THE county’s School Nursing Service (SNS) became “untenable” in trying to manage an increasing number of  children subject to child protection plans – most of whom were already in the care of other health professionals.

Work to identify the number of children served by two or more care sources is starting to ease the strain on SNS with new referral criteria applying since December.

A report prepared for Wye Valley NHS Trust confirms that the county’s high child protection workload continues to place “increasing pressure” on a number of health services.

This pressure manifested itself in increased attendance at meetings, case report writing, child protection medicals and health assessments and more safeguarding supervision.

In another example, the Integrated Sexual Health service (ISH) escalated a safeguarding risk to “major/possible”  citing insufficient  staff to manage the increasing vulnerabilities its team was seeing.

ISH has a key role in identifying children at risk of sexual exploitation and the sharing of data related to potential perpetrators.

As at the end of March, 269 children were in care in the county – up from 242 at the same time last year.

Nearly 200 county children were on specific child protection plans at the end of March, a figure that represented a decrease that only occurred at the end of the financial year – previous levels having been significantly higher.

Neglect, specifically chronic neglect, makes up much of ongoing caseload work.

Over the past year, SNS emerged as a particular concern  with the service said to have “untenable”  given the demands posed by child protection.

SNS undertook a detailed analysis of its safeguarding caseload to identify the most appropriate provider of care to individual children.

The analysis highlighted some children as receiving services from a number of health care professionals and not needing specific school nursing services.

From this analysis, a new referral criteria was launched to link children  to the most appropriate service.

Since the application of the new criteria in December the SNS caseload has significantly reduced.

But the report concedes that it is still “early days” with further work needed embed the change.

Earlier this year, the government lifted the intervention notice served on Herefordshire Council’s child protection services, recognising improvements made to child protection practice in the county since the “inadequate”  finding by Ofsted in 2012.

Last year, Ofsted returned to record substantial progress being made.

Related reports cite a “new found confidence” within the service given “added impetus” to the progress being made.

The council wants to see the service graded “good” by 2016/17 but, from the frontline up, it is accepted that there is still some way to go.

Improvements are said to be not yet fully embedded and the staffing situation remains relatively fragile, though its reliance on agency appointments is easing.

As reported by the Hereford Times, permanent staff appointments are a priority with the council ready to pay “London rates” to recruit child safeguarding specialists.

Last year, the number of contacts with child safeguarding rose as high as 747 in July to drop to 421 by December – the latest available figure.

Over December, 10 children were put on to child protection plans, with another 29  on a protection plan for a second or subsequent time with primary factors being domestic abuse, drug misuse, and mental health issues within families.

Over recent years, the number of children on specific protection plans in the county has hovered around 200 at any one time.

Individual safeguarding caseloads are now said to be manageable and averaging at 16, but there is variance between – and within – teams.

As a result of improvement initiatives, the service has had a number of legacy cases to assess.