Multi-agency Safeguarding Roles

SJT Textbook: Multi-agency Safeguarding Roles

Multi-agency Safeguarding Roles MSRA

This guide covers the complex web of Multi-agency Safeguarding Roles MSRA scenarios. In the Professional Dilemmas paper, simply “telling a senior” isn’t enough; you must demonstrate knowledge of the specific statutory bodies (MASH, LADO, MARAC, MAPPA) designed to handle specific risks.

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🎯 THE CORE PRINCIPLE

Multi-agency safeguarding exists because no single service ever sees the full risk picture. Local authorities, health, police and justice bodies work together through defined structures such as MASH, LADO, MARAC and MAPPA, overseen by Safeguarding Partners for children and equivalent arrangements for adults.

In the MSRA SJT, you are tested on whether you route concerns to the correct forum, share information lawfully (with or without consent where justified), and avoid ad-hoc, informal or delayed responses. High-scoring answers ensure that staff, children and adults at risk are protected through formal processes, not side conversations or generic emails.

The GMC expects you to raise and act on concerns promptly, cooperate with multi-agency safeguarding systems, and keep accurate records of what you shared, with whom, why, and what was agreed. Exam logic: recognise risk → choose the right mechanism → share proportionately → involve seniors → document.

⚡ HIGH-YIELD ACTIONS (What Scores Points)

1. Identify the correct multi-agency mechanism (MASH, LADO, MARAC, MAPPA, Safeguarding Partners) for the specific concern.
2. Inform an appropriate senior or Named Professional early (e.g. consultant, nurse in charge, safeguarding lead).
3. Share information on a need-to-know basis, using secure channels and recording the lawful basis for disclosure.
4. Use structured tools such as DASH for high-risk domestic abuse and SBAR to organise your referrals.
5. Build and attach a brief chronology where cumulative harm or repeated incidents are suspected.
6. Notify the LADO within one working day when there is an allegation about someone in a position of trust working with children.
7. Refer high-risk domestic abuse cases to MARAC and liaise with safeguarding teams to coordinate safety planning.
8. Engage with MAPPA processes via your organisation’s lead when violent or sexual offenders pose ongoing risk in the community.
9. Record clearly in the notes who you contacted, what information you shared, and what outcomes or follow-up were agreed.
10. Support colleagues who raise concerns (whistleblowing) and ensure their report is properly escalated, not minimised.

Trap options usually minimise risk, delay referral, use the wrong mechanism, or hide behind a poor understanding of confidentiality. High scorers activate the right forum quickly, share just enough information for safety, and leave a clear record.

💬 MODEL PHRASES (Use These in SJT Logic)

* “The DASH assessment suggests high risk, so I will refer to MARAC now and involve our safeguarding lead.”
* “I will share the minimum necessary information with MASH using secure channels and document my lawful basis for doing so.”
* “I have summarised the chronology and used SBAR so the multi-agency team can clearly see the pattern of concern.”
* “I will contact our trust MAPPA lead to share relevant clinical information and agree a plan to manage ongoing risk.”
* “I will record who I have spoken to, what I shared, and the agreed next steps, including any review dates.”

4 Ms + S = MASH • MARAC • MAPPA • (LA)DO • Safeguarding Partners.
Remember: match the type of risk to the right “M”, involve the Safeguarding Partners’ framework, and always record what you have done.

📋 QUICK FAQ

Is LADO only for school staff?
No. LADO processes apply to any allegation or concern about someone in a position of trust working with children in any setting, including healthcare, youth services and voluntary roles.

When should I use MASH instead of MARAC?
MASH is the front door for new child safeguarding concerns (s.17/s.47). MARAC is specifically for high-risk domestic abuse cases. Some situations need both (for example, high-risk domestic abuse in a household with children).

What is MAPPA and when might I be involved?
MAPPA coordinates the management of certain sexual and violent offenders in the community. You may be asked to contribute clinical information or be informed of risk plans through your organisation’s MAPPA lead or Single Point of Contact.

Can I share information without consent in these processes?
Yes, when it is necessary to prevent serious harm, safeguard children or adults at risk, or for public protection. You must share only what is needed, use secure routes, and record your lawful basis and reasoning.

What if I am unsure which mechanism to use?
Speak promptly to your safeguarding lead, Named Professional or senior clinician. It is safer to discuss and then route correctly than to delay or send a vague email that no-one owns.

