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The purpose of a medical assessment is to ascertain whether there is any medical evidence to support the existence or extent of abuse or other serious health needs and, if necessary, to treat the child.
A medical assessment will be necessary when any of the following apply:
- There is a reasonable suspicion of significant harm to a younger or otherwise vulnerable child (usually below the age of ten or having a disability which impairs the ability to communicate about any abuse being suffered).
- There is a serious injury and assault is established or considered likely.
- There are inconsistencies in the explanations given which require expert examination
- There have been previous injuries.
- There are indications of detectable previous injuries, or neglect, or other suspicious physical presentations.
- There is an allegation of sexual abuse.
The need for the assessment in the context of the section 47 enquiries should be discussed with the doctor due to undertake the medical assessment to ensure they are aware of its strategic significance. The person taking the child for the assessment should also be fully aware of the child’s circumstances and the purposes of the assessment.
Only doctors may physically examine the child. This will normally be a paediatrician. GPs must not perform a detailed examination in cases of suspected abuse unless this is agreed by the police and local authority children's social care. All other staff should only note any visible marks or injuries on a body map and then date and sign the record in the child's file.
Multi-Agency Safeguarding Hub
Multi-Agency Safeguarding Hubs (MASH) were developed to co-locate safeguarding agencies and their data into a secure assessment, research and referral unit for notifications of vulnerable children. This was in response to the inability of agencies, on occasions to effectively share information which has been the comment of numerous Serious Case Reviews and public enquiries.
These hubs aim to identify unknown risk by building a full picture on the child of concern and their family. The hubs aim to provide better informed assessments of risk and promoting the welfare of children; improved early identification of need; and enhanced partnership strategic assessment and problem solving.