Was not brought
Why worry about missed appointments?
Missed healthcare appointments are the most common reason for dentists to make child protection referrals. They cause concern because they:
- may be an alerting feature that a child or young person is being neglected
- are often found when a child has died or been seriously harmed by maltreatment, when a ‘serious case review’ is conducted
- should be followed up rigorously but that isn’t always easy to do
‘Was not brought’, rather than ‘Did not attend’ matters
Describing children and young people (CYP) as ‘Was not brought’ (WNB) instead of ‘Did not attend’ (DNA) encourages us to think about the situation from the child’s perspective and potentially take action to safeguard them.
Please download our guide:
Implementing 'Was not brought' in your practice and use 'Was not brought' in your practice.
Expectations for training
The following guidance gives a dental specific summary of the expectations for training from the Royal College of Nursing on the roles and competencies for safeguarding adults, children and young people .
These roles and competencies apply to both NHS and private providers in all settings in which dentistry is practised.
All new starters should have a mandatory safeguarding introduction (children and adults) for a minimum of 30 minutes within the first six weeks of taking up the post.
In general practice, for adults, children and young people:
Dentist inc
orthodontists |
Person with Specific safeguarding responsibilities |
Hours of refresher training over 3 years: |
Level 2
| Level 2
| minimum 4 hours + annual review of competencies |
Practice Manager |
Receptionist and other non-clinical staff |
Hours of refresher training over 3 years: |
Level 2
| Level 2
| minimum 2 hours + annual review of competencies |
The majority of dentists and dental care professionals will require level 2.
In larger organisations, including hospitals and community-based specialist services (special care dentistry, paediatric or other relevant dental specialties such as orthodontics) the precise number of dentists and dental care professionals requiring level 3 competencies should be determined locally based on an assessment of need and risk.
Under these circumstances, the following levels are required:
Practice Manager | Receptionist and other non-clinical staff |
Hours of refresher training over 3 years: |
Level 2
| Level 2
| minimum 2 hours + annual review of competencies |
Dentist with specific role in safeguarding | DCP with specific role in safeguarding |
Hours of refresher training over 3 years: |
Level 3
| Level 3
| minimum 8 hours + annual review of competencies |
CPD, References and resources
Child protection/ adult safeguarding training
|
Safeguarding Level 1 and 2. Training to help members of the dental team understand the importance of safeguarding, enable them to identify the signs of abuse and neglect and provide them with the tools to appropriately respond to concerns.
4 hours CPD, development outcomes A, B, C, D
|
Advice | Safeguarding patients
|
Expert templates | Template policies
|
BDJ articles |
Adult safeguarding; guidance for dental professionals
Development and evaluation of a 'was not brought' pathway: a team approach to managing children's missed dental appointments Do you see what I see? Identification of child protection concerns by hospital staff and general dental practitioners
Establishing comprehensive oral assessments for children with safeguarding concerns Guidance: Lost in translation Infant oral mutilation – a child protection issue? The Scottish dental practitioner's role in managing child abuse and neglect
|
Guidance
|
Implementing 'Was not brought' in your practice - a guide (pdf)
Adult safeguarding: roles and competencies for health care staff (intercollegiate document first edition 2018)
Child maltreatment: when to suspect maltreatment in under 18s (Clinical Guideline 89)
Child abuse and neglect (Nice Guideline 76)
Safeguarding children and young people: Roles and competencies for healthcare staff (January 2019)
Safeguarding vulnerable people in the reformed NHS (NHS England, July 2015)
Standards for the Dental Team. GDC, 2013
Working together to safeguard children (Statutory guidance on inter-agency working, 2018)
|
NSPCC
| We are a member of the
NSPCC Health Liaison Committee. This multi-organisation group discusses child protection issues within the healthcare setting and shares best practice for safeguarding children.
Other members of the group are British Medical Association, British Society of Paediatric Dentistry, Department of Health, Royal College of GPs, Royal College of Paediatrics and Child Health, Royal College of Pathologists, Royal College of Psychiatrists, Royal College of Midwives, and the Royal College of Nursing |