Erewash PCN: Using a Shared Record Across Primary Care, Urgent Care and Community Services to Identify Hidden Safeguarding Concerns
The Challenge of Identifying Hidden Risk
“The challenge wasn’t identifying children already known to safeguarding services – it was identifying those who weren’t.
We wanted a way to spot hidden concerns before they became visible to everyone else, and that’s where the power of SystmOne’s shared record became clear.”
Claire Thompson, Children’s Safeguarding Care Coordinator, Erewash PCN
Serving a population of more than 102,000 patients across nine GP practices, Erewash PCN wanted to move from a reactive safeguarding model to a proactive one.
While children already known to safeguarding services can be identified through Child Protection Plans, Child in Need plans and safeguarding alerts, identifying hidden safeguarding concerns is far more challenging. Information already exists across general practice, urgent care, health visiting and community services, but potential concerns can remain hidden when interactions are viewed in isolation.
Erewash PCN wanted to use inbuilt reporting to proactively identify children who may require review, bringing together information from multiple services to reveal patterns that may otherwise go unnoticed.
Creating a Consistent Approach to Safeguarding
Using SystmOne, Erewash PCN developed a suite of safeguarding reports that were deployed across all nine practices within the PCN, creating a consistent methodology for identifying children who may require additional support.
Identifying Children for Review
“The real value of SystmOne lies in its shared record.
By bringing together information from primary care, urgent care and community services into one place, it provides a complete picture of a child’s interactions across the NHS, helping us identify concerns that might otherwise go unnoticed.”
Julie Beardsall, Children’s Safeguarding Care Coordinator, Erewash PCN
The reports draw together information including:
- Number of domestic violence notifications recorded over the previous 12 months
- Three contacts within three months with services such as A&E, NHS 111 and Out of Hours providers
- DNA and Child Not Brought events within the previous three months across services such as CAMHS, Drug and Alcohol Services, Continence Services, Physiotherapy and Health Visiting
- Elective Home Education records
- Whether a child is currently subject to safeguarding alerts, has historical safeguarding alerts, or has no safeguarding alerts in place
Using NHS numbers and event dates, report outputs are brought together into a single view of a child’s contact across NHS services over time. This enables safeguarding teams to identify patterns and trends that would not be visible when reviewing individual services in isolation.
Reviewing and Escalating Concerns
Children meeting agreed thresholds are reviewed through safeguarding MDT meetings involving Children’s Safeguarding GP Leads, Children’s Safeguarding Care Coordinators and Health Visitors, Safeguarding Leads of local schools and local PCSO’s.
As part of the review process, checks are undertaken to establish whether there is any current or historical social care involvement before decisions are made regarding intervention, referral, ongoing monitoring and engagement with other agencies.
The reports identify children for review, while the MDT determines the appropriate action. Applying the same methodology across all nine practices ensures safeguarding is reviewed consistently, regardless of which practice a child attends.
Reports have been configured as local reports, enabling Children’s Safeguarding Care Coordinators and practice teams to access them directly when required, supporting collaborative working and enabling concerns to be reviewed and escalated quickly.
The Shared Record Advantage
The reports identify children for review, but it is SystmOne’s shared record that provides the context needed to identify risk.
Information from primary care, urgent care, community services and wider partner organisations can be viewed together within a single record, allowing safeguarding teams to identify patterns that may not be visible to individual services. Many of the services contributing to the reports would not ordinarily review each other’s interactions with a child.
While interoperability can exchange information between systems, it cannot replicate multiple services contributing directly to and working from the same patient record. That shared record is what makes this approach possible.
Improving Outcomes
Although safeguarding outcomes can be difficult to quantify, the initiative is already helping practices identify children who may otherwise have remained below the threshold of concern and supporting earlier intervention where risks are emerging.
Key benefits include:
- Earlier identification of vulnerable children by bringing together information from multiple NHS services and highlighting patterns that may not be visible within a single organisation.
- More proactive safeguarding interventions, enabling concerns to be reviewed and escalated before risks become more significant or social care involvement is already established.
- Greater consistency across practices, with all nine Erewash PCN practices using the same methodology to identify and review potential safeguarding concerns.
- More focused MDT discussions, helping safeguarding teams concentrate on children with emerging risks rather than those already receiving extensive support through established safeguarding pathways.
- Improved collaboration between services, supported by a shared record that provides a broader understanding of a child’s interactions across primary care, urgent care and community services.
- Significant time savings, reducing the need for manual patient-by-patient record reviews by using automated reports and data analysis to identify children requiring further review.
The most important outcome has been improved patient safety. By transforming isolated interactions into meaningful intelligence, the approach helps ensure vulnerable children are identified earlier and receive the support they need before concerns escalate.
When the Full Picture Becomes Visible
“SystmOne is helping us move from a reactive to a proactive safeguarding model, giving us the insight to identify vulnerable children earlier and the opportunity to ensure support is in place before concerns escalate.”
Claire Thompson, Children’s Safeguarding Care Coordinator, Erewash PCN
A recent case involved a child which through the reports was identified as having several A&E attendances, a number of DNA’s for hospital appointments and a recent discharge letter held on file from their Dental Practice.Â
Viewed independently, neither service had identified a safeguarding concern.
Contact was then made with the child’s school and further safeguarding concerns were shared. School and the local PCSO then attended the practice MDT through having a bigger picture for the child that they were possibly at risk of exploitation (CRE).Â
A plan was then agreed with stakeholders and a lead professional identified and subsequent referrals to the CRE and Children’s Social Service team made. Â
The concern was identified not because more information was available, but because information from multiple services could be understood in context through a shared record.
Lessons for Other Practices
This initiative demonstrates that valuable safeguarding intelligence already exists within routine healthcare interactions. The challenge is bringing that information together in a way that allows patterns to be recognised and acted upon.
The combination of a shared record, targeted reporting and multidisciplinary review enables organisations to move from a reactive safeguarding model to a more proactive one, helping ensure vulnerable children are identified earlier and receive support sooner.
Importantly, the approach is scalable and repeatable, providing a consistent methodology that can be adopted across practices while supporting local safeguarding processes. By bringing together information that would otherwise remain disconnected, it helps make hidden safeguarding concerns visible before they escalate.