Introduction The purpose of this observational study was to compare the child protection referral pathways for Haringey children at two London hospitals.

Aims This study has three main aims: to investigate whether the hospital with co-located social workers had more efficient child protection referral pathways; to gain descriptive information regarding the reasons behind the referrals, and how these cases were subsequently handled by the medical and social work teams; and to investigate possible causative factors that affect the numbers of referrals in different regions (such as poverty).

Methods A period of 28 days of observation was spent at each of the two hospitals. During this time, every referral made by the medical team was identified, and followed up until its conclusion. Specific information was taken from the referral form using a proforma. The times of presentation, referral to social services, admission (if applicable) and discharge were all recorded. Information regarding the management of the cases by social workers was obtained by attending weekly meetings.

Results The hospital with co-located social workers had a shorter average inpatient stay, fewer inpatients with delayed discharge, and shorter average delay time than the hospital without co-located social workers. However these differences were not significant at the p≤ 0.05 level. Relative affluence was found to be a significant factor (p≤ 0.05 level) in relation to the number of child protection referrals made.

Conclusions Although there were differences between the two hospitals, these were not statistically significant meaning that it is possible that the differences observed may not be solely attributable to the co-located social workers. Areas that were less financially affluent had significantly higher numbers of child protection referrals than areas with greater financial affluence; and physical assaults on children on the street was identified as a significant and yet untackled issue in child protection.