Fabricated or Induced Illness – what it means, what it does, and how to identify it | Online sessions available 23/24/25 January 2024, with 24-hour access PLUS 1 hour live workshop with presenter- 3pm, 25 Jan

Fabricated or Induced Illness (FII for short) is a rare form of child abuse, and occurs where a parent, or occasionally another adult, invents, induces or exaggerates a child’s illness. Recent exploration of the condition has led to a wider definition which includes ‘Perplexing Presentations’ (PP).

Parents can be persuasive and authoritative, and obtaining objective evidence is usually difficult. Situations can be made more complex by increasing numbers of professionals involved and appointments at multiple sites. Yet matching information across agencies can be essential, for example, between health professionals, social workers and schools.

A parent may be genuinely mistaken, or an excessive worrier who refuses to accept medical advice.

In other cases, deception may reflect a desire for control, attention, sympathy and support, or even financial gain. Some serious cases have been characterised by parents who are relentless in their pursuit of diagnosis and treatment.

In extreme cases, children have undergone unnecessary invasive medical treatment, including operations. It is, therefore, essential that a wide range of professionals who work with children and families are aware of FII, how it may be spotted, and what to do next.

FII can also take place in health care settings with devastating consequences, as shown by the recent and shocking case of nurse Lucy Letby deliberately inducing illness and death in babies under her care.

This online learning will consider the nature of FII, and the kind of perpetrator behaviours which have been observed. There is no simple route to ‘diagnosing’ FII, but the sessions will look at guidance available, how it may be possible to pick up clues that suggest practitioners should consider FII as a possibility, and in-case examples. There are also exercises to complete which support learning, and a live online workshop with the presenter on 25th January.

SPEAKER

The learning day will be facilitated by Pippa Waterman.

Pippa is a qualified nurse, midwife and health visitor, and a qualified teacher and trainer in safeguarding.  She is a Fellow of the Higher Education Academy, and was a Senior Lecturer for MSc in Safeguarding at the University of Birmingham. Pippa has been a Named Nurse and lead trainer for safeguarding children in a large NHS Trust, and has sat as a magistrate and worked in domestic violence courts.

Session 1 (24 minutes recording)

• Introduction
• Definitions of Fabricated or Induced Illness, including wider concepts of Perplexing Presentations
• What do we know about FII?
• The perpetrators of FII: how they may fabricate illness, and how they may present
• What to look out for
• Other factors: siblings, wider family, and health professionals

Session 2  (18 minutes recording)

• How the child may present to professionals
• What harms may impact the child – short term and long term; physical and mental
• Common presentations of FII
• Key points to look out for
• Examples of inducing illness
• Two case examples

Session 3 (30 minutes recording)

• Professional responses
• What counts as objective evidence?
• RCPCH Guidance 2021
• Process and agencies involved
• What do you say to the parents?
• S47 considerations
• Chronology, information sharing, care proceedings
• Health and education rehabilitation plan
• Case examples

Live workshop – 1 hour at 3pm on 25 January.

This is an opportunity to ask questions and raise your own case issues with the presenter.