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					                            AG Serious Case Review Action Plan –September 2007




         Recommendation                       Action                      Lead                When       Outcome
                                                                                                         measure
10.1     Health
10.1.1   Hospital Trusts in Bristol ensure    Both NBT and                NBT-       Maureen Jan 08      Audit health staff
         that the support of an Epilepsy      UBHT       Epilepsy         Betts                          knowledge        re
         Nurse is available to all            and       neurology         UBHT-        Finbar April 08   access to services
         paediatricians         managing      nurse to provide            O’Callaghan                    for children with
         children with epilepsy, to           support,     Advice         Paediatric                     Epilepsy. – Sept 08
         emphasise safety precautions         and          written        Neurology
         and provide further information      information to all          Consultant                     The development
         about     epilepsy     and     its   trust          staff,                                      of a standardised
         treatment.                           managing Children                                          Paediatric Epilepsy
                                              with Epilepsy                                              pathway

10.1.2   Hospital Trusts in Bristol ensure    Notes will reflect NBT –              Maureen Jan 08       Audit of notes -
         that children with epilepsy and      the      information Betts                                 September 08
         their     parents/carers      are    offered            to
         provided with information about      families/children
         safety      precautions,      and    with Epilepsy.
         management of the child’s
         epilepsy, and that this is           Joint development UBHT-Finbar                   Sept 08    Audit pathway Sept
         documented.                          of       Paediatric O’Callaghan                            09
                                              Epilepsy     Care
                                              Pathway.




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                            AG Serious Case Review Action Plan –September 2007

         Recommendation                       Action                Lead              When     Outcome
                                                                                               measure
10.1.3   Hospital Trusts in Bristol           For both Acute UBHT           Geraldine Dec 07   UBHT/ NBT audit
         develop a policy on ‘did not         trusts to Have a Johnston-                       To ensure staff
         attend’. This needs to include       ratified DNA policy Divisional manager           aware of the policy
         consideration of whether there       for children                                     and if the policy is
         are child protection issues and if                                                    followed
         so a letter to all concerned                               NBT David Jarrett          appropriately      -
         informing that the child did not                           – General Manager Dec 07   June 08
         attend (DNA), whether the                                  Women           &
         appointment is being re-booked,                            Children’s Health
         and how to go about seeking a                              Directorate.
         further appointment if required.
         This needs to take into
         consideration                  the
         recommendations         of     the
         National Service Framework for
         children, young people and
         maternity services (DH 2004) to
         fully assess/ address the
         potential     child     protection
         implications for each child.
10.1.4   The named GP ensures that            Develop            Jo Walsh & Kim April 08       Audit compliance
         there is a GP policy on did not      recommendations    Hearn Named GP                Nov 08
         attend (DNA) if this is not          for GP relating to for BPCT
         already in place.                    chronic    disease
                                              management and
                                              Children who DNA




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                            AG Serious Case Review Action Plan –September 2007

         Recommendation                        Action                   Lead               When      Outcome
                                                                                                     measure
10.1.5   Community          paediatricians     NBT-Review clinic NBT-       Jennifer Jan 08          2 stage audit to
         should offer local clinics, which     provisions/venues   Turner Community                  identify numbers of
         are appropriately staffed and         alongside nursing Matron                              children seen in
         supported.                            resources        to                                   local clinics – Jan
                                               ensure         best                                   08 & Jan 09
                                               provision

                                               UBHT- to carry out
                                               a scoping exercise       UBHT- Geraldine              Audit number of
                                               of    the  current       Jonhston- Manager April 08   children seen in
                                               provision for all        & Jackie Cornish             the community and
                                               Paediatric               Medical director             the    number   of
                                               Outpatient clinics                                    DNA’s in June 08
                                               including                                             and June 09
                                               community clinics
                                               and        nursing
                                               resources
10.1.6   A         brief,        accessible    BPCT-All    Health       Carol Bryant – Oct 07        Audit records June
         summary/chronology to be kept         Visitors (HV) to         Locality Manager             08
         in an identified set of health care   record chronology        BPCT
         notes on the whole family, which      of events in their
         identifies significant events and     records
         issues of concern.
                                                                    Katherine Penney Dec 07
                                                                    and        Sharon                Audit records June
                                               UBHT-        ensure School,      school               08
                                               School       Health nurse managers-
                                               Nurses      maintain UBHT
                                               key    life   event
                                               charts               Martin Bell - IT Dec 07
                                                                    lead
                                                                                                     Audit access June
                                                                                                     08

