GP training should overlap with paediatrics to improve child health, say colleges

GP and paediatric trainees should work together throughout training across primary and secondary care settings to improve child care and outcomes, royal colleges have said.

Paediatricians and GPs working side-by-side during and after training will enhance standards of healthcare and reduce strain on services, the RCGP and Royal College of Paediatrics and Child Health (RCPCH) have said.

Jointly launching the Learning Together to Improve Child Health report on Friday, the colleges called for extra GP training in childcare and closer GP collaboration with paediatricians, after pilot schemes saw emergency and specialist appointments drop and standards of care improve.

A key recommendation in the report advocates extending GP specialty training to four years ‘to include specialist child health training’.

It also recommends that trainee GPs should spend time in specialist settings such as hospitals alongside paediatricians so that they can be exposed to large numbers of sick children in a safe, supervised environment.

Collaboration should be a two-way street, with paediatric trainees coming to work with GPs in a general practice setting, the report said.

This joined up way of working should continue even after training, with the two professions working side-by-side in both general practice and specialist settings, it said.

GP paediatric training

Exposing trainee GPs and paediatricians to increased numbers of children outside of their traditional healthcare setting will enable them to learn from one another, improve health outcomes for children and reduce costs to the wider healthcare system, the colleges argue.

The report includes results from the Learning Together pilot scheme, a London initiative in which GP and paediatric registrars worked together.

The trial helped reduce referrals to specialist child care and A&E visits by 55% and saw compliance with national guidance increase from 57% to 76%.

The report calls for commissioners across the country to roll out similar schemes where outreach services are jointly run by paediatricians and GPs and other primary care colleagues.

Professor Nigel Mathers, honorary secretary for the RCGP, said: ‘A quarter of patients in general practice are under 19 years of age, so it is important that GPs are able to share knowledge and skills with our paediatrician colleagues in order to ensure that our young patients receive the best possible care.

‘This important report adds further weight to the College’s calls for GP trainees, as part of an enhanced four-year training programme, to receive specialist-led training in child health – but also puts forward a number of proposals that should be beneficial for both GP and paediatrician trainees alike.

‘We hope that ultimately, if implemented correctly, the recommendations in this joint paper will improve the quality of care that both GPs and paediatricians can deliver to our young patients.’

Dr David Evans, vice president (elect) for training and assessment at the RCPCH, said: ‘Children make up nearly one-fifth of the population and are estimated to account for around a quarter of a typical GP’s workload.

‘Yet less than half of GPs are given the opportunity to undertake a paediatric placement during their training so the development of these new training models will also strengthen the child health learning opportunities for GP trainees and introduce paediatricians, who mainly train in hospital settings, to common community based child health concerns.

‘With NHS reforms on-going and a shift towards healthcare closer to home, this type of exposure is very important for future general paediatricians as some are likely to spend more time out of the hospital setting.’

Photo: iStock

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