Source: Royal Collage of Paediatrics and Child Health (RCPCH) published on this website Wednesday 26 November 2025 by Jill Powell
Intoduction to the updated document Intercollegiate document (2025) Safeguarding children and young people & children and young people in care: Competencies for health care staff published November 2025
‘Health care staff in every service recognise the necessity to protect people with increased vulnerabilities and those in need of safeguarding. There is a moral, professional, and statutory duty of care. Being able to do this effectively is built upon a structure of personal knowledge, skills and competence, and access to health care staff with appropriate expertise and strategic leadership.
The safeguarding remit encompasses protection of a person’s health, wellbeing and human rights, enabling them to live free from harm, abuse and neglect. Health care professionals need competencies to navigate a range of situations. From support and acknowledgement of need – including for adults, child protection for Children and young people, and responsibility for children and young people in the care of a local authority/council/health and social care trust. Children in care and young people are protected by separate legislation, processes, outcomes, workforce, and leadership.
This 2025 revision incorporates a review and update of two documents – the intercollegiate knowledge, skills and competencies for Safeguarding Children and Young People: Roles and Competencies for Health Care Staff (2019) and Looked after Children: Roles and Competencies for Health Care Staff (2020). The principles of equity, inclusion, listening to the voice of the child, and considering a four nations approach were used in the development of this competency framework.
Accepting the range of the safeguarding responsibility and circumstances, the safeguarding children and looked after children competence frameworks have been combined in this Inter-Collegiate Document (ICD). This is for ease of reference and to raise the expectation of capability when providing services for children in care. Each area of practice is recognised as important and complex. As such, different competencies, separate job roles and leadership are required.
When children in the care of a local authority/council/health and social care trust are discussed, different terminology is used, and this is echoed across the four nations. This reflects preferences described by representations from the children themselves and a determination to use ‘child-first’ language. The authors have agreed to use the term “children and young people in care”. However, where specific quotes, references, legislation are included, or when referring to previous iterations of the competency guidance, the term ‘looked after children and young people’ is used.
When the term ‘children and young people’ is used, this refers to everyone up to their 18th birthday, as this is the United Nations Convention on the Rights of the Child definition of a child, and when safeguarding transfers from child to adult services. The definition also applies when an individual in need moves from being a child to adult, or when “children in care” become “care leavers”. Services that meet the needs of children and young people need to match with adult care services seamlessly, so the transition is timely and supportive.
These competencies should be considered when ensuring all Health care staff have the continuing professional development that they need to keep children and young people safe and understand the specific needs of children and young people in care. The rights of a child or young person to have assessments and processes explained in a developmentally appropriate way, in a language of their choice or in the different way they access communication is fundamental. A trauma-informed approach/practice and understanding the impact of adverse childhood experiences should be embedded within all training and subsequent delivery of care.
Each health care staff group and individual will need to adapt and review their own learning needs. Competencies can be achieved via training and experience, and an adult learning approach is needed to embed these topics in day-to-day delivery, continuing professional development, and appraisal. There are specific roles within services for children and young people in care and safeguarding children and young people which require clinical expertise and skills – child protection medical assessments, including CSA (child sexual abuse) and Initial and review health assessments which are a statutory duty for children and young people in care.
A few of the behaviours, knowledge, skills and competencies described may not be applicable to all staff roles, services or organisations. The guidance is not statutory, and health care providers have a responsibility to ensure that the duration and frequency of training (alongside the identified syllabus) is appropriate for the staff and the children and young people they support.
The competence levels are not limited to the suggested staff groups. Therefore, organisations should ensure that training is allocated to staff based on level of contact and involvement with the individuals they support.
Everything health care staff do can have an impact on children and young people. Knowledge, skills, behaviours and competence allows staff to recognise and act to safeguard children and young people, and to ensure we work in a system that values and prioritises their needs.
