What steps should I take if a child discloses abuse during a consultation?

Steps to take if a child discloses abuse during a consultation:

• Listen carefully and sensitively: Use open questions, listen actively, be empathetic, and avoid leading questions to allow the child to share their experience at their own pace in a private and comfortable setting.
• Explain confidentiality: Inform the child about confidentiality limits and who you will need to tell, discussing what will happen next and when.
• Do not delay referral: If the child is in immediate danger, refer immediately to children’s social care and/or the police.
• Make a referral to children’s social care: Follow local multi-agency safeguarding procedures to report the disclosure, even if details are not precise.
• Seek consent carefully: Obtain consent from the child if Gillick competent or from their parent/carer if not, unless sharing information is necessary to protect the child from harm.
• Document thoroughly: Record what was said verbatim, observations, concerns, decisions, and actions taken in the child’s clinical record.
• Do not perform intimate examinations unless urgent health needs exist: For suspected sexual abuse, avoid intimate examinations unless medically necessary and refer to specialist services for forensic examination if needed.
• Seek advice and support: Consult safeguarding leads, designated professionals, or experienced colleagues as needed.
• Consider the child’s communication needs: Tailor communication to the child’s age, developmental stage, disabilities, language, and cultural background.

These steps ensure the child’s safety, respect their rights, and comply with statutory safeguarding guidance.

References: NICE NG76,NICE CKS