action plan, additional support is already being focused in areas where the CQC report had set out the most pressing issues. 

“One example of this additional support is our community services for children, where we are recruiting more school nurses in addition to those we recruited earlier this year, improving the way information is shared between teams and offering extra safeguarding training to help colleagues identify vulnerable patients who may be at risk of abuse, and to raise concerns in the proper way, said Barnett. 

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