Safeguarding Children Explained: What UK Health and Care Staff Need to Know

Safeguarding adults gets a lot of attention in UK care settings, and rightly so — but safeguarding children carries its own statutory framework, its own training levels, and its own referral pathways, and every health and care worker who has any contact with children, or with adults who are parents or carers, has a role to play in it. This guide sets out what safeguarding children actually requires of frontline staff, separate from the adult safeguarding duties most care providers already train on heavily.

What is safeguarding children?

Safeguarding children means protecting children from abuse and neglect, preventing harm to their health and development, ensuring they grow up in circumstances consistent with safe and effective care, and taking action to enable all children to have the best outcomes. It is broader than simply responding after abuse has occurred — it includes early identification of risk and working with families before a situation escalates.

The legal duty

The Children Act 1989 and Children Act 2004 place duties on a wide range of organisations to safeguard and promote the welfare of children. Section 11 of the 2004 Act applies to bodies including NHS England, integrated care boards, NHS trusts and NHS foundation trusts, and requires them to make sure that services provided on their behalf also have regard to the need to safeguard and promote children's welfare. Registered care providers are covered through CQC's Regulation 13 safeguarding requirements. The statutory guidance "Working Together to Safeguard Children" sets out how organisations and individuals should work together; the current edition was published by the Department for Education in March 2026 and replaced the 2023 edition. CQC looks at how providers safeguard children under its "safe" key question and Regulation 13 (safeguarding service users from abuse and improper treatment), so providers need to be able to show that staff are trained and know how to escalate a concern. Unlike some compliance topics that sit within a single regulator's remit, safeguarding children draws on child protection law, CQC registration requirements, and professional regulatory standards (for example from the NMC or GMC) simultaneously.

The training levels for health and care staff

The intercollegiate document, produced jointly by the Royal College of Paediatrics and Child Health and partner bodies including the Royal College of Nursing, was revised in November 2025. The 2025 edition, now titled "Safeguarding children and young people and children and young people in care: competencies for health care staff", replaces the 2019 edition and sets out competencies for five levels of health care staff, plus core competencies for senior managers and executives. The guidance is not statutory: providers are responsible for deciding the duration and frequency of training, and should allocate levels according to each person's level of contact with children and young people.

Level 1 (recognition) applies to all health care staff, including non-clinical staff and volunteers, whatever their level of contact with patients — this covers almost the entire health and care workforce, including reception and administrative staff. It builds basic awareness of what safeguarding means and how to recognise a possible concern. A yearly update is recommended as part of mandatory training.

Level 2 (response) applies to staff who encounter children and young people but do not provide clinical care to them, and who need to know how to respond by seeking advice or escalating a concern — for example healthcare students, phlebotomists and healthcare assistants working in adult services. Clinicians in adult-based services whose caseloads regularly include under-18s, including 16 to 18 year olds, are expected to hold Level 3. It goes further than Level 1, covering how to use professional curiosity to spot additional vulnerabilities, recognising indicators of abuse and neglect, and knowing how to escalate a concern through the correct referral pathway. A yearly update is again recommended.

Level 3 (expertise and action) is the baseline for all health care staff who deliver a clinical service to children and young people under 18. It also applies to some staff in adult-based services, including adult mental health and drug and alcohol services where a parent or carer's situation significantly affects children, and clinicians whose caseloads regularly include 16 to 18 year olds. Some roles at this level, such as child protection medical assessments or initial and review health assessments for children in care, need additional specialist skills. Competence at this level is expected to be discussed at annual appraisal and formally reviewed roughly every three to five years, typically alongside professional revalidation.

Above Level 3, the 2025 document sets out Level 4 (leadership role and additional responsibility), for senior leaders within providers such as named doctors, nurses and midwives and safeguarding leads, and Level 5 (strategic oversight and system response), for senior system leaders such as designated doctors and nurses. It also includes core competencies for senior managers and executives.

Recognising abuse and neglect, and referring concerns

Staff at every level need to know the four recognised categories of abuse — physical, emotional, sexual, and neglect — and understand that safeguarding concerns are rarely obvious on first contact. "Professional curiosity" is a term widely used in safeguarding practice for actively asking questions and following up on a nagging feeling that something isn't right, rather than accepting a surface explanation. Where a concern is identified, the correct next step is to follow the organisation's local safeguarding policy, which will typically involve raising it with a named or designated safeguarding lead and, where appropriate, referring into the local authority's children's social care team or Multi-Agency Safeguarding Hub (MASH).

How this differs from safeguarding adults

Safeguarding adults, covered in depth in our guide to Safeguarding Adults Reviews, generally applies where an adult has care and support needs and is unable to protect themselves — the Care Act 2014 sets the framework. Safeguarding children applies to every child regardless of vulnerability status, reflecting the principle that children as a group need protection by virtue of their age and dependency, not because of an assessed care need. Staff working across all-age services, such as community health teams or GP practices, need to hold both sets of competencies, and provider training plans should reflect that overlap rather than assuming one safeguarding module covers both. Related mandatory training, such as the Oliver McGowan training on learning disability and autism, sits alongside safeguarding children as part of a joined-up mandatory training programme rather than replacing it.

Frequently asked questions

Who needs Level 3 safeguarding children training? Anyone who delivers a clinical service to children and young people under 18. Level 3 also applies to some staff in adult-based services, such as adult mental health and drug and alcohol practitioners where the situation significantly affects children, and clinicians whose caseloads regularly include 16 to 18 year olds.

How often does safeguarding children training need to be refreshed? The intercollegiate document recommends a yearly update for Levels 1 and 2, but it is not statutory and leaves the duration and frequency of training to providers, so check your employer's policy. Levels 3 to 5 are discussed at annual appraisal, and competence in safeguarding is considered at each revalidation cycle (every three to five years).

How many levels does the intercollegiate document use? The 2025 intercollegiate document uses five levels (Levels 1 to 5), plus core competencies for senior managers and executives, and was developed with a four nations approach. Schools and colleges follow separate statutory guidance, Keeping Children Safe in Education, so terminology and training expectations differ outside health.

What is professional curiosity? It's the practice of actively questioning and probing beyond an initial explanation when something about a child's presentation or circumstances doesn't add up, rather than accepting it at face value.

This article is general information, not legal advice. Training levels and refresher periods are set by your employer, commissioner and the current intercollegiate document; check the latest edition and your local safeguarding partnership's requirements.

Our healthcare compliance and CPD training covers requirements like this for Irish and UK services.