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GPs buried under trusts' workload dump

GP factors found in third of sudden child deaths

By Nigel Praities

A confidential inquiry led by GPs has linked a third of sudden child deaths to errors or lack of preventive advice in general practice.

The Department of Health is to consider the implications of the report, which found misdiagnosis of serious infections and ‘inadequate' management of asthma and epilepsy were important contributors to unexpected deaths among children.

The GP leading the inquiry said it was ‘lamentable' so little attention had been paid to boosting quality of care for children through QOF indicators.

‘Avoidable primary care factors' were identified in a fifth of sudden deaths, while the inquiry found ‘preventive advice' from GPs could have helped prevent a further 12%.

The confidential inquiry – published online by the British Journal of General Practice – analysed 128 child deaths from England, Wales and Northern Ireland, 35% of which were sudden, and looked at the role of primary care.

It found some deaths were the result of GPs diagnosing children with minor infections when they had serious illnesses such as meningitis and pneumonia. Other children had uncoordinated care of chronic illnesses that had contributed to their deaths, or were not given pneumococcal vaccinations when they had been recommended by a specialist.

Only 59% of the 149 children with immunisation records had received the full range of vaccines on time.

The report – which is being looked at closely by the RCGP as well as the DH – comes at a sensitive time for GPs.

A report into the Baby P case earlier this year highlighted failings in children's care and advocated a stronger role for GPs in monitoring those at risk.

Inquiry leader Dr Anthony Harnden, a lecturer in general practice at the University of Oxford and a GP in Wheatley, Oxfordshire, said the audit had uncovered many examples of good care of children by GPs, but there were ‘recurring themes'.

‘We cannot say that if something had been done in a different way, that child would have survived, but these are factors that possibly had an impact on the child's death.

‘It is lamentable that a huge part of our care is for children, yet 3% of the markers in the QOF are for children. Children are relatively neglected compared with adults with chronic disease,' he said.

Dr Harnden, who is a Government adviser on vaccination with a special interest in paediatrics, said he would be lobbying NICE to include more childhood markers in the QOF and was planning to meet DH officials to discuss the report.

A DH spokesperson said: ‘There are always improvements that can be made and we will work with the profession to see what more should be done.'

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