Safeguarding arrangements are underpinned by two key principles:

  • Safeguarding is everyone’s responsibility. For services to be effective each professional and organisation should play their full part; and
  • A child-centred approach. For services to be effective they should be based on a clear understanding of the needs and views of children.

Safeguarding and promoting the welfare of children is defined as:

  • protecting children from maltreatment;
  • preventing impairment of children’s health or development;
  • ensuring that children are growing up in circumstances consistent with the provision of safe and effective care; and
  • taking action to enable all children to have the best life chances.

Child protection is part of safeguarding and promoting welfare. It refers to the activity that is undertaken to protect specific children who are suffering, or are likely to suffer, significant harm. See glossary below for definitions of types of abuse

Glossary of Terms Working Together to Safeguard Children 2018

NHS South East London CCG (Southwark Borough) recognises the paramount importance of safeguarding children and that all children have a right to protection from abuse and neglect. We are committed to child protection procedures and working alongside allied professional bodies including Southwark Safeguarding Children Partnership, Social Care, Education and Police.

Primary Care and GP practices are well placed to respond to the needs to Children and Families, as a universal service with duty of care to both the child and adult in their parenting/caring role. We hold both the short term and longer-term view for families and situations.

Referrals, Local Key Agencies and Contacts

Southwark Safeguarding Children & Young People Key Contacts For Primary Care ​

Refer all cases of suspected child abuse (neglect, physical, emotional, sexual) via MASH except:

Acute injuries – liaise with on-call consultant paediatrician at local hospital

At immediate risk of harm – contact the police on 999

Please use the London Safeguarding Children Thresholds guide to support referral.


Children’s Social Care MASH
Multi Agency Safeguarding Hub – Sumner House
Refer over the phone (if urgent Child Protection) or by using the MASH Inter-Agency Referral Form. Referrals over the phone must be followed up in writing within 48 hours
020 7525 1921
020 7525 5000 (out of hours)
Fax: 020 7525 7992
Family Early Help
For families in need of increased support not meeting threshold for social care intervention
Phone for advice or refer using the Early Help Inter-Agency Referral Form
020 7525 2714
Fax: 020 7525 2670


Advice and guidance

Social Worker Consultation
To discuss cases of concern if unsure if thresholds for referral are met.
Access to MASH health advisors also available
020 7525 1921
Safeguarding Specialist Nurses
On-call mobile available 09:00-17:00
07789 741518
Community Paediatrics/Named Doctor/
Designated Doctor
For community paediatric advice on medical aspects to a safeguarding case or concern
020 3049 8010
Looked After Children Team Sunshine House ​020 3049 8037
Designated Nurse for Safeguarding Children
Michele Sault
020 7525 4529
07554 407 823
Named GP for Safeguarding Children
Dr Shimona Gayle


Key local agencies

Parental Mental Health Team
Chaucer Resource Centre-for parents experiencing or who are at risk of experiencing a mental health problem and have a child aged under 5 years
020 3228 9800
ParentalMentalHealthTeamSouthwark@slam.nhs.ukParental Mental Health Team Information
Domestic Abuse Team:
(abuse: emotional, physical, financial etc.)
Sexual Abuse : The Havens
for children of all ages and adults 24/7
020 3299 1599
Private Fostering team:  Southwark Children’s Social Care 020 7525 7972
07539 346 808​
CGL- Hidden Harms Service For child/young person 5-18yrs affected by parental/guardian substance misuse 020 8629 2348
07778 356 726
School Nursing Team
Central Hub for the 4 locality teams
Contact with name of child’s school
020 3049 4777
Referral to School Nursing September 2020 
School Nurses Lambeth Southwark Allocation March 2020
Health Visiting Teams 020 3049 8166
Evelina London Health Visitor and Community Nursing Teams Southwark April 2021
Local Authority Designated Officer (LADO)
See LADO section for more information
Eva Simcock
020 7525 0689
07943 076 608

NEW – Health Visitor-GP liaison protocol

GP practices are asked:

  • To schedule meeting dates and times in advance with all communication going through team and nurse managers, according to locality.
  • To share list of children and families to be discussed in advance of meeting to allow Health Visitors to gather updates from colleagues. Health Visitors will update practices on local service developments e.g. E-red book update and local children centre provision.
  • To provide list of children under 5 years old newly registered, in response to examples of families identified via MASH/ MARAC referrals who have been in borough for extended periods but have not been known to the Health Visiting service.

