Part 2A: Roles and responsibilities for child protection 54 National Guidance for Child Protection in Scotland 2021 Version 1.0 September 2021 School Nurse 2.106 The role of the school nurse has been redefined (Transforming nursing, midwifery and health professions roles: the school nursing role in integrated community nursing teams) . School nurses are registered nurses or midwives who have undertaken additional education, in order to support school-aged children in attaining their health potential. School nurses deliver proportionate universal services to school-age children, based on their professional assessment of need. School nurses aim to work in collaboration with named persons and health and social care teams to provide early support, and prevent escalation of need. School nurses will be alert to children who may be at risk or experiencing significant harm, and must raise their concerns in line with local policy. General Practitioners 2.107 General Practitioners (GPs) and practice staff are well placed to detect early or developing concerns about children and families. Their roles encompass prevention, recognition and early response, and out of hours GP services. GPs may be involved in provision of on- going therapeutic support to children and families who have experienced harm, often into adulthood. In addition, GPs and their teams may be working directly with adults who pose a risk to children and young people, including those experiencing problematic alcohol and drug use or living with domestic abuse, and those who have mental health difficulties. 2.108 GPs will alert a statutory agency without delay if they are concerned that a child or young person has experienced or is at risk of harm from abuse or neglect. GPs are also key in the identification and support for adults with significant risk factors, such as alcohol and drug use and mental health difficulties, which may impact on their ability to care. Emergency health care services 2.109 Emergency health care services include out of hours primary care and GP medical services, NHS 24 and the Scottish Ambulance Service, as described separately below. Emergency Departments 2.110 Children or young people may be taken or present themselves at accident and emergency departments. In some instances, abuse or neglect may be suspected, so in addition to care and treatment, local procedures for raising child protection concerns must be followed. Local guidance must be in place to respond to refusal of treatment, or premature removal of a child from the emergency department. If health staff suspect that a child or young person has experienced or is at risk of abuse or neglect, they must provide any immediate medical care required, gather information from the child or young person’s medical records, and contact social work standby services. They must examine the child for evidence of injuries (remembering that these may be concealed under clothing), document carefully all clinical findings including skin condition, bruising, scars, weight and height, and ensure that senior practitioners are involved in any decision-making process. They must follow local child protection procedures, including ensuring concerns are raised immediately with social work services.