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Audit of child protection medical reports against local child protection procedures
  1. B A Klepacka,
  2. R Brockelbank,
  3. L Hayman,
  4. S Banerjee
  1. Community Paediatrics, GOSH in Haringey, London, UK

Abstract

Aims Child protection is currently a particular challenge to paediatricians. Local safeguarding procedures have been developed to guide practice by medical professionals, social care and police. They include guidance on the writing of child protection medical reports and inter-agency communication. Our aim was to improve the quality of care offered to children, by assessing our performance against the local guidelines and identifying areas for improvement. We also compared outcomes with a previous audit.

Methods This was a retrospective notes audit. 59 child protection medicals took place in our Community Paediatrics department between 1 September and 30 November 2009. 54 sets of notes were located. The medical reports were assessed according to a proforma based on 12 points of information required by the local safeguarding procedures. Data regarding presence of correspondence from social care were gathered in August 2010. Data were analysed using excel and were compared with a previous audit.

Results See figure 1 and table 1.

Abstract G213(P) Figure 1

Demographics

Abstract G213(P) Table 1

Details of report writing.

When a case conference was recommended in the medical report, in 25% there was no documentary feedback that this had taken place. Feedback from social care was only received in 44% of the child protection medicals.

Conclusions This audit highlighted numerous improvements which could be made in this department. The need to formulate a clear, comprehensive opinion in the medical report alluding to the likelihood of the child being subject to abuse (physical, emotional, sexual, neglect) is essential. This part of the report is crucial in the decision making of other agencies. Omissions in the reports were partly due to administrative error which highlights the importance of an efficient administrative infrastructure within a child protection department. This audit also highlights that there is room for improvement in the channels of communication and sharing of information between agencies. Finally, by comparing the demographic data from this audit with the previous one, we highlight the increase in the number of referrals made for Child Protection medicals. This may be attributed to recent high profile cases and this will be important for commissioning future services in a restructured recessionary National Health Service.

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