New-Bright Beginnings Early Intervention Health Visiting – please see letter and referral form attached for this new service following Family Nurse Partnership decommissioning. Bright Beginnings is part of the Evelina Health Visiting Service that provides rapid assessment and enhanced support to families who have complex health and social care needs to improve health outcomes for children and families

Parents/carers/families can be referred to the service if they present one or more of the following risk criteria and have a child under the age of 2 years:

  • Young parents aged 19 and under
  • Significant mental health conditions (not issues of low mood alone)
  • Domestic violence and abuse posing current risk or impact (including intimate partner violence, forced marriage, honour-based violence)
  • Alcohol and substance misuse posing current risk or impact
  • Parent with a learning disabilities or complex medical needs posing current risk or impact
  • Parental history of safeguarding issues (Child Looked After, Child in Need or subject to a Child Protection Plan, gang affiliation, female genital mutilation, sexual exploitation, adverse childhood experiences) posing current risk or impact
  • Concealed pregnancies posing current risk or impact

Useful documents

Information Sharing, Record Keeping and Online Services

Guidance on Information Sharing with link to summary from myth busting guide from Working Together 2018 and suggested wording for incomplete information requests is available below. All requests for information should contain context as to concern in order that we can review our records accordingly.


Children Act Parental Consent Required
Request for information Information gathering from multiple agencies to assess level of concern Yes
Child in Need:  Section 17 Concerns about reasonable level of health or development, which is likely to be significantly or further impaired, without the provision of services; or a child who is disabled Yes
Child Protection:  Section 47 Concerns about maltreatment where there is reasonable cause to suspect that a child is suffering, or is likely to suffer, significant harm No*

*Good practice to discuss with a parent/carer who has parental responsibility unless this would put child/ren at risk or jeopardise an investigation 

Only share information deemed relevant to case. Remember that many professionals reading the reports will not be medical, so ensure that risks and significance of medical history are clear.–2

Information of factors with potential to impact parenting capacity should be considered –

General Medical Council (2018), Protecting Children and Young People: The responsibilities of all doctors Paragraphs 2, 32-38

Key Principles of information sharing

  • Necessary and proportionate
  • Relevant
  • Adequate
  • Accurate
  • Timely
  • Secure
  • Record

Record Keeping for Child Protection 

Child Protection Reports are as important as records of serious physical illness and should be recorded in the same way and with the same degree of permanence.

  • All reports should be scanned onto the relevant child’s records.
  • Appropriate coding and templates should be used in Active and Past Problem Lists and priority lists
  • Child’s records should be linked in some way to parents even if not living at the same address, siblings and others in household by use of appropriate templates and codes.
  • Snomed codes expressing that a child is on a Child Protection Plan should be entered into notes of all individuals living at same address.

It is vital that when a child who is or has been on a Child Protection Plan moves to another area that the full clinical record including Case Conference Reports be sent to the next GP. Therefore they must NOT be kept separate or isolated from the child’s written or computer records.

Online Services for patients under 16 years and cases with safeguarding concerns.

Particular concerns surround:

  • Risk of coercion in domestic abuse relationships, thereby sharing access to notes against a person’s will
  • Active child protection and safeguarding cases
  • Third party access by an authorised third person, consider for family members with language barriers
  • Child proxy access and the point at which it is unsuitable for parents to access their child’s notes.

EMIS tools have now been developed to facilitate ‘child proxy access’ for parents with age maturity notifications.

Automated emails are sent 3 months before and on patient’s 11th notify that proxy access will be switched off.
Recommendation stands that access should not be given between ages of 11 and 16 years.

Online service guides are available at the site

Where safeguarding concerns exist and we feel it is not in the best interest for the patient or family at that time, access should be declined with reason documented in the notes

All primary care staff should familiarise themselves with the online visibility functions available within EMIS.

Online learning toolkits are available through RCGP and NHS England which hosts a useful FAQ document and training slides for practice use in the webinar section.

