CONFIDENTIAL: Not to be shared with family unless agreed at Multiagency Strategy Meeting Page 3 - Chronology (To be completed by Health Professional) Child’s Name: Date of Birth: NHS Number: ICS/Pupil Number: Record of Treatments (medication / operations / other): Investigations carried out Indication for investigation Result
CONFIDENTIAL: Not to be shared with family unless agreed at Multiagency Strategy Meeting Page 4 - Chronology (To be completed by Health Professional) Child’s Name: Date of Birth: NHS Number: ICS/Pupil Number: Medical Teams Involved: Team Consultant child under care of Where team is based Indication for team’s involvement Time period of involvement
Spectrum of Cases where FII concerns may arise CONFIDENTIAL: Not to be shared with family unless agreed at Multiagency Strategy Meeting Page 3 Child’s Name: Date of Birth: NHS Number: ICS/Pupil Number: Carer’s insight It is usually possible to reassure carer although they are likely to present again in future Difficult to reassure carer; carer and professionals may not agree on the cause of symptoms and/or the need to consult or investigate further It is not possible to reassure carer; carer’s objectives are diametrically opposed to those of professionals Carer lacks insight into their involvement in the child’s supposed illness Carer’s ‘illness behaviour’ will usually be appropriate for the signs displayed by child, although any child protection interventions may affect the carer’s behaviour Information supporting evidence of carers insight
Analysis of risks and Protective Factors CONFIDENTIAL: Not to be shared with family unless agreed at Multiagency Strategy Meeting Page 1 Child’s Name: Date of Birth: NHS Number: ICS/Pupil Number: Table 1 Example 1 Example 2 Example 3 Example 4 Example 5 Type of presentation Simple anxiety, lack of knowledge about illness, over interpretation of normal or trivial features of childhood; may in some cases be associated with depressive illness in carer Child’s symptoms are misperceived, perpetuated or reinforced by the carer’s behaviour; carer may genuinely believe the child is ill or may have fixed beliefs about illness Carer actively promotes sick role by exaggeration, non-treatment of real problems, fabrication (lying) or falsification of signs, and/or induction of illness (sometimes referred to as ‘true’ FII) Carer suffers from psychiatric illness (e.g. delusional disorder) which leads them to believe child is ill Unrecognised genuine medical problem becomes apparent after initial concern about FII Level of risk Seldom reaches the threshold of significant harm May be disabling for the child; often some risk of significant harm, including emotional or educational harm, or social High risk of harm; always some resultant harm, often severe May be risk of harm Risk of harm due to inappropriate child protection process and delay in correct diagnosis Evidence supporting level of risk (actual harm / concerns about probable harm)
Child’s Name: Date of Birth: NHS Number: ICS/Pupil Number: Page 2 Need / risk identified Action Person Responsible When action is to be completed Outcome and date of completion Completed by: Signature: Name: Job Title: Date of Completion: Completed individually / in a professio