Child Protection Neglect Medical

The aim of this procedure is to ensure that children who have been made the subject of a child protection plan under the category of neglect where there are outstanding health needs which cannot be addressed by universal services receive a paediatric assessment and any outstanding health needs are addressed.

Medical Assessment Procedure where children/young people are subject to a protection plan for neglect


Severe neglect of young children has adverse effects on children’s ability to form attachments and is associated with major impairment of growth and intellectual development.  Persistent neglect can lead to serious impairment of health, development and long-term difficulties with social functioning, relationships and educational progress.  Neglected children may also experience low self-esteem and feelings of being unloved and isolated.  Neglect can result, in extreme cases, in death.  The impact of neglect varies depending on how long children have been neglected, their age and the multiplicity of neglectful behaviours they have experienced.


Where it is agreed at an Initial Child Protection Conference (ICPC) that a Child Protection Plan is required under the category of Neglect the Chairperson/Independent Reviewing Officer, along with the other professionals present, should agree if a Neglect Paediatric Assessment is required.  This decision will be based on information indicating outstanding unaddressed medical needs, concerns re growth and/or developmental delays which cannot be addressed by universal services for example GP’s, Health Visitors or School Nurses.

Health Professionals attending the ICPC will provide advice and guidance as to if the criteria for a Paediatric Assessment has been reached.

The outcome of the consideration, decision and rational will be clearly recorded in the ICPC minutes including the specifics of why Paediatric Assessment is required.  Details of which should also be recorded on the paediatric assessment referral form sent to the hospital requesting the medical.

If it is agreed a full paediatric assessment is required this should be an integral part of the Child Protection Plan.

Parents/carers will be informed at the Initial Child Protection Conference that the child is required to have a paediatric assessment as part of the protection plan. 

The child’s social worker, as the key worker, will complete a paediatric assessment referral form including consent, within 5 working days following the child protection conference and sent via an agreed secure process.

Where an assessment is deemed necessary then either the Paediatrician currently providing care to the child or an allocated Paediatrician will undertake the Paediatric Assessment.  Each provider trust will have its own process in place for arranging this.

The hospital provider trust will book an interpreter at the time of arranging the child’s appointment, where the social worker has requested this.  Family members should not provide interpretation.

The hospital provider trust, on receiving the referral, will contact the social worker and offer an appointment for the child within 8 weeks.  If the presenting issue requires urgent attention this should be clearly identified on the paediatric assessment referral form.  Each provider trust will have its own process in place and will identify an appropriate paediatrician to undertake the assessment.

The Child Protection Conference Administrator will securely forward the health professionals’ reports submitted to the ICPC to the relevant contact referral point.

The paediatrician who is to carry out the paediatric assessment will obtain any records on the child, which are held by the hospital trust including any A&E notes.

The hospital provider trust will send to the child’s parent/carer and the social worker the appointment date, time and venue for the paediatric assessment plus the name and designation of the clinician the child is to see.

Where ever possible sibling groups will be seen at the same appointment but will undergo separate medicals.

The social worker, with the support of the health professionals involved in the core group will make every effort to support the child and family to attend the paediatric assessment as part of the child protection plan.

As far as possible either Social Worker or another appropriate Core Group member who knows the child and family should accompany the child for the Paediatric appointment so that the examining Paediatrician has a complete background history of the child.

Following the paediatric assessment the Paediatrician will complete a report, using the appropriate proforma, showing the outcome of the assessment and the plan in relation to any findings.  This will be sent to the social worker, GP and Health Visitor/School Nurse within 2 weeks of the assessment taking place.  The report must be available for the Review Child Protection Conference (RCPC).

The Paediatrician will also send an appropriate report/letter to the parents/carers.  If the Child is over the age of 12 years the Social Worker will be responsible for sharing the report with the child and capturing their views for feedback to the Core Group and RCPC.  If this is not to be shared with the child the Social Worker will record the reasons why not.

The Paediatrician will, as necessary, refer the child for additional services and this will be facilitated in accordance with the hospital provider trust’s policy.


Prior to seeking parent/carer consent for a paediatric assessment, consider whether the child is mature enough to give consent i.e. following Fraser guidelines.  If the child declines consent the implications of this will be explored by the Core Group and appropriate action taken where necessary. 

The paediatrician will inform the social worker where a child fails to attend for assessment and consideration will be given to offering a further appointment where this is in line with trust policy.

Where a parent fails to present a child for a paediatric assessment on two or more occasions and the social worker, supported by the health professionals within the core group, are unable to facilitate the child’s attendance; the local authority will consider what action to take to safeguard the child’s welfare.  This may require the Local Authority to seek legal advice.

AMF 08.10.15