Safeguarding involves all aspects of minimising risk and promoting the welfare of a child.
Child protection involves the active process of protecting a child who is at risk of or suffering significant harm.
A child in need refers to a child who is likely to require input from services to achieve or maintain their health or development, or is disabled.
The Department for Education publishes the “Working together to safeguard children 2023: statutory guidance”, which provides the framework for a multidisciplinary approach to safeguarding children. This builds on the Children Act 1989 and Children Act 2004.
Safeguarding is an essential part of the role of anyone working with children. Children are vulnerable to abuse and do not have the means to protect themselves or look out for themselves. It is the responsibility of healthcare professionals to take a child-centred approach and act in the best interests of the child.
This is a summary and overview to help your basic understanding for exams and is not a substitute for safeguarding training you may require for clinical practice. When you have safeguarding concerns, discuss these with a senior who can advise on the appropriate course of action.
Types of Abuse
The basic types of abuse are:
- Physical
- Emotional
- Sexual
- Neglect
Other types of abuse also exist, such as exploitation, online grooming and forced marriage.
Risk Factors
- Domestic violence
- Previously abused parent
- Mental health problems
- Parent-child relationship difficulties
- Emotional volatility in the household
- Social, psychological or economic stress
- Disability in the child
- Parental learning disability
- Alcohol misuse
- Substance misuse
- Non-engagement with services
Signs of Possible Abuse
The following signs may indicate abuse, but do not confirm it. It is essential to consider the context and other potential explanations and refer appropriately. Potential signs of abuse include:
- Change in behaviour or extreme emotional states
- Bullying, self-harm or suicidal behaviours
- Unusually sexualised behaviours
- Unusual behaviour during examination
- Poor hygiene
- Poor physical or emotional development
- Missed appointments
- Not complying with treatments
Management
All NHS organisations should have a safeguarding team and a safeguarding lead who is available to assist with safeguarding concerns. Once a safeguarding concern is identified, the person who identifies it is responsible for escalating it or referring to someone who can investigate further and take appropriate action.
Actions when a safeguarding concern is identified include:
- Maintaining open and professional communication with the family
- Discussing with a senior or safeguarding lead
- Completing a safeguarding referral form
- Discussing with children’s social care services
- Documenting everything clearly in the medical records
Safeguarding cases are generally referred to children’s social care (social services). When a child is in immediate danger, the police may need to be involved. When the child is unwell or needs a place of safety, they may be admitted to hospital.
Information sharing refers to the passing on of information about a child and family to relevant organisations, such as children’s social care, when needed to protect a child. Where safe and appropriate, parents should be involved and informed of the need to share the information. Normally, information is kept confidential. However, when a child is at risk of significant harm, the need to share information can override confidentiality.
Where safe and appropriate, maintaining a professional, open, honest and trusting relationship with parents or carers is important, even when they are responsible for the abuse. This will make all aspects of any investigation and management easier and lead to better outcomes.
There are several measures that appropriate professionals can arrange to help support families of children with safeguarding concerns:
- Home visit programmes to support parents
- Parenting programmes to help parents develop parenting skills and manage their child’s behaviour
- Attachment-based interventions to help parents bond and nurture their child
- Child–parent psychotherapy
- Parent–child interaction therapy
- Multi-systemic therapy for child abuse and neglect (MST-CAN)
- Cognitive behavioural therapy for children who have suffered trauma or sexual abuse
Last updated November 2025
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