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GP education for children in special circumstances: Syllabus competency based

Aims

All GPs should be able to:

	Take an active and informed role at all stages of the child protection process (primary and secondary prevention, recognition, assessment and continuing management). (RCGP Position Statement www.rcgp.org )
	Contribute to promoting the welfare of and safeguarding children in primary care who live in special circumstances, within the multi-agency context (NSF http://www.doh.gov.uk/nsf/children.htm)
	Understand the importance of parental issues, such as domestic violence, drug or alcohol misuse or mental ill health of carers. (NSF http://www.doh.gov.uk/nsf/children.htm)

Educational principles:

Education should be effective and evidence based

Education should be considered as a developmental/incremental process, knowledge and skills are built upon.

The expectation is that GP registrars will be able to demonstrate learning at an entry level and be able to demonstrate competence in a limited number of areas.

Experienced GPs should be able to demonstrate more detailed in depth learning in a more areas.

Learning activities should be recorded and reflected upon as part of the GP's PDP and should contribute to the GP's annual appraisal.

Assumptions:

	A sound understanding of Child Development is assumed for all GPs.
	GPwSI are expected to be members of the RCGP and to be on the PCO child health Surveillance list.

Curriculum framework:
based on Framework Curriculum for SAC's from the Royal College of Physicians, London. (www.rcplondon.ac.uk/files/curricformat.doc)

All GPs

Objectives	Subject matter	Teaching/learning method (exemplars)	Assessment (exemplars)	Evidence of competence for inclusion in PCT (exemplars)
1. ROLE: Can describe their own role within child protection in the general practice setting.	Role of the GP in child protection, (primary prevention, early recognition, detection, assessment, continuing management, secondary prevention) difficulties and barriers, feelings, duties of the doctor. Paramountcy principle. Legal and ethical framework, policy and literature re GP role.	Attendance at recognized and relevant course, either in house, within the VTS, within postgraduate education or as part of ACPC or other recognized training. May be supplemented by evidence of additional reading, reflection or case study.	Able to describe GP role in child protection agrees with and can explain paramountcy principle. Able to describe legal, and policy child protection basis of child protection.	Confirmation of attendance at recognized and relevant course. Identification of learning need within PDP or through appraisal and appropriate courses or personal study to meet learning gaps identified. Evidence of personal study and reflection.
2. RECOGNITION: Can describe child protection issues as they present in the general practice setting and describe how to recognize them	Recognition of child abuse and neglect as it presents in the general practice setting. Definitions. Morbidity, mortality and possible outcomes, long term and short term sequel.	Attendance at recognized and relevant course, or personal study	Able to describe child protection concerns as they present in the general practice setting Can describe and define the types of abuse Can demonstrate knowledge of incidence, prevalence, morbidity and mortality	Confirmation of attendance at recognized and relevant course, inclusion of this within PDP, and with evidence of reflection related to this (what was learnt, what learning needs have been identified). Evidence of personal study and reflection.
	Working with the other members of the PHCT, such as health visitors or school nurses.	Case study to demonstrate working within the PHCT where there is a child protection issues and/ or discussion(s) with other members of the PHCT, such as health visitors	Demonstrate understanding of joint working within PHCT.	Case study has evidence of reflective learning. Discussion is recorded and reflected upon.
3. REFERRAL: Can describe how to refer a child where there is a child protection concern, can show how to communicate with parents where there is a concern	Referral pathways, protocols, Information sharing. Know about child protection procedures in keeping with their status and role. Support and advice networks	Written information concerning referral.	Able to describe referral pathways Able to describe where and how to seek advice in difficult/grey cases	Has read and has ready access to information concerning referral, local protocols, national guidance,
	Confidentiality within and outside the practice.	Courses or personal study such as RCGP confidentiality teaching pack.	Able to describe how to and when to seek consent and when not to. Able to describe where and how to seek advice in difficult/grey cases.	Can demonstrate practice confidentiality agreement or information sharing protocol and has reflected upon the content of this.
	Communication skills relevant to child protection.	Consultation skills teaching, especially that around dealing with difficult or challenging situations.	Able to demonstrate ability to deal with (simulated or real) cases (referral pathways, safety netting) Able to demonstrate relevant consultation skills (role play)	Has read about and can demonstrate reflective learning on confidentiality and information sharing.
4. Children in special circumstances: Can explain this term and show how it relates to general practice. Can describe role, recognition and referral of children in special circumstances.	Parental health issues effects of mental health problems, drug/alcohol misuse etc. Parenting in difficult circumstances, such as: children/families who are asylum seeking, traveller’s health, where there is domestic violence. Health of Looked after Children (LAC)	Attendance at relevant courses, preferably multi-agency. Personal study/case study	Able to demonstrate knowledge of associated problems (drug and alcohol abuse, mental health problems, domestic violence) Able to demonstrate knowledge of parenting in difficult circumstances and of causes and effects of being a child in special circumstances. Able to describe health issues related to LAC	Confirmation of attendance at relevant courses. Has read about and can demonstrate reflective learning on children in special circumstances.

• Contents page •
• Up • Child Protection • Communication • Ethics • Genetics • HIV • IT • Learning Disabilities • Medical Ignorance • Mental Health • Musculoskeletal • The New GP • Out of Hours • Rural • South Yorkshire • NE Scotland SHO •
• Victoria Climbie Inquiry •
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