This is not about criticising GPs. Quietly, behind the scenes, we do an enormous amount of work to support families. But what we have to do now is say we are doing it.
GPs often see multiple family members and they can detect stressors — such as violence, parental depression, drug or alcohol abuse — that put children at risk of maltreatment.
We hold the continuous health record and are a key resource for sharing information about maltreatment-related concerns.
Yet, from our research, we found GPs have worries about writing something in the notes that could cause argument or offence later on.
GPs do sometimes feel underconfident about the legal aspects of recording information about third parties in records, but this is covered by the Caldicott guidelines on information governance. New GMC guidance will be published next month that will address the ethical questions over this.
The key thing is to develop a relationship with the patient to keep them engaged with services and get the help they need.
It is about a balance of benefit and harm and feeling confident in saying to a parent or carer, ‘We have raised some important issues. We will do all we can to support you and your family – what arrangements shall we make to check how you (and the child or young person) are getting on?
‘I need to talk with the others involved with your care, with your agreement.’
Dr Janice Allister a GP in Peterborough and co-author of the study