Multi-Agency Safeguarding and System Risk Management in NHS Integrated Care Systems

Safeguarding within Integrated Care Systems (ICSs) cannot be managed by individual providers in isolation. NHS-commissioned organisations must align their NHS risk management and safeguarding approach with wider system governance structures. Across complex NHS community service models and pathways, safeguarding risk often sits at organisational interfaces, requiring coordinated information-sharing, shared thresholds and collective accountability.

Clarifying shared responsibility

Multi-agency safeguarding demands clarity around roles, escalation routes and information governance. Providers must understand local safeguarding partnership arrangements and how these interact with NHS contract requirements.

Operational example 1: Joint risk management in high-risk domiciliary pathway

Context: An individual with complex needs receives care from multiple providers and presents escalating safeguarding risks.

Support approach: Coordinated multi-agency meeting including community health, social care and safeguarding lead.

Day-to-day delivery detail: Shared risk plan agreed with defined responsibilities. Weekly virtual review meetings scheduled. Information-sharing protocol clarified and documented.

How effectiveness is evidenced: Reduction in repeated safeguarding alerts. Clear documentation of shared decision-making across agencies.

Operational example 2: Cross-boundary discharge safeguarding gap

Context: Discharge from one ICS area to another results in safeguarding oversight gap.

Support approach: Escalation through safeguarding leads in both areas and contract management channels.

Day-to-day delivery detail: Transfer checklist created to confirm safeguarding status before discharge closure. Named safeguarding liaison officers appointed for cross-boundary cases.

How effectiveness is evidenced: Audit demonstrates 100% safeguarding status confirmation prior to pathway transfer.

Operational example 3: Information-sharing hesitation delaying escalation

Context: Staff uncertainty about data protection leads to delayed safeguarding referral.

Support approach: Clarification training on lawful information-sharing under safeguarding duties.

Day-to-day delivery detail: Updated guidance integrated into policy manual. Managers reinforce in supervision sessions. Case scenarios used in team briefings.

How effectiveness is evidenced: Faster escalation times and improved documentation of information-sharing rationale.

Commissioner expectation (explicit)

Commissioner expectation: Commissioners expect providers to demonstrate proactive engagement in safeguarding partnerships and transparent reporting of system risks impacting contract delivery.

Regulator / Inspector expectation (explicit)

Regulator / Inspector expectation (e.g., CQC): Inspectors examine how providers work with partners to keep people safe, particularly at service boundaries and during transitions.

Governance mechanisms supporting system assurance

• Formal safeguarding partnership attendance records.
• Cross-agency action tracking logs.
• ICS-level thematic safeguarding reporting.
• Board review of system risk trends.

Embedding system-level learning

Multi-agency safeguarding is strengthened when learning is shared beyond organisational boundaries. Providers who invest in partnership working, transparent reporting and shared risk ownership are better positioned to evidence system contribution and meet commissioner expectations within Integrated Care Systems.

---