Further guidance from November 2019 available from NHS England and regularly updated from NHS Digital National Network of Named GPs Accelerating Citizen Access Dec 2023

Online access to GP health records – NHS Digital

Parental Responsibility

GMC Protection Children and Young People

A ‘person with parental responsibility’ means someone with the rights and responsibilities that parents have in law for their child, including the right to consent to medical treatment for them, up to the age of 18 years in England, Wales and Northern Ireland, and up to 16 years in Scotland.

Mothers and married fathers have parental responsibility, and so do unmarried fathers of children registered since 15 April 2002 in Northern Ireland, since 1 December 2003 in England and Wales and since 4 May 2006 in Scotland, as long as the father is named on the child’s birth certificate.

An unmarried father whose child’s birth was registered before these dates, or afterwards if they are not named on the child’s birth certificate does not automatically have parental responsibility. He can gain parental responsibility by reregistering a birth, by entering into a parental responsibility agreement with the child’s mother or by getting a parental responsibility order from the courts. Married step-parents and registered civil partners can gain parental responsibility in the same ways.

Parents do not lose parental responsibility if they divorce. If a child is taken into local authority care under a care order, their parents share parental responsibility with the local authority. If the child is in voluntary care, the local authority has no parental responsibility. Parents lose parental responsibility if a child is adopted. Parental responsibility can be restricted by a court order.

Guide on Parental responsibility and consent from BMA.

Southwark Safeguarding Children’s Partnership (SSCP)

Southwark Safeguarding Children’s Partnership (SSCP) holds responsibility for co-ordinating all safeguarding and child protection activity in the borough

  • Policy and guidance
  • Child Safeguarding Practice reviews
  • Child Death Overview Panel
  • Learning and improvement
  • Raise local awareness

For more information please see the Southwark Safeguarding Boards website.

Child Safeguarding Practice review (formerly Serious Case reviews) and Local Learning Reviews

Child Safeguarding Practice review- formerly Serious Case reviews/Local Learning Reviews are commissioned when a child suffers serious injury of death as a results of child abuse of neglect.

Understanding not only what happened but also why things happened as they did can help to improve our response in the future. Understanding the impact that the actions of different organisations and agencies had on the child’s life, and on the lives of his or her family, and whether or not different approaches or actions may have resulted in a different outcome, is essential to improve our collective knowledge. It is in this way that we can make good judgments about what might need to change at a local or national level.

The purpose of reviews of serious child safeguarding cases, at both local and national level, is to identify improvements to be made to safeguard and promote the welfare of children. Learning is relevant locally, but it has a wider importance for all practitioners working with children and families and for the government and policy-makers. Understanding whether there are systemic issues, and whether and how policy and practice need to change, is critical to the system being dynamic and self-improving.

The process is set out in statutory guidance, Chapter 4 Working Together to Safeguard Children.

Any practice with a case will be supported by the safeguarding CCG team, throughout from initially case review to learning and recommendations.

Summary and key learning from recent reviews

Child T – a multi-agency review,15 year old girl, case of CSE,

Key learning on consistent documentation of adult accompanying children, giving children opportunity to consult alone, opportunity to identify vulnerable patients at registration and identity over use of OOH services.

Child T – Brief Summary

Child U- Serious Case Review, 16 year old boy killed following knife attack Sept 2015

Key learning on recognising impact of background of childhood trauma.

Child V-Multi-agency review as possible ‘near miss’ for baby on Child in Need plan as parents disabled, with non-accidental injuries

Key learning on ensuing medical records for children contain details on known parental vulnerabilities.

Child V – Brief Summary

Child W – A multi-agency review following serious incident, 6 year old who told staff in his primary school he wanted to die, rapid escalation in behavioural issues.

Presented to the GP on a friday afternoon directed by the school following a significant episode, deemed a suicidal attempt. Child W’s mother is a care leaver who became pregnant at age 16 in foster care with additional vulnerabilities. We discussed events prior to his admission, the admission itself and his discharge to a full care order in a specialist residential unit.

Key learning on the emerging and developing crisis CAMHS protocol, recognition of parental vulnerability and record keeping.

Child A and B were the subject of a multi-agency thematic review and presented at a GP forum January 2021, presentation attached, with backgrounds detailing significant childhood trauma.

