An NSPCC survey,¹ in 2000, involving 2,869 children showed that 7% suffer 'serious physical abuse', 6% suffer 'frequent and severe emotional maltreatment' and a further 6% 'serious absence of care'. Around 1% had suffered sexual abuse by a parent or carer, 3% by a relative, and 11% by someone they knew who was not related to them.

For the average UK GP principal, this would equate to 28 children on their list suffering physical abuse, 24 emotional abuse, 24 neglect and 60 sexual abuse.

In 2005, the RCGP launched its strategy for safeguarding children and young people Keep me Safe.² It identified further work needed including guidance on consent and confidentiality, identification of competences and production of materials for clinical and non-clinical staff working in primary care teams. In particular, it called for the development and support of practice leads for child protection, the promulgation of good practice and the production of an encompassing toolkit for practices.

The toolkit³ has now been developed and can be downloaded free from the RCGP website. It contains advice on features that might raise concerns of possible abuse, and a flowchart indicating how members of the practice team should respond to suspected abuse, which practices can tailor to fit their local needs. It also lists relevant Read codes.

There is a template for policy and procedures, in which contact details of key personnel can be inserted and local guidance should be incorporated. The toolkit also provides a statement of commitment for practices to sign up to, and a good practice checklist.

Each practice is asked to identify a lead who will take overall responsibility for safeguarding children. This person will ensure that policies are updated when required, and liaise with named and designated professionals, safeguarding board training staff, and other agencies involved with safeguarding children locally.

Finally, the toolkit contains an audit tool, which allows practices to evaluate their systems for safeguarding children and young people and understand how those systems might be made more robust and responsive.

The toolkit does not replace other local guidance; rather, it is intended to help practices know what that guidance is and how to access it.

The stimulus for this work came largely from the report of the Victoria Climbie Inquiry,⁴ which called for the introduction of training for all GPs in "the recognition of deliberate harm to children, and in the multidisciplinary aspects of a child protection investigation … at regular intervals of no less than three years" and "the feasibility of introducing training in the recognition of deliberate harm to children as part of the professional education of all general practice staff."

The Role of Primary Care in the Protection of Children from Abuse and Neglect⁵ highlighted the importance of the involvement of primary care teams in protecting children, stating: "Because of their unique and continuing contact with children and families, GPs and other members of the PHCT are well placed to recognise situations where children are at risk or are in need of protection, and where families are in need of additional support."

We hope that the toolkit will provide an impetus to achieve the highest standards of care for vulnerable children in primary care.