Children Presenting to Emergency Departments who are not Registered with General Practitioners: Are we Missing Opportunities for Child Protection Intervention?

Background: Children not registered with a general practitioner (GP) may be living with a non-engaging family, a recognised risk factor for child abuse. Each paediatric attendance in Emergency Departments (ED) or Minor Injury Units (MIU) generates a letter shared with other healthcare professionals, allowing an accurate chronology. Prior to our study there was no system in place to identify unregistered patients, thus sub-optimally safeguarding children. In this retrospective study we investigate prevalence of child protection (CP) concerns within this group in 3 EDs and 3 MIUs in Glasgow, Scotland.

Methods: Data was collected on patients not registered with a GP, under 16 years old, over a 2 year period. Country of residence, clinical aietiology, and clinical notes were reviewed to identify potential CP concerns.

Results: 405 presentations were identified over the study period, of which 75 were resident in Scotland. Of the Scottish residents, 3 were associated with CP concerns. All cases with CP concerns in the study were identified at time of presentation to hospital.

Conclusions: We demonstrated no evidence of missed opportunity for CP intervention, however nonetheless initiated a regional best practice model to reduce risks of poor communication amongst healthcare professionals. By identifying this potentially vulnerable group in a timely manner we hope to improve communication between health and social care professionals to aid potential CP interventions.