Significant concerns about safeguarding of outpatients at Northern Ireland’s main hospital trust have been escalated to the organisation’s chief, a watchdog said.
Shortcomings in the training, knowledge and awareness of staff at the Belfast, Health and Social Care Trust were identified.
The safeguarding concerns did not surround allegations of physical or mental abuse, like at Muckamore Abbey, but more systemic flaws like not following up missed appointments.
The Regulation and Quality Improvement Authority (RQIA) conducted a review focused on neurology following the suspension of Belfast neurologist Dr Michael Watt, but also including other specialisms.
We could not be confident that safeguarding matters would be recognised or actioned appropriately in the context of outpatients services delivered across the Belfast TrustRQIA
It said: “Overall, the levels of training, knowledge and awareness of staff across outpatients’ services in relation to safeguarding were a significant concern for the expert review team.
“We could not be confident that safeguarding matters would be recognised or actioned appropriately in the context of outpatients’ services delivered across the Belfast Trust.”
The matter was escalated by RQIA’s medical director to the Belfast Trust’s chief executive Dr Cathy Jack and relevant executive directors.
The Belfast Trust has since met with senior RQIA staff to discuss the implementation of a targeted action plan to address the findings.
The trust is a regional centre for many treatments in Northern Ireland and is by far the largest of the regional health authorities.
It said the regulator’s review raised challenges but it was actively working to establish the recommendations put forward to ensure its service produced the best outcomes for patients.
It has always been our view that health and social care should be adaptable with patient care at its heartBelfast Health and Social Care Trust
“In addition to this work, we continue to liaise closely with the Department of Health as the review into neurology services continues and other health and social care transformations are considered.
“It has always been our view that health and social care should be adaptable with patient care at its heart.”
The trust has worked closely with the regulator to implement safeguarding measures for patients attending outpatient services.
This includes the appointment of dedicated safeguarding liaison nurses who will support the clinical outpatient teams.
The trust initially reported that the majority of relevant staff at the Royal Belfast Hospital for Sick Children had completed appropriate safeguarding training.
The RQIA said: “During unannounced inspections of the Royal Belfast Hospital for Sick Children, undertaken as part of this review, our inspection team found many examples of staff who had not been trained to level two and staff who could not identify when they had last completed their training in safeguarding of children.”
During engagement with trust managers and frontline staff across outpatients services, the team found it difficult to evidence a culture of safeguarding.
It added: “Staff we spoke to indicated that they had undertaken safeguarding training, but despite this we found inconsistencies in their knowledge of local safeguarding arrangements.
“Across adult and children’s outpatients services in the trust we found that staff were often unclear about the common signs or signals of a potential safeguarding concern, and were also unclear about the common triggers that could or would require escalation.
“Consequently, the expert review team was not assured that safeguarding concerns would be appropriately identified, reported or escalated within outpatients services across the trust.”