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What to do if you are concerned that a child may have been
abused?
Paediatricians may become concerned that a child is being
abused or neglected because:
- child discloses abuse
- parent alleges/discloses abuse
- as part of the differential diagnosis of a medical
problem (eg unexplained injury or faltering growth)
- children’s social care or the police request assessment
of a child when concerns have been raised by others
- other professionals eg health visitor has concerns about
a child
The golden rules are:
- consult widely and gather information (HV, School Nurse,
GP, emergency department)
- check the child protection register
- a referral should be made by telephone to children’s
social care with a written referral within 48hours
- record all concerns and discussions, including telephone
conversations
- if you feel that your concerns have not been addressed
contact the named professionals
Remember
- the interests of the child are paramount (Children Act
1989)
- do not accuse anybody of harming the child (a concern
does not mean a diagnosis has been made, but it does require further
assessment and investigation)
- discuss your concerns with the parents (and the
child/young person if developmentally appropriate)
- explain to the parents that you are making a referral to
children’s social care (except in suspected cases of fabricated or induced
illness or sexual abuse)
Make an immediate referral to:
- Police when there are
- Allegations of recent rape or sexual assault
- Dead or severely injured children where abuse is
thought likely
- Threatened removal from hospital where the child is
thought to be in danger
- Children’s Social Care and/or police o Suspected
abuse/neglect where siblings may be unprotected
- Serious abuse that has been witnessed eg shaking of
infant or smothering of child
The Police have extra powers of
protection that may be required in serious circumstances
Most abused and neglected children do not require admission to
hospital but consider admission for:
- Injured children requiring treatment
- Any infant or child requiring in-patient investigation eg
neuroimaging
- Where the family or social situation indicates an
immediate need for a temporary safe and supportive space whilst
investigations take place
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