Call for GPs to act on early signs of child maltreatment

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GPs should play a greater role in identifying child abuse and neglect, a report says.

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GPs could do more to step in and help struggling families, the report says

The joint report by family doctors and the NSPCC said there was a large gap between cases of child mistreatment in the community and the proportion of cases identified in social care.

As a first point of contact for families GPs are ideally placed to work with other professionals to act on early warning signs of child neglect and emotional abuse, said the report by the Royal College of General Practitioners (RCGP), the NSPCC and academics from UCL and the University of Surrey.

The report suggests that early intervention by GPs could lead to a fall in the number of families in the child protection system.

The RCGP has previously developed a child safeguarding toolkit for GPs with the NSPCC, which will be updated late this year.

Dr Maureen Baker, chair of the RCGP, said that caring for children and their families was a major part of GPs’ work and the report acknowledged the expertise of family doctors in this area.

But she added that it was ‘unacceptable’ that only half of GPs have the chance to undertake a specialist paediatric placement during their training.

The RCGP is campaigning to extend GP training from three to four years, with a specific focus on child health and mental health.

Chris Cuthbert, NSPCC head of strategy and development, said, ‘This report highlights an opportunity for GPs to contribute to a new public health approach to child maltreatment, by using their skills to provide children and parents with direct support. Their unique position within the local community means they can often get to know families better than many other professionals.

‘By spotting opportunities to help families face to face, and to intervene before problems become chronic, GPs could ultimately reduce the number of children needing to enter the child protection system. For example, they could monitor a parent who is struggling to care for their children, give them advice and support at appointments and check-ups, and advocate for the family with children’s services.

‘This innovative approach calls for changes in the perception of the GP role within the health service, by acknowledging GPs’ unique insight into family life and encouraging them to take personal action to protect children from abuse and neglect.’

Jenny Woodman of the UCL - Institute of Child Health and lead author of the report said, ‘Policy and guidelines focus on the GPs’ role in referring children to social care services – but this is only a small part of what GPs can do. Policy makers should look at what is already happening in some GP practices and think about the policy and other services that can support GPs to use their skills as family doctors to help maltreated children and their parents.’

Commenting on the report, Anne Longfield, chief executive of 4Children said, 'It is true that many GPs are well-placed as pillars within their communities to support families, and help by acting as the first point of contact with a family at times of crisis, including when a child is being maltreated. Yet, research from 4Children published earlier this year shows that there are real barriers to expanding their role further, with a only one in three people believing that GP surgeries are family-friendly.'

With changes to the health service in the next year, including local authorities taking over the commissioning of health visitors and the new integrated checks for two-year-olds, she called for a new approach to provide joined up, preventative health support for children and families at the heart of the community in and around extended children and family centres.

'If we are going to reduce the health inequalities that many families and children face, especially disadvantaged families, we need to put their needs first by offering joined up support in the community, near to home,' she said.