March 2, 2021

new guidance from the Royal College of Paediatrics and Child Health (RCPCH) – Perplexing Presentations (PP) and Fabricated or Induced Illness (FII) in Children

Fabricated or induced illness by carers (FII) is a clinical situation in which a child is, or likely to be, harmed due to the parent’s behaviour and action to convince doctors that the child is ill or more unwell/disabled than is actually the case. This new guidance is an update to the 2009 guidance and aims to better support paediatricians when involved with perplexing presentations or fabricated or induced illness. It provides procedures for safeguarding children who present with PP or FII and best practice advice in medical management of these cases to minimise harm to children. 

It is a result of an expert working group convened by the college and led by Dr Alison Steele, and involved a survey of child health professionals to understand their experiences of managing cases of FII, and a consultation period receiving input from stakeholders including BMA, GMC, RCGP, RCN, RCP and NHSE.

Three of the authors were be able to go through the updated guidance with journalists and answer questions about fabricated or induced illness in children.

Speakers included:

Dr Alison Steele, Officer for Child Protection and Safeguarding at the RCPCH, Consultant Paediatrician at Great Ormond Street Hospital

Dr Danya Glaser, Visiting Professor at UCL and Honorary Consultant Child & Adolescent Psychiatrist at Great Ormond Street Hospital

Dr Emilia Wawrzkowicz, Assistant Officer for Child Protection at the RCPCH, Consultant Paediatrician and Designated Doctor for Safeguarding Children, Cambridge and Peterborough