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

  1. Understand and uphold the professional responsibility of safeguarding CYP

  2.  Document any safeguarding concern, alert senior staff of such concern and seek advice and guidance.

  3.  Understand the long term impact of child maltreatment and other adverse childhood experiences.

Key Capabilities

  1. Recognize presenting features of children where child protection issue may be a concern.

  2.  Recognize vulnerable children and distressed families that need assistance or intervention

  3.  Apply knowledge on how to act in cases of suspected child maltreatment

  4.  Apply knowledge of local multidisciplinary procedures for CYP in need of safeguarding support, including adoption and foster care.

  5.  Document clearly and accurately all examination results, assessment and communication relating to possible safeguarding issues.

  6.  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.

  7.  Participate actively in multidisciplinary conference and welfare meetings

Illustrations

  1. Apply knowledge to recognise the diversity of physical signs and symptoms that might indicate or mimic child abuse, including skin injury and genital warts

  2. Recognise that frequent emergency department attendance may be a presentation of child abuse and/or neglect

  3. Recognise that behaviour changes, including soiling and/or bed wetting, can be a presentation of psychological abuse or neglect.

  4. Recognise the health indicators of possible neglect, including failure to meet the child’s routine health needs, school absence and severe, untreated dental caries.

  5. 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).

  6. Recognise the risk factors which contribute to vulnerability, including disability in children, maternal mental illness, parental substance abuse and teenage parents.

  7. Recognise the risk factors for maltreatment in the unborn child (e.g. maternal substance abuse, maternal mental illness)

  8. 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)

  9. Employ and interpret investigations in suspected child maltreatment e.g. blood tests, skeletal X ray

Higher Training

Learning Objectives

  1. Lead independently the detection, assessment, reporting and decision making in the safeguarding of CYP

Key Capabilities

  1. Handle with sensitivity the disclosure and any need to escalate action regarding case with possible safeguarding issue

  2. Follow the established guidelines and procedures in the identification, assessment, referral and follow-up of CYP who may have been sexually abused.

  3. 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.

  4.  Provide oral or written reports for welfare meetings, multidisciplinary case conferences and produce written reports for the police, social service or court hearings independently.

  5. 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

  1. Obtain valid consent for examination in the case of suspected abuse

  2. 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).

  3. Apply knowledge of the local referral pathways for child sexual abuse

  4. Respond to the safeguarding needs of the unborn child, including in families with domestic violence, or maternal substance abuse.

  5. Respond to the safeguarding needs of vulnerable children in high risk family by proper referral for support, comprehensive assessment, risk assessment and welfare planning

  6. Participate and lead in the management of children in need of protection, and uses local pathways to ensure referral and follow-up.

  7. Understand the principles of forensic examination and recognize the importance of the chain of evidence

  8. Recognise when additional expert advice is needed (e.g. radiology, orthopaedics, neurology and ophthalmology, psychiatry or clinical psychology).