Fabricated and Induced Illness: Professional Dilemmas w/ Dr Sarah Steele

The AoCPP Podcast

Welcome to Association of Child Protection Professionals' Podcast, a podcast where we, alongside guest hosts, share with you the latest in child and family safeguarding. This episode is a Special Episode. In these special episodes, we take a more focused look at a singular issue that professionals working with children and families need to know about. These are often specific and urgent – so we’ll be talking with a professional at the forefront of the issue.

In today's episode, Wendy Thorogood, Chair of the Association of Child Protection Professionals, talks to Dr Sarah Steele about Fabricated and Induced Illness and the professional dilemmas that come along with it.

It is widely recognized and acknowledged across the health, police and social care economies that Fabricated and Induced Illness by Carers (FII) is one of the most challenging areas of Child Protection in which to work. Practitioners have to make extremely exacting professional judgements and can experience various levels of stress when addressing the multiplicity of complex issues inherent in such cases.

There is no universally agreed definition of FII, and there is no unique profile in the context of those who perpetrate this form of child abuse. Hobbs et al refer to FII as ‘a deceptive, secretive and interactional liaison which has at its centre the child, the doctor or other professional and the perpetrator…..’. It is imperative therefore that all professionals recognize this risk from the very start of the case as a first step towards, not only better protecting the child victims, but, also in beginning to protect the professionals themselves from being negatively impacted by the inherent divisiveness of such cases as well as from potentially being entrapped in the abusive cycle.

Having a heightened professional awareness of the intrinsic risks in FII cases can be a first step in helping to prevent or contemporaneously address any conflicts and issues as they arise on the front line.

Dr Sarah Steele is an Independent Child Safeguarding Consultant and formerly Head of Safeguarding and Consultant Nurse at a large university hospital NHS foundation Trust and active member of two LSCBs. She has over fifteen years experience as a practitioner, manager, teacher and strategic leader specialising in child protection in both community and acute settings.

Sarah is currently director of Patronus Child Protection Consultancy which provides specialist advisory services including expert advice, guidance and support on a range of aspects of child protection and safeguarding to national and regional organisations including health, police and social care professionals, charities and LSCBs/Safeguarding Partnerships amongst others both in the UK and beyond.

She has undertaken numerous Serious Case Reviews, Appreciative Inquiries, Internal Management Reviews, Child Death and other Reviews. She has led on Culture and Practice Change Initiatives in relation to closer working with adult safeguarding teams and for many years has promoted the concept of triangulation of information and working practices in the context of the children of vulnerable adult patients who are parents/carers to inform and support contextual safeguarding.

Sarah has a particular interest in and significant experience of managing the full range of Fabricated and Induced Illness (FII) spectrum cases in multi-agency and acute hospital settings. She contributed to the DCSF 2008 national guidance document ‘Safeguarding Children in whom illness is fabricated or induced’, as well as co-developing a local standard operating procedure (SOP) with a senior police colleague in 2015 to facilitate and support enhanced collaborative multi-agency working across such complex cases.

She has developed and supported the implementation of comprehensive and wide-ranging programmes of child protection training for all levels of multi-agency staff including FII training and presentations.

Most recently she has reviewed and commented on the draft new RCPCH FII guidance document which is due for publication in the near future and has contributed to the iHV 2020 FII good practice points (GPP) programme.

Wendy Thorogood is a retired Designated Nurse Consultant for children. She trained at St Guy's hospital in London, specialising in child and adult nursing, intensive care and cardiac and renal transplants.

Wendy delivered the national leadership programme for safeguarding for the Department of Health and worked directly with the NHS Confederation in relation to current changes; providing assurance that current and future providers of services are compliant in relation to safeguarding national and local standards;working with Lead Commissioners and the performance team to develop agreed key performance indicators and safety metrics for providers; identifying and taking appropriate action on key risks and issues across commissioned services that may affect safeguarding of children, young people.

She is currently the chair of the Association of Child Protection Professionals.

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For those listening in the future, this episode is being recorded and published while the UK (and the world) is experiencing the COVID19 pandemic. Many frontline professionals are finding themselves overworked, time poor and confused as government guidance is changing daily. To alleviate the pressure child protection professionals are under, we have created the AoCPP Podcast, which will provide support to these professionals who continue to serve our country, its vulnerable children, and families, in unprecedented circumstances.

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Find us at:

childprotectionprofessionals.org.uk

Twitter: @AoCPPTweet

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Find out more about Dr Sarah Steele at: http://patronuschildprotection.co.uk/

Find out more about Wendy Thorogood at: https://www.childprotectionprofessionals.org.uk/wendy-thorogood

Music by Alexander King

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