Safeguarding Adults, England, 2022-23

This publication provides the findings from the Safeguarding Adults Collection (SAC) for the period 1 April 2022 to 31 March 2023. Safeguarding Adults is a statutory duty for Councils with Adult Social Services Responsibilities (CASSRs) in England under the Care Act 2014, in order to safeguard vulnerable adults from abuse or neglect. For ease of reading and consistency ‘local authority’ will be used subsequently in this report to refer to CASSRs.

This publication presents information about safeguarding concerns that were raised and where enquiries took place during the year. It also contains case details for safeguarding enquiries which concluded during the reporting period. A safeguarding concern is where a local authority is notified about a risk of abuse or neglect of an adult which could instigate an enquiry under local safeguarding procedures. Statistics on children’s safeguarding are published by the Department for Education.

Chart 1 shows the timeseries data on the number of Concerns, Section 42 Enquiries and Other Enquiries reported by local authorities.

The data used in this publication were collated by NHS England from the SAC mandatory data collection of local authorities in England. Data were provided by 151 out of 152 local authorities. One local authority was unable to provide data, and consequently the England totals have been estimated – more information on this can be found in the Data Quality Key Information section. Data was provided in aggregate form and therefore no individual’s details have been passed to NHS England.

The publication consists of:

• data tables providing data at local authority, regional and national level
• data quality assessment, including data completeness and integrity measures
• supporting information
• open data
• the dashboard, an interactive business intelligence tool

A new set of local authority ‘peer groups’ has been added to the dashboard tool for 2022-23, replacing the previous CIPFA (Chartered Institute of Public Finance & Accountancy) nearest neighbours tool. For each local authority data can be grouped alongside a total of fifteen other local authorities that are similar with regard to various socio-economic and geographic factors, such as age profile, ethnicity, density, education. The new tool uses different features to CIPFA and has been created from the latest open data from sources such as the 2021 national census. It is able to be adapted to any future data updates and also any local authority or boundary changes. The full model will be released publicly on our GitHub page later in 2023. Local authority data can continue to be displayed by region within the dashboard. If you have any feedback on the new peer groups, or would like any further detail, please send to [email protected] marked for the attention of the adult social care statistics team.   

In order to prevent the risk of disclosure of data about individuals, figures 0, 1, 2, 3 and 4 are displayed as a [c] in the data tables. All other figures have been rounded to the nearest multiple of 5. Proportions (percentages) are calculated on the unrounded figures.

Within the collection and this publication we distinguish between Section 42 part 2 enquiries that met the criteria under Section 42 part 1 of the Care Act 2014 (referred to in the report as ‘Section 42 enquiries’) and those where the adult did not meet all of the Section 42 part 1 criteria, but the local authority considered it necessary and proportionate to have a safeguarding enquiry. These are referred to in the report as Other enquiries.

Data on Section 42 enquiries is mandatory to collect except for the data on ‘Making Safeguarding Personal’, which is voluntary. Data on Other enquiries is voluntary to collect and submit, except for one table, which captures the overall number of Other enquiries that commenced in the reporting period. Similarly, data on safeguarding concerns is voluntary to collect and submit, except for one table, which captures the overall number of concerns received in the reporting period.

The publication was previous labelled as Experimental Statistics, this badge was removed for the 2021-22 publication and the publication continues to be labelled as Official Statistics.  However, limitations remain around the interpretation and usage of the data due to local variation in how safeguarding activity is defined and reported (this is explained further within the Data Quality Key Information section). In August 2019, the Local Government Association (LGA) published a framework to support local safeguarding decision making. The framework was developed by the LGA and the Association for Directors of Adult Social Services (ADASS) and it is hoped will help reduce local variation via alignment of the SAC to the framework. In 2020-21, LGA and ADASS also published a related framework around what constitutes a safeguarding concern; again if this is adopted as the standard this should improve the utility of the SAC data. 2021-22 represented the first full year after publication of both frameworks. There is some evidence over the last two years that the variation described above is decreasing.

Data quality is measured on submission of annual data by local authorities, and processes are followed to try and improve quality of data submitted. The Data Quality Statement gives further information, and presented below is an overview of the key data quality issues impacting on the 2022-23 Safeguarding Adults data.

