Non-attendance, repeated contacts and hidden patterns

Repeated non-attendance or frequent urgent requests can signal safeguarding concerns, especially for children with long-term conditions, developmental delays, mental health needs, medication dependence or existing safeguarding records.

One missed appointment on its own may be incidental. A pattern of missed child health reviews, repeated cancellations, delayed presentation, gaps in medication or unreachable contact details suggests the child's health needs may not be being met.

Patterns to notice

• Repeated missed reviews, immunisations, screening appointments or blood tests.
• Parents declining appointments after urgent requests or cancelling when asked to bring the child in.
• Changing contact details, unreachable families or frequent address changes.
• Medication gaps for asthma, epilepsy, diabetes, mental health needs or safeguarding-related treatment.
• Repeated requests from different adults with inconsistent explanations.

Think "was not brought"

Children usually do not control attendance. Using "was not brought" keeps the focus on the adult's responsibility and the child's unmet need rather than implying the child is to blame.

When patterns should be escalated

Escalate when missed contact could affect safety, treatment, development or necessary follow-up; when there are previous safeguarding concerns; when the child has a significant health condition; or when staff remain worried after checking records. The safeguarding lead or a clinician should decide whether early help, child protection, clinical review or another route is needed.

Was not brought

Safeguarding risk may sit in the pattern, not in one missed appointment.