Table 1: Vulnerabilities and Risk Factors for CSE Vulnerabilities for CSE include: Abuse or neglect by parent/carer/family member History of Authority care Family history of domestic abuse Family history of substance misuse Family history of mental health difficulties Breakdown of family relationships Low self esteem Learning difficulties in the or young person Moderate Risk Indicators include: Staying out late Multiple callers (unknown adults/older young people) Use of a mobile that causes concern Expressions of despair (self-harm, overdose, eating disorder, challenging behaviour, aggression) Sexually transmitted infections Drugs misuse Alcohol misuse Use of the Internet that causes concern Unsuitable/inappropriate accommodation (including street homelessness) Isolated from networks Lack of a positive relationship with a protective/nurturing adult Exclusion from school or unexplained absences from or not engaged in school/college/training Living independently and failing to respond to attempts by worker to keep in touch Significant Risk Indicators include: Periods of going missing overnight or longer ‘boyfriend’/relationship with controlling adult Physical/emotional abuse by that ‘boyfriend’/controlling adult Entering/leaving vehicles driven by unknown adults Unexplained amounts of money, expensive clothing or other items Frequenting areas known for on or off street sexual exploitation Physical injury without plausible explanation Disclosure of sexual/physical assault followed by withdrawal of allegation involved in clipping (receiving payment in exchange for agreement to perform sexual acts but not performing the sexual act) or sexual exploitation
Sexual Exploitation (CSE) Prevention Strategy for the NHS in 2016-2018 ACTION PLAN PREPARE OBJECTIVE 1: A range of organisational arrangements with strategic leadership and accountability will be put in place to evidence the effectiveness of the strategy and inform perpetual improvement Priority Action How we will do it? Who will do it? By when? How will we know? Strategic leadership and accountability in Health organisations Evidence of implementation of CSE strategy Health Boards and NHS Trusts will have an identified CSE Lead within their safeguarding structure Priority services recognise their role in protecting children and young people at risk of CSE Safeguarding quality assurance and reporting systems to include CSE Health Boards and NHS Trusts 2016-17 Organisational arrangements in Audit of CSE referrals across Health Boards and NHS Trusts to identify gaps Health Boards and NHS Trusts Safeguarding Annual Report CSE outcomes incorporated into Safeguarding Children Quality Outcomes Framework Annual review of NHS Wales CSE Prevention Strategy and Action plan to ensure up to date with new developments NHS Wales Safeguarding Network 2017-18 Safeguarding Children Quality Outcomes Framework Review and revision of NHS Wales CSE Prevention Strategy and Action plan NHS Wales Safeguarding Network 2018-19 Updated NHS Wales CSE Prevention Strategy and Action plan
OBJECTIVE 3: Continued... Priority Action How we will do it? Who will do it? By when? How will we know? Validated risk assessment framework for use by health professionals (see Objective 6) Child sexual exploitation is included in safeguarding training of health professionals Network involvement in Welsh Government review of SERAF Research into adaptation of SERAF for use across different health settings consistent with WG review of SERAF to include: 1. Identification of best available risk assessment framework to be used in health 2. Consultation with CYP re acceptability of risk NHS Wales Safeguarding Network 2016-17 Report to NHS Safeguarding Network Risk assessment framework identified Scoping exercise of curriculum content in undergraduate training in relation to understanding the needs of young people, communication with young people and safeguarding issues that impact on young people NHS Safeguarding Network 2018-19 Scoping exercise presented to Network
PREVENT OBJECTIVE 4: Health professionals in who work with families, children and young people will promote healthy interpersonal relationships to ensure children attain their health and development potential Priority Action How we will do it? Who will do it? By when? How will we know? Delivery of effective universal and selective primary prevention in relation to CSE NHS Wales Safeguarding Network acts as an advocate for the needs of children and young people at risk from CSE Universal primary prevention: Identify the reporting processes of the effectiveness of current health promotion programmes to promote healthy and safe relationships from cradle to grave delivered by universal health services work with children, young people and their families (Healthy Child Wales programme, Building a Brighter Future: early years and childcare plan 2013-23) Network recognised and influences new policy relevant to safeguarding CYP in the NHS e.g. provision of adolescent friendly health services for young people Network advocates for the inclusion of CSE prevention in the policy and delivery of health promotion programmes Health contribute to multi agency work to promote healthy relationships and prevent CSE (United in Improving Health, partnership working to improve health outcomes in Wales) NHS Wales Safeguarding Network NHS Safeguarding Network Health Boards and NHS Trusts NHS Wales Safeguarding Network Report to Network Evidence of contribution to relevant consultations