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Lewisham Safeguarding Children Partnership

If you are worried about the welfare or safety of a child or young person

Email: mashagency@lewisham.gov.uk

Tel: 020 8314 6660

Fabricated or Induced Illness and Perplexing Presentations Guidance



1. Introduction

This guidance is written to support multi-agency frontline practitioners to make appropriate decisions on how to safeguard children who present with perplexing presentations (PP) and Fabricated or Induced Illness (FII), additionally advise practitioners on how to recognise these issues, how to assess risk and how to manage these types of presentations in order to obtain better outcomes for children.

This guidance is based on the Royal College of Paediatrics and Child Health (RCPCH) 2021 guidance Perplexing Presentations (PP)/Fabricated or Induced Illness (FII) in children – guidance – RCPCH Child Protection Portal  as well as learning from Serious Case Reviews, and aims to put the RCPCH 2021 document in context for practitioners working in Lewisham.

Whilst mainly applicable to health practitioners, this multiagency guidance is applicable to all frontline staff working with children, young people, and their families.

The term ‘children' or ‘child’ applies to all children and young people who have not yet reached their 18th birthday as per the Children Act 1989. The fact that a child has reached 16 years of age; is living independently or is in further education; is a member of the armed forces; is in hospital; in prison or in a young offender's institution, does not change his or her status or entitlement to services or protection under the Children Act 1989.

2. Purpose

The purpose of this policy is to:    

  • Provide Lewisham frontline practitioners with a single consistent approach in the management of PP, or suspected FII.
  • Advise safeguarding partnerships of a single consistent approach across local providers and staff in the management of PP, or suspected FII.
  • Provide staff with the information and guidance they need to fulfill their statutory duties to safeguard and protect children and young people when there is suspected PP or FII.
  • Clearly define roles and responsibilities so that the process is transparent, and staff understand the complexities involved and have realistic expectations about the timeframes within which any given case can be managed.

      LSCP Multi-agency Guidance for the management of Perplexing Presentations, or, suspected Fabricated or Induced Illness

      Appendix 1 : Generic flow chart when there are alerting signs

      Appendix 2 : Spectrum of cases where FII concerns may arise (RCPH, 2013)

      Appendix 3 : Sample of chronology template

      Appendix 4 : Health and education rehabilitation plan template

      Tri-Borough 7 Minute Briefing : Fabricated & Induced Illness and Perplexing Presentations

      14. References


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