Missed appointments and no-access visits are recurring themes in Child Practice Reviews , Adult Practice Reviews and Domestic Homicide Reviews across Wales and the UK. These can be early warning signs of abuse or neglect, especially when missed appointments are repeated and unexplained. It is essential to recognise these patterns and respond appropriately.
The National Safeguarding Service, in collaboration with the NHS Wales Safeguarding Network, has developed this NHS Wales guidance to provide a strategic framework for NHS Wales organisations and multi-agency safeguarding partners. It supports a consistent, system-wide approach to situations where a child or adult at risk is not brought to a scheduled appointment (face to face or virtual), or professionals are unable to gain access during a planned home visit. Non-attendance and no-access scenarios may indicate unmet needs or safeguarding concerns. This guidance outlines key principles and expectations to ensure a proactive and coordinated safeguarding response across NHS Wales.
Safeguarding Responsibility and a Whole Picture Approach:
Multi-agency collaboration remains critical to delivering holistic, person centred care and support, ensuring no one is left at risk due to missed healthcare contact. To support practitioners in understanding the ‘whole picture’ approach the guidance includes a set of Risk Identification Factors that can be used alongside professional judgement and multi-agency procedures.