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How I work as a named doctor for child protection

GP Dr Denise Milford finds overseeing child protection for four PCTs a rewarding challenge

I took up this post early this year. I work for the four PCTs in Liverpool and South Sefton and by far the greatest workload for serious case reviews is Liverpool. I do four sessions a week ­ one for each PCT.

What the job involves

The job has many strands to it. I audit the training needs of GPs in child protection and provide education to meet those needs. This can be on a one-to-one basis but a systematic approach is also necessary. A new RCGP group has been formed to look at training in this area and we are discussing the best way to deliver it.

I also sit on committees: most importantly, the area child protection executive committee and several sub-groups that discuss the role of health professionals in child protection policy-making.

Lastly, I have to analyse and review the role of general practice when a child is killed or injured to see what was done well and what lessons can be learned. This sometimes generates training issues and I work closely with clinical governance.


A very satisfying aspect of my work is offering advice on cases and working with other agencies to protect children and encourage communication between professionals. This area of work is called 'supervision' and is used widely in counselling and psychotherapy disciplines to debrief therapists. It is especially useful for GPs who have experienced distress, for instance when patients threaten to complain, move list or worse. Sometimes I have to defuse confrontations between patients and doctors ­ and sometimes between doctors.

Finally, my role involves trying to alert doctors to possible abusive situations or when a child is vulnerable. Most doctors are grateful to receive this kind of information but occasionally it is seen as meddling or criticism. On one occasion it created a difficult situation but I was well supported and it was realised that education about my role was paramount for future situations and to encourage others into this role.

Qualifications and experience

Part of my experience in children's health before this appointment was as the lead for the practice's baby clinic. I also had a few years' overseas experience in child health and protection in Canada and South Africa and was a CMO in the community during my childbearing years before settling into general practice.

I was also a 'clinical champion for children's health' for South Sefton PCT for a year or so. I still, however, benefited from an induction period to bring me up to date on the law and the roles of other professionals in child protection.

I find it an immensely rewarding addition to my portfolio. The rest of the week I am a half-time GP, which I still love. But I can't help but see everyone through 'child protection spectacles'.


The pay rate is as a GPwSI. It accounts for more than half of my income. I also have a generous allowance for locum cover to enable me to be flexible. There is also an allowance for sitting on committees away from home that includes accommodation if necessary. I also get travel expenses using my home as a base because of being spread among four PCTS.


I must admit it isn't all roses. When doing the chronology for a serious incident involving a baby or child it can be very upsetting and time-consuming to meet deadlines within the law and to aid the police and social services.

I often want to throw in the towel when I'm working from home on an involved case in the middle of an evening.

Are there any other named doctors out there? Please feel free to contact me ­ e-mail ­ to exchange ideas and set up a network. And for would-be named doctors:

do contact me ­ I'd be happy to discuss the role with you.

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