Peer review in child protection

Safeguarding children work is complex and challenging. Peer review provides a forum for paediatricians to discuss child protection cases to ensure the management of the child meets accepted standards of practice. The process involves retrospective review of cases, photo documentation, the medical report and multiagency working. It provides a culture of learning, professional development and support, with an opportunity to discuss cases in a suitable environment and to debrief following difficult cases.Clinical governance frameworks identify the importance of peer review and clinical supervision: there are increasing expectations that Health Trusts/Boards will have to provide data on attendance for external review. Both clinical supervision and peer review are forms of reflective practice and developmental activities that give practitioners the opportunity to learn from their experience and develop their expertise within clinical practice.Child protection peer review meetings with clear terms of reference should be set up in all health organisations employing paediatricians working in child protection. All paediatricians should be able to access and attend child protection peer review, supervision and support which should be identified in their job plans. Peer review is recognised as Continual Professional Development.Following discussion any change in opinion is the lead consultant's responsibility. It must be clear that peer review supports the responsible paediatrician in reaching a conclusion and does not provide a formal second opinion to be used in court.Peer review has a role to play in maintaining public and court confidence. It is the paediatrician's attendance at peer review that provides assurance to court that standards are being met, not that the specific case has been peer reviewed. Clinicians who don't attend are at risk of being perceived as maverick.