Toolkit for general practice

   Introduction

This toolkit has been drawn up by Alcohol Concern following discussion with primary care professionals. It is one of five interlinked sets of materials for a range of professionals working with children in generic settings. The starting point for the project overall is the fact that, at present, many professionals working with children whose parents misuse alcohol often feel insufficiently trained and unconfident in dealing with this issue. However, much can be done by professionals routinely in contact with such children to promote resilience to long term harm.

A key problem for many professionals is that they often (quite unconsciously) see parental alcohol misuse differently to the way they view a range of other problems facing children, feeling a disproportionate sense of inadequacy in dealing with the issue and fearing the need to react within the context of potential child protection concerns - more so than they would in respect of other problems commonly faced by children living in difficult family situations.

Staff in GP practices hold a unique position in that they not only, in most cases, get to see the whole family (albeit at different times) but also have responsibility for the whole range of health issues. They may therefore have a number of opportunities to spot the signs of parental drinking becoming a matter of concern in relation to the children. Parents bring children to the surgery for a variety of reasons - vaccinations, routine medical matters and general advice - as well as when the child has a specific illness. Practice staff will therefore see children who are no longer seen routinely by health visitors unless a reason has already been identified for them to continue contact. They may also see older children alone.

They also have the opportunity, either through routine screening or via the GP’s gathering of background information during a specific consultation, to assess and discuss parents’ drinking levels and any potential impact that it may be having on other family members.

However, research suggests that practice staff, including GPs, often lack confidence in initiating these discussions or in knowing what is the appropriate action to take. The materials in this toolkit aim to help build confidence, suggest signs to look for, together with ways of responding that will minimise long-term harm to the children.