Table 3 Examples of quality markers suggested by GPs for acute illnesses, health promotion and practice structure and communication

Acute illness

▪

All children seen with an acute illness should have good safety netting and parental advice.

▪

Every child that presents with a urinary tract infection has had a dipstick urine test 99% of the time.

▪

Develop a pathway in the community for the management of mild croup by general practitioners.

Adolescent health

▪

Discuss contraception with each patient after giving post-coital contraception.

▪

Every sexual health related consultation in under 18 year olds must include discussions on basic contraception and testing, explored child protection issues and recorded the discussion in the patient record.

▪

During all consultations with an adolescent, ensure you have the opportunity to meet with them without their parents present and ensure they are aware they can return without their parents.

Developmental screening

▪

Measure the height and weight of children annually and plot it on a growth chart.

▪

Formalise health checks, such as have 90% of your three year-olds been seen in a practice.

▪

Post-natal education of carers (guardian, mother, father) on nutrition, paediatric life support, etc.

▪

Questionnaire at key points to be completed by general practitioner or health visitor whether diet was addressed in a reputable way.

▪

Child developmental screening checks by the general practitioner, including physical examination, social evaluation and school performance.

▪

Appropriate health promotion with children and young people by discussing diet, healthy eating, exercise, smoking, alcohol, sexual health and teenage pregnancies.

Obesity

▪

Develop a register of children with a body mass index (BMI) over a certain number.

▪

Have education classes about obesity, giving patients advice, referring them to a dietician or having a dietician assess their home and giving the whole family advice.

Practice structure and communication

▪

Annual review of all children who default on an appointment.

▪

In children that fail to arrive for immunisations, have general practitioners made and enquired to the parents regarding why?

▪

Computer flagged up children that consulted >5 times per year for planned review.