GPAtlas🧭 When to suspect
Safeguarding is everyone's responsibility.
• Maltreatment covers physical abuse, sexual abuse, emotional abuse, neglect and fabricated or induced illness.
• Concern usually builds from a pattern of events, behaviours or unexplained injuries over time rather than a single incident.
• Always consider the wider family context – domestic abuse, parental substance misuse and parental mental illness (sometimes called the “trigger trio”) all raise risk.
Recognise the alerting features, decide whether to consider, suspect or exclude maltreatment, and act through the safeguarding pathway.
A point of principle runs through everything below: in general practice you recognise and refer; you do not have to investigate, prove the cause, or confront anyone.
| Category | What it involves |
|---|---|
| Physical abuse | Hitting, shaking, burning, poisoning or otherwise causing physical harm, including fabricating or inducing illness. |
| Sexual abuse | Forcing or enticing a child into sexual activities (contact or non-contact, including online and exploitation), whether or not the child is aware. |
| Emotional abuse | Persistent emotional maltreatment – conveying worthlessness, inappropriate expectations, witnessing abuse of another, or serious overprotection. |
| Neglect | Persistent failure to meet basic physical and/or psychological needs – food, shelter, supervision, medical care, immunisations or emotional warmth. |
| Fabricated or induced illness (FII) | • Reported or induced symptoms inconsistent with findings • Investigations and observations that do not fit the history |
Source: NICE CG89 · NICE NG76 · Working Together to Safeguard Children
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