Staff Zone - When and Where Should I Refer a Child?

Staff Zone

When and Where Should I Refer a Child?

Local policies may vary, but in general the following applies.

Select the headings to find out more.

If you suspect child maltreatment

If you suspect child maltreatment, refer immediately to the most appropriate of the following agencies:

Local child social services
The police
The National Society for the Prevention of Cruelty to Children (NSPCC)

If the child needs admission, ensure that the paediatrician is aware of your concerns.

The local social services, police and NSPCC have statutory child protection powers to act immediately to secure the safety of the child.

Consider the safety of other children living with or in contact with the presumed perpetrator.

For further information on the choice of the most appropriate agency, go to Resources for a link to NICE, Child maltreatment - recognition and management.

If sexual abuse is suspected

Do not perform an intimate examination, unless there is an urgent health need to do so
Only use open questions to enquire about the causes and circumstances of the presenting features and record these questions and responses verbatim
Refer urgently to collect forensic evidence and assess the need for contraception and sexually transmitted infection prevention
- A forensic intimate examination should only be undertaken by professionals specifically trained in forensic aspects of sexual assaults. A general examination may be appropriate to assess their general health and to look for other injuries

If there is any uncertainty about suspected child maltreatment

If there is any uncertainty about suspected child maltreatment, or risk of immediate harm to the child, seek advice from a named or designated professional for child safeguarding or a more experienced senior colleague.

Confirm in writing, within 48 hours, any telephone referral to social services; they will formally acknowledge your written referral within 48 hours after receipt. Contact the local social services again if your referral has not been acknowledged within 3 working days.

Before referring, obtain consent from the child/young person or parent/carer to share confidential information unless there is reason to believe that this will increase the risk of harm to the child/young person. For further information see Resources for a link to Child maltreatment - recognition and management.

What should I document?

Document all your concerns, including any minor concerns, and the details of any action you have taken, information you have shared and decisions you have made relating to those concerns
If you share information about the child/young person, this should be recorded in the child's/young person's notes. If you share information about other members of the family, this should be recorded in their records if you have access to them
If there is not enough evidence to support your concerns that a child/young person is being maltreated, or evidence arises that shows your concerns are incorrect, then this should also be recorded in the child/young person's record and their parent's/carer's record
Ensure that the coding correctly reflects the current situation

If you have serious concerns about the welfare of a young person

You have serious concerns about the welfare of a young person (i.e. you are concerned that the young person might be at risk of significant harm). Here is a checklist to remind you what to do:

Make a note of your concerns and observations
Discuss with senior medical and nursing colleagues
Discuss what you are going to do and why with the child and their parent(s) or carer(s) - as long as this does not put them at increased risk
Notify and refer to children's social services by phone. In an emergency (e.g. the child absconds or parent tries to take the child), call the police
Participate in a strategy discussion with social services, police and other agencies (e.g. school)
If the strategy discussion concludes the young person is at risk of significant harm, a Section 47 Child Protection enquiry should be called
After completion of the enquiry, a case conference is held
The case conference decides whether or not the young person should be placed on the Child Protection Register and subject to a Child Protection Plan

The following agencies have a duty to work collaboratively.

Children's Social Care (CSC)

Commonly referred to as social services, they take the lead in coordinating responses and support when there are concerns that a child needs extra support or protection from harm.

Education

Schools have a statutory responsibility, like healthcare organisations, to safeguard children and young people.

Health

All parts of the health service have a statutory responsibility to safeguard children and young people. This includes health visitors, GPs and staff in secondary and tertiary healthcare e.g. specialist hospitals, private hospitals, mental health services, genitourinary and family planning services, dentists and professions allied to medicine.

Police

Safeguarding children is a fundamental part of the duties of all police officers. All forces have child abuse investigation units which undertake criminal enquiries in cases of suspected child abuse.

Family Justice System

The Family Justice System is a network of organisations including family courts, the Children and Family Court Advisory Support Service (CAFCASS), the Child Support Agency and lawyers. Safeguarding children's welfare is a key consideration for all professionals working in the Family Justice System. In all cases, the child's welfare is the court's paramount consideration and the role of the court is to make decisions which are in the best interests of children based on the evidence before it and the law.

Other

All other local authority services (including adults' social care, housing, libraries, leisure and youth services), probation service, early years providers, secure settings, UKBA, voluntary and private sectors, faith organisations, etc.

Child Protection Procedures

Serious Case Reviews (SCRs) are undertaken when a child dies (including death by suspected suicide), and abuse or neglect is known or suspected to be a factor in the death.

Additionally, Local Safeguarding Children's Boards may decide to conduct an SCR whenever a child has been seriously harmed and the case gives rise to concerns about the way in which local professionals and services worked together to safeguard and promote the welfare of children (including inter-agency and inter-disciplinary working):

Each agency involved with the child or young person contributes a report outlining and analysing its involvement with the child
Information is gathered by the independent reviewer who produces the SCR

Healthcare staff having regular contact with parents, children and young people have an important role (and a duty of care) in helping to keep children safe.

It is not always clear that a child is being maltreated:

Healthcare staff may encounter behaviours or signs that should lead them to consider maltreatment as one of a number of possible diagnoses to explain the child’s presentation. Alternatively, the indicators of abuse may be stronger, leading healthcare staff to suspect that a child is being maltreated
All healthcare staff need to respond appropriately and effectively when they consider or suspect that a child is being maltreated, and understand the importance of sharing concerns with colleagues and other agencies
To respond effectively, healthcare staff need to know who other key safeguarding agencies are, what their roles are and have an understanding of the next steps in the child protection process

What happens after your referral?

Select the images for information.

Case conference

After a referral, social care will make enquiries and the local child safeguarding organisation will call a multi-disciplinary case conference, where all involved will be invited and asked to send a report. In some cases, you will have limited information about the family but it is still worth sending a report.

In other cases, the family may have been registered for a while but the first you know about a child protection concern is through an invitation to write a report or to attend a case conference or child in need meeting.

Medical examination

You may be asked to carry out examinations of the children involved before a case conference. A paediatrician may be asked to examine the child if they attend secondary care or if a specialist examination is required. You may also need to examine a child presenting in an emergency situation, where an incident of abuse is suspected.

It is imperative that all facts and findings are recorded with accuracy and in considerable detail (preferably using a standard proforma) because the potential legal ramifications are not always apparent at the outset.

Hand-written notes and drawings may be seen in court. Clear, well written notes are important documents on which your formal typewritten report must be based.

Medical notes, including all diagrams and photos, must always be dated and signed, with the times that any interviews or observations were made.

Rights of the Child

The United Nations Convention on the Rights of the Child (UNCRC) is an international human rights treaty that grants all children and young people (aged 17 years and under) a comprehensive set of rights. The UK signed the convention on 19 April 1990, ratified it on 16 December 1991 and it came into force on 15 January 1992.

The Joint Committee on Human Rights published its report on children’s rights in 2009. This report was produced in response and obligations set out in the UNCRC are protected in England and implementation of the convention is achieved.

Children have the right to be protected from being hurt and mistreated, whether physically or mentally.

Governments should ensure that children are properly cared for and protect them from violence, abuse and neglect by their parents, carers or anyone else who comes into contact with them.

Children have the right to survival.

Children have the right to develop to the fullest.

Children have the right to participate fully in family, cultural and social life.

Children have the right to health and healthcare.

Children have the right to protection from all forms of violence.

Page updated

Google Sites

Report abuse