Neglect: Professionals increasingly desensitised to warning signs as it has become normalised
Neglect has become ‘normalised’ as poverty has risen and community support for parents has decreased. However, too often it does not meet the threshold for intervention.
A report from the NSPCC warns that while neglect is one of the most common forms of maltreatment on Child Protection Plans, professionals ‘are frequently desensitised’ to the warning signs – simply because it has become ‘so widespread’.
The report, which has been written by Eavan Mckay, a senior policy officer at the NSPCC, also warns that the response from social care to referrals concerning neglect is too often ‘inadequate and slow’.
Furthermore, when incidents do not meet the threshold for intervention – which is set locally under Section 17 (Children's Act) – action is often simply not taken at all.
The study considers all forms of neglect, including physical, educational, emotional and medical. Children of school age who have experienced neglect are more likely to suffer mental health problems including depression, PTSD and panic disorders. Neglect can also increase the risk of other forms of harm, including child criminal exploitation.
The latest Child in Need data shows that neglect is one of the most common forms of abuse, featuring in more than 82 000 Child in Need assessments in 2022/23 (DfE, 2023).
The NSPCC report draws on evidence from 700 multi-agency safeguarding professionals as well as focus groups with social workers, teachers, police and healthcare professionals and evidence from the NSPCC Helpline. Its report paints a picture of children's services under immense pressure, which it says has led to increased thresholds and less spending on preventative work.
And while there is no direct link between living in poverty and neglect, poverty does heighten the risk for children because of its impact on factors like parenting capacity, housing, food and clothing.
The report states: ‘Children are experiencing neglect in the context of rising rates of poverty and a cost-of-living crisis which is making it harder and harder for many families, all the while resources to support them are at an all-time low. This combination is disastrous for children and families at risk of neglect.’
One teacher told researchers: ‘I see children living in absolute chronic poverty, who are hungry at times, whose clothes aren't clean and housing situation is dire. But that's not because of lack of information or education on the parents' part, it's that they're doing their very best with very limited resources.’
The report adds: ‘Across all agencies polled – healthcare, the police, children's social care and education – 54% said they'd seen an increase in neglect cases during their professional life with 90% saying they believed the rising cost of living and poverty rates was a driving factor and 76% saying a reduction in community support to parents was also a key factor in neglect increasing.’
The system seems to be so overwhelmed that many referrals are not being followed up adequately: ‘Professionals are frequently desensitised to warning signs of neglect as it is so widespread. When individual incidents don't meet the Section 17 threshold of harm for intervention, which is set locally, those polled told us action is often not taken. Referrals and assessments are made but, in the view of the professionals, they don't necessarily lead to adequate follow-up.’
Teachers taking part in the study in particular reported that they sometimes have to make multiple referrals to children's social care, often without receiving any follow-up information regarding the action taken – indeed 52% of the teachers polled said children's social care usually responded ‘slowly’ to neglect referrals with an initial assessment and 43% said early help interventions following assessments were also ‘slow to be put in place’.
Around 1 in 4 teachers (24%) felt that following a referral to children's social care, the appropriate action was ‘never or rarely taken’ to provide the necessary support for children and families.
The report concludes: ‘The slow pace of action are major challenges to tackling neglect.’
The report reveals that social care is much quicker to react to referrals needing a child protection response (44%) rather than those flagged as ‘early help’ (29%).
One teacher and designated safeguarding lead told researchers: ‘In our school we just feel like the response is not fit for purpose. We're flagging safeguarding concerns about neglect and, whether it be an early help response or a response from children's social care, it is frequently just not meeting the family's needs. From a school perspective, we feel like we're left holding the baby but we've got no resource.’
Teachers in the study were confident in their ability to identify neglect (98%). However, a key barrier identified in the report is that when neglect is the primary form of maltreatment it may not necessarily present as an individual incident that meets the threshold for serious harm: ‘Instead, it is often a patchwork of concerning lower-level reports built up over time to form a picture of cumulative harm. Neglect is a complex harm that requires a great deal of professional skill to assess its cumulative impact. For this reason, professionals in England are tasked with deciding when omissions in care reach the threshold of ‘persistent’ ‘serious harm’. This is difficult within a child protection system heavily skewed towards thresholds.’
