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GPs buried under trusts' workload dump

This contractual postnatal checks idea is giving me sleepless nights


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I have good news, bad news and worse news.

The good news is that I’ve just discovered something wonderful about a recurring chore in general practice that I’ve only endured over the years because I assumed I had to: I don’t have to.

Apparently, the pointless ritual known as the ‘six-week postnatal check’ which has mums mumbling, as they leave, ‘That was a waste of time’ – largely because it was – is not mandatory. I’ve been doing them for as long as I can remember, and I’m guessing you have, too, as I’ve always assumed they were a specified part of the maternity Additional Service contract.

But they’re not. Trouble is, I’ve only realised this because someone has now decided that they should be. And that’s the bad news. For reasons which utterly escape me, incorporating the six-week check into our contract is part of the 2019/20 contract negotiations. The even worse news is that the National Childbirth Trust seems to be the frontrunner in coming up with the check’s format. Yup, that’s right. The NCT.

We all know that postnatal checks are a worthless, unscientific tradition

I’ve got nothing against them personally, even if an NCT antenatal class 28 years ago did make me miss the England v Germany World Cup semi-final. But I have to say that, if I was looking for an evidence-based approach to support post-natal checks, the NCT wouldn’t be my first port of call.

Then again, anywhere I’d look would prove pointless, because this is an evidence-free zone. We all know that postnatal checks are a worthless, unscientific tradition, so let’s not regress to the dark ages. Midwives and health visitors can do the routine, proactive touchy-feely bits.

New mums are welcome to see me whenever about whatever. I’ll even try to make opportunistic enquiries in the post-natal period, if you like, though I’ll probably steer clear of one of the NCT’s suggested questions – ‘Does your perineum feel OK?’ – especially if she’s just come in with a sore throat.

But please: no arbitrary six-week check which wastes patient time and a precious appointment. On the other hand, if mandatory six-week checks are the forceps that lever out a shiny, healthy, GP-friendly new contract and there are no other nasty perinatal surprises, then feel free to completely disregard the above, Mr Vautrey. Like I said, I’m doing them already.

Dr Tony Copperfield is a GP in Essex

Please note: this headline was changed at 9:45am on 6 November 2018 to reflect that Copperfield is referring to postnatal checks - not 'baby checks', as the original headline implied

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Readers' comments (18)

  • Marie Louise this is nothing to do with the 6-8 week check for babies, that is standard GP care. The article is about the postnatal check for mum which isn't contractual or standardized. They are talking about introducing a postnatal check for mother's into the GP contract in lieu of actually improving maternity services.

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  • Let common sense prevail

    When I entered General Practice the routine for a postnatal check included mandatory examination of the breasts, and an internal vaginal exam. Not only have those drifted into obsolescence, I suspect that they would land you in court, or at least with a nasty local reputation!!

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  • @Chris Ho
    Because the free market would never offer useless non evidenced based screening which might harm patients?

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  • Cobblers

    DrA 9:50pm I think that the ambiguity has been caused by Copperfield in that his headline mentions one thing and the article is about another. That being said until 2004 the two, PNs and Baby checks were conflated, at least in my practice.

    And, yes, baby checks were fun! Even for an old fart like me.

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  • It's not often I disagree with Dr Copperfield, but this is one such occasion. Totally agree with Marie-Louise Irvine and another last man standing ...over the past 20 years I've picked up dozens of cardiac defects in babies, (several requiring surgery) 3 babies with congenital hip dislocation, 2 babies with serious chromosomal abnormalities missed at the birth check, a baby with persistent jaundice that mum had not noticed due to biliary atresia who required a liver transplant and numerous other medical problems. The postnatal check is an ideal opportunity to look for postnatal depression and anxiety.

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  • 6 week checks can pick a few things up but one needs to be careful these days in the toxic uk environment. Ask a question about bleeding, perineum or discharge can get you in hot soup. If you are damned if you do and damned if you don't then I might as well save the effort and be damned anyway unless it is compulsory.

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  • Some 36 years ago my GP told me I needed to,attend his surgery for a 6 week post natal check.he was very surprised when I turned up.”where’s baby?” he asked. “You asked to,see me,” I replied. “Yes but but that means with your baby, “ he retorted. “You should have specified” I said. He struck me off his list. And yes, the visit was a total waste of time.

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  • @Angus P
    totally agree

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