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Lothian inter-agency child protection guidelines: impact on a children's NHS trust
Objective:
To evaluate the process involved in cases of suspected child abuse within a children's NHS Trust, 6 months after implementation of new inter-agency Child Protection guidelines.
Design:
Prospective evaluation of case records.
Setting:
Four departments within a combined child health trust in Edinburgh.
Main Measures:
Review of practice within each department, according to the Inter-Agency guidelines.
Results:
No standard procedure existed for the child protection process prior to the guidelines. In the first 6 months following implementation of the guidelines, a substantial increase in workload was experienced by community paediatricians. Medical examinations were better co-ordinated, with fewer children receiving repeated, intrusive examinations. However, note keeping was deficient, as 3% of referrals did not appear to be recorded in the case notes. Cross-referencing between departments was variable, with 81% of cases referred to Community Child Health not recorded in hospital case notes.
Conclusions:
The Inter-Agency guidelines have resulted in better coordination of the early referral stages. Deficiencies highlighted in this audit are due to record keeping and lack of liaison between departments within a combined children's trust.