There were three groups. Each took one of the emerging questions:
1. What are GP roles in Safeguarding?
The most important emerging theme was around “core” and “non-core” work.
The consensus was that there is a lot of core GP work with patients, families and staff requiring the skills of empathy, tolerance, compassion and scepticism.
Then there is the “layering” of responsibility regarding the wider primary care and safeguarding communities, which can require more specialist skills.
2. What are the special contributions GPs can make to the assessment of the process of neglect?
The main theme emerging was that it is hard to set thresholds for neglect, in comparison with physical or sexual abuse where there tend to be incidents or disclosures that demand action. Often the diagnosis of neglect is made by recognising a pattern from many different factors over a long period of time. Each factor on its own may be relatively minor, and only worrying when taken in context with other factors. Therefore GPs tend to be the agents best placed to pick up a pattern.
i. Medical Neglect – lack of antenatal care, immunisations; failure to keep appointments; late presentations.
ii. Overuse or inappropriate use of the Emergency Department or Out of Hours services.
iii. Other conditions which may contribute to neglect such as the learning disability of parents or mental health, drug or alcohol problems.
iv. Faltering Growth.
v.Signs of physical abuse may also co-exist. The GP is the only professional allowed routine examination of children.
Some difficulties were recognised:
a) Where GPs are familiar with families there can be conflicting loyalties.
b) Recent dilution of the GP role.
c) Reduced priority given by GPs.
d) Seeming reduced availability of health visitors and school nurses with whom to share concerns.
3. How can we involve Children and Young People?
The group differentiated between
i. Involving the child or young person in the process of the consultation – how and when to exclude the parent; including GMC 0-18 guidance; the use of video-links for children giving evidence; thinking about language used and to whom they might disclose something personal; continuing care.
ii. Involvement for service – using existing feedback from children and young people from mentoring, bullying and drug abuse helping agencies including voluntary groups. Preparing scenarios which could be used for discussion in focus groups.
iii. “Seeing the child behind the adult” – when consulting with an adult patient, being aware of the impact of the adult’s condition on his or her children.
PCCSF is an independent professional organisation set up to
support doctors with an interest or involvement in protecting
and safeguarding children. At present, it is funded by membership subscription, run as a not-for-profit company. PCCSF is affiliated to the Alliance of Primary Care Societies from the Royal College of General Practitioners.
We welcome members from all four UK jurisdictions, representing doctors from Primary Care with an interest in
the protection and promotion of welfare of children and young people. Our membership is predominantly GPs but we welcome doctors from other specialties interested in this work.
The benefits of membership include:
· A secure email discussion group;
· A regular newsletter;
· An annual conference ( The 7th is at RCGP in 2014)
A special seminar was held in 2013 to help define the role on Named GPs for Safeguarding Children and prepare a position statement on primary care safeguarding. Membership has grown year by year from 24 in 2007 to 70 in 2014.
For details of membership contact: firstname.lastname@example.org
Vice Chair, PCCSF