title: Notifications for child safeguarding from an acute hospital in response to presentations to healthcare by parents.
abstract: BACKGROUND
  Consideration of child safeguarding is routine within maternity services but less common in other health services for adults. We audited notifications for child safeguarding from an acute general hospital where the policy includes questioning adults presenting with violence, mental health problems or drug or alcohol misuse to any department within the hospital about children at home and notifying to the local authority children's social care services if there are safeguarding concerns.
  
  
  METHODS
  Cross-sectional audit of notifications for child safeguarding, including abuse, neglect or victimization, from all departments in one hospital to the local authority children's social care department during 12 months (2010/11).
  
  
  RESULTS
  Of 681 notifications (57 per month), 40% (270/681) were triggered by parents' presentation to acute hospital services. Of these, 37% (100/270; 12 teenage mothers) presented for maternity care and 60% (162/270; 8 teenage parents) presented to the emergency department (ED). Of the 60% (411/681) of notifications prompted by children presenting for healthcare, most originated from the ED (358/411; 87%): two-thirds of these presented with injury (250/358; 70%).
  
  
  CONCLUSIONS
  Given a policy to ask adults about children at home, a substantial proportion of children notified for child safeguarding were recognized through presentations to acute healthcare by their parents. Further research and development of this policy needs to ensure that questioning results in effective interventions for the children and their parents.
authors.affiliation: Centre of Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Gonzalez-Izquierdo
authors.forename: A
authors.initials: A
authors.lastname: Ward
authors.forename: P
authors.initials: P
authors.lastname: Smith
authors.forename: C
authors.initials: C
authors.lastname: Walford
authors.forename: J
authors.initials: J
authors.lastname: Begent
authors.forename: Y
authors.initials: Y
authors.lastname: Ioannou
authors.forename: R
authors.initials: R
authors.lastname: Gilbert
mesh_terms: D000293:Adolescent; D002648:Child; D002649:Child Abuse / Q000175:diagnosis* / Q000517:prevention & control; D002669:Child Welfare; D016241:Child of Impaired Parents / Q000523:psychology*; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000458:organization & administration; D005192:Family Health; D005260:Female; D006769:Hospitals, General / Q000458:organization & administration*; D006801:Humans; D008131:London; D008297:Male; D010290:Parents / Q000523:psychology*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012947:Social Work / Q000458:organization & administration* / Q000706:statistics & numerical data
keywords: child maltreatment; child safeguarding; paediatric emergency; social care; victimization