Working with doctors Working for patients

0-18 years guidance - Child protection

56. Doctors play a crucial role in protecting children from abuse and neglect. You may be told or notice things that teachers and social workers, for example, may not. You may have access to confidential information that causes you to have concern for the safety or well-being of children.

57. Early identification of risks can help children and young people get the care and support they need to be healthy, safe and happy, and to achieve their potential.

58. If you work with children or young people, you should have the knowledge and skills to identify abuse and neglect.30 You should be aware of the use of frameworks for assessing children and young people’s needs, the work of Local Safeguarding Children’s Boards and Child Protection Committees, and policies, procedures and organisations that work to protect children and promote their welfare.

59. Children, young people and parents may not want you to disclose information about them if they think they will be denied help, blamed or made to feel ashamed. They might have had bad experiences or fear contact with the police or social services. You should help them understand the importance and benefits of sharing information. But you must not delay sharing relevant information with an appropriate person or authority if delay would increase the risk to the child or young person or to other children or young people.

60. Confidentiality is important and information sharing should be proportionate to the risk of harm. You may share some limited information, with consent if possible, to decide if there is a risk that would justify further disclosures. A risk might only become apparent when a number of people with niggling concerns share them. If in any doubt about whether to share information, you should seek advice from an experienced colleague, a named or designated doctor for child protection, or a Caldicott Guardian. You can also seek advice from a professional body, defence organisation or the GMC. You will be able to justify raising a concern, even if it turns out to be groundless, if you have done so honestly, promptly, on the basis of reasonable belief, and through the appropriate channels.

61. Your first concern must be the safety of children and young people. You must inform an appropriate person or authority promptly of any reasonable concern that children or young people are at risk of abuse or neglect, when that is in a child’s best interests or necessary to protect other children or young people.31 You must be able to justify a decision not to share such a concern, having taken advice from a named or designated doctor for child protection or an experienced colleague, or a defence or professional body. You should record your concerns, discussions and reasons for not sharing information in these circumstances.

62. You should participate fully in child protection procedures, attend meetings whenever practical and co-operate with requests for information about child abuse and neglect. This includes Serious Case Reviews set up to identify why a child has been seriously harmed, to learn lessons from mistakes and to improve systems and services for children and their families. When the overall purpose of a review is to protect other children or young people from a risk of serious harm, you should share relevant information, even when a child or young person or their parents do not consent, or if it is not possible to ask for consent. You must be prepared to justify your decision not to share information in such cases.

63. You should make sure that there are clear and well-understood policies and procedures for sharing information with agencies you work with closely or often. You should have an understanding of the roles, policies and practices of other agencies and professionals. This includes understanding the circumstances in which they consider disclosure to be justified. Teachers, social workers, police, youth offending teams and others all have different relationships with children and young people. They also have different cultures, policies and guidance on sharing information. You should understand and respect these differences but remember the particular responsibilities you have as a doctor and the importance of trust in your relationship with your patients.