G95(P) Auditing the summary and opinion sections of child protection reports against the guidelines set out in the royal college of paediatrics and child health (RCPCH) child protection companion

Abstract

Introduction Child protection medicals are a necessary step in the multi-agency process of safeguarding children. The summary and opinion section offers an opportunity to provide information to assist children’s services in keeping children safe. Poor adherence to the guidelines set out in the RCPCH Child Protection (CP) Companion can lead to the medical report being less useful in guiding actions in safeguarding children’s welfare. Methods All CP reports completed in a DGH over an eight-month period were retrospectively analysed against the guidelines set out in the RCPCH CP Companion (2013). Categories audited included ‘balance of probability, likelihood of abuse, risk of significant harm, backed up by evidence, considered differential diagnosis, concise/highlighted key points, recommendations, follow up’. Results 34 child protection medicals were performed in the time with final CP reports on 28 analysed. Documented a balance of probability or likelihood of abuse (25%); documented the child’s risk of significant harm (43%); Use referenced evidence (20%); Referred to a differential diagnosis (10%); specific category of abuse mentioned (81%); concise reports (75%); medical recommendations mentioned (80%); need for follow up documented (57%). Conclusions The audit results highlight that guidelines in the RCPCH CP companion are not being followed. While not mandatory, adherence to practice Guidelines, enables medical reports to contribute to informed and safe multiagency actions to protect potentially vulnerable children. Despite the subjectivity of our analysis, our results suggest that further training on report writing and attendance at recommended safeguarding peer review sessions is required to improve the quality of medical reports.