National guidance for child protection in Scotland - Scottish ...

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GPs may identify children or young people where there may be concerns: When receiving information or examining an adult with health problems including adults who are the carers of children or young people registered with another GP. When a child or young person has general health problems. When a child or young person has been brought by parents/carer following an allegation. When a child or young person has been seen by another member of the primary care team (e.g. PHN-HV, family nurse). GPs may identify children or young people where there are clear signs or indications of abuse or neglect and should follow local guidance for raising concerns about such children or young people with social work services. They may also see children or young people where the explanation for presenting concern may include abuse or neglect. In such cases they must also record concerns, share information with relevant professionals and consider raising concerns with social work. This is particularly important when considering neglect or emotional abuse where careful recording and discussion of concerns is important to avoid missing such presentations. NICE clinical guidelines 89, When to Suspect Child Maltreatment¹ gives advice on identifying children and young people who may be being maltreated. When GPs see adults who present potential risks to children or young people they must assess and consider the impact of this risk on the child or young person. It is critical that the GP responds appropriately and follows local and national guidance. GPs have a duty to report concerns and share information about children or young people promptly and directly with other agencies. Further advice and guidance is provided in the RCGP Safeguarding Children Toolkit² and the GMC guidance, ‘Protecting Children and Young People - the Responsibilities of all Doctors³ 1 http://www.nice.org.uk/CG89 2 http://www.rcgp.org.uk/clinical-and-research/clinical-resources/child-and-adolescent-health/safeguarding-childrentoolkit.aspx 3 http://www.gmc-uk.org/guidance/ethical_guidance/13257.asp 17
Emergency and Urgent Care Medical Services This includes Out of Hours GP Medical Services, NHS 24 and Scottish Ambulance Service. During office hours it is best practice for social work services to direct a request for health or medical assessment through the local NHS child protection services in the first instance. The urgency and type of health assessment can be discussed as part of the joint assessment with appropriate healthcare staff. It should therefore be rarely that a social worker contacts emergency medical services directly. If social work staff contact an emergency medical service/NHS 24 because of concerns regarding a child or young person’s injuries or illness the first contact health professional should: Establish whether social work have discussed the case with the local NHS child protection service and held a joint investigation. Consult previous medical records (plus IT systems) to check any previous attendance. Consider what clinical care is appropriate at the time of presentation. Consider deferring the examination until the child protection doctor is available, as it may not be appropriate to examine the child. It is critical that for all cases of child sexual abuse, where a specialist two doctor Joint Paediatric Examination must be conducted or for chronic neglect where a Comprehensive Medical Assessment can be planned at a later date when all relevant information has been collated, that the child protection service is involved as soon as possible. Emergency Medicine Services Children or young people with suspected abuse or neglect may be taken to the Emergency Department for the provision of immediate medical care or for an opinion about possible mechanisms of injury. Local procedures for raising child protection concerns should be followed as appropriate. Local systems should be in place if the child or young person or their parent/carer leave the Emergency Department prematurely or refuse treatment. The Named Person should be informed and child protection procedures for “immediate concerns” should be followed. If, after examination, healthcare staff suspect that a child or young person attending the Emergency Department has experienced, or is at risk of abuse or neglect, Emergency Department staff should: Provide any immediate medical care required. Gather information from the child or young person’s medical records and the local child protection register by contacting social work standby services. Examine the child for evidence of injuries, remembering that these may be concealed under clothing. Document carefully all clinical findings including skin condition, bruising, scars, weight and height. Ensure that senior staff are involved in any decision-making process. 18
Page 1 and 2: CHILD PROTECTION GUIDANCE for Healt
Page 3 and 4: © Crown copyright 2013 You may re-
Page 5 and 6: MINISTERIAL FOREWORD Keeping Scotla
Page 7 and 8: affecting children, young people an
Page 9 and 10: and must be familiar with local pro
Page 11 and 12: experiencing difficulties in lookin
Page 13 and 14: Chapter 2 Roles and Responsibilitie
Page 15 and 16: Chapter 3 Sharing a Child Protectio
Page 17 and 18: Healthcare staff have a duty to co-
Page 19: Specific advice is provided below r
Page 23 and 24: Specialist Child Protection Paediat
Page 25 and 26: PART 2 HEALTH SERVICES RESPONSIBILI
Page 27 and 28: NHS 24 NHS 24 is Scotland’s Natio
Page 30 and 31: Specification for a Child Protectio
Page 32 and 33: The Executive Director Lead Child P
Page 34 and 35: Provide advice and support on child
Page 36 and 37: Healthcare staff should seek advice
Page 38 and 39: individuals made through provisions
Page 40 and 41: All medical staff require both sing
Page 42 and 43: from the reporter or from an agent
Page 44 and 45: Appendix 1 Key Definitions and Conc
Page 46 and 47: Informal kinship care refers to car
Page 48 and 49: What is Harm and Significant Harm i
Page 50 and 51: Where a child is thought to be at r
Page 52 and 53: decision to remove a child's name w
Page 54 and 55: GIRFEC PRACTICE MODEL 51
Page 57 and 58: Proformas for Medical Assessment Ap
Page 59 and 60: 8. Reason for referral Briefing tak
Page 61 and 62: 11. Birth/Medical history 14. Devel
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Page 65: Details of female genital findings
Page 68 and 69: Details of anal findings Natal fold
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Body diagrams Appendix A 67
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No access visit - when a visit has
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Missing Family Alert The purpose of
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High Risk Families High Risk Famili
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Risk taking behaviours as a result
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and child protection orders) to pro
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Children and Young People with Disa
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High Risk Families ACMD (2003). Hid
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Hester, M., Westmarland, N., Gangol
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Straus, M.A., Hamby, S.L., Finkelho
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© Crown copyright 2013 ISBN: 978-1
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National guidance for child protection in Scotland - Scottish ...

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