Examples of high profile cases have included Victoria Climbie and Baby Peter.

Reviews and inquiries into such cases often identify the same concerns:

• poor communication and information sharing between professionals and agencies
• inadequate training and support for staff
• failure to listen to children.

Nurses, midwives and health visitors are well placed to identify children and young people who may be at risk and act to safeguard their welfare.

Safeguarding (the term 'child protection' is used in Scotland) and promoting the welfare of children is defined in Working Together (2018) as: 

• protecting children from maltreatment; 
• preventing impairment of children’s health or development; 
• ensuring that children are growing up in circumstances consistent with the provision of safe and effective care; and 
• taking action to enable all children to have the best outcomes.

A substantial minority of children experience severe maltreatment and abuse at home, in school, in the community, from adults and from peers. A report by the NSPCC found that:

• 1 in 5 children have experienced severe maltreatment
• Children abused by parents or carers are almost 3 times more likely to also witness family violence
• 1 in 3 children sexually abused by an adult didn’t tell anyone at the time
• All types of abuse and neglect are associated with poorer mental health
• Strong associations were found between maltreatment, sexual abuse, physical violence, and poorer emotional wellbeing, including self-harm and suicidal thoughts.

Society is changing with the emergence of differing and new forms of abuse such as social media, modern slavery, human trafficking and recognition that young people are vulnerable to abuse in a range of social contexts. The types of abuse include:

• physical abuse including fabricated and induced illness, and female genital mutilation
• neglect
• emotional abuse, forced marriage, modern slavery and grooming and exploitation to support and/or commit acts of terrorism (known as radicalisation) missing children, county lines (young people involved in organised crime who are coerced to traffic drugs or other illegal items around the country) and child trafficking (internal and external)
• sexual abuse, including child sexual exploitation, missing children, county and child trafficking (internal and external)
• domestic abuse

The UN Convention on the Rights of the Child (1989) includes the requirement that children live in a safe environment, be protected from harm and have access to the highest attainable standard of health. NHS services are constantly changing and evolving. Over recent years many previously NHS funded services are being commissioned and provided by non-NHS organisations. Chief executives have responsibility to have in place arrangements that reflect the importance of safeguarding and promoting the welfare of children within organisations.