Toolkit for general practice

   Opportunities to identify children where there is cause for concern

In addition to the usual steps that staff working in general practice would take for any child about whom they are concerned, there might be opportunities to identify and support children directly:

• Practice staff should be aware of families where children are not being brought for routine health checks and vaccinations
• Health visitors and practice nurses will have an opportunity to see children who are bought in and will pick out any they are particularly concerned about
• In both the cases above practice staff need only be aware that parental alcohol misuse may be a factor and be prepared to look out for this
• School nurses might refer children to the practice if they are concerned about anything
• Older children may visit the practice independently of their parents about a health matter
• In severe cases an older child might accompany a younger child to an appointment
• Practice based counsellors may see people with alcohol related problems
• Reception staff may note patterns of attending – missing appointments, last minute cancellations, using emergency appointments frequently, the nature of presentation. Practices should therefore develop a culture of sharing concerns within the team to ensure that families presenting a cause for concern do not slip through the net.