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- community child health
- general practitioner with special clinical interest
- interprofessional learning
- out-of-hours care
- primary care
Patterns, trends, and influences in child health
I don’t anticipate tomorrow’s children will be very different from today’s. More extreme pre-term survivors, maybe; growing taller perhaps, and certainly more likely to be obese, these children are likely to be subjected to ever increasing pressures to perform in their schools and conform in their streets. There is something timeless about childhood, but child healthcare is as subject to the fads and fashions of the era as is the nurturing process. In planning primary care paediatrics, we need to look further than the child. We need to think about parents and parenting, about societal influences, and about workforce issues.
GENERALIST AND SPECIALIST
Nearly 30 years ago, Donald Court, whose report drew heavily on the wishes of parents, raised the notion of the “GP paediatrician”.1 The general practitioner with special clinical interests (GPuSI) has resurfaced in the NHS Plan.2 Already as many as 4000 general practitioners (GPs) specialise,3 but rarely in paediatrics. This is not for lack of GPs with expertise or interest in paediatrics; the reason is that Primary Care Trusts have prioritised identifying GPuSIs who are trained and skilled in procedures such as endoscopy, or able to help reduce costs or waiting times in specialities such as ENT, or musculoskeletal medicine. Experience in other specialties has shown that GPuSIs may become valued either by taking formal or informal referrals from less experienced generalist colleagues, or by leading and developing a local service.4 Quality assurance,5 and …