Protecting chidlren and young people

Question 1

Responsibility as a pharmacists

Answer 1

• Professional, legal and moral duty to protect children from abuse or neglect.
• Work with other organisations and authorities to safeguard children (one of the pharmacy professional standards).

Question 2

Physical abuse

Answer 2

• Unusual/unexplained injuries
• Injuries in inaccessible places
• Bite marks
• Fingertip bruising
• Age of injury inconsistent with account given by adult.
• Injuries blamed on siblings.

Question 3

Neglect

Answer 3

-Poor growth/weight.
- Poor hygiene (dirty and messy).
- Inappropriate food or drink (diet).

Question 4

Emotional abuse

Answer 4

• Evidence of self-harm/self mutilation.
• Behavioural problems
• Inappropriate verbal abuse
• Fear of adults or a certain adult

Question 5

Sexual abuse

Answer 5

• Indication of STD
• Evidence of sexual activity or relationship that is inappropriate to the child’s age or competence.

Question 6

Additional signs

Answer 6

• Parent/carer delays seeking medical treatment or advice
• Patient/cared reluctant to allow treatment.
• Detachment from the child
• Lacks concern at the severity or extent of injury
• Reluctant to give information
• Aggressive towards child or children

Question 7

What to do with suspected child abuse

Answer 7

• Local child protection procedures.
• Usually, referral to social services or getting advice from them - you should share suspicions of abuse even if it is not proven.
• Do not attempt to investigate suspicions or allegations of abuse directly.
• Record concerns, suspicions, decisions taken and reasons whether or not further action was taken.

Question 8

Child abuse - emergency

Answer 8

• Contact the police

Question 9

Suspected child abuse - no local child protection procedures available

Answer 9

Refer to diagram

Question 10

Sexual activity (under 13)

Answer 10

• Under 13 = too young to consent to SA (legal).
• Cases should be reported to social services, UNLESS there are exceptional circumstances backed by documented reasons for not sharing.

Question 11

Sexual activity (13-16)

Answer 11

• Can be consensual .
• Law does not prosecute mutually agreed SA between young people of a similar age, unless it involves abuse or exploitation.

Question 12

Provision of contraception to individuals under the age of 16

Answer 12

• Must meet the Fraser criteria.
• Can provide contraception (on prescription or pGD) and sexual health advice.
• Patient confidentiality applies - seek consent prior to disclosing any information.
• Information may be shared if you judge that sharing is in the child’s best interest (e.g. prevent harm to the child).

Question 13

Fraser criteria

Answer 13

• They have sufficient maturity and intelligence to understand the nature and implications of the proposed treatment.
• They cannot be persuaded to tell her parents or to allow the practitioner to tell them.
• They are very likely to begin or continue having sexual intercourse with or without contraceptive treatment.
• Their physical or mental health is likely to suffer unless they receive the advice or treatment.
• The advice or treatment is in the young person’s best interests.