Haringey Community Paediatrics: Pathway for child with child protection concerns

Email for referrals: whh-tr.CP-Central@nhs.net

Who is this care pathway for?

This care pathway has been written primarily for families and carers of a child who has an emerging or identified concern regarding child protection.

This information in this page is also likely to be of interest and helpful for professionals as well.

Who do we see?

We see children and young people up to 18 years of age where there are concerns about possible abuse or neglect, who have an Haringey GP or attend a school in Haringey.

How to use this tool

When you scroll down you will see the information provided in this care pathway is set out in the following sections:

Who we see?
Who can refer and how?
Care Pathway: gives a flow-diagram type overview of the pathway
Detailed actions: sets out in more detail what is involved in the different parts of pathway
Associated documents: more for use by professionals
Resources: these are links to relevant web sites
Quality standards: this is a list of the quality standards that we report on annually on this web site and these are designated by QS where they appear in the text

Child Protection Care Pathway

Detailed Actions to be Completed

Referral received	We take phone referrals for our Daily Referral clinic (primairly form social care) and written referrals for the other clinics (from any professional). We use RiO as our electronic patient data base and this is where we hold all our progress notes and documents which in turn are accessible to other professionals who work for Whittington Health. At the end of each appointment we will write a report that is sent to families with an agreed plan and copy list of all relevant professionals � QS-1. we aim to send this out within 2 weeks of the appointment. QS-2 - We welcome and actively seek, and act on feedback from all who use our services.
Referral triaged	Administration: Baseline information is recorded for phone referrals to our Daily Referrals Clinic and this is passed onto the paediatrician on call Referrals to the other clinics are passed onto the Consultant leads in each of the Clinics. Paediatrician: For the Daily Referrals clinics the paediatrician on call reviews all available information, and contacts the Social Worker to agree a time for the appointment and participate in a conference call strategy meeting if possible. For the Weekly clinic the Named Doctor for Child Protection or deputy reviews all available information and requests any additional information. For the non-acute Child Sexual Abuse Clinic the lead Consultant in this clinic will review all the information and request any additional information. If any referral is not accepted then the Paediatrician will discuss this with the social worker (Daily Referrals clinic), or write to the referrer.
Daily referral clinics	Children seen in this clinic will be offered an appointment on the day of referral of the next working day. The child will have a holistic paediatric assessment that will focus on any alleged incident, the medical, developmental, social and family histories. All children seen in this clinic should be accompanied by a social worker who is familiar with the case and when involved, a police officer. Consent is a requirement for these assessments to go ahead. We record the examination findings on body maps and have the option of getting medical photography on the same day. At the end of the assessment we give the social worker a hand written summary and recommendations. All investigation results will be fed back to the family. All cases are discussed at our weekly peer supervision meeting and from this there may be variations or additions to our recommendations. We aim to attend the case conference following our assessment but this will depend on other clinical commitments.
Weekly clinic	Children seen in this clinic are either: New referrals where there is no acute injury, typically where neglect or historical abuse is the concern, or Those seen in the daily clinic where follow up is agreed Otherwise the assessments undertaken and way of working is similar to that in the Daily referral clinic.
Non-acute Child Sexual Abuse	Children seen in this clinic are either: New referrals where there is an allegation of non-acute sexual abuse, or Children referred to us for follow up by one of the HAVEN acute sexual assault centres As in our other clinics consent is a requirement, the assessments undertaken are holistic, and in doing this work we work closely with colleagues in social care and the police. The same quality standards on feeding back results to families and discussion of cases at our peer supervision meeting apply to this clinic. We also work closely with colleagues in Sexual Health which is also located on site at St Ann�s.
Discharged	When our work is complete then we will discharge the child or young person from follow up while ensuring that colleagues in universal health services were informed of the child�s needs. Professionals are always able to refer back to us if there were any further concerns about the child or young person.

Associated Documents

Resources

Haringey Council - reporting concerns	This link gives information on what to do if you are worried about a child for any reason.
Working together to safeguard children	A guide to inter-agency working to safeguard and promote the welfare of children (March 2015).
London Child Protection Procedures and Practice Guidance	These procedures and practice guidance contains setions on core procedures, parctice guidance, threshold docunets, and amendments and archives.
Haringey Local Safeguarding Children's Board	Haringey LSCB is a statutory body that helps all Haringey organisations who have contact with children, young people and their families to work together effectively in order to safeguard and promote the welfare of children and young people.
NICE clinical guide: When to suspect child maltreatment	This NICE guideline covers the alerting features in children and young people (under 18 years) for physical, sexual and emotional abuse; neglect; abricated or induced illness.
NSPCC - A child's legal rights: Gillick competency and Fraser guidelines	The Gillick competency and Fraser guidelines help us all to balance children�s rights and wishes with our responsibility to keep children safe from harm.
The Havens	The Havens are specialist centres in London for people (children and adults) who have been raped or sexually assaulted.

Quality Standards Title

QS-1	We will send out clinic letters within 2 weeks of the appointment
QS-2	We welcome and actively seek feedback. This helps us to improve the service