Abstract

Awareness of Child Sexual Exploitation (CSE) in the UK has increased following a number of high profile cases.

We retrospectively analysed District General Hospital encounters for 79 children and adolescents highlighted by a specialised local multi-agency safeguarding group to be “missing” or at high risk of CSE. All Emergency Department (ED) and outpatient attendances were reviewed.

Of the 79 children identified: 69% female, 31% male, mean age 16.2 yrs (range: 9.3 yrs–19.1 yrs). We analysed all ED attendances and outpatient attendances from the age 5 yrs to date (excluding orthodontics appointments).

76.4% of females presented to ED in total 196 times (mean 3.56 visits each). Attendances were for self-harm (27.5%), accidental injury (18.36%), overdose (13.77%), medical illness (12.75%), recreational drug/alcohol and conduct related (12.2%) and seeking Child and Adolescent Mental Health Services (CAMHS) support (10.7%). There were 9 episodes for alleged physical assault (4.5%). 3 females presented with ‘going missing’ for 24–72 h, 1 female presented with suspicion of pregnancy and 1 female with alleged sexual assault.

62.5% of males attended ED in total 54 times (mean 2.25 visits each), Presentations were for accidental injury (29.6%), recreational drug use/alcohol and conduct related (25.9%), medication overdose (14.8%), alleged assault (12.96%), self-harm (9.25%) and medical illness (7.4%).

13.9% of the cohort (males and females combined) have documented learning difficulties. 12.5% of males have ASD/ADHD, 5% of females have ASD. In Children’s outpatients, 43% saw a hospital specialist most commonly in General Paediatrics, Community Paediatrics or CAMHS.

Our results show that these children and young people present regularly to hospital. We noted high numbers of ED visits: assault, mental health and alcohol/drug related attendances featuring frequently. We suspect a high prevalence of neurodevelopmental conditions and learning difficulties.

This data can be used to target bespoke CSE sessions for ED staff. Improved information-sharing between professionals (in particular with access to mental health information) can assist in identifying those with particular risk factors and co-morbidities. In light of frequent ED attendances it is essential that a robust system for sharing information on ‘missing children’ with ED departments nationwide is established.