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GPs should step up child protection role, says BMA

By Nigel Praities

GPs are being asked to hold weekly meetings with health visitors, attend child protection cases and maintain registers of vulnerable families, in a bid to prevent cases like the Baby P tragedy, as part of new BMA guidance.

The 60-page document, which lists 40 signs and symptoms to look out for, is the latest move in a major shake-up in the role GPs play in child protection.

Pulse revealed earlier this year that PCTs were cracking down on GP involvement in case conferences and draft NICE guidelines advise GPs to ‘seek explanations for any injury' that presents to them.

The BMA guidance says: ‘Each week, two GPs should sit down with the health visitor and midwife and discuss how these families can best be supported.

‘As far as possible, doctors should attend [child protection case conferences] in person, in addition to sending a written report containing relevant information such as immunisations, A&E and OOH attendance and non-attended appointments,' the guidance reads.

Chairman of the BMA's Medical Ethics Committee, Dr Tony Calland, said the advice would help GPs decide when to intervene.

‘There is always a degree of risk when dealing with child protection issues, at one end there is the danger of leaving a child for too long in a dangerous situation and on the other the risk of removing a child unnecessarily from its family. We hope this tool kit will help doctors weigh up the risks,' he said.

Dr Harry Yoxall, a GP in Somerset and secretary of Somerset LMC, welcomed the additional guidance, but stressed that some of it was too prescriptive.

‘Setting up more meetings is always a problem. The first one is great, the second one quite useful and the third one fades away and nothing happens after that.

‘Rather than having such formal structures we would prefer obvious channels of communication within the practice to make sure the key people are aware of a child in need,' he said.

Dr Yoxall also said it was difficult for GPs to attend case conferences, even if they really wanted to, as they were often scheduled at awkward times.

‘It's very difficult for GPs to refuse to do morning surgery on a Monday because they have to attend a case conference, particularly where they don't feel they have anything useful to contribute,' he said.

What the guidance says

- GPs are likely to be the first professionals to come into contact with children at-risk, and should always bear in mind the ‘child behind the adult'

- Practice teams should know how to act on concerns over a child, with written protocols about what they should do

- There should be ‘structured liaison' between GPs and health visitors in order to identify children at risk

- Best practice is to maintain a register of vulnerable families where children who may be at-risk and have weekly meetings with health visitors and mid-wives about these children

- GPs should attend child protection case conferences in person, as much as possible, as well as submitting a report

Source: BMA 2009, Child protection – a toolkit for doctors

New BMA guidance asks GPs to do more on child protection

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