Title:
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Safeguarding children in primary care : a critical review of the role of the prime worker : necessity or luxury?
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The Laming Report in 2003 criticised organisations including the health service,
for what appeared widespread organisational malaise and a failure of good basic
practice in respect of safeguarding children.
This study set out to answer the research question of how. staff should be
supported within primary health care teams in relation to safeguarding children. It
sought to gain an organisational perspective on the value of the existing role of a
lead professional for child protection and to identify and compare other similar
models. The direction for this study stemmed from a Policy Analysis and Service
Development Project as precursors to this study and _part of a Professional
Doctorate programme.
The study took place during 2004-2007 in a PCT in the UK, within a context of
prolific organisational and policy change.Q-methodology was selected -as the
most appropriate way to systematicaliy examine subjective data, illuminate
different viewpoints and perceptions, and to 'hear many voices'. This approach
allowed apparent chaos of the Prime worker role to be explored in depth through
generation of the concourse, the Q-sort and through the discourse generated. A
purposive sample for the Q-sort included ten people within the organisation and
wider stakeholders who had a key strategic role and influence on child protection.
Interviews were undertaken with a Government Policy Advisor and a PCT
Director, and an on-line GP discussion group sought to explore different aspects
of the findings.
An inductive approach to analysis was undertaken in order to discover factors and
themes emerging from the data. Descriptive statistical analysis prOVided initial
data reduction and demonstrated significance in the Sorting. All discourse from
the sort process and interviews were taped and transcribed by the researcher to
support data immersion. A manual method of coding was employed.
From the themes emerging from this study, a number of building blocks that
contribute to the facilitation of child protection systems in primary care have been
identified. These include the importance of meta communication (how
communication is communicated), the need for the PCT to support GPs in
developing their role in safeguarding, the importance of the PCT leading
innovation and a consensus as to the value of a lead professional for child
protection within primary care (Prime worker). This study also identified concerns
about the perceived impact of competing government policy on child protection
systems and networks. Recommendations have been made that include the nPCT
supporting and developing the Prime worker role in all GP Practices across the
County.
The researcher proposes the Q-sort method is a useful and reliable method for
liberating opinion in a politically charged area where senior staff may be reluctant
to express personal views and subjective opinion.
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