• “Worrying gaps” identified in MIU safeguarding policies by CQC
  • No system in place for staff to flag safety concerns about children in care
  • CQC report also finds that GP involvement in child protection cases is “frequently too basic”


Regulators have identified “major concerns” about the treatment of children in care attending minor injuries units.

The Care Quality Commission published the findings of its first national review of healthcare received by children in care last week.

It identified a “worrying gap” in child safeguarding policies and procedure in minor injuries units which, it said, could result in staff failing to recognise when a child is being abused or exploited.

The CQC raised concerns in 40 per cent of the 25 MIUs it reviewed for the report, finding that some departments:

  • had no system for staff to flag safeguarding concerns either manually or electronically
  • were reliant on children or adults voluntarily disclosing recent visits to other emergency departments
  • were not gathering details about the adult accompanying the child and his or her relationship to the child or recording in writing the child’s own story about what had happened
  • did not have paediatric-trained staff in the department and employed staff that had not received adequate training in child safeguarding

The regulator also identified concerns in almost a third of the 50 reports it reviewed about how accident and emergency departments recorded the visits of children in care.

CQC clinical fellow Devin Gray said: “Staff in urgent and emergency settings play a key role in identifying and protecting children at risk. We know that abusive and neglectful behaviour can be masked by moving between different services. That’s why we’re highlighting how A&E departments and MIUs really need to get this right.”

Along with reviewing and improving child safeguarding procedures, the CQC is calling on emergency departments to implement the “Child Protection – Information Sharing” project, which allows unscheduled care visits to be securely shared and reviewed along with other child protection information.

The report, Not Seen, Not Heard, which looked at all healthcare services that engage with children in care, also found that there was an “inconsistent approach” to GP involvement in child protection services, with 69 per cent of cases reviewed needing improvement in this area.

The report said: “In many cases there had been no GP contribution at all. Where GPs had been involved, the information submitted about the child’s health was frequently too basic.” It attributed these shortcomings to GP workload capacity and a lack of flexibility from social services to rearrange case conferences to fit in with GPs.

The CQC reached its conclusions by analysing 50 reports written by its children’s services inspection team in the 15 months to December 2015.