GPs encouraged to take on ICB advice on supporting bereaved parents
Guidance produced by one ICB to help GPs support bereaved parents after the death of a child should be taken on board by practices around the country, the RCGP has said.
A framework produced by Cheshire and Merseyside ICB to help GPs supporting bereaved parents noted that 3,500 children die every year in England.
Child deaths are also stark and sensitive indicator of the social determinants of health with deprivation a strong and consistent association, the guidance pointed out.
Yet death of a child is a rare event for which GP practices may not feel equipped to support parents, with some bereaved families reporting they did not feel looked after.
Co-developed by Dr Jonathan Griffiths, a GP in Cheshire whose young son died in 2004 from a rare haematological condition, the guidance aims to support practices in ‘providing solace and support’ to bereaved parents.
It will be applicable to practices around the country and it is hoped other ICBs will adopt it for their area, Dr Griffiths said.
He told Pulse that a child death is an unusual event for GPs, but a very significant one.
He added: ‘People don’t like to talk about child death, it’s such a deeply upsetting subject for so many people, and therefore bereaved parents can feel that they’re unheard and not very well supported. GPs struggle to know what to do, and they may not have encountered it before.’
The guidance includes a checklist, which Dr Griffiths, who is also the ICB’s associate medical director of primary care, advised practices to work through when they are notified of a child death.
It includes removing the child’s name from the NHS Spine and Child Health Information Service so parents are not contacted inappropriately and consideration about who to notify as well as adding a code to the parents record that their child has died.
And it advises GPs about taking part in sudden and unexpected death of a child (SUDIC) processes.
The framework advises on potential ways to support bereaved parents including listening to their needs, signposting to services and organisations that can help them and discussions about how and when they return to work.
It also advises GPs not to over-medicalise the grieving process with parents reporting they were offered antidepressants when they really did not feel they were required.
The final section of the guidance, co-authored by Dr Bryony Kendall, who is also a GP, relates to how to support the practice team where a child has died.
Dr Griffiths added: ‘We’ve given a lot of practical suggestions as to how we think you should approach this. When you have an early face to face conversation with them, we would encourage home visiting is probably going to be required, and talking about why you’re visiting them, and what you’re going to say to them.
‘We talk about where you might want to signpost them to, sorting out Fit notes for them, advice about returning to work, what language to use, how not to over medicalise things, and providing continuity.’
He added that there is ‘a real mix’ of experience of healthcare for parents who lost a child. ‘Some were very enthusiastic about how good their GP was, and others said I didn’t hear from them,’ he added.
‘The key role that you’re going to play as a GP is quite challenging because we are trained to fix things and you can’t fix this. Your most valuable and important contribution is probably going to be to sit and be there and to listen.’
He said they would really encourage other areas to take the framework and tweak it so that GPs have the information about local services available.
RCGP honorary secretary Dr Michael Mulholland said that the framework would help GPs to support parents through devastating grief while also looking to support themselves through the process.
He encouraged all GPs to read to read it and ‘adapt’ it for their own local settings.
He said: ‘The death of a child is a rarely talked about, deeply traumatic and upsetting event. At the heart there are grieving parents who need care, compassion and support.
‘When a Child Dies: An NHS Cheshire and Merseyside Framework for General Practice provides an essential checklist of actions to take, bolstered by a wealth of practical suggestions and resources. We would encourage all to read and adapt for their own local settings.’
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