Safeguarding Children

We cannot completely remove all possibility of risk from children and young people's lives. However, we can make sure that we have done as much as possible to minimise or manage the risk of harm while in our care.

A Safe Environment

All organisations have a duty of care to both their service users and their workers, particularly when this may involve children and young people. It is our initial responsibility is to ensure that our actions or inaction do no result in anyone coming to harm.

Please be extra vigilant in spotting potential hazards in the workplace that may result in harm - particularly children who may not be aware of the potential risk.


Safeguarding children is the action we take to promote the welfare of children and protect them from harm.

Professionals, such as GP's who come into contact with children, need to be alert to their needs and any risks of harm that individual abusers, or potential abusers, may pose to children. However, if you are likely to encounter children during the course of your normal working activities, you may be in a position to observe signs of abuse or neglect, or changes in behaviour, which may indicate a child may be being abused or neglected.

Remember - A person may abuse or neglect a child by inflicting harm, or by failing to act to prevent harm.

Each employee should ensure that they understand and work in line with our Child Protection Policies & Procedures.

Understanding and identifying abuse and neglect

The warning signs and symptoms of child abuse and neglect can vary from child to child. Children develop and mature at different rates so what appears to be worrying for a younger child might be normal behaviour for an older child.

Parental behaviours may also indicate child abuse or neglect, so you should also be alert to parent-child interactions which are concerning and other parental behaviours. This could include parents who are under the influence of drugs or alcohol or if there is a sudden change in their mood.

By understanding the warning signs, you can respond to problems as early as possible and provide the right support and services for the child and their family. It is important to recognise that a warning sign doesn't automatically mean a child is being abused.


Neglect is the most common reason for a child to be the subject of a child protection plan or on a child protection register.

1 in 10 children have experienced neglect in the UK

Neglect is the ongoing failure to meet a child's basic needs. A child may be left hungry or dirty, without adequate clothing, shelter, supervision, medical attention or health care. A child may also be put in danger or not protected from physical or emotional harm. They may not get the love, care and attention they need from their parents. A child who's neglected will often suffer from other abuse as well.

Neglect is dangerous and can cause serious, long-term damage.

Sometimes this is because parents or carers don't have the skills or support needed, and sometimes it's due to other problems such as mental health issues, drug and alcohol problems or poverty.

Identifying Neglect

Having one of the signs or symptoms below doesn't necessarily mean that a child is being neglected. But if you notice multiple, or persistent, signs then it could indicate that there's a serious problem.

Children who are neglected may have:

Poor appearance and hygiene
Be smelly or dirty
Have unwashed clothes
Have inadequate clothing
Seem hungry

Health and development problems:

Untreated injuries, medical and dental issues
Repeated accidental injuries caused by lack of supervision
Recurring illnesses or infections
Not been given required medicines and vaccinations
Poor muscle tone or prominent joints
Skin sores, rashes, flea bites, scabies or ringworm
Thin or swollen tummy
Faltering weight or growth and not reaching developmental milestones
Poor language, communication or social skills.
Have frequent and untreated nappy rash in infants.

It can be difficult to know when to take action to protect a child from neglect. Knowing when a child or family need help requires someone to recognise that there are ongoing or persistent patterns of neglect.

So it's important for concerns to be reported and recorded.

This helps social workers and other professionals build up a picture of a child's life over time.

Child Abuse

Child abuse is any action by another person - adult or child - that causes significant harm to a child. It can be physical, sexual and/or emotional, but can just as often be about a lack of love, care and attention.

It is estimated that over half a million children are abused in the UK each year.

An abused child will often experience more than one type of abuse, as well as other difficulties in their lives. It often happens over a period of time, rather than being a one-off event.

Types of child abuse:

Online abuse
Sexual abuse
Physical abuse
Emotional abuse
Child sexual exploitation
Female genital mutilation (FGM)
Bullying and cyberbullying
Domestic abuse
Child trafficking
Harmful sexual behaviour

The signs of child abuse aren't always obvious, and a child might not tell anyone what's happening to them.

Children might be scared that the abuser will find out, and worried that the abuse will get worse. Or they might think that there's no-one they can tell or that they won't be believed.

Sometimes, children don't even realise that what's happening is abuse.

The effects of abuse may be short term or may last a long time - sometimes into adulthood.

Physical Abuse

Physical abuse is deliberately physically hurting a child. It might take a variety of different forms, including hitting, pinching, shaking, throwing, poisoning, burning or scalding, drowning or suffocating a child.

