What Safeguarding Children Training and Duties Do NHS Doctors Have?
Protecting children is not only a job for paediatricians. A psychiatrist admitting a father, an ED doctor seeing a baby with a small bruise, or a GP reviewing a mother's depression may each be the one who notices that a child is at risk. This guide explains the duties every NHS doctor has, the training levels employers require, and how to escalate a concern.
Quick answer
Every NHS doctor must act on concerns about a child's safety, including doctors who mainly treat adults. GMC guidance says you must consider whether your adult patient poses a risk to children. Employers set mandatory training levels using the intercollegiate document, and most doctors who treat children, or adults who are parents, need level 3. Concerns go to your safeguarding team and children's social care.
What you will learn in our free Safeguarding Children and Young People course
Every NHS doctor has safeguarding duties — including in adult specialties — and panels ask about them. Be ready before your first shift. Our free online Safeguarding Children and Young People course is written for NHS doctors and international medical graduates. You study at your own pace in 6 short modules, with worked examples, interactive exercises and a short quiz at the end. There is no sign-up, and your progress is saved so you can stop and come back.
The 6 modules
Foundations: what safeguarding means: Why safeguarding matters in everyday NHS work, Safeguarding and child protection, The legal and policy framework (England), Your responsibilities as a doctor, Levels of safeguarding training
Recognising abuse and neglect: The four categories of abuse, Recognising maltreatment, Bruising in babies who are not independently mobile, Other injuries that should raise concern, Neglect
Specific forms of harm: Think Family — the children of adult patients, Domestic abuse, Female genital mutilation (FGM), Exploitation, extra-familial harm and online harm, Fabricated or induced illness and perplexing presentations
Children, consent and information sharing: Consent, competence and young people, Confidentiality and information sharing, Listening to children and responding to a disclosure
Taking action: referral and what happens next: Making a referral to children's social care, What happens next — section 17 and section 47, When a child dies or is seriously harmed
Practice, records and your career: Documentation, Allegations against staff and concerns about colleagues, UK practice that may differ from your home country, Safeguarding in your CV, portfolio and interviews
By the end of the course you will be able to
Explain safeguarding and child protection and the legal framework in England
Recognise the four categories of abuse and the warning signs NICE describes
Respond correctly to bruising in a baby who is not independently mobile
Apply 'Think Family' when treating adults who are parents or carers
Act on domestic abuse, FGM (including the mandatory reporting duty), exploitation and online harm
Use Gillick competence and share information lawfully to protect a child
Make a clear referral to children's social care and understand what happens next
Document concerns well and know where to get advice, including for concerns about colleagues
Why it helps your NHS application
Based on the newest guidance: Working Together 2026 and NICE's December 2025 update
Clear actions for real situations: bruising in babies, FGM, domestic abuse, 'Think Family'
Shows interviewers you understand UK law and practice that may differ from home
How to write it on your NHS application
In your CV and on NHS Jobs or Trac: list it under "Courses and CPD" (or in the training and courses section of the form), for example:
Safeguarding Children and Young People, online CPD course, CareerPro UK. Certificate of completion, [month and year]; verifiable online, ID CP-XXXXXXXX.
In your supporting statement: show what you learned and how you use it. For example (adapt it so it is true for you):
"Alongside my mandatory safeguarding training, I refreshed my understanding of child safeguarding and the Think Family approach through an online course."
At interview: the course also prepares you for questions such as "What would you do if you were worried that a child was at risk of harm?"
Your certificate of completion
When you pass the quiz, you can download a certificate pack:
A verifiable PDF certificate of completion with your name, the course, your CPD time and a QR code that shortlisters and appraisers can scan
An appraisal-ready reflective note, pre-filled with the course learning outcomes
A ready-to-paste line for your NHS Jobs or Trac application and CV, and a one-click "Add to LinkedIn" button
Studying is free. The certificate pack is a one-off £5, and you pay only after you pass
Online course — does not replace your employer's mandatory safeguarding children training (Levels 1–3).
Your professional duties as a doctor
The GMC's guidance Protecting children and young people sets the standard. It covers everyone from birth to their 18th birthday. The core duties are:
Act on any concern about the safety or welfare of a child. You do not need to be certain a child is at risk of significant harm before telling an appropriate agency.
Think about the children of adult patients. You must consider whether your patient poses a risk to children, for example through mental illness, substance misuse or domestic abuse. These factors don't mean a parent is unsafe, but they mean you should ask.
Share information appropriately. Seek consent where it is safe to do so, but don't let lack of consent stop you protecting a child. Explain why you shared unless that would increase the risk, and record your decision.
Get advice when unsure, from a named or designated safeguarding professional or an experienced colleague.
Keep your knowledge and skills up to date for your role.
The GMC is clear that if you act on an honest, reasonable concern through the proper channels, you will be able to justify it, even if the child turns out not to be at risk.
The framework in England: Working Together to Safeguard Children
The Children Act 1989 gives the local authority the duty to support children in need (section 17) and to make enquiries when a child is suffering, or likely to suffer, significant harm (section 47). The Children Act 2004 requires NHS organisations to have arrangements to safeguard and promote children's welfare.
Working Together to Safeguard Children is the statutory guidance that explains how agencies work together. The Department for Education published a new 2026 edition in March 2026, replacing the 2023 edition. Under it, local safeguarding arrangements are led by three statutory partners: the local authority, the police and the health service (through the Integrated Care Board). Changes in the 2026 edition include more emphasis on:
the needs of babies,
the impact of domestic abuse,
children facing several harms at once, and
the link between online harm and harm in person.
