Safeguarding Children, Level 3

What it covers

How a clinician notices harm nobody has named yet: the child's daily life, injuries in babies who cannot move, the clinical signs of sexual abuse, perplexing presentations and fabricated or induced illness, and what parental mental illness, substance use, domestic abuse and neglect do to children. Consent, competence and parental responsibility, harm outside the home, children in care, FGM and concerns before birth. The GP's part under the law in force from 30 September 2026, from a strategy discussion to a conference report, what child safeguarding practice reviews keep finding, coding and online access, supervision and the practice lead's role.

Who it is for

GPs, GP registrars, practice nurses, pharmacists, paramedics and the other clinical roles the RCGP places at Level 3, and the practice safeguarding lead and deputy.

By the end you will be able to

• Picture the child's daily life, ask the second question, and read across household records.
• Recognise injury in non-mobile babies, clinical signs of sexual abuse, and fabricated or induced illness.
• Judge how parental illness, substance use, domestic abuse and neglect affect children, including before birth.
• Apply competence, consent and parental responsibility, and act on harm outside the home and FGM.
• Contribute analysis to strategy discussions, conferences and reviews, and apply what reviews keep finding.
• Record, code and protect safeguarding information, and use supervision and the practice lead.

Modules

1. The child at the centre
2. Injuries, symptoms and perplexing presentations
3. The adults around the child
4. Young people, consent and care
5. The system around the child

This course is the e-learning part of Level 3. The RCGP also expects yearly learning and reflection in practice, such as case discussion, practice safeguarding meetings and multi-agency work, which is recorded separately.

Content mapped to the additional Level 3 learning outcomes of the Core Skills Training Framework (England) v1.1: Safeguarding Children, the Level 3 competences of the Intercollegiate Document (2025) and the RCGP safeguarding standards for general practice (2024). E-learning part only. Law named: Children Act 1989, sections 3, 46 and 47; Children Act 2004, section 16LA; Female Genital Mutilation Act 2003, section 5B and Schedule 2.