Key Learning- recognition of impact of childhood trauma and early neglect, all identified concerns regarding serious youth violence, gang involvement meets threshold for MASH referral.

Child A and B – Thematic Learning Review – GP Forum – January 2021

Child C – local learning review following death of Child C, 25 w old baby. Family new to Southwark during mother’s pregnancy, family previously known to social care services in other  London area

Key learning – threshold for urgent MASH referral met had previous children social care involvement been known, importance of coding child protection information in parents’ notes, risks around transient, sometimes deliberately evasive, families and importance of routine enquiry as to mood and domestic abuse during post-natal review.

Child C – Safeguarding Forum – May 2020

Domestic Abuse

See section in Adult Safeguarding for details of our commissioned service RefugeIris Programme and MARAC (Multi-agency Risk Assessment Conferences) for high-risk cases of Domestic Abuse. Further resources available through Safelives with DASH risk assessment tool.

All identified case of domestic abuse and violence within a family environment, whether child present or not, meets threshold for a MASH referral. Remember you can call MASH for a Duty Social Worker Consultation to discuss individual cases. See Multi-Agency Threshold Guide for further details.

Domestic Violence and Abuse NICE guidance available here

Routine Enquiry: in antenatal, postnatal, reproductive care, sexual health, alcohol or drug misuse, mental health, children’s and vulnerable adults’ consultations, trained staff should ask service users whether they have experienced domestic violence and abuse. This should be a routine part of good clinical practice, even where there are no indicators of such violence and abuse.

Yuva is a new service, working with young people (age 11– 25) who have used violent or controlling behaviours towards their parents /carers or towards their girl/boyfriends. They aim to help young people to look at their abusive behaviour and find safe, non-abusive alternatives.

Read more about Yuva on the Domestic Violence Intervention Project website and in the Yuva Young People’s Service leaflet.

Contact Yuva on 020 8222 8281 or at

Female Genital Mutilation (FGM)

All newly identified recent and historic cases of FGM for a child aged under 18 years must be referred to Children Social Care via MASH and the Police calling 101 as part of the FGM Mandatory Reporting Duty 2015

FGM comprises all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons. It has no health benefits and harms girls and women in many ways. It involves removing and damaging health and normal female genital tissue, and hence interferes with the natural function of girls’ and women’s bodies. The practice causes severe pain and has several immediate and long-term health consequences, including difficulties in child birth also causing dangers to the child.

Under the Female Genital Mutilation Act 2003 it is an offence for any person (regardless of their nationality or residence status) to:

  • Perform FGM in England, Wales and Northern Ireland
  • Assist the carrying out of FGM in England, Wales and Northern Ireland
  • Assist a girl to carry out FGM on herself in England, Wales and Northern Ireland; and
  • Assist (from England, Wales and Northern Ireland) a non- UK person to carry out FGM outside the UK on a UK national or permanent UK resident.
  • Perform FGM abroad
  • Assist FGM carried out abroad by a UK national or permanent UK resident
  • Assist a girl to perform FGM on herself outside the UKAssist (from outside the UK) FGM carried out abroad by a non-UK person on a girl or woman who is a UK national or permanent UK resident.

Online FGM training and resources

Key documents

Child Sexual Exploitation (CSE)

Sexual exploitation of children and young people under 18 involves exploitative situations, contexts and relationships where the young person (or third person/s) receive ‘something’ (e.g. food, accommodation, drugs, alcohol, cigarettes, affection, gifts, money) as a result of them performing, and/or another or others performing on them, sexual activities.

CSE can occur through the use of technology without the child’s immediate recognition; for example being persuaded to post images on the internet / mobile phones without immediate payment or gain.
Violence, coercion and intimidation are common. Involvement in exploitative relationships is characterised by the child’s or young person’s limited availability of choice as a result of their social, economic or emotional vulnerability.
A common feature of CSE is that the child or young person does not recognise the coercive nature of the relationship and does not see themselves as a victim of exploitation.

Because of the universal nature of most health provision, health professionals may often be the first to be aware that a child may be involved, or be at risk of becoming involved, in sexual exploitation. Children involved in sexual exploitation are likely to need a range of services, including advice and counselling for harm minimisation, health promotion, advice on sexually transmitted diseases and HIV.

