953 What do health care professionals in a children’s emergency department know about county lines?

Abstract

<h3>Aims</h3> County Lines (CL) is a drug supply model and form of Child Criminal Exploitation that uses young and vulnerable people to transports drugs from cities to rural areas. Children and young people may present to hospitals with injuries sustained as a result of criminal exploitation, however there is minimal research into how such presentations are responded to in a clinical setting. This report summarises activity undertaken to investigate the confidence of healthcare professionals (HCP) and medical students in understanding, identifying, and referring cases of CL from within Emergency Departments. <h3>Methods</h3> A quantitative survey of HCP was distributed within a Children’s Emergency Department in a city centre children’s hospital, both electronically and in person. The questions were chosen to allow a broad reflection on the understanding and confidence of HCP relating to CL and associated safeguarding. 1) How would you describe your understanding of County Lines activity? 2) How confident do you feel in identifying patients involved in County Lines activity? 3) How confident do you feel in initiating the correct safeguarding protocols surrounding County Lines activity? A separate survey was sent to medical students through the local university. This included the same questions with the third tailored to the role of a medical student. <h3>Results</h3> There were 22 responses to the HCP survey. 68.2% of HCP had either limited understanding or had never heard of the CL model (see figure 1), 54.5% of HCP were not so confident or not confident at all in identifying signs of CL involvement (see figure 2) and 36.4% of HCP were not so confident or not confident at all in initiating the relevant safeguarding protocols (see figures in main text). There were 44 responses to the medical student survey. Knowledge was also limited; 86.5% had little or no understanding of the CL model, 81.8% were not so confident or not confident at all in identifying the signs, and 81.8% were not so confident or not confident at all in who to contact if such a case arose (see figures in main text). <h3>Conclusion</h3> The results highlight that there is a gap in the knowledge of HCP and medical students surrounding CL. This may limit their ability to identify the involvement of young people and support and refer individuals vulnerable to criminal exploitation. There is therefore capacity for service improvement in this domain. Improving training for HCPs and medical students, creating concise visual aids for Emergency Departments and embedding youth workers within the Emergency Department may help bridge the gap between young people involved in CL and professionals who have an opportunity to identify victims and prevent further exploitation.