The report calls on the new government to introduce a National Neglect Strategy with improved guidance for professionals.
It also wants neglect to be considered as part of the government's stated plans to address child poverty and the new Family Help model also needs to address neglect as part of its support services.
The report states: ‘To protect children from neglect, all agencies need the resources, skills and knowledge to play their part. Police officers regularly attend incidents where they encounter children who have been neglected and are living in circumstances that are harmful. Healthcare workers such as health visitors and midwives visit homes for postnatal appointments. And teachers see children more regularly than any other professionals – almost every day in school.’
The start of the new school year could lead to measles surge UK Health Security Agency warns
The UK Health Security Agency (UKHSA) issued an urgent call on the 29th of August to parents to ensure their children catch up on missed vaccinations before they head back to school amid fears of a further surge in measles cases as the new term begins.
The campaign, delivered by UKHSA in partnership with the Department for Health and Social Care (DHSC) and NHS England, will remind parents and carers of the risk of their children missing out on protection against serious diseases, including measles, whooping cough, meningitis, diphtheria and polio.
The call comes after a number of major measles outbreaks occurred in the 2023-2024 school year. Despite the launch of a wide-ranging MMR catch-up programme, uptake rates remain too low in some areas in England and there is still potential to see outbreaks, particularly as children start mixing more on starting or returning to school the UKSHA warns.
Davina Barrett, a mother from Walsall, has spoken of her shock at how seriously ill her baby was after catching measles. Three-month-old Ezra was rushed to hospital after developing a red spotty rash. Within a few hours, he was suffering breathing difficulties and developed pneumonia. Very young infants are at highest risk of severe illness and developing lifelong complications from measles, but they are not able to receive their first MMR vaccine until they are aged 1.
Davina is now urging parents to vaccinate their children against the disease and protect those most vulnerable like Ezra. Davina said: ‘We were so shocked at how bad Ezra got quite quickly. The rash spread rapidly and covered his entire body. Seeing him struggling to breathe and being hooked up to oxygen was awful. I had no idea measles could make babies so ill. Parents need to know that they are not just protecting their own child, but that the MMR vaccine could save the life of a baby like Ezra who is too young to have his own protection.
Measles can be nasty but it's entirely preventable.’
Minister for Public Health and Prevention Andrew Gwynne said: ‘Measles cases have spiked significantly in recent years and can spread quickly among those who are unvaccinated. It can be a serious and sometimes deadly disease. Vaccines are our best form of protection, and it is vital that children receive all their vaccinations.’
New iHV UK Preceptorship Framework for Health Visiting
The Institute of Health Visiting (iHV) has published a new iHV UK Preceptorship Framework for Health Visiting this week.
The framework was developed to recognise the higher levels of autonomy and specialist knowledge and skills that health visitors require, beyond their first level registration as registered nurses and registered midwives.
Amanda Holland, professional services lead at the Institute of Health Visiting and Author of the iHV Preceptorship Framework for Health Visiting said: ‘In the current climate, with many organisations experiencing significant challenges to recruitment and retention of a highly skilled health visiting workforce, we know high-quality effective preceptorship can be an important part of the solution.
For more information, visit: https://ihv.org.uk/
News in brief
Even light smoking of just 1–2 cigarettes a day either before or at any time during pregnancy is significantly associated with major health problems in the newborn new research published in the Journal of Epidemiology & Community Health has found. More information at: https://jech.bmj.com/lookup/doi/10.1136/jech-2024-222259
An overhaul of sex education is needed to combat sexual and gender-based violence (SGBV) according to a new study. The growing problem of sexual and gender-based violence within school and online environments demands immediate and transformative solutions, according to researchers from the University of Surrey, UCL and Bedfordshire. Setty et al argue for a radical shift in addressing SGBV through the concept of post-digital sexual citizenship. Read the study here: https://tinyurl.com/nhfum2tj
While the internet is a place where children can play, learn and connect with others, it can also put them at risk of abuse and harm. Knowing how to respond can be challenging. The NSPCC has published a new briefing using insights from Childline counselling sessions and NSPCC Helpline contacts to share the types of responses children receive after they have told someone about their experiences of online harm or abuse. Visit: https://tinyurlcom/2s3kc7fh