Child protection in the family planning setting

Child protection in the family planning setting

A. Gunstone (1), D. Kinn (2)

North Liverpool Primary Care Trust, Abacus Clinics for Contraception and

Reproductive Health, Liverpool, UK (1); St. Helens Primary Care Trust,

Reproductive Health Services, St Helens, UK (2)

Introduction: Recent deaths from long-term child abuse in the U.K.,

highlighted the need to ensure a robust system, acceptable to clients and staff,

for managing children perceived to be suffering, or at risk of, abuse. Our

clinics provide open access, confidential contraceptive services to a population

of 612,000 at 26 sites including 4 young people’s clinics, with a total annual

attendance of 59,000 of which 1,700 are 516yrs of age. If a minor discloses

abuse, physical, sexual or other, our strict confidentiality rules must be

broken and the case passed to the appropriate agencies. Luckily this is rare.

However, much more often, the situation is not clearcut; we are worried about a

young client’s situation past, present or future, or a perceived risk to

others, but do not feel that immediate referral is in their best interest.

Design & Methods: We developed procedures, in consultation with

experts in the field, to enable these children to be monitored and supported.

The case is discussed immediately with a senior clinician; the client is

informed of our concerns, and reliable contact arrangements are made, eg mobile

phone, school. Within 24hrs, a member of our in-house Child Protection

Supervision Group (CPSG), of experienced nurses and doctors, will be consulted,

also other agencies as necessary. All staff receive training to make them aware

that children suffering, or at risk of, abuse may attend our clinics, and are

informed of the new procedures with regular updating.

Results: The protocols are implemented when abuse is suspected. Each

clinic site holds a Child Protection Folder containing instructions to staff,

forms for detailing the concern and labels to be stapled to the inside of the

case notes. Labelling the notes alerts staff to previous concern and ensures

that these vulnerable clients are fast-tracked to consultation with a senior

clinician at each visit. A copy of the case notes with a completed form is sent

to the CPSG and securely filed when any necessary immediate action has been

taken. Cases are reviewed quarterly until the young person is no longer a

concern, or reaches 18yrs (19yrs if from vulnerable groups eg learning

disabilities, looked-after children) and is passed to adult services.

Conclusions: Robust and acceptable child protection systems can be

implemented within a confidential community family planning service.

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