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Re: - Safeguarding referrals and clinicalsupervision

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Sounds absolutely superb. Guwande also seems to argue for a set of 5 items on a checklist. V interesting.

I shall follow up all these references you are providing -- out of sheer interest!

Thank you,

Diane

Re: - Safeguarding referrals and clinical supervisionDear Diane,I like his writing too. His approach is based on aircraft safety checklists and it provides a good mnemonic for those days when you're distracted and don't have time to talk yourself through processes. But some of the checklists we've seen for child protection use are big, wobbly consensus-based things (bit like those Framework documents, or even the old Orange Book) where you find every conceivable aspect included and there's no way to make sense of it. We want to make practice easier and safer, not hit practitioners round the head with more wodges of paperwork.I tend to favour actuarial approaches so that the checklists don't just stretch into infinity and practitioners get fed up with them. If the problems you're highlighting are the most important risk factors and there's decent empirical evidence for choosing them, I think it helps you get the most salient points across and keep focused. No wodges!Snag is, we don't collect any data in the UK, neither in nursing nor health visiting nor social services. So we've got limited UK empirical stuff to base checklists on. I liked Browne's approaches, but it was so laborious to do from scratch and took so long to refine, so that one would probably have to start by using some of the better US models from Baird and Wagner in Illinois and then use UK data to modify over time. It means you're making assumptions that people in the US would tend to maltreat children when faced by the same psychosocial pressures and weaknesses that would affect UK parents, but we've kind of taken that for granted since Kempe anyway.H

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