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 3 Sharing a Child Protection Concern

This section:

  • Provides information on sharing concerns about a child or young person.
  • Gives detail on joint investigation/assessment.
  • Describes the role of healthcare staff in a Child Protection Case Conference (CPCC).

When it is recognised that a child or young person's safety is compromised and/or that they are likely to experience significant harm (Appendix 1), healthcare staff have a responsibility to follow local procedures for reporting and sharing these concerns.

Healthcare staff must telephone the local social work department as per local guidelines, clearly stating that their call is a child protection matter. This communication between social work and health must then be followed up in writing confirming the conversation using a locally agreed form. This must provide sufficient information to enable social work to make an informed decision. A copy will be placed in the child or young person's records.

Clearly state:

Who you are and your role

You have concerns about the safety of a child or young person

Once speaking to a social worker state:

What your concerns are

All relevant information

Where the child is now

What you have observed, heard and what sense you have made of the information. Be clear about what is fact and what is opinion

Clarify what action the social worker will take as a result of your concerns and when you can expect to know of the outcome

Record the discussion

If staff experience any difficulty accessing the duty social worker/police or in sharing child protection concerns, ask to speak to a more senior social worker/police officer. It is important that staff feel supported through this process. Advice and support is available from line managers or the child protection Nurse Adviser.

At each stage consideration must be given to whether emergency action is required to protect the child or young person and to involving the child or young person and their family.

It is good practice during this period to continue to work with the family. It is only in exceptional circumstances that the family would not be informed, for example, if the healthcare staff felt at personal risk or it may place the child at additional risk or result in evidence being destroyed. Advice on this is available from the child protection advisory team or social worker if staff are unsure what to do. The next stage would be a joint investigation/assessment.

Joint Investigation/Assessment

Social work services and police have a clear statutory role in deciding whether an investigation should take place. The purpose of joint investigations is to establish the facts regarding a potential crime or offence against a child or young person and to gather and share information to inform the assessment of risk and need for that child or young person, and the need for any protective action.

It enables relevant information from key agencies to be considered. Healthcare staff have a duty to share relevant background information regarding a child, young person or family to inform whether an investigation is required or immediate action is needed to protect the child, young person and any others in the community. Healthcare staff need to be involved in planning all child protection investigations to ensure appropriate decisions about the wider health needs of the child or young person and whether or not a full medical examination is required are fully considered. Decisions about whether or not a medical examination is required should not be taken by police and social work staff without consulting a suitably qualified health professional as identified and agreed locally. In planning a medical assessment or forensic medical examination, discussion with healthcare staff is essential in order that the welfare needs of the child or young person are considered together with the need to collect forensic evidence. Decisions about the nature and timing of medical examinations should be made by appropriately trained paediatricians.

The process of responding to child protection concerns in diagrammatic form is represented in Appendix 3. However, it should be noted that at any stage, the process may be stopped if it is felt emergency measures are required to protect the child or no further response under child protection is necessary.

Child Protection Case Conference

A core component of GIRFEC is the child's plan. Within the context of child protection activity, where the plan includes action to address the risk of significant harm, it is known as a Child Protection Plan (CPP) and any meetings to consider such a plan is known as a CPCC. Further detail on CPCCs is contained in Part 3 of the National Guidance.

Healthcare staff may be invited to attend a CPCC where services and agencies can share information, assessment and chronologies where there are suspicions or allegations of child neglect.

Healthcare staff have a duty to co-operate with the Local Authority in line with national and local child protection procedures.

Healthcare staff must submit a report in advance, attend the CPCC and be responsible for checking minutes for accuracy following the meeting. It is expected that the health professional will discuss with the family the content of their report. If the health professional is unable to attend the meeting they should discuss with their line manager and child protection team.

When a specialist service is working with the family it will be appropriate for that specialist to attend the CPCC contributing to the process; providing relevant health information; interpreting the significance and the potential impact on the health issues on the child (e.g. a member of the mental health service, adult addiction services, and speech and language therapist).

All attending healthcare staff should receive the CPCC minutes and must check these carefully alerting the CPCC chair to any errors and ensuring that in particular any inaccurate information or dissention is clearly minuted.

Healthcare staff should seek advice and support from their child protection team if required to ensure they are supported, confident and competent to fulfil their responsibilities.

Healthcare staff must be prepared to be open and honest about their views even in the presence of parents/carer who may also be their patients. In some situations it may be appropriate for the staff to be accompanied by a more senior member of staff, but in general only those actively involved with the child and family should be involved in the CPCC.

Healthcare staff will be involved in the CPP and demonstrate active commitment to this interagency plan. Healthcare staff must feel confident to influence and shape the CPP. Healthcare staff have a responsibility to ensure that CPPs are outcome focused avoiding task allocation and time constraints. Healthcare staff will remain focused on the improvements required to achieve positive outcome for the child. It is important that healthcare staff regularly review and re-evaluate the CPP and the desired outcomes for the child have been achieved. Healthcare staff should be involved and attend the Core Group which meets regularly to review decisions and the plan. This can be particularly challenging in case of neglect. If healthcare staff have difficulty in fulfilling their role within the CPP they must inform the Chair of the CPCC and seek advice from their line manager or child protection team.


Email: Fiona McKinlay

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