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                            AG Serious Case Review Action Plan –September 2007
         Recommendation                       Action                    Lead            When    Outcome
                                                                                                measure
10.1.7   A sheet should be included in        All HV to complete Carol Bryant – Oct 07          Audit records June
         the front of all health visitor      a signature sheet Locality Manager                08
         records, which should be signed      in Child’s records BPCT
         when the first entry is made.
         This would allow staff to identify
         how many people have been
         involved with the family and the
         level of responsibility.     This
         would adhere to the Nursing
         and       Midwifery       Council
         Guidelines for Records and
         Record Keeping (2005), which
         states ‘the entry should be
         signed … with the signature
         printed …’
10.1.8   A separate sheet should be           All HV records To         Carol Bryant – Oct 07   Audit records June
         included for address changes to      have a chronology         Locality Manager        08
         provide a clear chronology of        of          address       BPCT
         house moves.                         changes in the
                                              child’s records
10.1.9   That there is a formal review of     Working party to          Carol Bryant – Jan 08   Audit records June
         health visitor records and           review HV record          Locality manager        08
         guidance is given to the filing of   keeping         and       BPCT
         notes in records to ensure a         storage
         consistent approach across the
         PCT.




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                          AG Serious Case Review Action Plan –September 2007

          Recommendation                    Action                    Lead               When       Outcome
                                                                                                    measure
10.1.10   When health visitor records       HV Clerks to date stamp Sally Kinkead – Oct 07          Audit HV records
          transfer to another clinic, a     records when they move  BPCT     Locality               June 08
          clear note is made on the                                 manager
          record of when they are sent
          and received.
10.1.11   The recommendations are           Cascade           through NBT     -Maureen Oct 07       Audit of meeting
          shared and adopted across         appropriate   Trust CP Betts                            minutes -Jan 08
          hospital trusts so that all       meetings
          children using the services of                                                            Attendance      at
          the UBHT or NBT will receive      Developing a UBHT and Finbar                 Sept 08    regular meeting
          the same standard of care.        NBT Paediatric Epilepsy O’Callaghan
                                            joint care pathway
                                                                                                    Sharing common
                                            Named Nurses for both                                   standards of care
                                            acute trusts to have                                    via the CP health
                                            regular     meetings        to Carol Sawkins & Dec 07   Advisory    Group
                                            standardise care               NBT Named CP             (CPHAG)
                                                                           nurse
10.1.12   All health professionals need     All 3 health trusts in all CP Carol Bryant & April 08   Audit HV records in
          to     record    the    child’s   training the need to record Anne Fry- BPCT              June 08
          expression of wishes and          the voice of the child is
          feelings where these can be       emphasised. The voice of Carol Sawkins –                NBT & UBHT-Audit
          identified.                       the child may include the UBHT                          inpatient  notes
                                            Child’s body language                                   June 08
                                                                           NBT’s    named
                                            UBHT- appointing a youth Nurse CP
                                            worker to represent the
                                            voice of the child

                                                                      Barbara Sherriff- April 08
                                                                      UBHT



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                         AG Serious Case Review Action Plan –September 2007
10.2     Children    and     Young
         People’s Services - Social
         Care

