What Makes Primary Healthcare Professionals Suspect Child Abuse?

By Priyesh Agravat

I’ll start this off with some rather harrowing statistics…in 2015, a report by the Office of the Children’s Commissioner found that around 85 per cent of young people who are sexually abused do not receive the help and treatment they need. This is because the services responsible for identifying victims rely on the children themselves speaking out. Therefore, whilst 50, 000 cases of sexual abuse were reported from 2012 to 2014, it is estimated the actual number of victims in those two years could be as high as 450, 000. Scary…

Undertaking an iBSc in Primary Health Care means I can pretty much do my research project on anything I want so long as I can link it back to the primary care team in some way — it’s probably the best thing about this iBSc as I don’t think many others if any can offer that same amount of freedom.
Having a passion for child health (moment of silence for those who applied but didn’t get into the Paediatrics and Child Health iBSc 2k17) meant I was keen to incorporate this hugely relevant and fascinating area of medicine into my project — my interest stems primarily from the detective-like nature of a doctor’s job when it comes to communicating with children, especially when they are pre-verbal — whether it is something as menial a common cold, or perhaps something more sinister, such as child abuse.

Over the summer I decided to read the case reports of Baby P and Victoria Climbie, two of the more recent cases that received nationwide coverage. Going through them in their entirety was an interesting, eye-opening, emotional and at times upsetting experience. It is so important that from these cases of truly unimaginable cruelty that lessons are learnt and progress is made in the field of child safeguarding, and in fairness, over the years we have seen several new policies and guidelines put into place in the hope of avoiding such tragedies.
Looking at all the evidence, the missed signs, the mistakes made and the organisational/management issues made me wonder about how much different health professionals actually know about safeguarding — a key component of healthcare that is ultimately everyone’s responsibility — from the reception staff overlooking the waiting areas all the way to the doctors and nurses in the consultation rooms.

For these reasons, my research question for my project is “What Makes Primary Healthcare Professionals Suspect Child Abuse?”, which aims to identify the factors that trigger the act of child abuse reporting among primary healthcare professionals in the UK. Most importantly it hopes to gain an insight into the decision-making process that goes on in such complex scenarios; which can ultimately come down to a single clinician’s professional opinion. This will be a qualitative study, involving interviews with members of the primary care team, such as doctors, nurses, health visitors, social workers and receptionists. It will be quite a small study due to various limitations, but I am hoping it will stimulate further research within this area which could eventually influence future safeguarding guidelines.