
Domain 9
Safeguarding
RCPCH Child Protection Portal Front Page stated that:
As child health professionals, child protection plays a role in everything we do. It is about protecting individual children identified as suffering, or likely to suffer, significant harm as a result of abuse or neglect. Safeguarding is a broader issue, and covers how we ensure children grow up in a safe environment.
Basic Training
Learning Objectives
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Understand and uphold the professional responsibility of safeguarding CYP
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Document any safeguarding concern, alert senior staff of such concern and seek advice and guidance.
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Understand the long term impact of child maltreatment and other adverse childhood experiences.
Key Capabilities
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Recognize presenting features of children where child protection issue may be a concern.
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Recognize vulnerable children and distressed families that need assistance or intervention
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Apply knowledge on how to act in cases of suspected child maltreatment
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Apply knowledge of local multidisciplinary procedures for CYP in need of safeguarding support, including adoption and foster care.
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Document clearly and accurately all examination results, assessment and communication relating to possible safeguarding issues.
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Provide oral or written reports for welfare meetings, multidisciplinary case conferences and produce written reports for the police, social service or court hearings under supervision.
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Participate actively in multidisciplinary conference and welfare meetings
Illustrations
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Apply knowledge to recognise the diversity of physical signs and symptoms that might indicate or mimic child abuse, including skin injury and genital warts
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Recognise that frequent emergency department attendance may be a presentation of child abuse and/or neglect
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Recognise that behaviour changes, including soiling and/or bed wetting, can be a presentation of psychological abuse or neglect.
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Recognise the health indicators of possible neglect, including failure to meet the child’s routine health needs, school absence and severe, untreated dental caries.
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Identify the presenting features of possible abusive head trauma in infants and knows the conditions that might mimic such presentations (e.g. inherited metabolic disorder).
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Recognise the risk factors which contribute to vulnerability, including disability in children, maternal mental illness, parental substance abuse and teenage parents.
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Recognise the risk factors for maltreatment in the unborn child (e.g. maternal substance abuse, maternal mental illness)
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Apply knowledge of the principles and practice of latest local guideline in handling of case of suspected child maltreatment (e.g. Protecting children from maltreatment - procedural guide for multidisciplinary cooperation)
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Employ and interpret investigations in suspected child maltreatment e.g. blood tests, skeletal X ray
Higher Training
Learning Objectives
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Lead independently the detection, assessment, reporting and decision making in the safeguarding of CYP
Key Capabilities
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Handle with sensitivity the disclosure and any need to escalate action regarding case with possible safeguarding issue
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Follow the established guidelines and procedures in the identification, assessment, referral and follow-up of CYP who may have been sexually abused.
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Initiate and take part in the comprehensive multidisciplinary assessment of the developmental, physical and psychological status and the family function of CYP who have been possibly maltreated and draw up a conclusion about the nature of the case.
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Provide oral or written reports for welfare meetings, multidisciplinary case conferences and produce written reports for the police, social service or court hearings independently.
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Assess the role of a Paediatrician as it relates to those of other professionals in the management of children in need of protection and ensure suitable follow-up
Illustrations
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Obtain valid consent for examination in the case of suspected abuse
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Identify the risk factors, and physical and behavioural indicators for child sexual abuse (e.g. missing from home or school and presenting with a controlling adult).
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Apply knowledge of the local referral pathways for child sexual abuse
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Respond to the safeguarding needs of the unborn child, including in families with domestic violence, or maternal substance abuse.
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Respond to the safeguarding needs of vulnerable children in high risk family by proper referral for support, comprehensive assessment, risk assessment and welfare planning
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Participate and lead in the management of children in need of protection, and uses local pathways to ensure referral and follow-up.
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Understand the principles of forensic examination and recognize the importance of the chain of evidence
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Recognise when additional expert advice is needed (e.g. radiology, orthopaedics, neurology and ophthalmology, psychiatry or clinical psychology).