All identified and suspected cases of Child Sexual Exploitation meets threshold for a MASH referral. Remember you can call MASH for a Duty Social Worker Consultation to discuss individual cases. See Multi-Agency Threshold Guide for further details.

Further information is available from the London Child Protection Procedures

NHS England Pocket Guide available for Health Care Staff.

Stop it Now! UK and Ireland is a useful website for anyone with concerns about child sexual abuse.

CEOP helps keep children and young people safe from sexual abuse and grooming online. They offer help and advice to parents and carers

See ‘Child Safeguarding Practice review- formerly Serious Case reviews section’- Child T

Key documents

Community Harm and Exploitation - including youth violence

The term Community Harm and Exploitation  encompasses Youth Violence, Child Sexual Exploitation, Criminal Exploitation and County lines

Youth violence and knife crime is a key part of the Southwark Safeguarding Children Board’s agenda for 2021/22 under the Community Harm and Exploitation work.

All identified case of concern regarding gang affiliation, criminal exploitation and violent crime in a child <18 years meets threshold for a MASH referral. Remember you can call MASH for a Duty Social Worker Consultation to discuss individual cases. See Multi-Agency Threshold Guide for further details.

Southwark’s Information, Advice and Guidance Pilot team available to contact directly, providing support pilot for parents and young people currently experiencing harm or exploitation.

Presentation on Southwark Joint Strategic needs assessment 2019 and Southwark’s Extended learning review available in documents

See ‘Child Safeguarding Practice review- formerly Serious Case reviews section’- Child U, A and B

Key documents

Avenues of support

A recent report called “keeping kids safe” by the Children’s Commissioner estimates that there are 27,000 children across the country who identify as a gang member; far more then previously thought. One of the most important things that GPs can do is to chat to parents if they think that a child is at risk of exploitation. Parents Against Child Exploitation (PACE) has produced a guide which gives GPs ideas about how to initiate such a conversation. The Home Office explain here exactly what the options are once a risk of child exploitation has been identified. In Southwark we have the expert support of Barnardos and the Children’s Society

Fearless is the youth branch of independent charity, Crimestoppers, where young people can access non-judgemental information and advice about crime and criminality.

They provide a safe place to give information about crime 100% anonymously. When giving information through their online form, no personal details are taken and their anonymity promise has never been broken. Professionals’ page available here.

Be Fearless Against Crime in London information sheet

The National Child Safeguarding Practice review panel recent publication ‘It was hard to escape- safeguarding children at risk from criminal exploitation available here.

Safer London’s Webinar Dec 2020 series available here.

Private Fostering- children in the care of adults who do not hold PR for longer that 28 days

Private fostering is where a child, under the age of 16 (under 18 if disabled) who is cared for, or proposed to be cared for, and provided with accommodation by someone other than; a parent, a person who is not a parent but who has parental responsibility, a close relative i.e. an aunt, uncle, sibling, grandparent, step parent, which excludes a cousin, a great uncle/aunt and great grandparents or a friend/neighbour for a period of more than 28 days.

A relative is defined in the Children Act 1989 as a grandparent, uncle or aunt (whether by full-blood, half-blood or by marriage or civil partnership), sibling or step-parent.

Key points of identification are patient registration, immunisations and routine GP appointments where we have the opportunity to ask key questions. Private foster carers do not hold Parental Responsibility.

All possible cases of private fostering need to be referred to the Local Authority

Private Fostering Team available 020 7525

video guide to private fostering

CoramBaaf’s guide to private fostering

Statutory guidance on national minimum standard for private fostering

Private Fostering in Southwark information

Private Fostering in Southwark leaflet

Child Death Overview Panel (CDOP)

It has been a statutory requirement since April 2008 that each Local Safeguarding Children Partnership (SCP), formerly Local Safeguarding Children Board (LSCB) must review deaths of children (under 18 years) ordinarily resident in the SCP area. These processes are outlined in the Children Act 2004 and Chapter 5 of the statutory guidance Working Together to Safeguard Children

As part of this process GPs will be required to complete reporting Form B on the eCDOP database. This process, as used by all agencies contributes to analysis of potential factors contributing to the death.

