Child Protection - Clarification of GP obligations

The LMC view is that there is now a clear legal and professional requirement for GPs to engage with and cooperate with local child protection procedures.

GPs have always had a legal and professional responsibility to take any necessary action to safeguard vulnerable children and to defend any failure to take appropriate action in the event of a child suffering as a result.   Since the Laming report it has become quite clear that GPs are expected to work in close collaboration with other professionals involved in child protection.

A recent legal case makes it absolutely clear that, if a GP believes a child to be at risk, the needs of the child are always paramount and override the duty to maintain patient confidentiality. 

Interpretation of new legislation is always difficult, but we believe that the new legal requirements now make it essential that GPs work in cooperation with local procedures and can demonstrate to their PCT that they are fulfilling their statutory obligations in this respect.

Section 11 of the Children Act 2004 sets out quite clearly that PCTs and SHAs must ensure that any services provided by them, or by others on their behalf, are provided with due regard to their new legal obligations.  The new duties in relation to child protection extend to all GPs and have been in effect since October 2005.  By April 2006 new local safeguarding children boards (LSCBs) must be in place to coordinate and ensure the effectiveness of local work to safeguard and promote the welfare of children.  Section 11 sets out that each person or body to whom it applies must have regard to any guidance on the subject provided by the Secretary of State. 

The staff training and continuing professional development requirements are described in 'Section 11 Statutory Guidance on Making Arrangements to Safeguard and Promote the Welfare of Children', which was published by the government in August 2005.  This guidance specifies that staff should understand their role and responsibilities, and those of other professionals and organisations, in order to ensure essential multi and inter-agency collaboration.  It also encourages inter-agency as well as single agency training.

Standard 5 of the National Service Framework for children and young people relates to Safeguarding and Promoting the Welfare of Children and Young People. It sets out that "all agencies must work to prevent children suffering harm and to promote their welfare, provide them with the services they require to address their identified needs and safeguard children who are being or who are likely to be harmed." 

It specifies that PCTs should ensure that their own staff and those in services contracted by them;

o are trained and competent to be alert to potential indicators of abuse or neglect in children
o know how to act on their concerns and fulfil their responsibilities in line with the local ACPC (Area Child Protection Committees) or its successor the LSCB (Local Safeguarding Children Boards) procedures
o undertake child protection training, including refreshers to ensure that they are competent and aware of any changes
o are supported by a funded training strategy for child protection.
o have a designated nurse and a designated doctor who have over-arching responsibility across the Primary Care Trust area, which includes all providers

PCTs, with LMC input, are currently trying to make sensible, realistic and safe decisions about child protection training which will fulfil these new legal obligations.

The practice management Organisational Indicators in the GMS contract specify that individual healthcare professionals should have access to information on local procedures relating to Child Protection.  A child protection lead in each practice may be a helpful way of ensuring that all statutory and professional standards are met by the practice, although this is not a requirement. 

In practical terms the key areas of responsibility for each practice are that all staff;

o are adequately trained
o know the local procedures that are in place
o know how to recognise when a child is at risk
o know who to call for further advice or to notify if a child may be at risk

The LMC will try to provide further updates on child protection as they become available. 

Further information may be obtained from;
Child protection guidance
http://myweb.tiscali.co.uk/lmclive/genguide/ichldprt/ichldprt.html
Children Act 2004
http://www.opsi.gov.uk/acts/acts2004/20040031.htm
What to do if you are worried a child is being abused
http://www.everychildmatters.gov.uk/_files/D9FECC5F6F3BC7B3FBD8950FC949AB09.pdf
Section 11 Statutory Guidance on Making Arrangements to Safeguard and Promote the Welfare of Children http://www.everychildmatters.gov.uk/_files/9204C14C73ACCA279701DDF9731B16F6.pdf
National Service Framework for children
http://www.dh.gov.uk/PolicyAndGuidance/HealthAndSocialCareTopics/ChildrenServices/ChildrenServicesInformation/ChildrenServicesInformationArticle/fs/en?CONTENT_ID=4089111&chk=U8Ecln

CED         17/1/07

Click here to download Child Protection - GP obligations in Word format.