Child safeguarding toolkit
This toolkit provides busy practitioners with an easily navigable resource to ensure excellence in safeguarding practice in Primary Care.
We are awaiting a review before updating this resource. Please use with caution.
What comes after a Child Protection referral?
As there will be some differences between devolved government policy, and across regions, this section provides a generic account of what might be expected following a referral to statutory agencies. It is important that GPs and practice staff familiarise themselves with local criteria and processes and check their local safeguarding partnership (or equivalent) website regularly to keep abreast of any changes.
Children's Social Care is expected to acknowledge and act upon a child protection referral within 24 hours of receiving it. They may seek more information by discussion with the referrer; for example, ascertaining the existence of any previous records or referrals for the child and for any other members of their household, checking whether the child has been/is already subject to a child protection plan, checking whether there is a history of a past or current Early Help Assessment, contacting other agencies as appropriate (e.g. the police if an offence has been or is suspected to have been committed, or probation services if the child may be at risk of harm from an offender). GPs may be invited to take part in a strategy discussion, together with Children's Social Care and the police (which can take place over the telephone in an emergency). The purpose of an assessment is to gather information, analyse the needs of the child and/or the nature and level of any risk and harm and determine a course of action; which may lead to statutory intervention to safeguard and protect their welfare.
Why do GPs play such an important role in child protection?
GPs are perceived as having specific and relevant knowledge relating to the children and families in their care. Good record keeping remains an essential component of effective general practice and an important aid to early recognition of parental or carer problems and risks to children. See Section 3 of the toolkit for resources on coding and recording of safeguarding information in medical records.
Report Writing (See also Top 10 Tips for Making a Child Safeguarding Referral)
GPs may be asked to provide reports for children in need of extra services, safeguarding or protection. Reports of statutory child protection investigations (for example those delivered under Section 47 of the Children Act 1989) or Child Protection Care Conferences may be written without consent, if to obtain such consent could increase risk of 'significant harm' to the child. It is however good practice, wherever possible, to involve the child and family and to ensure they have full access to the report before it is sent. This may be difficult within the short timescale required for a statutory report.
At Case Conferences, families are usually shown all reports prior to the start of the meeting. GPs will be aware that many parents in this situation are themselves vulnerable and may have learning disabilities, mental or physical health problems, be substance misusers or may themselves be legally children (i.e. under the age of 18 years). GPs may worry about destroying a relationship perceived as therapeutic, but a concern to avoid potential distress or disruption of the doctor-patient bond must never be allowed to prevent disclosure of information to relevant agencies in a child's best interest. Such disclosure must be relevant, proportionate, objective and factual.
Reports for 'early help' and 'child in need' services (for example those delivered under Section 17 of the Children Act 1989) usually require full parent/carer/child consent and collaboration, with detailed descriptions of care required for any physical or learning disability, medication and/or aids.*Refusal to give consent for this information to be shared may require a child protection referral.
*In Wales, Section 17 has been superseded by the Social Services Wellbeing Act.
Absence of contact with a child or family may be pertinent to an investigation and should be communicated in the report. Relevant information should be provided on parents, carers and all adults resident within the household, significant adults resident elsewhere, also siblings, half and step siblings and other children within or connected to a family.
Information that the GP has no concerns about a family is as important to the conference as a long list of concerns about a family.