There is a significant degree of variation between local authorities for certain measures. In many instances this variation will result from differing interpretations of the Care Act (2014) and different practices by local authorities, rather than from poor data quality per se.  Attempts have been undertaken to help develop frameworks around elements of the Care Act, ‘Understanding what constitutes a safeguarding concern and how to support effective outcomes’ and Making Decisions on the duty to carry out Safeguarding Adults enquiries, to result in more consistent approach to defining these key elements and reduce variation. This has been led by the Local Government Association (LGA) and the Association of Directors of Adult Social Services (ADASS).

The frameworks support consistent local authority decision making and achieve greater understanding across sectors of what constitutes a safeguarding concern and enquiry. They aim to support safeguarding practice and consistent decision making so that people get a response that is right for them. They also offer clarity on elements of reporting in the SAC around concerns and Section 42 enquiries and we have refined the data collection guidance further for 2022-23, particularly around safeguarding concerns, in order to improve consistency of reporting in accordance with these new frameworks.  It is hoped these will be adopted and over time this will reduce local variation. Some councils have mentioned changes in practice and there is some evidence that variation in the conversion rates from concerns to enquiries is reducing.

In order to better understand local practice across England before the LGA frameworks were developed, NHS Digital (as was) undertook a voluntary survey of local authorities in 2018 to understand how they defined and recorded aspects of adult safeguarding within their SAC submission. Responses to the survey can be used to inform analysis of the data published in this release, in order to aid interpretation of the data submitted by local authorities and any differences between local authorities.

Additional care must be taken in particular when comparing the following areas:

Safeguarding concerns:

The data identify a wide variety in the numbers of concerns submitted by local authorities. Discussions with local authorities have identified that differing approaches to how concerns are addressed by the ‘front door’ services will vary between them. In some local authorities concerns are filtered out before they reach the safeguarding team and are not included in the submitted data. Where they exist, Multi Agency Safeguarding Hubs (MASHs) may have an impact on the numbers of concerns that are reported in the SAC.

Trigger for a safeguarding enquiry:  

A safeguarding enquiry starts when the initial information gathering has established that there is reasonable cause to suspect that all three of the Section 42 part 1 (S42(1)) criteria are met, or where the criteria are not met the decision has been made that it is necessary and proportionate to respond as a safeguarding enquiry (called Other enquiry).

At present there is still variation in the point at which initial information gathering, following a concern being raised, then triggers a Section 42 part 2 enquiry (simply called a Section 42 enquiry in the SAC) or Other enquiry, according to explanations provided by data providers.

There is no fixed point during the early phase of an enquiry when a practitioner must determine how to report activity within the SAC return. It may be that this is determined, and therefore recorded and reported as a Section 42 enquiry, after the practitioner has already done part of it. Reporting and recording reflect practice decisions.

Section 42 and Other enquiries:

The methodology by which local authorities determine whether enquiries are undertaken under Section 42 part 2 of the Care Act (2014) or not varies, as can be seen from the counts of Other queries submitted in the SAC. As much of the data on Other enquiries is voluntary to submit, including demographics of the individuals involved and the nature of the risks faced, we are unable to reliably analyse this in further depth. Therefore care should be taken when comparing data as there may not be a complete picture of safeguarding in those authorities with high numbers or proportions of Other enquiries.  It should be noted that the distinction between Section 42 and Other enquiries only exists within the SAC; as part of the survey of local practice 43.6% of completed responses stated that the distinction between Section 42 and Other was not used for local operational or reporting purposes.

‘Conversion rate’ of concerns to enquiries

There should be no logical conclusion drawn that the number of safeguarding concerns that lead to a Safeguarding enquiry is a reliable indicator of whether people are protected. This must not be used as a comparator for effectiveness and care must be taken in analysing conversion rates and they cannot be used to inferring ‘good’ or ‘bad’ safeguarding practice. For this reason, the conversion rate metric can be found within the Data Quality Annex within the data tables.

Local information about those circumstances that do not warrant such a statutory enquiry will support a broader picture about the effectiveness of safeguarding support in a local area. Aspects of the data and other available information should be used as a ‘can opener’ to ask questions rather than attempting to draw generalised conclusions.

