Lack of specialist help leaves A&E staff at risk of missing cases of child abuse

Doctors working in high pressure hospital emergency departments risk missing non-accidental injuries in babies through a lack of specific guidance, multi-agency information, and specialist safeguarding help, an investigation by the Healthcare Safety Investigation Branch (HSIB) has found. 1

HSIB analysed 10 serious incident reports from NHS trusts in cases where non-accidental injuries were missed, and interviewed staff at three acute trusts. Staff pointed to the high workload and time pressures in emergency departments, along with the sensitivity of raising the matter, as barriers to a diagnosis of non-accidental injury.

The investigation found that although there was guidance on child abuse from the National Institute for Health and Care Excellence and from the Royal College of Paediatrics and Child Health, there was no specific guidance for emergency department clinicians on the identification of suspected non-accidental injuries and how to act on a suspicion.

There was a lack of systems focus in the …