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152 The impact of coronavirus on safeguarding referrals to a tertiary UK hospital
  1. V Timmis,
  2. F Payne,
  3. L Alison,
  4. E Asumang
  1. UK


Background Have coronavirus restrictions resulted in missed child protection concerns.

Objectives To evaluate the:

  1. impact of coronavirus, and the public health measures taken to address it, on child protection referrals.

  2. effect on child protection referrals following the re-opening of educational services.

Methods A retrospective review of patient notes was carried out for all safeguarding medicals to a tertiary dedicated UK children’s hospital between:

  • April and June 2020 (peak lockdown)

  • April and June 2019

  • September to November 2020 (as schools and childcare settings re-opened to all children)

Data was entered into an Excel spreadsheet and quantitative analysis undertaken.


  • The total numbers of safeguarding referrals were similar across all 3 time periods.

  • Physical abuse was the most common category for referral throughout. There was a higher proportion of neglect in both 2020 data sets compared to 2019.

Abstract 152 Table 1
Abstract 152 Table 2
  • Children were previously known to social care at the time of their referral in 38% of cases in 2019 compared to 60% of cases in both 2020 data sets.

  • Most children were managed as outpatients: 84% in April- June 2019, 76% in April- June 2020 and 92% of September- November 2020.

  • In April – June 2020 20% children required ongoing medical care or intensive care in comparison to 10% of cases in 2019.

  • Abuse was confirmed or suspected in 54–55% of cases across all 3 time periods.

Conclusions Concerns about children not being referred for safeguarding medicals are not supported from this data. In contrast, other UK centres have reported their referrals dropped by a third. [i],[ii]

During the lockdown period more children required hospitalisation including to intensive care compared to 2019, reflecting more significant injury.

The 2020 data sets had a higher proportion of neglect cases, potentially reflecting the increased pressure coronavirus had put on already vulnerable families.[iii]

During lockdown educational settings identified safeguarding concerns in only 6% of cases, potentially explained by extensive educational closures. 15% of referrals in September- November 2020 data were identified by education, not supporting the concern of a spike in referrals as schools re-open. This has been found elsewhere also. [iv]


  1. Bhopal S, et al. Who has been missed? Dramatic decrease in numbers of children seen for child protection assessments during the pandemic. Archives of Disease in Childhood Published Online First: 18 June 2020. doi: 10.1136/archdischild-2020-319783

  2. Garstang J, et al. Effect of COVID-19 lockdown on child protection medical assessments: a retrospective observational study in Birmingham, UK. BMJ Open 2020;10:e042867.

  3.’s%20Commissioner’s%202019%20report%20reveals%20rates%20of%20childhood%20vulnerability&text=New%20report%20reveals%20that%20an,of%20a%20vulnerable%20family%20background. (accessed 23.12.2020)

  4. Jentsch B, et al. Child welfare in the midst of the coronavirus pandemic—Emerging evidence from Germany. Child Abuse & Neglect 2020; 110 (2):104716

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