Responding to harm: Managing risk and safeguarding responses in front line emergency care

The initial assessment of injured children in emergency care is critical for identifying potential signs of intentional injury, abuse or neglect, and ultimately to decisions as to whether or not a child is safe to remain in their family. The initial assessment therefore has significant impact, subjecting a family to intrusive and distressing assessments that may be unnecessary, or a child to ongoing harm if the level of risk is not recognised. Clear medical opinions are therefore essential for ensuring the best outcomes for the child and family. However, NHS staff often face challenges such as limited training, lack of confidence, time pressures, fear of false accusations, and uncertainty about referral policies and inter-agency communication.

This qualitative project will explore the confidence of clinicians at Sheffield Children’s Hospital (SCH) in assessing and reporting the signs and risk factors of abuse, neglect, or intentional injury. Additional insights will be collected from families attending A&E regarding how clinicians might best engage them with safeguarding concerns, and from safeguarding professionals regarding current and future collaborative working. This will support the development of recommendations to inform future practice within SCH and in collaboration with local safeguarding services, as well as training resources for SCH staff that will be shared nationally via the Children’s Hospital Alliance.

The successful applicant will be based within SCYPHeR (the South Yorkshire Children and Young People’s Health Research) network: a collaboration between Sheffield Children’s Hospital, Sheffield Hallam University and the University of Sheffield, developed to embed high-quality research and practice across South Yorkshire. Our institutional collaboration offers the perfect environment to undertake robust and impactful research on this topic. SCH handles 60,000 emergency cases annually, and is the regional children’s trauma centre, seeing around 500 cases of potential major trauma per year. As one of three pilot centres for the ‘Suspected Inflicted Head Injury Service,’ SCH is funded to develop effective multidisciplinary responses to suspected abuse, and is therefore well-positioned to lead sector-wide improvements in safeguarding practices. This initiative is led by Dr Sophie Parry-Okeden, consultant and safeguarding lead, and a supervisor of this doctoral research.

The project is linked to SCYPHeR’s ‘Child Welfare and Safeguarding’ theme, led by the other two supervisors – Prof Nathan Hughes and Dr Katie Ellis – providing access to research and practice expertise across children’s health and social care provision. The student will also join a vibrant group of care and social care researchers in two University research centres: CIRCLE and the ESRC Centre for Care.

We welcome applicants with an interest in social research methods, from a broad range of subject areas, including health, social work, social care, or any related discipline. Applicants should be passionate about improving outcomes for children and families and committed to conducting research with real-world impact. Please email nathan.hughes@sheffield.ac.uk should you have any questions.