GPs can co-ordinate care for children showing sexualised behaviour, says NICE

GPs should be prepared to take the lead in co-ordinating care and support for children where there are concerns about their sexual behaviour, according to NICE draft guidance.

The draft guideline on harmful sexual behaviours – which covers under-18s and young people up to 25 with special educational needs or a disability – is open for consultation until 6 April.

Harmful sexual behaviours can include using sexually explicit words, pornography use, inappropriate touching or having sex with other children or adults.

The guideline suggests that children exhibiting sexual behaviours inappropriate for their age or development status should be offered an early assessment.

This should be conducted by an appointed lead practitioner – who could be their GP – who should be responsible for acting as a single point of contact for the child and their family, act as their advocate and co-ordinate care across services.

The NICE committee team contemplated making a firm recommendation that this should be a GP's responsibility for all children outside of the care system, but eventually decided that this would be 'too prescriptive'. A patient's family support worker, school nurse, social worker or other health staff member could also take on the role, they advised.

Harmful sexual behaviour

The draft advice adds that doctors should liaise with families before developing an intervention and keep in mind the impact of the child’s behaviour on all family members.

A reccomended approach should include helping young patients develop a strong sense of personal identity, arranging access to mental health services if needed, promoting continuity of care to help develop trust, and developing an action plan to put the guideline into practice

Professor Gillian Leng, director of health and social care at NICE, said: ‘Inquisitive behaviour is a normal part of growing up. It is natural for children to explore sexuality as part of this. There are normal things they will do such as asking about what body parts do, but there may be some actions such as forcing others to simulate sexual acts, that signal something is wrong.

‘It is important to strike a balance between taking no action, ignoring problem behaviour that could be the sign of another underlying issue, and overreaction which can lead to a child being stigmatised for life.

‘We want all professionals who come into contact with children and young people to take notice if they are displaying harmful sexual behaviour. This guideline will help them to take appropriate action when needed.’

GPC deputy chairman Dr Richard Vautrey said: ‘This is part of the safeguarding responsibilities all GPs are very aware of and have regular training on.

‘Most practices already have a lead person for safeguarding but this would not necessarily be the person all patients see, and most practices and their patients wouldn't expect it to be the case as patients could present to any GP or nurse within the practice so all need to and do have an awareness of this.’

Photo: AJ Photo/Science Photo Library

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