Family Practice Vol. 20, No. 6, 733-734
© Oxford University Press 2003, all rights reserved
Correspondence |
It is not parental choice
Community Paediatrics, Medway Hospital, Windmill Road, Gillingham, Kent, ME7 5NY, UK
Correspondence to Dr E Stathopulu; E-mail: estathopulu{at}hotmail.com
Hampshire et al.1 have shown that child health surveillance helps to develop the relationship between families and the primary health care team and provides important opportunities to discuss parental concerns and to identify children requiring treatment or follow-up. Didcock and Polnay2 described how primary health care teams have taken over child health surveillance and promotion, so community paediatricians could develop specialist services. In our area, Medway and Swale in Kent, 148 of the 178 (83%) GPs offer child health surveillance, and 172 (97%) childhood immunisations. This does not compare favourably with the overall 94% of GPs registered for child health surveillance in England.3
It is left to community paediatricians to offer the rest of child health surveillance in our area, an average of 29 sessions per month, equivalent to one full-time staff grade paediatrician. Historical reasons and parental choice have been suggested for child health surveillance offered by community paediatricians. In order to identify the community paediatricians' activity in these clinics and the extent to which attendance was parental choice, we performed an audit of 37 baby clinics. The audit was completed in 32 clinics (86% response rate). From the 303 children in the 32 clinics, 39% were seen for the 6 weeks check, 28% for the 8 months check, 16% for the first immunisation course, 9% for MMR and 7% for the pre-school booster.
From the 303 children attending the clinics, the majority (216 children) attended because the service was not offered by their GP; 87 (29%) came to the community paediatric child health surveillance clinic, although their GP offered the same service. However this was not parental choice; reasons given were that the appointment came earlier than the GP's one, the GP was a longer walk than the community paediatric clinic and the practice nurse or GP were on holiday.
We presented the results of this audit to the Primary Care Trusts in a forum on child health surveillance, where it was decided for the PCT to employ a registered nurse to offer immunisations under Patient Group Directives. Issues why the GPs in the area do not offer child health surveillance would be investigated and a training programme will be developed. We believe that all GPs should be trained and given sensible incentives to carry out child health surveillance for their patients. The primary health care team offers better continuity of care and this becomes very important now that the universal screening will be reduced, as recommended in ‘Health for all children’ by Hall and Elliman.4
References
1 Hampshire AJ, Blair ME, Crown NS, Avery AJ, Williams EI. Are child health surveillance reviews just routine examinations of normal children? Br J Gen Pract 1999; 49: 981–985.[Medline]
2 Didcock E, Polnay L. Pioneers, paediatricians and public health: the evolution of community child health services, Clifton, Nottingham 1983–1999. Public Health 2001; 115: 412–417.[Medline]
3 Department of Health Statistical Bulletin. Statistics for General Medical Practitioners in England 1984–1994. London: HMSO, 1995.
4 Hall DMB, Elliman D. Health for all children. Fourth Edition. London: Oxford University Press, 2003.
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||