Background Peer review and reflective supervision were to be introduced and evaluated across two sites of an NHS Trust. Within the educational literature was evidence that participants may become more peripheral within a community of practice (Fuller and colleagues, 2005; Lave and Wenger, 1991).
Aim To determine if access to regular peer review and reflective supervision support or inhibit paediatricians’ ongoing participation in safeguarding?
Methods Alternating sessions of peer review and reflective supervision planned at each site, during clinical governance sessions, for a six months period from May/June to November/December 2014. Data on safeguarding activity were gathered retrospectively at the end of the service evaluation for the period April 2014 to March 2015. Capture-recapture technique was used to determine the completeness of ascertainment.
Results Paediatricians were not able to access the planned peer review and reflective supervision (Stewart, 2015) so the influence of these on participation cannot be determined. However, at site 1, for physical abuse and neglect assessments, 60 children were identified through the outpatient database and the 59 from the report database. 55 were common to both databases. The capture-recapture confirmed that the total number of cases as 64 (95% CI as 63.1 to 65.5). The participation in physical abuse and neglect assessments is given below.
53 children were seen for child sexual abuse assessments. All were identified through the outpatient database and 49 were identified from the report database. The participation in child sexual abuse assessments are given below.
Data on safeguarding work at site 2 showed that sixty-three children were seen for child protection assessments. Data about who completed assessments were available for only 16 children. The numbers are small but every consultant paediatrician completing clinical work, at site 2, had seen at least one child.
Conclusion Before, peer review and reflective practice had been established, there were paediatricians who were peripheral participants in this community of practice. It has been proposed that workstreams are reviewed to support all community and general paediatricians’ participation in planned child protection assessments to maintain and evidence their safeguarding competences.
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