Child protection medical examination

This resource provides details of the child protection medical examination and the process that we follow to make sure that children in our care are kept safe where there are concerns about neglect or abuse.

We understand that this can be a difficult time for children and their parents and carers. We want you to understand what is happening, and we are here to listen to your concerns.

Because this is a legal process, it is very important that you understand what we are doing and why.

Key principles

The child safeguarding team and staff at the hospital are guided by the following key principles:

• children have a right to be safe and should be protected from all forms of abuse and neglect
• safeguarding children is everyone’s responsibility
• it is better to help children and their families as early as possible, before issues get worse and may become more damaging
• children and families are best supported and protected when everybody works together

What is safeguarding?

Safeguarding is the action that is taken to promote the welfare of children and protect them from harm.

Safeguarding means:

• protecting children from abuse
• preventing harm to children’s health or development
• making sure children grow up safely and well cared for

Why do we safeguard?

The Sheffield Children’s NHS Foundation Trust is committed to protecting the children and young people using our services from harm, abuse or neglect.

Your child has come to hospital with something that cannot be explained, or which national guidance tells us may be because your child may have been harmed. Our job is to help work out if there is a reason for the concern and if we can treat or resolve it by asking you and other agencies for help.

What is our responsibility in safeguarding children?

The Children Act 1989 and 2004 makes it a legal duty for all Sheffield Children’s Hospital staff to protect all children under the age of 18 from the risk of significant harm. Our legal duties include safeguarding and promoting the welfare of all children and young people to make sure they grow up happy and healthy.

If there is a concern about the safety or welfare of your child we will follow our child protection policies and the procedures as set by the Sheffield Children’s Safeguarding Partnership (SCSP).

Consent

You will be asked to confirm you have ‘parental responsibility’. We need to check this because not every carer or person accompanying the child has legal parental responsibility.

If you agree to the examination going ahead, you will be asked to confirm that you give ‘consent’. Before giving consent, please ensure you understand what is happening and why.

We may also ask your child for their consent if we feel they are old enough to understand what will happen.

If you or your child refuse to consent for the child protection medical examination, then we may discuss this with Children’s Social Care or the police to ensure your child’s safety.

There are occasions when your consent is not legally needed, because the law requires us to share certain medical information (with Children’s Social Care or the police) if it is in the child’s best interest.

The process

An experienced children’s doctor will ask you questions about your child and may do a physical examination. The doctor might feel that further tests or photographs are needed to help get a better understanding of what is worrying us.

Working in partnership to safeguard your child

We understand that it is upsetting to have concerns raised about a child’s safety and wellbeing and we always try to work in partnership with parents and carers to offer support. We ask that you cooperate with us and the other agencies involved in the best interests of your child.

Children’s Social Care are always informed if we follow this process as they have a legal duty to investigate our child protection concerns. With their support we can ensure that your child receives the best help needed.

Child protection medical examination

A ‘child protection medical examination’ is the full check-up by a senior children’s doctor to look for any signs of harm that may have happened to your child. A chaperone will always be present with the doctor to ensure your child’s safety.

The doctor and nurses involved will talk to you about the child protection process and any decisions that are made about your child’s safety, including when your child can safely leave the hospital.

Sometimes we must discuss our medical concerns with the police, but we will usually tell you if we are going to do this.

Investigations

As part of the child protection medical examination more tests or investigations are sometimes needed. These will be explained to you, but please ask if you have any questions.

These tests might include:

• X-rays
• CT scan
• specialist examination of the eyes
• blood, urine and other tests

More information is available, so please ask your doctor or nurse if you have any questions or concerns.

Medical photography

Sometimes we need to take photographs as part of the child protection medical examination.

These will either be done by the doctor who examines your child (using a secure camera) or by the specialist medical photography team.

All medical photographs are stored securely in your child’s electronic records.

Intimate or sexual abuse examination

A senior doctor may need to look at your child’s genital area as part of the general child protection medical examination. However, if it is suspected or disclosed that your child may have been sexually abused, they will be seen by specially trained doctors and nurses at the SARC (sexual abuse referral centre).

Information will be given to you if this is thought to be needed. The SARC is within the Sheffield Children’s hospital.

Sharing information about your child

We usually provide a child protection medical report for the professionals who are involved in your child’s care. This may be for the social worker, GP and health visitor. The child protection medical report and any forms we complete to document our examination are stored securely within your child’s medical records.

Sometimes we are also asked to provide a report and share information with the police.

In order to gather information, we may contact your child’s GP, 0-19 health visiting and school nurse service, school or other agencies that may help.

Where can I get more information?

Please ask any questions you have at any time during the child protection medical examination.

If you have questions either before or afterwards then please speak to the doctors or nursing staff looking after your child. They will either be able to answer your questions, or contact someone who can. If your child is admitted to hospital they will have a named consultant in charge of their care.

For more information about the child protection process, please contact the social worker appointed to the child’s care if applicable.

If you are unhappy with the healthcare your child has received, please make contact with the Sheffield Children’s Hospital PALS team or discuss with a member of staff who can signpost you to someone who will help.

Please remember

• There is no such thing as a silly question. We will always listen, so just ask
• If you do not understand what we are doing or why, keep asking us to explain until you do understand
• Feeling upset is only natural, but please remember our staff are just doing their job