Forensic Paediatrics A Report by the Short Life Working Group

Report outlining findings and recommendations from expert group


Annex D: Definitions of Tasks performed by a Paediatrician in Forensic Paediatrics

1. Paediatricians with a "Special Interest in Child Protection"

  • Participation in daytime and out of hours child protection rotas. They may have their training origins in Acute or Community Child Health and are likely to be combining their posts with other community and/or acute responsibilities. Their contribution to rotas can be very variable, from 5 sessions per week to out of hours only. It is essential that these duties are explicit and protected within job plans.
  • These are paediatricians who have had further training and experience in child protection and are competent in the provision of paediatric/forensic examination including the interpretation of injury.
  • They work within the structure of local and regional services and with support and advice from tertiary specialists.
  • The current RCPCH curriculum may be inadequate for these enhanced posts. In the future it will be important for skills and competencies to be defined for this level, in relation to all forms of abuse, including physical abuse, sexual abuse and neglect. Appropriate post-graduate qualifications will need to be identified with options such as DFCASA, DMJ or Fellowship of the Faculty of Forensic and Legal Medicine, or a post-graduate qualification through RCPCH or modular credentialing. (For paediatricians the preference is for RCPCH training programmes because these can be linked to ST training and to RCPCH standards and guidelines).
  • There is a requirement for regular attendance at peer review, a minimum of 5 times per year, a need to undertake regular CPD and to keep abreast of the child protection literature.
  • These consultants will offer mentoring, supervision and support to more junior colleagues, and participate in multi-agency training.
  • Their duties will include giving advice to non-specialist colleagues for example GPs, health visitors and adult physicians.
  • They will be required to give advice to social work, police and education through regular contribution to IRD/tripartite/strategy discussions.

2. "Specialist Consultant Paediatrician in Child Protection"

These paediatricians will be consultants usually working in tertiary centres, or across regional MCN's. It is important to note that these post holders alone cannot deliver the services without the support of a team of Paediatricians with a Special Interest and junior staff. Tertiary specialists fulfil the following functions:

Strategic

  • Providing strong leadership in the field of child protection, including leading regional MCN's and participating at a national level.
  • Offering commitment to the strategic development of the service.
  • Providing advice to Health Boards and regional planning groups in relation to policy and practice, service development, high profile cases.
  • Provides a link with Lead Nurse in child protection and other nursing professionals across the Board.

Clinical

  • Providing specialist clinical care and expert forensic opinion in complex cases.
  • Providing specialist advice and support for consultant and junior medical staff managing difficult and complex cases, both in the community and the hospitals. This includes cases being managed by other specialties e.g. Paediatric Surgery, Plastics, Orthopaedics and A & E.

Training and Education

  • Providing an overview of clinical governance (including contributing to multi-agency IRD reviews, significant case reviews, audit and research).
  • Providing leadership and supervision of post-graduate training at all levels within the community and hospital services.
  • Providing leadership of peer review.
  • Providing a second opinion to colleagues across the regional MCN.
  • Providing expert opinion to the courts.
  • Providing the lead Paediatrician role for each local authority Child Protection Committee (in most cases currently also the health vice chair).
  • Taking an active role in multi-agency training and quality assurance.
  • Having an active role in College activities.

Contact

Email: Fiona McKinlay

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