Intended for healthcare professionals


Safeguarding children: a challenge to doctors

BMJ 2014; 349 doi: (Published 01 October 2014) Cite this as: BMJ 2014;349:g5898
  1. Julie Thomas, named GP for child protection1,
  2. Sarah Humphery, Islington named GP for child protection and safeguarding children2
  1. 1Haringey Clinical Commissioning Group, Vale Practice, London N8 5SU, UK
  2. 2Goodinge Group Practice, London, UK
  1. Correspondence to: J Thomas juliethomas5{at}

Doctors have an important role in detection and referral of child abuse

Doctors find safeguarding children complex and challenging. To complicate matters, the landscape is always changing as new information comes to light.

Lord Laming’s review of the Victoria Climbie case 11 years ago1 was followed by greater awareness of child abuse, widespread changes in practice, and increasing acknowledgment of the role of the medical profession in safeguarding. In 2014 the brutal reality of the harm and suffering endured by young people abused in Rotherham has jolted us anew.2 This is tragic, not only because of the horrific physical, psychological, and sexual abuse experienced by these children, but also because it was known about for 16 years. During that time an estimated 1400 children were abused. As a profession we need to ask how we might further hone our skills to provide effective understanding, detection, and referral of child abuse—and, particularly, how to recognise suspicious patterns at an early stage.

Lord Laming’s review increased awareness of the role of general practitioners in safeguarding, which arises because they provide a universal service and have a position of trust. Doctors now understand the strong associations between domestic violence, abuse, and other forms of child maltreatment.3 The Royal College of General Practitioners endorses good registration practice,4 and general practices now have systems that link adults in a household with the children. Coding of factors that increase the risk of child abuse—such as substance misuse, mental illness, and domestic violence—are used as alerts …

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