title: Lothian inter-agency child protection guidelines: impact on a children's NHS trust.
abstract: OBJECTIVE
  To evaluate the process involved in cases of suspected child abuse within a children's NHS Trust, 6 months after implementation of new inter-agency Child Protection guidelines.
  
  
  METHODS
  Prospective evaluation of case records.
  
  
  METHODS
  Four departments within a combined child health trust in Edinburgh.
  
  
  METHODS
  Review of practice within each department, according to the Inter-Agency guidelines.
  
  
  RESULTS
  No standard procedure existed for the child protection process prior to the guidelines. In the first 6 months following implementation of the guidelines, a substantial increase in workload was experienced by community paediatricians. Medical examinations were better co-ordinated, with fewer children receiving repeated, intrusive examinations. However, note keeping was deficient, as 3% of referrals did not appear to be recorded in the case notes. Cross-referencing between departments was variable, with 81% of cases referred to Community Child Health not recorded in hospital case notes.
  
  
  CONCLUSIONS
  The Inter-Agency guidelines have resulted in better coordination of the early referral stages. Deficiencies highlighted in this audit are due to record keeping and lack of liaison between departments within a combined children's trust.
authors.affiliation: Edinburgh Sick Children's NHS Trust, Sciennes Road, Edinburgh EH9 1TS.
authors.forename: J
authors.initials: J
authors.lastname: Mok
authors.forename: F
authors.initials: F
authors.lastname: Forbes
authors.forename: J
authors.initials: J
authors.lastname: McBride
authors.forename: J
authors.initials: J
authors.lastname: Phillips
authors.forename: T
authors.initials: T
authors.lastname: Squires
mesh_terms: D002649:Child Abuse / Q000517:prevention & control*; D002651:Child Advocacy / Q000592:standards*; D002662:Child Health Services / Q000458:organization & administration; D002675:Child, Preschool; D004282:Documentation / Q000592:standards; D017408:Guidelines as Topic; D006779:Hospitals, Public / Q000458:organization & administration; D006801:Humans; D007373:Interinstitutional Relations; D017064:Process Assessment, Health Care; D015397:Program Evaluation; D011446:Prospective Studies; D012017:Referral and Consultation / Q000592:standards; D012606:Scotland; D012947:Social Work / Q000458:organization & administration* / Q000592:standards; D013222:State Medicine