National Escalation Protocol for Issues from Safeguarding Adults Reviews from Safeguarding Adult Boards (2021)

The National Network for Chairs of Safeguarding Adults Boards covers England and Wales, Northern Ireland, the Channel Islands and the Isle of Man.

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This is the 2021 version of the National Escalation Protocol. The latest revised version of the National Escalation Protocol for issues from Safeguarding Adults Reviews (SARs) from Safeguarding Adult Boards (SABs) is available to read on the National Network of Chair of Safeguarding Adult Boards website.

 

Context

The National Analysis of SARs April 2017- March 2019 (2020) provided priorities for sector-led improvement, including priority No 27, which was: ‘How SABs, regionally and nationally, should discuss the role of SARs in sharing learning with central government departments and national regulatory bodies and holding them to account when findings require a response that is beyond the scope of local SABs.’

Subsequent discussions with safeguarding policy leads at the Department of Health and Social Care clarified that a nationally agreed escalation protocol would be helpful to confirm a process for escalating issues that arise from local Safeguarding Adults Reviews, which require a national response. A proposal for escalation was discussed at SAB Chairs national and regional meetings during 2021, and the process was agreed at the Executive meeting of the National SAB Chairs Network on 19 July 2021.

Stage 1 Regional discussion

When the local SAB formally agrees a Safeguarding Adults Review (SAR) report (mandatory or discretionary), any issue or learning identified by the SAR author that meets the criteria, is taken forward by the SAB Chair to their regional network(s). This may include regional SAB Chairs, regional SAB Managers, Regional SAR groups.

The purpose of discussion at the regional level is to allow consideration as to whether the issue/learning affect the specific locality or affects other localities in the region; whether the issue/learning can be addressed or resolved regionally; to establish if the policy issue/learning is national in order to warrant escalation. Contact with the SAR author may be helpful for clarification of the recommendation/learning, and they should be made aware that the escalation process is being initiated. 

The SAB Chair presenting the issue/learning should provide background information from the SAR and present the case for escalating the issue/learning to the regional meeting. This should include how it meets the criteria.

Criteria for referral of a SAR issue or learning: it concerns statutory guidance or national policy; and /or it involves a national organisation (e.g. CQC, NHSE), or sector (e.g. Police, emergency services)

Stage 2 National discussion

If the regional SAB Chairs group agree that the issue/learning warrants national escalation, the Chair of the regional group escalates the issue/learning and presents to a meeting of the National SAB Chairs Network, with the relevant SAB Chair presenting their SAR at the regional meeting, who can provide detailed knowledge and answer questions about the SAR.

The purpose of discussion at the national level is to allow consideration as to whether the issue/learning has a national impact; whether the issue/learning can be addressed or resolved through established national networks and connections; and to establish if the policy issue/learning warrants national escalation.

Stage 3 Contact with DHSC policy leads and others

The Chair of the National Network should email the DHSC safeguarding adults policy leads to consider how to take forward the policy issue/learning, summarising the outcome of discussion at Stage 2.

Depending on the issue/learning and the discussion, the DHSC policy leads would respond by email and advise on how to progress and address the issue/learning. The SAB Chair who presented the SAR would advise the Chair of the National Network and DHSC policy leads regarding the escalation of relevant issues arising from the SAR, alongside other SAB Chairs with evidence of the relevant issues.

In some circumstances a direct approach may be appropriate to a national body or organisation e.g. the Anti-Slavery Commissioner’s Office.  If appropriate the Chair of the National SAB Chairs Network, in consultation with the SAB Chair presenting the SAR, should agree how best to undertake any such approach. The Chair of the National Network and/or the SAB Chair presenting the SAR would contact Care Quality Commission, NHS(E), ADASS, LGA, Police, Emergency services or other national body (through their safeguarding adults leads) to consider how to take forward the policy issue/learning.

The email referral should:

  • demonstrate clearly that the issue raised is not a ‘one off’ and should provide the links to the relevant SARs.
  • Summarise the problem/policy issue/learning clearly
  • Suggest what could be done to address it, from the national perspective

There may be other further relevant considerations, such as joint reviews or parallel processes such as Children’s safeguarding Case Reviews, Domestic Homicide Reviews, and this may affect the escalation process and the agencies involved.

Stage 4

Feedback to the National SAB Chairs Network should be monitored to establish the outcomes of escalation of issues. The operation of the escalation protocol should be monitored on an ongoing basis by the Network. Feedback will be provided to the regions regarding progress, through the Executive meetings or emails.

Response times

Every effort will be made to ensure that unnecessary delay is avoided, including the use of ad hoc meetings.

Any queries of comments regarding this protocol, please contact National Network of Safeguarding Adults Board Chairs or  Adi Cooper, Care and Health Improvement Partnership [email protected].

Escalation Flow chart 

Stage 1:  Regional Discussion

Local SAB Chair raises issue/learning in region

Stage 2:  National Discussion

Regional group escalates to National Network

Stage 3: Discussion with DHSC

National Network Chair(s) escalate to DHSC

Stage 4: Feedback

National Network Chairs report back