The Royal National Orthopaedic Hospital (RNOH) is committed to putting the service user and carer at the centre of everything we do and strives to improve patients' and service users' experience of our service.

The Trust takes all issues of abuse or neglect of adults at risk and children very seriously. It is committed to dealing with them effectively to minimise the risk of harm to all its service users, including those who are at risk of domestic abuse.

The Children Acts of 1989 and 2004 set out the specific duties for local authorities, working with partner organisations and agencies, to safeguard and promote the welfare of all children in their area. The Children and Social Work Act 2017 strengthens this already important relationship by placing new duties on key agencies in a local area.

All practitioners should follow the principles of the Children Act 1989 and 2004 – that the welfare of the child is paramount.

Working Together to Safeguard Children (2018) is the statutory guidance covering the legislative requirements placed on individual services.

Working Together defines safeguarding and promoting the welfare of children as:

  • Protecting children from maltreatment
  • Preventing impairment of children’s health or development
  • Ensuring that children grow up in circumstances consistent with the provision of safe and effective care
  • Taking action to enable all children to have the best outcomes

Abuse is a form of maltreatment of a child. Somebody may abuse or neglect a child by inflicting harm, or by failing to act to prevent harm. Children may be abused in a family or in an institutional or community setting by those known to them or, more rarely, by others. Abuse can take place wholly online, or technology may be used to facilitate offline abuse. Children may be abused by an adult or adults, or another child or children.

Abuse can include one or more of the following:

  • Physical Abuse: A form of abuse which may involve hitting, shaking, throwing, poisoning, burning or scalding, drowning, suffocating or otherwise causing physical harm to a child. Physical harm may also be caused when a parent or carer fabricates the symptoms of, or deliberately induces, illness in a child.
  • Emotional Abuse: The persistent emotional maltreatment of a child such as to cause severe and persistent adverse effects on the child's emotional development.
  • Sexual Abuse: Involves forcing or enticing a child or young person to take part in sexual activities, not necessarily involving a high level of violence, whether or not the child is aware of what is happening.
  • Neglect: The persistent failure to meet a child's basic physical and/or psychological needs, likely to result in the serious impairment of the child's health or development.
  • Child sexual exploitation: Is a form of child sexual abuse and occurs where an individual or group takes advantage of an imbalance of power to coerce, manipulate or deceive a child or young person under the age of 18 into sexual activity.
  • Extremism: Extremism goes beyond terrorism and includes people who target the vulnerable – including the young – by seeking to sow division between communities on the basis of race, faith or denomination; justify discrimination towards women and girls; persuade others that minorities are inferior; or argue against the primacy of democracy and the rule of law in our society.
  • FGM (Female Genital Mutilation): FGM involves procedures that involve total or partial removal of the female external genitalia or other injuries to the female genitalia for non-medical reasons. Predominantly carried out on young girls, it is considered child abuse and is illegal in the UK.

Safeguarding Children Executive Lead:
Louise Morton, Chief Nurse

Deputy Lead for Safeguarding and Staff Allegations
Mercy Wasike, Deputy Chief Nurse

Named Nurse Safeguarding Children:
Christina Kelly: 020 8909 5337 

Specialist Advisor Safeguarding Children:
Anne Byrne: 020 8909 5337 

Named Doctor Safeguarding Children:
Dr Sherine Dewlett: 020 8909 5386

Safeguarding Administrator:
Jack Lo /Dupe Dalmeida: 020 3947 0100

The Royal National Orthopaedic Hospital (RNOH) is committed to protecting and safeguarding children and young people and has taken all reasonable steps to promote safe practice and protect children and young people from harm, abuse and exploitation.

The safety and welfare of children and young people who come into contact with our services either directly or indirectly is paramount and all staff have a responsibility to ensure that best practice is followed, including compliance with statutory requirements. The Trust Board are committed to ensuring that RNOH practitioners are enabled to children and support families they work with, in partnership with local agencies and are engaged in the work of the Harrow Safeguarding Children Board (HSCB).

Governance and assurance: The Director of Nursing is a Board Level Executive Director with specific responsibility for safeguarding children. This includes accountability for ensuring the Trust employs robust audit processes, ensuring safeguarding children practices are efficient and effective. The Executive Director is the identified Trust named (senior) individual who attends the Harrow Safeguarding Children Board, and nominated individuals attend their committees.

The Trust Board takes its statutory responsibility for safeguarding children seriously and receives a Safeguarding Children annual report, monthly reports and exception reports as required. The Safeguarding Committee meets bi monthly and reports to the Quality Committee a sub-committee of the Trust Board.

The Trust has an identified Named Nurse Safeguarding Children (1.0WTE), Named Doctor Safeguarding Children (2PA’s) and Safeguarding Children Advisor (1.0WTE). The Named Professionals are clear about their roles, have sufficient time to dedicate to safeguarding, and receive relevant support, supervision and training to undertake their role. This includes close liaison with other social and health care organisations.

Recruitment and employment practice: The Trust ensures it has safe recruitment practices in place, meeting legislative and regulatory standards, which includes the statutory requirement with regard to the carrying out of Disclosure and Barring (DBS) and referral to the Independent Safeguarding Authority (ISA). There is a Whistleblowing Policy and Managing Allegations Policy.

Training: It is a mandatory requirement that all staff at the Trust attend safeguarding children training relevant to their role and responsibilities. In line with national guidance (Safeguarding Children: Roles and Competencies for Health Care Staff 2014) the RNOH ensures that all staff undertake safeguarding children training, appropriate to their role and level of responsibility. This is monitored monthly.

Safeguarding children policy and procedures: The Trust ensures it has policies and procedures in place to protect children which reflect national recommendations. These policies are regularly reviewed and updated and monitored by the Safeguarding Committee.

Missed appointments: The Trust has a process in place for following up children who miss outpatient appointments to ensure their care, and ultimately their health, is not affected in any way. In addition, the Trust has a system in place for flagging children for who there are safeguarding concerns.

Professor Paul Fish
Director of Nursing, Quality and Patient Experience
Executive Lead for Safeguarding
August 2018