Physical abuse can happen in any family, but children may be more at risk if their parents have problems with drugs, alcohol and mental health; or if they live in a home where domestic abuse happens. Babies and disabled children also have a higher risk of suffering physical abuse.

Physical harm may also be caused when a parent or carer fabricates the symptoms of, or deliberately induces, illness in a child. Physical abuse can also occur outside of the family environment.

Some of the following signs may be indicators of physical abuse:

Children with frequent injuries
Children with unexplained or unusual fractures or broken bones
Children with unexplained bruises or cuts, burns or scalds and/or bite marks.

Emotional Abuse

Emotional abuse is the persistent emotional maltreatment of a child. It is also sometimes called psychological abuse and it can have severe and persistent adverse effects on a child's emotional development.

Emotional abuse may involve deliberately telling a child that they are worthless, or unloved and inadequate. It may include not giving a child opportunities to express their views, deliberately silencing them or making fun of what they say or how they communicate.

Although the effects of emotional abuse might take a long time to be recognisable, practitioners will be in a position to observe it. For example, in the way that a parent interacts with their child.

Some of the following signs may be indicators of emotional abuse:

Children who are excessively withdrawn, fearful, or anxious about doing something wrong.
Parents or carers who withdraw their attention from their child, giving the child the 'cold shoulder'.
Parents or carers blaming their problems on their child.
Parents or carers who humiliate their child, for example, by name-calling or making negative comparisons.

Sexual abuse & exploitation

Sexual abuse is any sexual activity with a child. You should be aware that many children and young people who are victims of sexual abuse do not recognise themselves as such. A child may not understand what is happening and may not even understand that it is wrong. Sexual abuse can have a long-term impact on mental health.

Sexual abuse may involve physical contact, including assault by penetration (for example, rape or oral sex) or non-penetrative acts such as masturbation, kissing, rubbing and touching outside clothing. It may also include non-contact activities, such as involving children in the production of sexual images, forcing children to look at sexual images or watch sexual activities, encouraging children to behave in sexually inappropriate ways or grooming a child in preparation for abuse. Sexual abuse is not solely perpetrated by adult males. Women can commit acts of sexual abuse, as can other children.

Some of the following signs may be indicators of sexual abuse:

Children who display knowledge or interest in sexual acts inappropriate to their age.
Children who use sexual language or have sexual knowledge that you wouldn't expect them to have.
Children who ask others to behave sexually or play sexual games.
Children with physical sexual health problems, including soreness in the genital and anal areas, sexually transmitted infections or underage pregnancy.

Children who are sexually abused may:

Stay away from certain people.
They might avoid being alone with people, such as family members or friends.
They could seem frightened of a person or reluctant to socialise with them.
Show sexual behaviour that's inappropriate for their age.
A child might become sexually active at a young age.
They might be promiscuous.
They could use sexual language or know information that you wouldn't expect them to.
Have physical symptoms.
Anal or vaginal soreness.
An unusual discharge.
Sexually transmitted infection (STI).

What to do if you suspect abuse

An assessment by professionals used to dealing with cases of suspected abuse will be the best way forward, even if the child has not directly revealed that something is wrong or if there's any other uncertainty on your part.

Even if your primary responsibility does not relate to children, many professionals will have the opportunity to observe and identify behaviour which could indicate a child is being abused or neglected. If you work with children on a regular basis you are well positioned to be able to identify abuse or neglect.

Even if you are in a profession where you may not encounter the same children as frequently, you will nevertheless be in a position to observe signs of abuse and neglect

You should discuss your concerns with your manager, a named or designated professional or a designated member of staff.

You should always record, in writing, all concerns and discussions about a child's welfare, the decisions made and the reasons for those decisions.

How to make a report

Details - The child's or young person's name, age and address if known.
Indicators of harm - The reason for believing that the injury or behaviour is the result of abuse or neglect.
Reason for reporting - The reason why the call is being made now.
Safety assessment - Assessment of immediate danger to the child or children.
Description - Description of the injury or behaviour observed.
Child's whereabouts - The current whereabouts of the child or young person.
Other services - Your knowledge of other services involved with the family.
Family information - Any other information about the family.
Cultural characteristics - Any specific cultural or other details that will help to care for the child, for example, cultural origins, interpreter or disability needs.

A report should still be made, even if you don't have all the information listed above. The reporter's identity is protected unless they provide written consent for it to be disclosed or it is required by order of the court.

You can also seek advice at any time from the NSPCC helpline - or 0808 800 5000.

Please ensure that you are familiar with the IGP's Policy on Safeguarding Children and Health & Safety

The Independent General Practice