Intended for healthcare professionals

Clinical Review

Safeguarding adults at risk of harm

BMJ 2013; 346 doi: (Published 14 May 2013) Cite this as: BMJ 2013;346:f2716
  1. Billy Boland, consultant psychiatrist and lead doctor for safeguarding adults1,
  2. Jemima Burnage, head of social work and safeguarding1,
  3. Hasan Chowhan, general practitioner2
  1. 1Hertfordshire Partnership NHS Foundation Trust, St Albans AL3 5TL, UK
  2. 2Creffield Medical Centre, Colchester CO2 7GH, UK
  1. Correspondence to: B Boland billy.boland{at}
  • Accepted 23 April 2013

Summary points

  • Doctors have a key role in safeguarding adults at risk from harm. Identifying and reporting safeguarding events is the duty of all clinicians, and doctors need to familiarise themselves with how to do this

  • Preventing abuse is a key component of any effective safeguarding system. Listening to concerns, promoting self determination, and offering choice supports people in protecting themselves

  • Be sensitive to the challenges of inquiring about abuse. Does the patient want the support of a trusted person? Have you made sure the abuser is not present at the assessment?

  • Information sharing and reporting are necessary to protect adults at risk. Be aware of when the need to share information outweighs the right to confidentiality

  • Working in partnership with other agencies and organisations is recognised as good practice and fundamental to ensuring that services provided are safe and of a high quality. Adults at risk may receive care from several different providers, and so a coordinated approach is most effective in safeguarding adults

Sources and selection criteria

In preparing this review we have used our personal experience and personal archives and conducted searches of the Cochrane Collaboration, PubMed, and Clinical Evidence using search terms including “safeguarding adults” and “vulnerable adults”. In addition we have drawn on information about safeguarding investigations reported to the Health and Social Care Information Centre, as well as government publications and “serious case reviews” of safeguarding events.

What is safeguarding adults?

Safeguarding adults is about protecting those at risk of harm. It involves identifying abuse and acting where harm is occurring. The UK Department of Health’s No Secrets guidance defines a vulnerable adult as a person aged 18 years or over “who is or may be in need of community care services by reason of mental or other disability, age or illness; and who is or may be unable to take care of him …

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