New guidance on child protection is published today (Wednesday 6 May 2009) by the British Medical Association (BMA) to help primary care teams deal with suspected cases of abuse or neglect.
The guidance gives GPs and their teams extra support to assist them when faced with complex child protection issues, often faced in difficult and demanding circumstances.
GPs are often the first professionals to come into contact with children at risk and they, together with all members of the local primary healthcare team, should be fully aware of how to act in child protection matters, says the guidance.
The BMA Child Protection Tool Kit also states that doctors working in emergency departments and other hospital departments, who come into contact with children at risk, must inquire about any previous hospital admissions and gain access to all relevant notes and records if possible.
The guidance advises that any child considered at risk must be thoroughly examined within 24 hours of admission to hospital and should not be discharged unless a discussion has taken place with local social services. Weekend admissions should not be allowed to interfere with emergency protection proceedings.
Dr Tony Calland, Chairman of the BMA's Medical Ethics Committee (MEC), said: "Doctors and their teams work very hard to protect children and we hope this guidance will be of extra support to them.
"Child protection issues are very difficult and demanding for doctors. No two cases are the same and the needs of children and families vary.
"What is important for doctors to remember is that if they have concerns about a child or children who may be at risk of abuse or neglect, they need to act immediately – the best interests of the child or children must dictate all their actions."
Dr Calland added: "There is always a degree of risk when dealing with child protection issues; at one end there is the danger of leaving a child for too long in a dangerous situation and on the other the risk of removing a child unnecessarily from its family. We hope this tool kit will help doctors weigh up the risks and reassure them that they are not alone and that support is available to help them make these difficult decisions."
The Child Protection Tool Kit advises doctors to be alert to physical and emotional signs of potential abuse. Physical signs include broken bones, bruise marks shaped like hands, fingers or belts, cigarette burns, human bite marks and evidence of internal bleeding.
Emotional indicators of potential abuse or serious neglect can include a baby or child who cries constantly, a baby or child who fails to thrive normally without clinical explanation, a child who is often very dirty or smelly, a child who is often left at home alone or a child who is left in unsafe situations.
It is essential, says the guidance, that doctors listen to the views of children and if at all possible involve them in the decisions being made on their behalf.
Your comments (terms and conditions apply):
"Yes. Recently in my own GP practice one of the younger GPs came across a case of suspected nonaccidental injury to a toddler. She was able to access the appropriate services without delay and in fact the child had a skull fracture and multiple bruising. He is now in care and the mother and boyfriend are being investigated. However, the GP in question raised the case in a Critical Case review and expressed how hesitant she felt with regard to the initial course of action. All of the clinical team felt uncomfortable with this vital issue. Clearer discussion and guidance could perhaps help." - L Williamson, Northumberland
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