Hospitals fail to do routine checks on injured children despite Baby P

By David Rose

February 19, 2009 / The Times Online

Two thirds of hospitals fail to conduct routine checks on injured children despite warnings after the death of Baby P, The Times has learnt.

A poll of NHS trusts conducted by the Conservative Party suggests that staff at many accident and emergency departments are not able to check whether children are in contact with social services or subject to a child protection plan, even when they have suspicious injuries.

Doctors’ failure to detect evidence of non-accidental harm and poor links between health and social services were identified last year as key failings contributing to the death of Baby P in Haringey, North London, in 2007. But few hospitals can check databases of children at risk, while one in ten clinical staff has not had child protection training, the survey suggests.

The Conservatives, who received responses from 120 out of 171 hospital trusts under the Freedom of Information Act, said that problems identified by the independent report into Baby P’s death appeared to be systemic.

Only one in seven hospitals claimed to be able to make any sort of online check on whether social services were involved in the care of an injured child, the Tories said. Some trusts said that it was not permitted for staff routinely to check whether children were subject to child protection plans.

Last month the Government announced the setting up of a database of 11 million juveniles in England for professionals working with children. The Tories have attacked the £224 million ContactPoint as “another expensive data disaster waiting to happen”.

“A far better solution would be to make sure basic checks are maintained in A&E and that other hospitals learn from those that are doing well so that children who are really at risk are identified before it’s too late,” Andrew Lansley, the Shadow Health Secretary, said. “The NHS is doing its best, but many hospitals are getting incoherent messages about what to do to prevent tragedies like the Baby P case from happening again.”

John Heyworth, president of the College of Emergency Medicine, said that although A&E departments could be overwhelmed because of staff shortages or a need to see patients within a government four-hour target, trusts had a “major responsibility to find out whether the child is on a protection plan or in a family that is in contact with social services”. “Access to and use of databases varies widely across the country,” he said. “In some areas links between A&E and social services are sub-optimal while in other areas there are next to no links at all.”

Ben Bradshaw, the Health Minister, said that rules on child protection applied to all trusts, including arrangements for checking if a child was subject to a child-protection plan, and staff training. “The Conservatives are confusing the requirement to check if a child is subject to a child protection plan with accessing details of the plan itself,” he added. “That is not a requirement and not something we would expect NHS staff to do.”

Rosalyn Proops, child protection officer for the Royal College of Paediatrics, said that all A&E professionals should have an awareness of child protection and be able to check quickly with social services if they had concerns.

However, there was a danger that routine checks on child-protection status could override clinical judgment about whether injuries were suspicious. “There has never been a system of routine checks on children coming to A&E and any such system would be at best unhelpful and at worst dangerous to the child,” she said. “If children were formally screened, it could provide a false sense of security.”

The Healthcare Commission, the NHS watchdog, is expected to publish a review of the matter shortly.

Two thirds of hospitals fail to conduct routine checks on injured children despite warnings after the death of Baby P, The Times has learnt.

A poll of NHS trusts conducted by the Conservative Party suggests that staff at many accident and emergency departments are not able to check whether children are in contact with social services or subject to a child protection plan, even when they have suspicious injuries.

Doctors’ failure to detect evidence of non-accidental harm and poor links between health and social services were identified last year as key failings contributing to the death of Baby P in Haringey, North London, in 2007. But few hospitals can check databases of children at risk, while one in ten clinical staff has not had child protection training, the survey suggests.

The Conservatives, who received responses from 120 out of 171 hospital trusts under the Freedom of Information Act, said that problems identified by the independent report into Baby P’s death appeared to be systemic.

Only one in seven hospitals claimed to be able to make any sort of online check on whether social services were involved in the care of an injured child, the Tories said. Some trusts said that it was not permitted for staff routinely to check whether children were subject to child protection plans.

Last month the Government announced the setting up of a database of 11 million juveniles in England for professionals working with children. The Tories have attacked the £224 million ContactPoint as “another expensive data disaster waiting to happen”.

“A far better solution would be to make sure basic checks are maintained in A&E and that other hospitals learn from those that are doing well so that children who are really at risk are identified before it’s too late,” Andrew Lansley, the Shadow Health Secretary, said. “The NHS is doing its best, but many hospitals are getting incoherent messages about what to do to prevent tragedies like the Baby P case from happening again.”

John Heyworth, president of the College of Emergency Medicine, said that although A&E departments could be overwhelmed because of staff shortages or a need to see patients within a government four-hour target, trusts had a “major responsibility to find out whether the child is on a protection plan or in a family that is in contact with social services”. “Access to and use of databases varies widely across the country,” he said. “In some areas links between A&E and social services are sub-optimal while in other areas there are next to no links at all.”

Ben Bradshaw, the Health Minister, said that rules on child protection applied to all trusts, including arrangements for checking if a child was subject to a child-protection plan, and staff training. “The Conservatives are confusing the requirement to check if a child is subject to a child protection plan with accessing details of the plan itself,” he added. “That is not a requirement and not something we would expect NHS staff to do.”

Rosalyn Proops, child protection officer for the Royal College of Paediatrics, said that all A&E professionals should have an awareness of child protection and be able to check quickly with social services if they had concerns.

However, there was a danger that routine checks on child-protection status could override clinical judgment about whether injuries were suspicious. “There has never been a system of routine checks on children coming to A&E and any such system would be at best unhelpful and at worst dangerous to the child,” she said. “If children were formally screened, it could provide a false sense of security.”

The Healthcare Commission, the NHS watchdog, is expected to publish a review of the matter shortly.

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