Why read this summary?

Maltreatment of children is common, with 538 500 reported referrals to social services departments in England1 and 43 411 in Wales2 in the year ending 31 March 2008, although these probably underestimate the true scale of the problem. Child maltreatment includes neglect; physical, sexual, and emotional abuse; and fabricated or induced illness. It may present in various ways to different healthcare professionals, who have a “duty . . . to be proactive in safeguarding children”3 but often find it difficult to act on what they find.

Child maltreatment has short and long term harmful effects on a child’s health and wellbeing; emotional, interpersonal development; and behaviour; and in extreme circumstances it may lead to death. Children may present with both physical and psychological symptoms and signs that constitute alerting features of one or more types of maltreatment, which may also be observed as part of the interaction between the parent or carer and the child.4 The effects of maltreatment may continue throughout adulthood and include physical disability or disfigurement as well as the profound psychological consequences of anxiety, depression, substance misuse, and self destructive or antisocial behaviours, which may lead to difficulties in forming or sustaining close relationships, sustaining employment, and parenting capacity.3

Child maltreatment is under-recognised and inconsistently reported to children’s social care by healthcare professionals in England and Wales.5 The recent death of Baby Peter is yet another reminder of the consequences of missing the alerting features of child maltreatment.6 The recently published guidance from the National Institute for Health and Clinical Excellence (NICE) aims to raise the awareness of healthcare professionals to the alerting features of child maltreatment.7 It also aims to support healthcare professionals who are not specialists in child protection in identifying children who may be being maltreated and …