By Nick Triggle
Health reporter, BBC News
Child protection has been in the spotlight since the Baby P case
The NHS risks missing another Baby P abuse scandal because of gaps in child protection, the health regulator says.
The Care Quality Commission warned a lack of training, poor monitoring and high workloads were commonplace after surveying all 392 trusts in England.
The regulator was asked by the government to look at the issue following the death of the toddler.
A host of agencies involved in his care have been criticised for failing to spot and stop the abuse he suffered.
The toddler - now named as Peter - had been seen by health services 35 times by the time he died in 2007 aged 17 months after suffering more than 50 separate injuries.
WHERE THE NHS MUST IMPROVE
Training - Just over half of the relevant health staff get the proper training. Figure drops to a third for GPs
Monitoring - NHS boards criticised for not putting child protection higher on their agenda - a third did not get a single presentation from staff on the issue in 2008
Workloads - Key staff are being overworked with a fifth of trusts reporting they had health visitors with too many children on books
Processes - Many hospitals failing to follow-up children who miss appointments
This included appointments with GPs, health visitors, paediatricians as well as being seen at walk-in centres.
The catalogue of abuse he suffered emerged during a court hearing at the end of last year that led to the conviction of his mother, her boyfriend and their lodger for causing his death.
The CQC has already looked at the role of the NHS organisations that came into contact with him, saying they missed valuable opportunities to save his life.
But the regulator was also asked to carry out an NHS-wide review of child protection.
The report found that some trusts failed to follow basic good practice principles - a third of hospitals had no follow-up process for children who miss appointments.
It also highlighted a worrying lack of oversight from boards with nearly a third not having at least one presentation from child protection staff during 2008.
A fifth of trusts also reported having health visitors with case loads of more than 500 children - the recommendation is 400 at most.
The NHS was also criticised on training. Just 54% of staff who work with children have completed the correct training.
For GPs, this drops to a third and even for doctors working in A&E departments the figure only stands at 58%.
The regulator said all NHS trusts should now review the practices they have in place and warned they will be carrying out visits to those with the most problems.
CQC chief executive Cynthia Bower said: "Immediately after the Baby P tragedy, everyone agreed that everything possible must be done to prevent a recurrence.
"This must not prove to be hollow rhetoric."
Health Secretary Andy Burnham agreed. "I wish to make it clear that I see these basics as non-negotiable and that the NHS must ensure their full implementation."
Peter Carter, of the Royal College of Nursing, said NHS trusts should be shamed by the findings.
He added: "Health professionals ask for regular child protection training, but their employers do not set aside the necessary time and money for it to happen."
Jo Webber, deputy director of policy at the NHS Confederation, which represents trusts, admitted "clearly much more can be done".
She promised the lessons would be learned.