For surgeries not yet signed up to eCDOP the CDOP Administrator will first send you an e-mail explaining that a sign-up request will shortly be sent from Holistix/QES/eCDOP For further details see ‘Announcement for GPs to start using eCDOP for Reporting Forms

Local contacts and Single Points of Access Lambeth/Southwark deaths:

Helen Turnage  (, tel: 0207 525 3105)

Further information is available on the Southwark Safeguarding Board Website alongside Government guidance

Sudden Unexpected Death in Infancy- Sleeping on a sofa with your baby increases the risk of Sudden Infant Death Syndrome (SIDS) by up to 50 times (

Safer Sleep for Babies – A Guide for Parents

Children Who Are Home Educated

As a cohort these children are not receiving the health offer from the school programme or the safeguarding element to school life e.g. sex and relationship programmes, immunisations. These families are just as likely, if not more, to have vulnerabilities such a significant parental mental health, substance misuse and domestic violence and abuse. Without the safeguarding aspect of school more responsibility falls to Primary Care.

Practices are reminded to review registration forms to check if children registrations forms contain a question about school attended; this will help identify any children who are home educated

Suggested code: Home-schooled [Snomed 302139001]

Southwark Pupil Tracking and Licensing Team

Tel. 020 7525 0528/0428

Please find presentation from GP safeguarding Forum 2017 below covering the various aspects to elective home education, including definitions, legal aspects and the 2017 Southwark picture.

Elective Home Education in Southwark – GP Forum – December 2017

Young Carers

Young carers are those aged from 5 to 18 who have a significant caring responsibility for a member of their family

It is estimated that there are over 2000 young carers in Southwark, many of whom remain unknown to services.

The 2014 Children and Families Act made it a statutory duty of the LA to offer a Young Carers assessment to all those who have been identified as having caring duties.

There is far reaching impact of caring on children and young people:

  • Young carers have statistically poorer educational outcomes than their peers
  • They also have poorer mental health and high rates of anxiety
  • They can become socially isolated, as they stay at home with the cared for parent

Imago runs the Southwark Young Carer Service, referral form available on the Imago website.

GP practices are well placed to identify young carers in their direct work with parents and carers.

Local Authority Designated Officer (LADO)

The LADO deals with allegations made against people working and volunteering with children in Southwark.  This can also include allegations in people’s private lives which can impact on a person’s suitability to work with children. The role was introduced following the Bichard Inquiry published in 2004.

Further details in statutory  and local guidance and procedure including Chapter 2 of Working Together to Safeguarding Children, Chapter 2 of the London Children Protection Procedures and Southwark local authority website.

Allegations can be made in relation to physical chastisement and restraint but can also relate to inappropriate relationships between members of staff and children or young people, for example

  • Having a sexual relationship with a child under 18 if in a position of trust in respect of that child, even if consensual (see s16-19 Sexual Offences Act 2003);
  • ‘Grooming’, i.e. meeting a child under 16 with intent to commit a relevant offence (see s15 Sexual Offences Act 2003);
  • Other ‘grooming’ behaviour giving rise to concerns of a broader child protection nature e.g. inappropriate text / e-mail messages or images, gifts, socialising etc;
  • Possession of indecent photographs.

In addition, when there is an allegation that any person who works with children has behaved in a way in their personal life that raises safeguarding concerns:

  • These concerns do not have to directly relate to a child but could, for example, include arrest for possession of a weapon;
  • As a parent or carer, has become subject to child protection procedures;
  • Is closely associated with someone in their personal lives (e.g. partner, member of the family or other household member) who may present a risk of harm to child/ren for whom the member of staff is responsible in their employment/volunteering.

Types of disclosures GP may get:

  • Historic allegations – an adult making a disclosure about childhood abuse eg. abuse suffered whilst in care
  • Remember recent historic abuse from young adults could suggest the person the allegation is about is still working with children
  • Parents/carers bringing a child to the GP because they are worried their child is being abused at nursery or school
  • If you are working with a patient who works with children
  • Worries about colleagues

Contact Southwark’s LADO to discuss any potential cases for referral.

Eva Simcock  0207 525 0689 / 07943 076608

Allegations Against Adults Who Work or Volunteer with Children – The LADO role

Key documents

South East London Integrated Care System

Visit ICS Website

Find out more