National Guidance for Child Protection in Scotland: Guidance for Health Professionals in Scotland

This guidance is intended to act as a practical reference point for all healthcare staff working within an adult and child service context.

It highlights the specific roles and responsibilities of specialist staff working in particular settings wherever children and young people will usually be seen.

It sets out the framework to aid practitioners in their role in dealing with child protection concerns.

Chapter 2 Roles and Responsibilities of Healthcare Staff in the Process of Protecting Children

This section:

  • Describes particular circumstances which may increase the chance of harm.
  • Sets out actions that should be taken when concerns appear.
  • Provides advice on how to recognise and understand when there are concerns about a child or young person.

The National on Child Protection Guidance states that: "All agencies that work with children and their families have a shared responsibility for protecting children and safeguarding their welfare. Each has a different contribution to make to this common task."

Where concerns are raised about the potential significant harm to a child or young person they should be considered child protection concerns.

All healthcare staff have a responsibility to act to make sure that all children and young people are protected from harm. This responsibility includes acting on concerns about a child or young person even if the child or young person is not your patient. All healthcare staff should be aware of the significance of the following situations as these may be an indication of stress within a family creating increased risk to the child/ren or young person. Local guidance should be available in relation to these issues and indicators of risk are discussed in more detail in Part 4 of the National Guidance. Further indicators of risk in specific circumstances are explored in more detail at Appendix 5.


  • Changes in family dynamics (e.g. bereavement, new partner, separation, relapse in addiction/ mental health, etc).
  • 'Closure' of a family (e.g. no access, non-engagement/non-compliance with professionals).
  • Longstanding educational difficulties.
  • Experiencing discrimination, perhaps because of their race, nationality, sexuality or religion.
  • Third party information shared with healthcare staff.
  • Refusal or withdrawal from health services - parents have the responsibility to act on behalf of their child/ren to ensure that they are in receipt of health services.
  • Refusal of treatment where a child or young person experiences or is likely to experience significant harm or neglect can never be considered in the child's best interest.
  • Not registered with GP - healthcare staff have a responsibility to support the process of facilitating registration.
  • Overuse/frequent attendees of health services.
  • The unseen child or young person
  • Disguised compliance and failure to improve outcomes for the child or young person.
  • Families who frequently move area.

Identifying and communicating concerns about a child or young person's wellbeing

All concerns regarding the wellbeing of a child or young person should be communicated to the Named Person. However, where there are child protection concerns there is an immediate need to fully consider concerns along with local policies, procedures and protocols. The following four questions will help understand those concerns:

1. Why do I think this child or young person is not safe?

2. What is getting in the way of this child or young person being safe?

3. What have I observed, heard, or identified from the child or young person's history that causes concern?

4. Are there factors that indicate risk of significant harm present and, in my view, is the severity of factors enough to warrant immediate action?

After the answers to the above questions have been considered, staff may continue to be concerned about the welfare or safety of the child or young person (their care and protection). In these circumstances staff need to act. Concerns must be raised with social work.

If this is the case and the practitioner considers abuse and/or neglect, the following actions are required:

  • Record your concerns and document actions.
  • Look for other features of maltreatment in the child or young person's history, presentation or parent/child interactions now or in the past.
  • Discuss concerns with a more experienced colleague or child protection adviser (as per local protocol).
  • Share information with other agencies and health disciplines as appropriate and record in the child or young persons clinical record details of the concern.
  • Ensure review of the child or young person at a date appropriate to the concern.
  • Be aware of repeated presentation of this or other features.
  • Ensure the concern has been brought to the attention of the Named Person.
  • Share concerns with social work department if appropriate.

If the child or young person is in immediate danger staff must speak directly to the police.


Email: Fiona McKinlay

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