Sources

• Intercollegiate document (2025) Safeguarding children and young people and children and young people in care: competencies for health care staff, Level 3 core competencies (professional opinion on short and long-term impact, compassion fatigue and vicarious trauma, children seeking asylum), RCPCH hosted, published November 2025
• Level 3 safeguarding training and standards, RCGP safeguarding standards for general practice: staff at Level 3, induction, the annual Level 3 update and annual learning and reflection, and the five areas of knowledge and capabilities (Royal College of General Practitioners, 1 October 2024)
• RCGP safeguarding standards: practice or organisational safeguarding lead, training requirements and person specifics (1 October 2024)
• RCGP safeguarding standards for general practice: introduction, training no longer based on hours, no formal supervision resource in general practice, practice leads do not need Level 4
• Core Skills Training Framework (England) Statutory/Mandatory Subject Guide v1.1, June 2021 (Skills for Health), Safeguarding Children (Version 3): Level 3 target group, Key Learning Outcomes a to r, refresher and delivery standards (archived copy)
• Safeguarding Children - Level 3, elearning for healthcare: ten sessions including sudden or unexpected death in childhood, parental risk factors, unexplained injuries, neglect in a disabled child, fabricated and induced illness and adolescent sexual assault (updated 3 March 2026)
• Working together to safeguard children 2026: statutory guidance (Department for Education, March 2026), paragraphs 15, 179 (child sexual abuse), 205 to 208 (babies and unborn children), 216 to 221 (harm outside the home), 272 to 280 (health, named GPs and practice leads), strategy discussions, section 47 enquiries, conference reports ('offer clear analysis based on their perspective') and chapter 5 paragraphs 372 and 385 to 387 (5 working days, 15 working days, 6 months, not to hold individuals to account)
• Working together to safeguard children 2026: summary of changes (Department for Education, 18 March 2026)
• Children Act 2004, section 16LA: duty to share information, inserted by the Children's Wellbeing and Schools Act 2026
• The Children's Wellbeing and Schools Act 2026 (Commencement No. 2) (England) Regulations 2026 (SI 2026/803), regulation 6: section 16LA in force on 30 September 2026
• Information Sharing Duty: statutory guidance for safeguarding organisations and their practitioners (Department for Education, September 2026): paragraphs 36 to 38 (lawful basis, Article 6(1)(c), Article 9 and Schedule 1 paragraph 18), 41 to 47 (consent, and the duty removing the public interest test) and the worked GP example
• Children Act 1989, section 3: meaning of parental responsibility, including subsection (5), a carer without it may do what is reasonable
• Children Act 1989, section 4: acquisition of parental responsibility by father
• Parental rights and responsibilities: who has parental responsibility (GOV.UK)
• Children Act 1989, section 20(7) and (8): accommodation by agreement, and section 33(3): the council has parental responsibility under a care order
• Children Act 1989, section 46: police protection, no more than 72 hours
• Children Act 1989, section 47, including subsections (9) to (11): the duty to assist enquiries falls on the NHS bodies listed in subsection (11)
• Crime and Policing Act 2026: Independent Inquiry into Child Sexual Abuse recommendations factsheet (Home Office, updated 19 May 2026), mandatory reporting
• Mandatory reporting of child sexual abuse in England: update on the Crime and Policing Act (NSPCC Learning, May 2026): healthcare professionals in scope, guidance to follow before implementation
• The Crime and Policing Act 2026 (Commencement No. 3 and Saving Provisions) Regulations 2026 (SI 2026/960), with Commencement No. 1 (SI 2026/689) and No. 2 (SI 2026/939): the reporting duty is not among the provisions commenced
• Child maltreatment: when to suspect maltreatment in under 18s, NICE clinical guideline CG89 (last updated 3 December 2025): recommendations 1.1.2, 1.1.9 to 1.1.11, 1.1.14, 1.1.16, 1.1.17, 1.1.24, 1.1.25, 1.1.28, 1.2.7, 1.2.11, 1.2.12, the sexualised behaviour recommendations in section 1.4, the neglect preamble and the definition of independently mobile
• Bruising protocol for immobile babies and children (Greater Manchester Safeguarding Partnership procedures, updated June 2025): an example of a local non-mobile injury protocol
• Perplexing Presentations (PP) / Fabricated or Induced Illness (FII) in children: RCPCH guidance (Royal College of Paediatrics and Child Health, March 2021), sections 1.2, 4.4, 5, 5.4 and 8
• Child Safeguarding Practice Review Panel annual report 2024 to 2025: 274 rapid reviews, babies under one 34 per cent of reviews and 57 of the 128 deaths (Appendix E, Table D; the summary's '60 per cent of deaths' is the share of baby reviews that were deaths, 61 per cent), neglect 60 per cent (164 of 274), known to children's social care 84 per cent, practice themes (paragraphs 3.80 to 3.83) and 'asking the second question'
• National review calls for urgent action to protect vulnerable unborn babies and infants (Child Safeguarding Practice Review Panel, 12 February 2026), and the review Protecting all vulnerable babies better
• Safeguarding reviews silent on Black, Asian and Mixed Heritage children (Child Safeguarding Practice Review Panel, 11 March 2025)
• Child death review: statutory and operational guidance (England): notifying the child's GP, and primary care on the child death overview panel
• ICON: Babies cry, you can cope
• Safer sleep information and co-sleeping (The Lullaby Trust)
• Drug misuse and dependence: UK guidelines on clinical management (2017): safe storage, restricting children's access, preventing children seeing doses taken, and take-home doses generally avoided with children at home (sections 4 and 7)
• Marac referral criteria (SafeLives): visible high risk (14 or more yes answers on the Dash checklist), professional judgement, potential escalation (three incidents in 12 months) and repeat referral (archived copy; the live page refuses automated fetching)
• Serious Crime Act 2015, section 75A: strangulation or suffocation
• Graded Care Profile 2 (GCP2): an NSPCC assessment tool for the quality of care, used by practitioners trained through NSPCC-supported local implementation
• 0-18 years: guidance for all doctors, paragraphs 24 to 31 (assessing capacity, one parent's consent, competent refusal) and 46 to 52 (disclosure to protect from risk of death or serious harm) (General Medical Council; archived copy, as the live site blocks automated fetching)
• Care Act 2014, section 58: assessment of a child's needs for care and support, including subsection (4)
• Promoting the health and wellbeing of looked-after children, statutory guidance (Department for Education and Department of Health, updated August 2022), paragraphs 38, 40 to 41, 52 to 53, 70 to 72 and 95
• Multi-agency statutory guidance on female genital mutilation (Home Office): risk indicators including travel vaccinations, FGM Information Sharing, the FGM Enhanced Dataset and FGM protection orders
• Female Genital Mutilation Act 2003, Schedule 2, Part 1: FGM protection orders
• Female Genital Mutilation datasets: health professionals and NHS organisations (NHS England Digital): the FGM Enhanced Dataset collection applies to NHS acute trusts, mental health trusts and general practices (archived copy; the live page refuses automated fetching)
• Female Genital Mutilation Act 2003, section 5B: duty to notify police
• Help after rape and sexual assault: sexual assault referral centres (NHS)
• RCGP Safeguarding toolkit: documenting and coding safeguarding information, and safeguarding codes (Royal College of General Practitioners)
• GP Online Services guidance: children and young people, v3.0 (RCGP, March 2022): proxy access, the 11th and 16th birthdays, and safeguarding
• Intercollegiate document (2025): competencies introduction, a yearly update based on adult learning principles, applied learning and reflection across a revalidation cycle; it sets no hours and no participatory proportion
• Keep methadone and other medications away from children (Royal Berkshire NHS Foundation Trust): as little as a teaspoon of methadone could kill a young child
• Graded Care Profile 2 (Durham Safeguarding Children Partnership): a tool licensed by the NSPCC that can only be used by practitioners trained to use it
• 'Disguised compliance': learning from case reviews (NSPCC Learning)
• Crime and Policing Act 2026, section 85: duty to report suspected child sex offences (prospective; not in force at Royal Assent on 29 April 2026, commenced by regulations under section 255)
• Crime and Policing Act 2026, section 87: the five cases in which a person is given reason to suspect a child sex offence
• Safeguarding Vulnerable Groups Act 2006, Schedule 4, Part 1: health care provided to children by a health care professional is regulated activity
• 0-18 years: principles of confidentiality, paragraphs 46 to 52, 57 to 61 (sexual activity) and 63 (contraception, abortion and STI advice and treatment without parental knowledge) (General Medical Council; archived copy, as the live site blocks automated fetching)
• Guidance on recording domestic abuse in the electronic medical record (RCGP, updated 25 January 2021): never disclose any allegation to the perpetrator or other family members
• Child Safeguarding Practice Review Panel annual report 2024 to 2025 (full report PDF, April 2026)

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