and other local agencies to coordinate and ensure effective
local arrangements to safeguard children.
The Children Act 2004 makes the welfare of the child
the clinician’s first concern and this takes precedence over
maintaining confidentiality when these are in conflict. GPs
will naturally want to maintain the doctor–patient relationship.
To this end, any action taken should be discussed with parents
or carers first, and their consent sought where possible, unless
this would put the child at risk of further harm. This Act also
requires each local authority to establish an LSCB.
Nurses are well placed to identify children and young people
who may be at risk. Nurses and other medical professionals
should be familiar with local referral arrangements—usually a
referral to children’s social care (formerly social services) who
have the statutory responsibility for investigating suspected
child abuse. There is a designated nurse and GP for child
safeguarding in each area, available for advice when the best
course of action is unclea