Child Safeguarding is the responsibility of everyone and is highly regarded at the Surgery. We make every effort to recognise issues and address concerns as they occur in the practice. By raising safeguarding children issues within the practice all staff will be aware of how they may access advice, understand their role in protection, and understand the importance of effective Inter-agency communication.

It is very important that all Practice staff understand the need for early identification, assessment and intervention when they have concerns about a child.  Case discussion and reflective practice is encouraged.  Child protection issues in general practice require a robust system of note-keeping and recording, message handling and communication of any concerns.   

Key Factors to be aware of in safeguarding children

The welfare of the child is paramount

Be prepared to consult with colleagues

Be prepared to take advice from local experts

Keep comprehensive, clear, contemporaneous records

Be aware of GMC guidance about sharing confidential information

Risk Factors and Identification – Child Sexual Exploitation

A child in need is defined as a child whose vulnerability is such that they are unlikely to reach or maintain a satisfactory level of health or development without the provision of services (section 17, Children’s Act 1989). This includes disabled children. The Children’s Acts 1984 and 2004 define a child as someone who has not reached their 18th birthday. The fact that a child has reached their 16th birthday and may be living independently, working, or be members of the armed forces does not remove their childhood status under the Acts.

Local authority social services departments working with other local authority departments and health services have a duty to safeguard and promote the welfare of children in their area who are in need. If you are considering making a referral to Social Services as a child in need, it is essential to discuss the referral with the child’s parents or carers and to obtain consent for the sharing of information. Social Services will then follow local procedures to undertake an assessment of the child and their family.

Child Protection Plan

Children judged to be at continuing risk have a child protection plan in place, this list is maintained by children’s social care (CSC).CSC, police and health professionals have 24 hour access to this. A child on the register has a “key worker” to whom reference can be made.

Recognising Child Abuse

(for full details please ref to Working Together to Safeguard Children 2013)

There are 4 main categories of child abuse:

Physical abuse

Sexual abuse

Emotional abuse

Neglect/failure to thrive

These are not however exclusive, and a number of abuse types can often coexist.

Physical abuse may include:

Injuries in children under 1 years of age or non-mobile children should be treated with a high degree of care

Hitting, shaking, throwing, poisoning, burning or scalding, or other forms of physical harm

Where a parent or carer deliberately causes ill-health of a child

Single traumatic events or repeated incidents

FGM

Sexual abuse may include:

Forcing or enticing a child under 18 to take part in sexual activities where the child is unaware of what is happening

May include both physical contact acts and non—contact acts

Emotional abuse may include:

Persistent ill-treatment which has an effect on emotional development

Conveyance of a message of being un-loved, worthlessness or inadequacy

May instill a feeling of danger, being afraid

May involve child exploitation or corruption

Living in families where domestic violence is taking place

Neglect may include:

Failure to meet the child’s physical or psychological needs

Failure to provide adequate food or shelter

Failure to protect from physical harm

Neglect of a child’s emotional needs

Common presentations and situations in which child abuse may be suspected include:

Disclosure by a child or young person

Physical signs and symptoms giving rise to suspicion of any category of abuse

The history is inconsistent or changes

A delay in seeking medical help

Extreme or worrying behaviour of a child, taking account of the developmental age of the child

Accumulation of minor incidents giving rise to a level of concern, including frequent A&E attendances

Some other situations which need careful consideration are:

Disclosure by an adult of abusive activities

Girls under 16 presenting with pregnancy or sexually transmitted disease, especially those with learning difficulties

Very young girls requesting contraception, especially emergency contraception

Situations where parental mental health problems may impact on children

Parental/ carer alcohol, drug or substance misuse which may impact on children

Parents with learning difficulties

Violence or domestic abuse in the family (please see separate document in safeguarding folder on domestic violence)

Acuminous separation of parents with alleged allegation