Trusting relationships underpin health standards for secure settings
Emily Harle
Monday, April 24, 2023
Healthcare standards in secure welfare and justice settings have been updated to place a greater focus on providing vulnerable children with trusting relationships.
The standards, first published in 2013 and last updated in 2019, help healthcare professionals, including commissioners, service providers and regulators, to improve the health outcomes of children in secure settings.
The refreshed guidance includes a new standard which advises that every child must have access to a trusted member of staff who they can go to with concerns relating to their safety or wellbeing within a setting, and who understands the appropriate routes for reporting such issues.
Another new standard has also been introduced to ensure that healthcare staff work collaboratively with the child to support them to communicate their views, wishes and feelings, which should be taken into consideration by healthcare professionals to ensure informed decisions are made in the best interests of the child.
Other additional new standards advise:
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Children should be informed in an age and developmentally appropriate way about the setting’s constant care and supervision practices.
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Healthcare staff should understand the value of health promotion activities as essential to children’s health, and actively engage with children in them.
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Support should be given to children in the setting to ensure good menstrual health, including education on the menstruation cycle and support to access sanitary products. The standards add that children should be supported in managing symptoms of menstrual health problems, and recieve prompt access to treatment for gynaecological health issues.
Existing standards have also been updated – several have been strengthened to include suicidal ideation or intent as a reason for intervention.
Standards outlining restraint and supervision procedures have been updated to align with current best practice.
The refresh was led by Health and Justice NHS England, alongside an expert reference group of clinical and non-clinical professionals including commissioners, providers and national bodies.
Young people with experience of secure settings also fed into the updates, through a collaboration with child’s voice organisation Peer Power Youth.
Dr Camilla Kingdon, president of the Royal College of Paediatrics and Child Health, said the changes reflect the “true and real need to put children and young people at the heart of these standards”.
“I am 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.”
Speaking at the launch event for the standards, Nicola Kidston deputy chief executive and head of programmes at Peer Power Youth, said: “We are very pleased that the refreshed standards are reflective of the young people’s views at Peer Power Youth. We are particularly pleased with the new standard that ensures that healthcare staff work collaboratively with the child to support them to communicate their views, wishes and feelings."
In the foreword for the standards, Children’s Commissioner for England Rachel de Souza added: “I am particularly pleased in these refreshed standards to see the emphasis on trusting relationships, as time and again the children I speak to in secure settings tell me that it is the quality of the relationships they have with those caring for them that make all the difference.”
