Aims To explore how framing the child at risk by primary health care professionals when making a child protection referral contributes to social workers’ decisions to progress the referral to assessment.

Methods A qualitative multiple case study strategy was adopted to construct an in-depth understanding of the inter-professional communications between primary health care professionals and social workers when making and assessing child protection referrals. The referral was the phenomena under investigation, and each case (n = 25) was defined as a triad of the referring primary health care professional, responding social worker and anonymised referral narrative. The study was undertaken over three sites (inner city n = 2, county n = 1). There were three elements of the data collection: (1) Documentary analysis of anonymised referrals (2) In depth interviews with primary health care professionals (3) In depth interviews with first response social workers. Thematic analysis was undertaken within and across cases.

Findings Interview and referral narrative data will be presented from a sample of cases (n = 4) to demonstrate how referrers assessed risk to a child through a process of framing. Constructing the referral narrative is viewed as the end point of this dynamic process, commencing with a ‘sense making activity’, followed by explicitly categorising the child at risk (or not), and finally articulating the risk assessment by assembling the salient features framing the child at risk on the referral narrative. Framing the child at risk supports social workers in analysing referrals and making timely decisions whether to progress the case for further assessment.

Conclusion The findings presented are a small subset of a larger body of analysis of child protection referrals. The strategy adopted has provided unique insights into the way in which primary health care professionals use their professional judgement in complex situations to frame the child at risk and report this in their referral narratives. By explicitly framing the child at risk, social workers are presented with the situational context from which to analyse the risk to the child and support their decisions to progress the case.