Standards updated to improve wellbeing of vulnerable children in secure settings

Updated standards have been published to improve the health and wellbeing of vulnerable children in secure settings.

The standards – first published in 2013, and refreshed in 2019 – help healthcare professionals, commissioners, service providers, regulators, managers, and governors ensure that young people receive the care they need to improve their health outcomes.

Key changes to the standards include removing the standard outlining the content of the CHAT assessments (Standard 4), renaming ‘neurodiversity care’ (Standard 8) to ‘neurodevelopmental care’, and updating standards outlining restraint and supervision procedures were to reflect current best practice (Standard 6).

Several standards were also strengthened to include suicidal ideation as a reason for intervention.

The refresh also included the addition of a new standard within Overarching Principles highlighting the importance of listening to children and working collaboratively with them to ensure their views, wishes and feelings are heard (Standard 1.4).

An additional safeguarding standard was developed to highlight the need for children to have a member of healthcare staff they have a trusted relationship with and they can go to with concerns which are appropriately reported.

The standards refresh has been led by Health & Justice NHS England and has been ratified by the Royal College of Paediatrics and Child Health (RCPCH), who worked together with an expert reference group comprised of clinical and non-clinical professionals including commissioners, providers and national bodies, including Dr Alison Steele, who was in post as Officer for Child Protection at the RCPCH throughout the refresh process.

NHS England also collaborated with Peer Power, a child’s voice organisation, to obtain relevant stakeholder feedback directly from young people with lived experience in secure settings, and this has been fed into the refresh.

“The update of these standards is a tremendously important piece of work that aims to standardise care for some of the most vulnerable children in our society,” RCPCH President Dr Camilla Kingdon said.

“These changes outlined today reflect a clear modernisation of this policy, and the true and real need to put children and young people at the heart of these standards – and making sure they are heard and listened to at all stages of their care.

“A significant addition to these standards is to reflect need and help ensure young people are supported with menstruation and gynaecological issues in a speedy way. This is essential to the well-being and empowerment of children and adolescents.

“I am also deeply heartened to see a specific focus on the emphasis of trusting relationships between children and secure setting staff. We know how significant a role staff play in the lives and future development on these children. Their work with these children is invaluable.

At any given time in England there are approximately 1,000 children and young people living in secure settings. These settings include young offender institutions, secure children’s homes, secure training centres and their equivalents. Children in these settings are some of the most vulnerable, often suffering poor physical and mental health.