Synopsis
Recognise possible abuse or neglect, listen safely to the child, address urgent health and protection needs, and share a proportionate concern through the correct national pathway while following it to a protective response.
- The child’s safety and welfare are central even when the clinician is treating an adult. Ask whether adult illness, violence, substance use or coercion creates risk for children at home.
- A disclosure is not a forensic interview. Listen calmly, avoid leading or repeated questioning, explain the limits of confidentiality and make a contemporaneous factual record.
- Treat urgent injury or illness and contact emergency services when danger is immediate. Discuss promptly with the named or designated safeguarding professional and refer on reasonable concern.
Reasoning priorities
Elicit enough information to assess health and safety without contaminating evidence.
Listen calmly and clarify only what is needed for immediate safety without leading or repeated questioning. Explain that relevant information must be shared for safety, promptly involve safeguarding services and make a contemporaneous factual record.
Worked reasoning
An eight-year-old treated for a forearm injury quietly says, “Mum’s boyfriend did it and said I must not tell.” The accompanying adult is asking to leave.
- Move the child to a safe, supervised setting, address clinical needs and listen calmly without leading or repeated questioning. Explain that the information must be shared with people who can help; do not confront the alleged perpetrator.
- Make a contemporaneous factual record of what was said, the history already given, objective findings, timing and who was present. Check for siblings, immediate access to the alleged perpetrator and any urgent threat.
- Discuss immediately with the named safeguarding professional and make a same-day referral under the applicable local pathway. Parental consent is not required for necessary information sharing to protect the child.
- Final action: agree a safe disposition with children’s services and police where indicated; arrange specialist child-protection assessment without duplicative questioning or delaying necessary treatment.
- Verification: obtain the receiving professional’s name and plan, document authority and information shared, then follow up and escalate if the child remains exposed or the response is inadequate.