The Data Quality issues should also be considered when reviewing the conversion rate data. Further details are provided in the ‘Other issues relating to 2022-23 data’ section below.

Data Gaps:

The LGA frameworks mentioned above emphasise that the mandatory SAC data reports activity under Section 42 part 2 (S42(2)) as set out above. The SAC does not reflect significant and effective early intervention and prevention in safeguarding people which takes place after a concern has been raised and within S42(1) information gathering, to find out whether there is reasonable cause to suspect that the three statutory criteria are met. The frameworks underline the importance of generating and making available local information (to complement the data in the SAC) to give broader assurance of effectiveness of support outside of S42(2).

In addition to the above, it is acknowledged that the definition of ‘Other Enquiries’ should be improved to increase consistency of (voluntary) reporting. This has previously been discussed in the SAC Working Group but no consensus has been reached due to the complex picture across different local authorities.

Other issues relating to 2022-23 data:

151 of the 152 local authorities, submitted a return for all mandatory cells by the mandated deadline. A validation report was subsequently sent to each of these 151 local authorities. The report includes a summary of measures of data integrity that identified logically inconsistent combinations of data, such as situations where table totals or total of rows within tables should be logically lower, higher or equal to other tables / rows within the submission template. Local authorities were then given a further opportunity to make amendments to their submission. The summary measures indicate that the data submitted was valid and complete to a high degree. Due to a serious cyber-attack in 2020, Hackney local authority has been unable to submit data since 2019-20 (see below for further information). As 151 out of the 152 local authorities made a valid submission by the final deadline, the final returns yielded a national completeness and validity score of 100% for the submitted data.

Making Safeguarding Personal information is voluntary to submit in the SAC. This year has seen an increase in the number of enquiries for which MSP was provided, from 116,185 in 2021-22 to 135,170 in 2022-23. 

Missing Data:

Due to a serious cyber-attack in 2020, Hackney Council (called London Borough of Hackney in the data tables) has been unable to submit SAC data to NHS England in 2020-21, 2021-22 and 2022-23.

In order to present England level statistics that can be compared to previous years, NHS England added 2019-20 Hackney data to 2020-21, 2021-22 and 2022-23 regional and national totals. Estimates are presented in the web page Key Facts, Key Measures data table, and all other detailed data tables and charts at regional and national level. The detailed data tables display London Borough of Hackney data as [x], denoting missing data. 

We investigated other options for estimating England level statistics, such as uplifting previous years’ data for the missing local authority by a factor equal to either the latest national or regional percentage increase. They all gave similar results leading to a narrow range of estimates, therefore we have chosen the option described above.

General:

Some local authorities gave comments in their data return to explain errors or issues with their data or explain changes made that impact on comparisons between years. NHS England would like to thank these local authorities for their transparency. Specific key issues relating to local authorities are given below.

This publication may be of interest to members of the public, policy officials and other stakeholders at local and national level, to support adult safeguarding policy development and reforms and to monitor services.

In particular, local authorities may find this data helpful in shaping services and making improvements, especially in terms of evaluating their services and comparing them with previous years or to share best practice with colleagues in other authorities. It is recommended that this data be used alongside local data and other forms of information (such as audits, peer reviews, feedback from adults themselves and staff) by Safeguarding Adults Boards and local authorities to ask questions and to seek necessary assurances about the effectiveness of safeguarding practice and outcomes.

Officials in the Department of Health and Social Care (DHSC) can use the data contained within this publication to make decisions about national policy and practice.

Members of the public and other stakeholders, such as charity organisations, can also use this SAC publication to help to understand safeguarding procedures and their outcomes.  

In 2018-19, following consultation with stakeholders, it was agreed to not include a report as part of the publication, all other data released remained the same.

This publication follows the same format as last years. 

Instead of providing in-depth analysis upfront, NHS England encourages any users wanting bespoke additional analysis to request this directly and we can work with you to understand your requirements and provide the data. We hope this will provide a more responsive and valuable service to meet your needs. Please send any such requests to [email protected]. Where this happened last year the resulting analysis was released alongside the publication.