10.2.1   Managers should ensure that      This     is    already    a   Angela Clarke     September   Evidence from file
         children are interviewed in the  procedural requirement –      Strategy Leader - 2007        audits        show
         course of assessment and         compliance needs to be        Safeguarding                  increased
         assist social workers to         monitored.                                                  compliance     with
         develop strategies to ensure     Request to CYPS social                                      this requirement
         this happens. Children and       care managers to monitor
         Young People’s Services staff    evidence of children being
         should be clear with parents     consulted      by    social
         that this is a requirement for   workers              during
         assessment.                      assessments.
                                          Update Leaflet SSL 1 –
                                          Child Care assessments –
                                          information for parents
                                          ensuring       that     the
                                          requirement to interview
                                          children is explicit
10.2.2   Managers should ensure that This          is    already    a   Angela Clarke     September   Evidence from file
         procedures are followed to procedural requirement –            Strategy Leader - 2007        audits        show
         ascertain the child’s view prior compliance needs to be        Safeguarding                  increased
         to closure.                      monitored.                                                  compliance     with
                                          Reminder       to     Team                                  this requirement
                                          managers to monitor that
                                          this is done before case
                                          closure




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                          AG Serious Case Review Action Plan –September 2007

         Recommendation                     Action                        Lead              When            Outcome
                                                                                                            measure
10.2.3   Children and Young People’s        1. A health closure letter    Angela Clarke     June 2007       Evidence from file
         Services     should     formally   has been developed in         Strategy Leader –                 audits        show
         inform child health when a         consultation with health      Safeguarding                      increased
         case is closed so that when        professionals. In addition                                      compliance     with
         health professionals have a        to informing local health                                       this requirement
         concern they know whether or       professionals in line with
         not there is current social work   current         procedural
         involvement.                       requirements,        social
                                            workers now inform Child
                                            Health of case closure
                                            using the template letter.
                                            2. Ensure health staff are    Maria Bredow
                                            aware of the use of health    Community
                                            closure letter                Paediatrician
10.2.4   Children and Young People’s        1. This is already a          Katrina Murphy     October 2007   Evidence from file
         Services social care managers      procedural requirement –      Area     Manager                  audits        show
         should ensure that regular         compliance needs to be        Bonus      Project                increased
         multi-agency children in need      monitored.                    Lead                              compliance     with
         reviews     are     held      in   2.    Restate     standard                                      this requirement
         accordance with procedural         requirements for new
         guidelines and that all-relevant   teams at the start of the
         agencies are involved.        At   Bonus Project
         each child in need review,
         consideration should be given
         as to whether or not a new
         core assessment should be
         undertaken.




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                          AG Serious Case Review Action Plan –September 2007

         Recommendation                     Action                       Lead            When          Outcome
                                                                                                       measure
10.4     Children       and       Young
         People’s       Services        –
         Education
10.4.1   The Lead for Child Protection      Email guidance to Head Chris Stevens     October 2007      Child     Protection
         (Schools) to issue guidelines      Teachers      and child Child Protection                   Lead (Schools) to
         to Headteachers about storing      protection leads        Lead - Schools                     audit outcome by
         confidential information and                                                                  June 2008 and
         forwarding this information                                                                   report    back    to
         when a pupil leaves their                                                                     BSCB quality sub
         school.                                                                                       group
10.4.2   The     Programme       Director Carry out an audit of the      Chris    Stevens November     All children who
         (Partnerships and Localities)    capacity of the current        Child Protection 2007         are registered for
         ensures     that   all    home-  Children Home Educated         Lead - Schools                home      education
         educated      pupils     receive Service     to     regularly                                 are visited every 3
         regular monitoring visits as per monitor all children on the                                  months
         DFES guidelines.                 home educated register
                                          and advise accordingly
10.4.3   All      teachers        whose Obtain a register of the         Chris    Stevens March 2008   Training delivered
         responsibility it is to make professionals          to    be    Child Protection              to    all  relevant
         home visits are trained in child targeted                       Lead - Schools                personnel.
         protection.
10.5     Overview recommendations
         – Chair
10.5.1   The     Bristol   Safeguarding Develop a briefing pack          Angela          March 2008    Serious     Case
         Children Board consider a for Serious Case Review               Clarke/Daryl                  Review     Panel
         format for training/preparing Panels similar to the one         Dugdale                       members feedback
         Reviewing Managers involved produced in Swindon
         in Serious Case Reviews
         about      their   role     and
         responsibilities.




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