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Child Protection Medical Assessment

“The central medical task in child protection is a comprehensive paediatric assessment. It should be conducted with the same thoroughness and attention to detail as you would any potentially life-threatening medical condition” (Victoria Climbie Inquiry 2003).

The assessment should be carried out by an experienced paediatrician (consultant, associate specialist, staff grade, or specialist registrar working under consultant supervision). We use the same structured approach recommended in the RCPCH/ALSG Child Safegaurding Training.
The degree of urgency depends on the nature of the concerns:
  • Physical injury should be seen if at all possible on the same day
  • Acute sexual assault – examination to collect forensic specimens should occur as soon as possible but evidence may still be gathered upto 7 days later. Examinations should be performed by a trained examiner (separate rota for Community Paediatrician on-call for Child Sexual Abuse – contactable via switchboard 24 hrs a day)
Before you begin:
  • Introduce yourself to the child and family and Social Worker.
  • Ensure the child has an appropriate understanding of the examination
  • Ask the Social Worker whether she/he wishes to speak to you alone first.
  • Establish consent for examination – link to consent form
  • Remember to make clear notes at the time of the consultation.
  • Use the Child Protection Examination Pack.
  • Medical notes including all diagrams must be dated, timed and signed
  • Ensure that patient identifiers are clear on each page
  • Avoid examining the child alone (even if a carer is present). Always ensure you have a chaperone.
  • Avoid asking leading questions
  • Record verbatim any comments made by the child/young person