It is statutory guidance, so it must be followed unless there is a good reason not to. Scotland, Wales and Northern Ireland have their own procedures.
Training levels: the intercollegiate document
Employers set safeguarding children training requirements using the intercollegiate document. The current version, Safeguarding children and young people and children and young people in care: competencies for health care staff, was published in November 2025. It combines the 2019 safeguarding document with the 2020 looked-after children document. It has five levels plus a board level:
Level 1: all staff working in health care settings, including volunteers.
Level 2: staff who meet children and young people but don't provide their clinical care.
Level 3: staff who deliver a clinical service to children and young people. It also covers staff in adult mental health and substance misuse services where there is a significant risk to children or families, and those treating adults who are parents or carers of under-18s.
Level 4: named professionals, such as the named doctor and named nurse for safeguarding.
Level 5: designated professionals with strategic oversight across an area.
In practice, many doctors' posts, including in emergency medicine, general practice and psychiatry, are set at level 3. The document says level 3 competence is gained through training and experience, and should be discussed at appraisal. Ask your employer which level your post needs before you start. A free online course can support your learning, but it cannot replace mandatory level 2 or level 3 training.
Think Family in adult specialties
"Think Family" means remembering that your adult patient is part of a household. National reviews of serious cases often find that adult services knew about a parent's problems but never asked about the children. Build these questions into every adult assessment:
Do you have children, or care for any children? Are you pregnant?
Who else lives at home?
Who is looking after the children now, while you are here?
How might this illness, treatment or admission affect them?
If there is an immediate gap in care, such as a child alone at home, act straight away with the nurse in charge and social care. Otherwise, share relevant concerns with the GP, health visitor or school nurse, or refer to children's social care. Remember young carers and unborn babies too.
For example, an FY2 on a gastroenterology ward admits a man with alcohol-related hepatitis who usually does the school run. Asking "Who is collecting your daughter today?" takes seconds and may keep a child safe that afternoon.
Recognising concern and making a referral
Be curious when the story doesn't fit the injury or the child's age, when there has been an unexplained delay in seeking help, or when a child "was not brought" to appointments again and again. NICE guidance on child maltreatment says bruising in a child who is not independently mobile should make you suspect maltreatment unless there is a suitable medical explanation. Follow your local protocol the same day.
When you are worried:
Immediate danger: call 999.
Discuss with your senior and the safeguarding team (named doctor or nurse). Out of hours, use the on-call paediatric or safeguarding route. Don't let this delay an urgent referral.
Refer to children's social care through your local "front door", often a multi-agency safeguarding hub (MASH), and follow up in writing as local procedures require.
Be specific: what you saw and heard, what the child and family said in their own words, and what you are worried might happen.
Tell the family you are referring, unless that would put the child or anyone else at risk.
Record the referral, who you spoke to and the agreed plan, and ask about the outcome.
How to escalate when you are still worried
Reviews of serious cases often find that professionals had worries but didn't challenge decisions they disagreed with. If you still think a child is at risk after a referral, for example because no action is planned or the situation has changed, don't let it drop:
Ask children's social care what was decided and why.
Discuss it with your named doctor or nurse for safeguarding.
Use your local safeguarding partnership's escalation (resolution of professional disagreement) procedure, usually with the safeguarding team's support.
Record each step and your reasons.
If you are worried that a colleague may be harming children, tell your safeguarding lead and senior manager. The organisation will involve the Local Authority Designated Officer (LADO). Don't investigate yourself or warn the person.
How this looks on an NHS application and at interview
Safeguarding questions come up at interview in almost every specialty. Panels want to see that you put the child first and work with the safeguarding team rather than alone. A strong answer covers:
Immediate safety
History, examination and records
Escalating to your senior and the safeguarding team
Referral
Communicating with the family where safe
Documentation and follow-up
In adult specialties, mention Think Family. On your CV, state your training level and date, for example "Level 3 Safeguarding Children, completed March 2026". The guide to the NHS person specification shows where safeguarding usually sits among the essential criteria.
Our free Safeguarding Children and Young People course builds these skills through realistic cases, from bruising in babies to the intoxicated parent in ED.
Start the free course
The Safeguarding Children and Young People course covers the categories of abuse, recognising maltreatment, Think Family, domestic abuse and FGM, information sharing, referral and escalation, in short modules that are free to study. It includes a quiz, an optional verifiable certificate and a reflective note for your appraisal. It is not accredited and does not replace your employer's mandatory level 2 or level 3 safeguarding children training. If you'd like your NHS application reviewed and rewritten (£35), email cvreviewexperts@gmail.com.
Frequently asked questions
Do doctors in adult specialties have safeguarding children duties?
Yes. GMC guidance says doctors must consider whether an adult patient poses a risk to children, and act on any concern about a child's safety. This applies in psychiatry, emergency medicine, general practice and every other specialty.
What level of safeguarding children training do NHS doctors need?
Employers set the level using the intercollegiate document. Level 3 applies to staff who deliver clinical care to children and to many who treat adults who are parents or carers, so many doctors' posts require it. Check with your employer.
What is the current version of Working Together to Safeguard Children?
The Department for Education published Working Together to Safeguard Children 2026 in March 2026, replacing the 2023 edition. It is statutory guidance for England.
Do I need parental consent to refer a child to social care?
No, not if you think a child may be at risk of significant harm. Tell the family where it is safe to do so, but don't tell them first if that could put the child or anyone else at risk.
What should I do if social care takes no action and I am still worried?
Discuss it with your named safeguarding professional and use your local escalation or professional disagreement procedure. Record each step and your reasons.
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