Abstract
Objectives: To determine any change in referral patterns and outcomes in children (0–18) referred for child protection medical examination (CPME) during the COVID-19 pandemic compared with previous years.
Design: Retrospective observational study, analysing routinely collected clinical data from CPME reports in a rapid response to the pandemic lockdown.
Setting: Birmingham Community Healthcare NHS Trust, which provides all routine CPME for Birmingham, England, population 1.1 million including 288 000 children.
Participants: Children aged under 18 years attending CPME during an 18-week period from late February to late June during the years 2018–2020.
Main outcome measures: Numbers of referrals, source of disclosure and outcomes from CPME.
Results: There were 78 CPME referrals in 2018, 75 in 2019 and 47 in 2020, this was a 39.7% (95% CI 12.4% to 59.0%) reduction in referrals from 2018 to 2020, and a 37.3% (95% CI 8.6% to 57.4%) reduction from 2019 to 2020. There were fewer CPME referrals initiated by school staff in 2020, 12 (26%) compared with 36 (47%) and 38 (52%) in 2018 and 2019, respectively. In all years 75.9% of children were known to social care prior to CPME, and 94% of CPME concluded that there were significant safeguarding concerns.
Conclusions: School closure due to COVID-19 may have harmed children as child abuse has remained hidden. There needs to be either mandatory attendance at schools in future or viable alternatives found. There may be a significant increase in safeguarding referrals when schools fully reopen as children disclose the abuse they have experienced at home.
Design: Retrospective observational study, analysing routinely collected clinical data from CPME reports in a rapid response to the pandemic lockdown.
Setting: Birmingham Community Healthcare NHS Trust, which provides all routine CPME for Birmingham, England, population 1.1 million including 288 000 children.
Participants: Children aged under 18 years attending CPME during an 18-week period from late February to late June during the years 2018–2020.
Main outcome measures: Numbers of referrals, source of disclosure and outcomes from CPME.
Results: There were 78 CPME referrals in 2018, 75 in 2019 and 47 in 2020, this was a 39.7% (95% CI 12.4% to 59.0%) reduction in referrals from 2018 to 2020, and a 37.3% (95% CI 8.6% to 57.4%) reduction from 2019 to 2020. There were fewer CPME referrals initiated by school staff in 2020, 12 (26%) compared with 36 (47%) and 38 (52%) in 2018 and 2019, respectively. In all years 75.9% of children were known to social care prior to CPME, and 94% of CPME concluded that there were significant safeguarding concerns.
Conclusions: School closure due to COVID-19 may have harmed children as child abuse has remained hidden. There needs to be either mandatory attendance at schools in future or viable alternatives found. There may be a significant increase in safeguarding referrals when schools fully reopen as children disclose the abuse they have experienced at home.
| Original language | English |
|---|---|
| Article number | e042867 |
| Number of pages | 6 |
| Journal | BMJ open |
| Volume | 10 |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - 29 Sept 2020 |
Keywords
- child protection
- community child health
- non-accidental injury
- Humans
- Child Protective Services/methods
- Coronavirus Infections/epidemiology
- Male
- United Kingdom/epidemiology
- Pandemics/prevention & control
- COVID-19
- School Health Services/statistics & numerical data
- SARS-CoV-2
- Child Welfare/statistics & numerical data
- Pneumonia, Viral/epidemiology
- Betacoronavirus
- Female
- Population
- Child Abuse/prevention & control
- Social Isolation
- Communicable Disease Control/methods
- Social Work/methods
- Child
ASJC Scopus subject areas
- Medicine(all)
