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BMJ Open ; 10(9): e042867, 2020 09 29.
Article in English | MEDLINE | ID: covidwho-807755

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.


Subject(s)
Child Abuse , Child Protective Services , Child Welfare , Communicable Disease Control , Coronavirus Infections , Pandemics , Pneumonia, Viral , School Health Services/statistics & numerical data , Betacoronavirus , COVID-19 , Child , Child Abuse/prevention & control , Child Abuse/psychology , Child Abuse/statistics & numerical data , Child Protective Services/methods , Child Protective Services/statistics & numerical data , Child Welfare/statistics & numerical data , Child Welfare/trends , Communicable Disease Control/methods , Communicable Disease Control/statistics & numerical data , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/psychology , Female , Humans , Male , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/psychology , Population , SARS-CoV-2 , Social Isolation , Social Work/methods , Social Work/statistics & numerical data , United Kingdom/epidemiology
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