• child protection
• clinician
• clinical records

• CFS, chronic fatigue syndrome
• CSA, child sexual abuse
• FII, fabricated and induced illness

Child protection is for many clinicians an important part of child health practice. Multidisciplinary teamwork in early recognition of child abuse and support for the family may be very rewarding,¹ although paediatric assessment and clinical evidence often play only a minor role. Very few cases involve criminal proceedings or high profile publicity. Yet in recent years the UK paediatricians’ professional body, the Royal College of Paediatrics and Child Health (RCPCH), has been aware of more complaints and controversies arising from child protection than from any other area of paediatric practice. Paediatricians have been criticised for ignoring signs of abuse, being over-zealous, making wrong diagnoses of abuse, failing to involve other agencies, upsetting parents, breaching confidentiality, or giving biased evidence in court. Websites criticise doctors and nurses working in child protection,² and the media disseminate libellous inaccurate stories, without fear of reprisal. The unfortunate but predictable result is that professionals are increasingly reluctant to be involved with child protection.³

This article considers how clinicians, managers, and national bodies can maintain a high standard of child protection work as part of mainstream practice, support staff and minimise the risk of complaints.