Service provision and improvement
Services for vulnerable children need to be informed by local need, wider guidance, lessons learned from reviews and their voice.
This page relates to the higher competency framework for safeguarding children and children in care (level 4).
Competencies
Below are the competencies relevant to service provision and improvement – please refer to the level 4 competencies in the intercollegiate document (2025) for more information.
Core
- advise on local safeguarding of children and young people, and services for children and young people in care using knowledge, research and learning from audits, training, learning from poor and exemplary practice, and address areas where there is an identified training/development opportunity
- contribute to the implementation of national learning reviews; leaders in should lead on creation and implementation of action plans and learning where they refer specifically to children in care:
- Child Safeguarding Practice Reviews (England), Child Practice Reviews or Single Unified Safeguarding Reviews (SUSR) (Wales), Learning Reviews (Scotland), Case Management Reviews (Northern Ireland)
- domestic abuse related death reviews involving 16-18 years old and/or children and young people e.g. domestic homicide reviews or domestic homicide & suicide reviews in Scotland
- individual management or agency reviews, and child death reviews, where requested
- be aware of cross-border/jurisdiction differences in legislation, guidance and practice throughout the United Kingdom and Ireland where appropriate
- advise and contribute to the development of Specific, Measurable, Achievable, Relevant, and Time-bound (SMART) action plans, in relation to above reviews, using a root cause analysis approach where appropriate or other locally approved methodologies; these reviews may also consider safeguarding children and young people or children and young people in care practice
- ability to understand and apply the Mental Capacity Act 2005 (c.9), Adults with Incapacity (Scotland) Act 2000 (asp 4) and Liberty Protection Safeguards (formerly Deprivation of Liberty Safeguards) (England and Wales only) and how this might apply to all 16-18year olds
- possess knowledge and expertise regarding transitional safeguarding
Additional – safeguarding
- be able to elicit, understand and consider the views of a child or young person and how these should be included in the service providing child protection medical examinations
- enable trauma-informed care to be embedded in practice acknowledging consequences of adverse childhood experiences and impact of child safeguarding
- possess expertise and knowledge about relevant adult issues e.g. how parental mental health issues and drug and alcohol misuse can impact on the safety and wellbeing of children. Support from a health perspective, as relevant to role, the management of those who pose a significant risk of harm to children
Additional – children in care
- ensure staff working with children and young people can elicit, understand, and consider the views of a child or young person and how these should be included in the health assessment
- initiate interventions to facilitate and support child resilience and reduce risk of emotional harm, ensuring trauma-informed care is embedded in organisations and services
- interpret regional, national, and local policy documents/reports and their implications for children and young people in care health and service provision
- work creatively with other specialist areas to deliver high quality services specific to the needs of children and young people in care
Suggested activities
- Learning through experience and reflection
- Formal education and training
- Multi-agency working and strategic collaboration
- Service improvement projects
- Involving children and young people
- Teaching, mentoring and supporting others
Examples from experience
Writing or reviewing a child protection guideline or recent policy document is useful in drilling down into the different components of a service and its implications for health and other partners. This could be done individually or as part of a guidelines group.
There may be meetings that your seniors are involved with such as Forensic HIS standards, national SARC networks, that you could attend in their place – your role is to provide a paediatric medical perspective which you already have.
Look at workplans from any operational or strategic meetings to understand what current priorities and barriers are.
Discuss with level 4/5 professionals how they approach any blocks to progressing change.
It’s also important that children and young people met in this work are approached in a trauma-informed manner. The National Trauma Transformation Programme has a wealth of resources and workshop to build your skills.