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Safeguarding children in private practice
  1. Sreena Das1,
  2. Omowunmi Akindolie2
  1. 1 King's College Hospital, London, UK
  2. 2 Child Health, King's College Hospital, London, UK
  1. Correspondence to Dr Sreena Das, King's College Hospital, London, UK; sreenadas{at}

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The perplexing presentations (PP)/fabricated or induced illness (FII) in children RCPCH guidance (March 2021)1 is a timely and comprehensive guide on the identification, management and escalation of children presenting to services with PP.

The guidance draws appropriate attention to the role of iatrogenic harm, as doctors wish to trust and work with parents. In addition, there may be a fear of complaints from families and concerns about missing an underlying illness—particularly in patients who already have a medical condition. This may also involve a referral to tertiary specialists either by the paediatrician or a request by …

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  • Contributors Both authors contributed equally to the letter.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.