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NICE offers new guidance to integrate services to protect children from abuse



The National Institute of Health and Care Excellence (NICE) has today, 22 February, released a consultation on new guidance to better integrate child protection against abuse and neglect.

The National Institute of Health and Care Excellence (NICE) has today, 22 February, released a consultation on new guidance to better integrate child protection against abuse and neglect.

The institute was asked by the Department of Health (DoH) and the Department for Education (DfE) to provide guidance for all professionals in order to better support the efforts of health care professionals and social services.

Professor Corinne May-Chahal, child protection researcher at Lancaster University and chair of the NICE guideline committee said: “Our awareness of the different forms of child abuse and neglect is developing all the time but it is difficult for professionals to keep track of the best ways to assess abuse and intervene effectively.

‘This guideline is important as it will help professionals spot the warning signs and then focus on what early help and interventions can be provided.’

What to do

‘The guidance tells you what to do if you’re worried. It shows you what to do when you have that first instinct that something is wrong,’ said Dr Danya Glaser, an honorary consultant child and adolescent psychiatrist and vice-chair of the NICE guideline committee.

The draft guidelines lists ‘soft signs’ that should be considered as potential signs of abuse such as low self-esteem, excessive clinginess and frequent rages at minor provocations.

It also indicates signals which should cause professionals to suspect abuse and mean that investigation in needed such as a child regularly arriving to school unclean or with injuries, overtly sexual behaviour in pre-pubescent children, and excessive physical punishments from parents. These indicators mean that health or social services should be contacted.

When to act

Professionals who work with children such as teachers are not legally obligated to report abuse or neglect in the UK but do have a professional requirement to voice their suspicions.

‘Err on the side of curiosity,’ Dr Glaser said. ‘There are far more false negatives than false positives.’

‘We know that families go through changes all the time,’ Ms Eaton said. It’s about noticing and acting upon it if a severe change in a child’s behaviour or demeanour gives you cause for concern.

It is important to take notice of the ‘pinch points’ that are putting pressure on families and link them with services which can help such as food banks.

‘The most important thing is to think critically and be curious’ Dr Glaser said.

Effective intervention

Most cases can be prevented for getting as far as child protection if people far earlier in the process speak out, children’s specialist and guideline committee member Debbie Eaton said.

‘It’s important to share information because everyone has a piece of the puzzle and then victims don’t have to keep repeating themselves.’

In 2015/16 there were over 50,000 children in England who needed protection from abuse according to DfE figures.

In 2014/15 incidents of sexual offences against children rose by 38% and incidents of neglect by 10% on the previous year, according to the NSPCC’s report, How safe are our children? 2015.

Service cuts

Universal services such as health visiting, designed to catch child safety problems early on, are being subjected to heavy funding cuts and decreased capabilities.

However, professor Gillian Leng, NICE deputy chief executive and director of health and social care said: ‘We are increasingly seeing commissioners who hold the purse strings of those services starting to focus more on prevention rather than just focusing on complex and therapeutic treatments later on.

‘Investing in these preventative services will relieve pressure on social services.’

The guideline aims to help those services know how to provide higher quality interventions.

The consultation on the draft guidance is open until 19 April. The committee will meet again in May to consider the comments that are submitted and the final guideline is expected to publish in September.