NICE issues new guidance on spotting child neglect or abuse

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Pharmacists should look out for potential signs of child neglect, such as parents or carers failing to administer essential prescribed medicine or not taking their child to follow-up appointments, updated guidelines from the National Institute for Health and Care Excellence (NICE) have said.

Health professionals should also suspect neglect if parents or carers “fail to seek medical advice for their child to the extent that the child’s health and wellbeing is compromised”, say the guidelines ‘Child maltreatment: when to suspect maltreatment in under-18s’, published in October 2017.

Community pharmacists are ideally placed to spot ongoing signs of child abuse, said clinical spokesperson at the Royal Pharmaceutical Society, Stephen Tomlin, who also sits on the NSPCC healthcare liaison committee.

“Abuse is never one thing, it’s about joining the dots. This guidance is a useful tool for pharmacists to refer to so things do not get overlooked,” he said.

“Those carrying out abuse may avoid the GP or other healthcare professionals, but don’t think about pharmacists in the same way. So pharmacists have the chances to spot things.”

Further potential signs of abuse highlighted in the guidance include persistently failing to engage with child health promotion programmes including immunisation, health and development reviews and screening programmes. Community pharmacists should also note if a child is having persistent severe cases of conditions such as scabies or head lice, or an inexplicably poor response to prescribed medication or other treatment.

Fabricated or induced illness should also be considered if a child’s history or presentations do not tally with a recognised clinical picture, even if the child has a past or concurrent condition. It should be noted if reported symptoms and signs are present only when the parent or carer is also present or reported symptoms have been observed only by them.

Other presentations to be considered as suspected abuse include bruising in the shape of a hand, ligature, stick, teeth, grip, or implement, and if the explanation for the bruising is “implausible, inadequate or inconsistent”.

Last updated
The Pharmaceutical Journal, PJ, October 2017, Vol 299, No 7906;299(7906):DOI:10.1211/PJ.2017.20203708

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