Joint statement from the RCGP, RCN, and RCPCH
Safeguarding children and adults is an essential and important duty of everyone who works in health and social care across the United Kingdom.
The RCGP, RCN and RCPCH have worked collaboratively on the review and update of the intercollegiate documents which set out safeguarding roles and competencies for all healthcare staff. There are three strands to this work:
- In August 2024, the RCN published the second edition of Adult Safeguarding: Roles and Competencies for Health Care Staff.
- In October 2024, the RCGP published the new RCGP safeguarding standards on these webpages. These are for all GPs and everyone working in a general practice setting in the UK. These standards are a single life course document incorporating child and adult safeguarding.
- The RCPCH are currently leading on revising and updating Safeguarding Children and Young People: Roles and Competencies for Healthcare Staff. This will incorporate Looked After Children: Roles and Competencies of Healthcare Staff. The RCPCH is working with a number of stakeholders across devolved nation governments and other Medical Royal Colleges, to ensure a document that works effectively for multiple users. The planned publication date is Spring 2025.
The safeguarding roles and competencies for practitioners requiring Level 4/5 safeguarding training, such as Named/Designated safeguarding professionals and equivalent roles, remain in the individual Adult Safeguarding and Safeguarding Children and Young People documents. These levels are not included in the RCGP Safeguarding Standards.
Introduction to the standards
Safeguarding is an integral part of working in general practice in the UK. GPs and general practice staff have distinct expertise and experience in providing whole person medical care whilst managing the complexity, uncertainty and risk associated with the continuous care they provide. Safeguarding is simply part of this holistic care. Victims and survivors of abuse are frequently in contact with general practice and GPs, and general practice staff often go to great lengths to safeguard their patients. Safeguarding is often described as a jigsaw puzzle with general practice holding one of the important parts of that puzzle. General practice are one of the key multi-agency safeguarding partners who work together to prevent, and stop, abuse and neglect from happening.
Safeguarding standards in general practice are vital so that any victim or survivor of abuse can be assured they will receive an appropriate response regardless of where they live and who they come into contact with.
This document sets out the RCGP safeguarding standards for GPs and anyone working in any general practice setting in the UK. This includes, but is not limited to, NHS GP practices, independent and online providers of general practice services, Primary Care Networks (PCNs), GP Out of Hours and Extended access services. The standards combine and include both safeguarding children and adults and are a whole life course document. These standards form part of the wider intercollegiate documents on safeguarding knowledge and competencies for all healthcare staff.
It is important to note that both adult and child safeguarding knowledge and capabilities are equally necessary and expected for all staff in general practice, even if the staff member only works with adults.
GMC standards
The GMC highlights the importance of safeguarding in their guidance for doctors:
- Good medical practice 2024 - GMC
- Protecting children and young people: The responsibilities of all doctors - ethical guidance summary - GMC
- 0-18 years: Guidance for all doctors - GMC
- Adult safeguarding ethical hub - GMC (this hub provides resources exploring how to apply the existing guidance in practice; it does not set out new professional standards)
GMC Good medical practice 2024 includes the following guidance on safeguarding:
Safeguarding children and adults who are at risk of harm
- You must consider the needs and welfare of people (adults, children and young people) who may be vulnerable, and offer them help if you think their rights are being abused or denied. You must follow our more detailed guidance on Protecting children and young people and 0-18 years: guidance for all doctors.
- You must act promptly on any concerns you have about a patient – or someone close to them – who may be at risk of abuse or neglect, or is being abused or neglected.
Aim of the RCGP safeguarding standards
The aim of the RCGP safeguarding standards is to set professional safeguarding standards for GPs and all staff in general practice that are:
- Focused on the needs and voice of victims and survivors of abuse.
- Focused on the specific skills, knowledge and expertise that GPs and general practice staff have.
- Relevant to the resources and context of general practice.
- Related to the role of GPs and general practice staff who provide universal health services to the whole population.
- Mindful of the welfare and wellbeing of GPs and general practice staff, and the impact being involved in safeguarding work can have on emotional wellbeing.
- Take into account the current significant and sustained pressure on general practice whilst also acknowledging the same pressures faced by our safeguarding partner agencies.
