Barrage of child protection cases dilutes health professionals’ early intervention work

Health professionals are struggling to cope with the “vast increase” in the number of child protection cases being referred to them, the Royal College of Paediatrics and Child Health (RCPCH) has warned.

In a written response to the education select committee’s inquiry into the child protection system, the college argued that a rise in caseloads is diluting professionals’ ability to offer early intervention to children and families before they reach crisis point.

“There has been a vast increase in referrals, and subsequent assessment, since November 2009, which has arguably overwhelmed many local authorities,” it said.

“This has consequently affected health professionals, including doctors, who are facing an increase in the number of children requiring paediatric examination and experiencing raised thresholds for referral when they have concerns.
“Many authorities are, due to increased workload and diminishing resource, focusing on children in need of direct protection, thus diluting early intervention and help.”

The college added that a combination of cuts to council funding and unmanageable workloads pose risks to safeguarding children.

“Professionals may find it difficult to recognise subtle evidence of abuse when reactive demands reduce the time available to analyse the evidence or discuss findings with specialist colleagues,” the response said.

“Moreover, social care workloads mean that preventative work can be difficult to arrange, such as support for parents with learning difficulties or those with complex or difficult backgrounds.”

According to the college, the standardised Common Assessment Framework (CAF), which is used to assess children who may need support from a range of agencies, is unfit for purpose.

“The availability of time is an ongoing problem; one example being the lack of time available to properly complete a CAF,” the response said. “CAF, although well-intentioned, is seen by some as unwieldy and inflexible, so it becomes a barrier to effective joint working.”

The response also claimed that teachers and GPs need more guidance on identifying abuse and neglect at an early stage.

“Professionals need to be supported to ensure they are confident in how to receive subtle disclosures and early warning signs, and know exactly how to action those concerns,” it said.

“There needs to be absolute clarity about when to break confidence and when to act without necessarily informing parents first when this is in the best interests of the child’s safety. Further, it is important to support GPs in understanding when child protection concerns override confidentiality, and when to share information, especially about adults in a family.”