GPs often have the greatest chance of spotting behaviour patterns and risk factors that a child may be being abused. Charlotte Hudson presents some child safeguarding tips for locums on the steps they can take to recognise the signs.
The past year has seen high-profile media coverage about the maltreatment of children – from children groomed for sex by gangs of men, to cases of horrific abuse and neglect such as those of Daniel Pelka and Keanu Williams. GPs are well-placed to spot early signs of abuse or risk factors that may transcend into abuse. In primary care, GPs remain the first point of contact for most health problems. A GP partner or regular salaried GP is more likely to have a wider understanding of family dynamics. However, there are some general indicators that locum doctors should be aware of and look out for. These include (but would not be limited to):
- Family environment
- Frequency of attendances
- Avoiding certain carers/seeing a different GP at each visit
- Number of calls to OOH
- A+E attendances
- Presentation with unusual injuries and/or bruising patterns
- Behavioural problems
- Difficult interactions with parents/carers/adults/older children
- Age-inappropriate sexualised play/knowledge
- Developmental problems
- Self-harming.
Family environment
One of the most effective ways of ensuring that children are safeguarded is by working in partnership with parents and carers. A GP may be the first to recognise parental and/or carer health problems, or behaviour in an individual that might pose a risk to children and young people. Locum doctors should be aware of possible parental risk factors including domestic abuse, drug and alcohol abuse, and a history of abuse or offending; all of which might impact on parenting quality and childcare abilities. GPs should be vigilant in identifying potentially vulnerable mothers and families in difficulty, for example, at the antenatal booking appointment.