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GPs need time and training to better protect children

GPs’ skills and family contact make them ‘ideally placed’ to lead on child concerns

Louise Prime

Tuesday, 08 July 2014

GPs need more time and support, as well as better training, so they can take more of a leading role in protecting vulnerable children, agree doctors’ leaders and charities. They said this morning that GPs are ideally suited to supporting parents and taking a “whole-family” approach to concerns over child neglect and emotional abuse.

The Royal College of GPs, charity NSPCC and researchers from University College London and the University of Surrey undertook a comprehensive analysis of policy, practice guidance and research evidence. In their report The GP’s role in responding to child maltreatment: time for a rethink?, they argue that children and families would benefit from giving GPs the time, support and autonomy to work with vulnerable families in the community.

The NSPCC estimates that eight out of nine vulnerable children are not subject to a child protection plan. The report’s authors point out that GPs have ongoing and consistent contact with parents and children, skills in building and maintaining relationships, and treat the “whole person” – so they are ideally placed to take more of a leading role in working with other front-line professionals to act on concerns about issues such as child neglect and emotional abuse. This could involve providing long-term support and monitoring of children and wider family members, advocating for parents to help them find their way through the health and social care systems, and advising and coaching parents about problems with alcohol use or mental health that affect their children.

But they warn that GPs are already stretched to the limit by their enormous workload, so they must be given more time, training and support to enable them to do more to protect vulnerable children. Professor Simon de Lusignan, University of Surrey, said: “As a practising GP involved in this research I understand how front-line pressures prevent GPs from having the time to fully explore complex social and family issues that impact on a child’s health and wellbeing.

“Reorganising care so that there is more time given to those who need it – in this context, children who are at risk or who are maltreated – can only improve general care and help keep families together and children safe from harm.

“GPs are the first service many families in this position encounter and without the right support and investment they will fall at the first hurdle. I urge policy makers and senior managers to make the necessary changes so that the recommendations put forward by the RCGP and NSPCC are put into practice.”

RCGP chair Dr Maureen Baker (pictured), said only about half of GPs will have had enough training in paediatrics to take on this role – and the College wants GP training to be extended from three to four years, focusing in particular an child and mental health. She said: “By recognising early signs of strain in children and their families, which may involve physical or emotional symptoms, GPs can be of real help and in some cases help prevent situations or conditions getting worse … yet only half of our trainee GPs currently get the opportunity to undertake a specialist paediatric placement during their training.”

Picture credit: Grainge Photography for the RCGP

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