“Safeguarding is not a policy document. It is a live framework that has to work in practice, every single session. When a young person or adult is in a session with one of our clinicians, they are placing significant trust in us, and in the service that commissioned us. That trust has to be earned through process, not promised through policy. The questions in this piece are the ones every clinical lead should be asking any external provider, and they are the ones we are confident answering.”
Heidi Robinson, Safeguarding Lead, Healios
When a CAMHS service or neurodevelopmental pathway commissions external clinical support, safeguarding is the area where the stakes are highest and where vague reassurance is least acceptable.
In our experience, it is also the area where due diligence varies most. Some services ask detailed, specific questions about duty-of-care protocols, digital session security and escalation pathways. Others accept a general statement about robust safeguarding frameworks without asking what that actually looks like on a Tuesday afternoon when a clinician has a concern mid-session.
That gap matters. This blog is about closing it.
Safeguarding in Digital NHS Services: Why the Framework Has to Be Different
Safeguarding in a digital service is not the same as safeguarding in a face-to-face one. The risks are real, and they are different.
A clinician working from home cannot physically intervene if a concern arises mid-session. They cannot look across a corridor for a colleague. They cannot read the room in the same way. Session security, escalation pathways and duty-of-care protocols all have to be explicitly designed for the digital context, because the geography, the timelines and the communication routes are different.
This is why the support network around a clinician matters so much. At Healios, our safeguarding team aims to be the person on the desk next to you that you can turn around to and say something just doesn’t feel quite right. In a physical office, that kind of conversation happens naturally. In a digital service, you have to build it. We do that through accessible supervision, named safeguarding leads and a culture where curiosity is not just permitted, it is expected.
Digital delivery done properly can be more consistent, more auditable and more transparent than face-to-face alternatives. But only if the framework behind it has been built for that context from the ground up.
“The question I always ask is: what actually happens in the first five minutes after a concern arises? Not in theory, not in the policy document, but in practice, in a live session. If a provider cannot answer that specifically, that tells you everything you need to know.”
Heidi Robinson, Safeguarding Lead, Healios
The Challenge of Being a National Service
Healios works with services across England. At last count, that means working within the frameworks of over 146 different local authorities, each with their own processes, thresholds and approaches to safeguarding.
That complexity is not something we manage from a distance or paper over with a single national framework. We invest in building real relationships with local teams, both the contracting teams and the local safeguarding boards, so that we are known, and so that we can have honest conversations when they are needed most.
When a concern arises, we are not starting from scratch. We are working in genuine partnership with the people who know the families and communities we are supporting. That is what it means to operate nationally but engage locally.
For any commissioner, it is worth asking an external provider directly: how do you work with our local authority safeguarding team? How do you ensure your clinicians know our local thresholds and processes? The answer will tell you a lot.
The new NHS Safeguarding Accountability and Assurance Framework
The NHS Safeguarding Accountability and Assurance Framework sets out how NHS organisations are expected to evidence their safeguarding arrangements, including when they commission externally. The message is clear: commissioning an external provider does not reduce your accountability. It extends it.
You need to be able to show a Commissioner or CQC inspector that the safeguarding arrangements of your external provider are genuinely integrated with your own, not simply sitting alongside them on paper.
“Commissioning an external provider is not a handoff. You remain accountable for the safeguarding of every person referred to that provider, and you need to be able to evidence that their framework meets your standards, not just on day one, but throughout the partnership. What I see most often is services accepting a document at the start and never revisiting it. That is not safeguarding governance. That is a paper exercise.”
Heidi Robinson, Safeguarding Lead, Healios
What Robust Safeguarding Governance Looks Like in Practice
Our clinicians do not work alone. Named safeguarding leads are accessible throughout the working day. Supervision is built into every caseload. And we have spent a lot of time creating a culture where raising a concern is not the exception, it is the expected response.
When something doesn’t feel right, we want our clinicians to say so. And we want them to know exactly who to turn to when they do.
Every session takes place within a secure clinical platform. Our safeguarding procedures set out exactly what happens when a concern arises: who is contacted, in what order, and how we work together. All safeguarding referrals are escalated within 24 hours of the concern being raised. Our responsive safeguarding support system operates both within and outside of working hours to make sure that timeframe is always met.
That procedure is not a document we hand over at the start of a partnership and leave to gather dust. It is a working framework, built collaboratively with each commissioning service and updated when either side’s structures or personnel change.
At Healios, safeguarding is not about policies and processes. It is about the people at the centre of it and the outcomes they experience. Through our extensive knowledge of both national and local safeguarding thresholds and signposting services, we are able to ensure that families access the right support at the right time.
We measure that. Consistently, over 90% of safeguarding referrals result in some form of additional support for a child or family.
“You cannot hand over a document at the start of a partnership and call it safeguarding governance. Both clinical teams need to build it together, test it together, and keep it current together. That is the only way it actually works when it matters.”
Heidi Robinson, Safeguarding Lead, Healios
Safeguarding Questions to Ask Any External NHS Provider Before You Commission
These are the questions worth putting to any external provider before a partnership begins. Good answers are specific. They describe a protocol, not a principle. They name the people involved, the timeframes and the tools. They show that the provider has thought about how their safeguarding framework works within your service and your local context, not just in isolation.
What is your safeguarding procedure during a live session? Can you walk me through it step by step? How does your safeguarding framework connect to ours, and how is that connection maintained over time? How do you work with our local authority safeguarding team? How are safeguarding concerns recorded and shared with us? How do you evidence your arrangements to CQC, and can we see that before we commission?
“If you are a clinical lead reading this and you are not sure whether your current external provider could answer these questions, that uncertainty is worth acting on. Not because it necessarily means something has gone wrong, but because safeguarding governance should never be something you are unsure about. Ask the questions. You are entitled to specific answers.”
Heidi Robinson, Safeguarding Lead, Healios
If you would like to understand how Healios approaches safeguarding governance within NHS partnerships, or to discuss what that would look like for your service, we would welcome a conversation.
Not a sales call. A clinical conversation about whether our framework is the right fit for your service.