Do I still need to document if I have made a verbal referral?
Yes. You must record the concern, who you spoke to, what was shared, the outcome of the discussion and any agreed follow-up, including timescales and review plans.

📚 GMC ANCHOR POINTS

* Raising and acting on concerns – duty to act when patient or public safety is at risk (Good medical practice 2024).
* Safeguarding children and adults at risk – cooperate with multi-agency systems and share information appropriately.
* Confidentiality – disclose information without consent when justified to prevent serious harm or safeguard the public.
* Working collaboratively – contribute to multi-disciplinary and multi-agency teams to protect patients.
* Record keeping – make clear, accurate and contemporaneous records of concerns, referrals and decisions.
* Leadership and accountability – follow local policies and know how to access safeguarding leads and structures.

💡 MINI PRACTICE SCENARIO

A student nurse tells you she saw a paediatric healthcare assistant (HCA) roughly handle and slap a child on the ward. The child is currently safe but distressed. No senior staff member has yet been informed and the HCA is still on duty caring for other children.

Best action: Inform the nurse in charge or consultant immediately, ensure the child is safe, contact the LADO via local procedures within one working day, and document the concern, information shared and steps taken.
Why: Allegations about staff in positions of trust working with children must go through the LADO pathway, with prompt senior involvement, proportionate information-sharing and clear records, in line with GMC duties to protect patients and raise concerns.

🎯 KEY TAKEAWAYS

✓ The exam rewards picking the correct multi-agency mechanism for the risk at hand.
✓ LADO is for allegations about staff or volunteers working with children and must be notified within one working day.
✓ MASH is the front door for new child safeguarding concerns; MARAC is for high-risk domestic abuse; MAPPA is for certain violent/sexual offenders.
✓ You may share information without consent for safeguarding or public protection, but only the minimum necessary and via secure routes.
✓ Senior and safeguarding leads should be involved early, not as an afterthought.
✓ Structured tools (DASH, SBAR, chronologies) strengthen referrals and support better multi-agency decisions.
✓ Clear documentation of who you contacted, what you shared, and what was agreed is essential for safe practice and for scoring well.

🔗 RELATED TOPICS

* → Adult Safeguarding and Section 42 Enquiries
* → Safeguarding Children and Young People (s.17/s.47; MASH)
* → Domestic Abuse and DASH/MARAC
* → Information Sharing, Confidentiality and UK GDPR
* → Whistleblowing and Speaking Up
* → Recognising Neglect and Cumulative Harm

📖 FULL PRACTICE QUESTIONS

Example SJT — Best of 3 (8 options; choose three)

A junior doctor in paediatrics hears from a student nurse that a healthcare assistant has been roughly handling children, including one incident where a child was slapped. The nurse is worried but fears getting the HCA into trouble. No family has yet complained. The children appear physically safe now, but the HCA remains on duty.

Options:
A. Ask the HCA directly in private whether the allegations are true and leave it at that.
B. Tell the student nurse to complete a local incident form and do nothing else today.
C. Inform the nurse in charge or consultant, make sure the child is safe, and contact the LADO within one working day.
D. Send a brief email to the generic safeguarding inbox marked “for information only”.
E. Encourage the student nurse to raise her concerns at the next team social event to see what others think.
F. Document the report in the notes with time, date, and who raised it, including that you have escalated to senior staff.
G. Wait to see if the child’s parents complain before taking any formal action.
H. Quietly adjust the rota so the HCA does not work in paediatrics again but avoid telling anyone outside the team.

Example SJT — Rank 5 (best → worst)

In general practice, you learn that a patient on your list is a high-risk sexual offender managed under MAPPA. You also receive new information that he has been loitering outside a local school. No immediate incident has been reported, but staff are worried.

Options:
A. Contact your practice safeguarding lead and the trust MAPPA lead to share relevant information, clarify current risk management arrangements, and document the discussion and plan.
B. Make a detailed entry in the notes but decide not to contact anyone else because there has been no confirmed offence.
C. Discuss the situation with colleagues over coffee in the staff room to see what they think before acting.
D. Phone the patient directly to warn him that he will be removed from the practice if he continues to go near the school.
E. Post a message in the practice WhatsApp group naming the patient and describing the concern.