Welsh Ambulance Services NHS Trust

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2 (WAST) 2.9 Million People 7 Local Health Boards Emergency Medical Service (over 315,000 emergency calls) 20,779 km² Patient Care Services (1.3 million Journeys) NHSDW (over 478,000 Direct Calls)

3 Where the Trust were in relation to Safeguarding Prior to 2007 Limited strategic planning around Safeguarding Limited staff knowledge in relation to Safeguarding Limited staff training around Safeguarding A process had been developed to share information but was not very robust with little governance and difficult to manage Specialist input concerning Safeguarding was external Some staff had the belief that it was alright to just inform the hospital of concerns

4 NHS Modernisation in the UK involving more healthcare in the community Children Act 2004 In 2007 WAST recognised the need for a dedicated Safeguarding Team providing clear lines of accountability and governance arrangements Healthcare Inspectorate Wales Reviews and monitoring All Wales Child Protection Procedures UNCRC Children Act 1989 Serious Case Review Recommendations

5 Table identifying factors involved in WAST Safeguarding Referral Activity

6 A 14 year old female (B) is intoxicated and is with her three friends at one of the friend's houses. They have all been drinking. Her friends are concerned for her so they call 999. The ambulance arrives and the crew establish that they have all been drinking alcopops. Most of them had only had one bottle but B has consumed 3 bottles. She is awake, has slurred speech and has vomited. The crew examine her and find that her observations are stable. B is crying and asking for her mother. The crew contact her mother to inform her that they will be taking B to the nearest A&E department. B s mother is upset and concerned she states that she will be at the house within a few minutes as she lives just around the corner.

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8 What the Staff Have Said I used this the other week it was really helpful because I was not sure if I should have made a referral, following COPE guided me in the right direction and I did. Graham Before I would automatically fill out a referral for youngsters who have been drinking. I dealt with one last week used COPE and felt there was no need to make the referral. Mike The thing that I like about COPE is that it helps me to capture all the important points, like the assessment framework. Kath If I was still on the road it would be very helpful as I have been in the situation with dealing with alcohol ingestion and not knowing what to do for the best interests of all concerned. This poster makes it quite clear. Richard (Paramedic Manager)

9 The Safeguarding Team have observed more appropriate alcohol related referrals since the introduction of the tool. An audit of WAST Safeguarding Children Referrals has been undertaken the findings of which are due to be reported. This looked at practitioner interpretation of thresholds of safeguarding concerns. A multi agency Alcohol Treatment Centre pilot is being commenced September December 2012 as part of the Public Health - Substance misuse strategy. WAST staff will be asked to utilise the COPE tool to support their involvement with this pilot. Other partners may also find this useful.

10 References All Wales Child Protection Procedures 2008 All Wales Protocol: Safeguarding and Promoting the Welfare of Children and Young People who are at Risk of Abuse through Sexual Exploitation 2008 Framework for Assessment of Children in Need and Their Families National Assembly for Wales, Working Together to Safeguard Children. Cardiff, 2000 Welsh Assembly Government, Safeguarding Children: Working Together Under the Children Act Cardiff, 2006