Children Presenting to Emergency Departments Who Are Not Registered with General Practitioners- Are We Missing Opportunities for Child Protection Interventions?

Background: Children not registered with a general practitioner (GP) may be living with a non-engaging family, a recognised risk for child abuse. Each paediatric attendance in Emergency Departments (ED) or Minor Injury Unit (MIU) generates a letter to other healthcare professionals. This information sharing contributes to an accurate chronology [1][2]. Prior to our study there was no system to identify unregistered patients, thus sub-optimally safeguarding children.

Objective: In this retrospective study we investigate prevalence of child protection (CP) concerns in unregistered patients within 3 hospitals and 3 MIUs in Glasgow, Scotland. We have since introduced a system where such children are identified monthly to minimise missed opportunities for intervention.

Methodology: Data was collected on patients age under 16 years presenting in a 2 year period from 1/1/17 to 31/12/18. Country of residence was recorded, and clinical notes reviewed to identify any CP concerns.

Results: 121 patients were identified. 10 (8.3%) were resident in Scotland. 4 (3.3%) were associated with CP/social work concerns, of which 3 related to parental alcohol misuse. All cases were identified at time of presentation.

Conclusion: While we demonstrated no evidence of missed opportunity to identify CP intervention during our study period, a new regional best-practice model was introduced to reduce risks of poor communication amongst healthcare professionals [3]. By identifying this potentially vulnerable group in a timely manner we hope to improve communication in cases with CP concerns.

[