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New guidance to help health workers spot child abuse

Date:22 JUL 2009

The National Institute for Health and Clinical Excellence (NICE) has published guidance for healthcare staff on how to spot children who may have been abused.

In an effort to avoid another Baby P, the guidance will allow staff to consider, suspect, or exclude, all forms of maltreatment, including neglect, physical, sexual, and emotional abuse, when treating children.

It provides comprehensive information on the physical and psychological symptoms that may alert healthcare professionals to suspect abuse, and it encourages staff to look at the whole picture surrounding the child to establish whether they suspect maltreatment.

The guidance advises to seek an explanation of what happened to a child "in an open and non-judgmental manner" and concerns should be raised with an expert in the field, such as a community paediatrician, if the health worker considers a possibility of maltreatment.

However, if a health worker more strongly suspects a child is being maltreated, they should refer them to social services.

Andrew Dillon, NICE chief executive, said: "We want to give healthcare professionals the confidence to recognise the signs of maltreatment and to know when to refer on to a specialist. This guidance does not include recommendations on how to diagnose, confirm or disprove maltreatment; this should be done by specialists in social care, following Local Safeguarding Children Board procedures."

One of the signs of neglect that healthcare staff are advised to look out for is whether a child is "persistently smelly and dirty" and if "the dirtiness is ingrained" or if the "smell is so overwhelming" even early in the day.

Sunburn, head lice or a lack of treatment for tooth decay could also trigger healthcare staff to consider whether the child is being maltreated.

Critics have warned that the guidance could mean more referrals of children who are not at risk and may cause parents to become reluctant to approach their doctor in case they are accused of abuse.