Child Protection Peer Review for Paediatricians

Abstract

Key Practitioner Messages Peer review involves a group of peers engaged in a discussion and providing an opinion on an individual's case that the individual can accept or reject while retaining ultimate responsibility for providing their opinion. Each health organisation employing paediatricians working in child protection should establish peer review processes in line with the recommendations and standards contained within this document and RCPCH Peer Review in Safeguarding (May 2012).

Availability and Utility of Peer Review and Emotional Support for Paediatricians Involved in Safeguarding in the UK

“…However, it is not made clear how this support should ideally be delivered: within peer review; as a component of clinical supervision; or independently of these processes. Thomas and Mott (, p. 62) contend that emotional support ‘can be given within the peer review or clinical supervision, but its importance as a separate element for the wellbeing of professionals in child protection is increasingly becoming recognised’. Although we did not directly examine the role of clinical supervision in providing support, our finding that most respondents would find additional support helpful does suggest an unmet need within this group.…”

“…‘Peer review’, ideally, describes the regular meeting of a group of clinicians of similar ability and expertise, in order to undertake an impartial appraisal of safeguarding cases and their management (Thomas and Mott, ). Thomas and Mott () add that, as well as ensuring that minimum safeguarding standards are met, peer review is commonly assumed also to provide both clinical supervision and emotional support to paediatric doctors. This assumption is particularly true for senior, non‐training grade or isolated paediatricians who may have no other regular or protected access to supervision or support apart from the peer review process.…”

“…However, although peer review in child protection is now well established in the UK, there remains little evidence as to its effectiveness, with considerable local variation in both the composition and experience of peer groups, and in their terms of reference. As Thomas and Mott (, p. 61) conclude:

‘There needs to be a careful balance between ensuring that paediatricians receive appropriate emotional support, supervision, education and training, and that practice is to the expected standards.’

The extent to which the RCPCH recommendations match current reality has not previously been examined, and we therefore aimed to explore the availability and utility of peer review as well as other means of psychological and emotional support for paediatricians involved in safeguarding in the UK.…”

The value of paediatric assessment in historic child sexual abuse

“…The multiagency team and parents, where appropriate, receive copies of the written report. Abnormal findings supportive of CSA (as defined by RCPCH16) are subsequently independently peer-reviewed 23. Contemporaneous documentation of the history and examination are recorded on a standardised clinical proforma (available on request) with relevant information from the play specialist.…”

Paediatric approaches to child maltreatment are subject to wide organisational variations across Europe

“…The Royal College of Paediatrics and Child Health (RCPCH) in the UK, in an intercollegiate document , stipulated the roles and competences that all doctors who see children in their practice must achieve. The RCPCH has also brought in good practice recommendations on paediatric peer review in safeguarding .…”