Child protection

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This article is a stub. Please feel free to expand it and make it more encyclopaedic.

QuotationMarkLeft.png Disclosure of personal information without consent may be justified in the public interest where failure to do so may expose the patient or others to risk of death or serious harm. Where the patient or others are exposed to a risk so serious that it outweighs the patient’s privacy interest, you should seek consent to disclosure where practicable. If it is not practicable to seek consent, you should disclose information promptly to an appropriate person or authority. You should generally inform the patient before disclosing the information. If you seek consent and the patient withholds it you should consider the reasons for this, if any are provided by the patient. If you remain of the view that disclosure is necessary to protect a third party from death or serious harm, you should disclose information promptly to an appropriate person or authority. Such situations arise, for example, where a disclosure may assist in the prevention, detection or prosecution of a serious crime, especially crimes against the person, such as abuse of children. QuotationMarkRight.png[1]

Doctors clearly have a role in child protection. Children may be encountered professionally by paediatricians, GPs, and emergency department doctors - and, of course by other doctors; and professional duties do not stop when not at work.

Part of the issue is that it might require a broader view of a child's life to recognise that they are in need of child protection. This means that it may only be when the whole picture - what the doctor sees, what the school sees, what other witnesses report e.g. to social services - is seen, that it becomes apparent that a child is at risk. It may, therefore, be appropriate and necessary for doctors to share information about a child who is their patient. This, however, immediately raises confidentiality issues, so a doctor has to tread the right line between appropriate sharing of information, and respect for confidentiality. A GP should not, for example, even reveal that an individual is registered as a patient with their practice unless they have the patient's (or their proxy's, if the individual lacks capacity) to do so.

In order to best protect children, while also complying with the professional duty to maintain confidentiality (unless there's an over-riding reason not to), clear guidelines have been developed for when a doctor can and should share information with others. This, in turn, places a duty on other (statutory and other) services - such as social services, the police, and child protection charities - to be responsible in the nature and manner of their requests to doctors for information about patients.

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What should a doctor do if they have concerns that a child might be at risk?

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What should a doctor do if they are asked for information about a child by another body?

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What should other bodies do if they wish to seek information from a doctor about a child?

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Mandatory training child protection for doctors

Child protection for employed doctors

Employed (eg hospital doctors) may be required, by their employer, to undertake child protection training and updates (mandatory training).

There are various "levels" of child protection training, and the level required (and frequence of updates) will respond to the doctor's role.

General practitioners

GPs will usually have received appropriate training as part of their training to be a GP - it is on the curriculum.

The RCGP has issued the following guidance (copied and pasted):[2]

"Following the publication of the Laming Report, we are writing to all NHS GPs on the issue of child protection. Protection of children is a clear duty for all GPs.
"There is currently some confusion over what GPs have to do to show that they are trained to undertake their normal child protection role. GPs who are UK-qualified will have undertaken child protection training as part of their training curriculum. No further certification is required, although all GPs have a duty to remain up-to-date with child protection matters. Non-UK trained doctors are likely to be required to demonstrate that they have been appropriately trained in child protection in order to be allowed to join a PCO’s performers’ list. Thus, additional training and certification may be required for non-UK trained doctors to be able to work as an NHS GP in the UK.
"As noted above, all GPs have a duty to remain up-to-date. This is set out in the GMC’s Good Medical Practice. As a GP’s work is likely to include child protection, you must maintain your skills and competence in this area in line with GMC guidance. There are various ways that this can be achieved – for example, by attendance at courses, by distance learning, practice team meetings, etc. To assist GPs and their practice staff (who need to be similarly up-to-date) in this, the English Department of Health will be reminding PCTs of the need to provide protected time for, and access to, training in child protection (which may be in the form of online resources).
"We would encourage you to take advantage of this for your own benefit and for the benefit of your patients.
"Child protection: resourcing and contractual issues
"Child protection work should be resourced by PCOs under the collaborative arrangements. Details of this and the contractual arrangements are available on the BMA website for BMA members at: http://www.bma.org.uk/employmentandcontracts/fees/medcertsandreports.jsp. The protection of a child must always take precedence over any resourcing or contractual issues."

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