Chambers, D. orcid.org/0000-0002-0154-0469, Cantrell, A. and Booth, A. (2020) Recognition of risk and prevention in safeguarding of children and young people : a mapping review and component analysis of interventions aimed at health and social care professionals. Report. NIHR Health Services and Delivery Research Topic Report . National Institute for Health Research (NIHR)
Abstract
Background: The term ‘safeguarding’ refers to measures designed to protect health, wellbeing and human rights, allowing people (especially children, young people and vulnerable adults) to live without fear of abuse, harm or neglect. The Children Act 2004 placed a responsibility on key agencies, including those in health and social care, to have regard to the need to safeguard children and promote their welfare.
Objectives: To address the question ‘What interventions are feasible/acceptable, effective and cost effective in: • improving health and social care practitioners' recognition of children or young people who are at risk of abuse? • improving recognition of co-occurring forms of abuse where relevant? • preventing abuse in these groups?‘
Data sources: Fourteen health and social care databases were searched from 2004 (date of Children Act) to October 2019.
Methods: This mapping review included an extensive literature search, independent study selection, extraction of study data and quality assessment of study design features. The research was carried out in two stages. We systematically retrieved and coded UK research and policy documents to gain a contemporary picture of safeguarding issues and practice. We also identified systematic reviews or narrative reviews that reported safeguarding practice from other high-income countries. Studies were summarised using narrative synthesis in four pre-defined groupings. A further grouping of policy/guidance documents was added based on examination of the evidence retrieved.
Results: The review included 179 papers (Strategies=15; Policy/Guidance=36; Cultural/Organisational=31; Initiatives=69 and Reviews=28). There were four empirical evaluations of strategies (‘what to do’) and 54 of initiatives (‘how to do it’). Most initiatives fell into three categories: training, service development and use of data. Promising initiatives included liaison nurses; assessment clinics; secondment; joint protocols; and a ‘hub and spoke’ model. Approaches using routinely collected data also appeared promising. However, the evidence base comprised mainly cross-sectional or before/after studies with no control group, providing little hard evidence of effectiveness. Barriers to effective implementation of safeguarding strategies were identified at all levels of the health and care system.
Limitations: We used a number of methods to abbreviate the review process. Limitations of the evidence base included lack of long-term follow-up, control groups and data on service relevant outcomes.
Conclusions: The UK and international literature documents increased awareness and activity in relation to safeguarding. A limited number of types of interventions have been reported and generally these lack rigorous evaluation. In particular, the user voice is muted in relation to experience of different interventions or services. Taken as a whole the topic of child safeguarding seems to be lacking a whole system approach which would facilitate a more joined-up approach.
Future work: Future research questions centre on the need to balance multi-agency training and development initiatives with the specific needs of individual health and social care professional groups.
Metadata
Item Type: | Monograph |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © Queen’s Printer and Controller of HMSO 2020. This work was produced by Chambers et al. under the terms of a commissioning contract issued by the Secretary of State for Health. This document may be freely reproduced for the purposes of private research and study and extracts may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > ScHARR - Sheffield Centre for Health and Related Research |
Funding Information: | Funder Grant number National Institute For Health Research 16/14 |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 15 Jul 2020 09:35 |
Last Modified: | 15 Jul 2020 14:42 |
Status: | Published |
Publisher: | National Institute for Health Research (NIHR) |
Series Name: | NIHR Health Services and Delivery Research Topic Report |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:163227 |