The role of GPs and general practice in safeguarding
Safeguarding in general practice can be defined as:
Contributing to the protection of children and adults from abuse and neglect using the specific skills, resources and capacity available in general practice by:
- implementing professional safeguarding responsibilities which includes continual professional development in safeguarding;
- preventing abuse and neglect;
- identifying abuse and neglect;
- responding appropriately to abuse and neglect, including supporting victims and survivors of abuse;
- having governance systems and processes in place to support safeguarding, and
- working collaboratively with other health colleagues, safeguarding partners and agencies.
GPs and general practice staff have trusted relationships with their patients and can be powerful advocates for the most vulnerable patients. Many of the skills that are needed for effective safeguarding in general practice, GPs and general practice staff already have. For example: compassion, empathy, listening, recognising patterns and small details, analysing risk, professional curiosity, having difficult conversations and supporting patients in times of distress. General practice can also hold important information about patients and their wider family which is vital to inform a robust and effective multi-agency safeguarding response. Safeguarding can be a deeply rewarding and satisfying part of general practice even though it can be complex and challenging at times.
General practice has a specific role to play in safeguarding along with other agencies such as other healthcare organisations, social care, police and education. At the time of development of the RCGP safeguarding standards, many of these agencies, like general practice, are under significant pressure and lack sufficient resources. This backdrop adds to the challenges of safeguarding in general practice.
Safeguarding is only one of many different areas that GPs and general practice staff need knowledge, skills and competencies in. While the learning needs of individual GPs and general practice staff may vary significantly based on experience, location and setting where they work, all need safeguarding knowledge and capabilities. The RCGP safeguarding standards recognise the knowledge and capabilities already in general practice whilst also building on these for now and the future. Safeguarding learning should continually develop and evolve over time. It should not be seen as a 'tick box' exercise or ever 'completed'.
In general practice, there are immense workload pressures on practices and the GP workforce is declining. Safeguarding in general practice can only operate within the parameters of the resources they have and the resources that other relevant agencies have. It is imperative that any agency (local, regional or national) who wish to make recommendations for change in general practice in regard to safeguarding workload, only do so with full engagement of GPs and general practice, taking into account the role of a GP and general practice as well as the current GP workload and pressure.
Impact of safeguarding on the wellbeing of GPs and staff
Safeguarding in general practice can be extremely rewarding however it can also be very challenging. Safeguarding can take a significant amount of time which impacts on the whole practice capacity to do other essential work. It can be emotionally and psychologically distressing. There is no current resource in general practice for formal supervision, although this is viewed as essential in other professions who deal with abuse and neglect. This impact is equally relevant for non-clinical staff in general practice as it is for clinical staff. The risk of vicarious trauma must not be overlooked. It is therefore of great importance that all staff receive appropriate support should they need it.
A note for employers
This guidance sets out indicative minimum training requirements. It is acknowledged that some employers may require certain staff groups to be trained to a higher level than described here to better fulfil their organisational intent and purpose.
Level 4 and 5 safeguarding training
GPs and nurses who hold strategic safeguarding roles such as ‘Named GP’, ‘Named Nurse, ‘Designated Professional’, safeguarding leads within health boards or authorities will require Level 4 or 5 safeguarding training (dependent on role). The RCGP safeguarding standards do not include Level 4 and 5 standards and practitioners needing these levels of safeguarding training should continue to refer to the separate intercollegiate documents which include roles and competencies for Level 4 and 5 staff:
- Adult Safeguarding: Roles and Competencies for Health Care Staff second edition: July 2024
- Safeguarding Children and Young People: Roles and Competencies for Healthcare Staff Fourth edition: January 2019
- Looked After Children: Roles and Competencies of Healthcare Staff: December 2020
It should be noted that GP practice safeguarding leads DO NOT require Level 4 or 5 safeguarding training. They require Level 3 training which is outlined in the RCGP safeguarding standards.
Safeguarding training for roles outside of general practice
Any GP or clinician who holds a role outside general practice such as a role on adoption panels for example, should ensure they are meeting the safeguarding competencies for that role as set out in the separate intercollegiate documents noted above.