GPs are ideally placed to spot early warning signs of child maltreatment and to work with families to prevent them from getting worse, according to a joint report by the Royal College of General Practitioners (RCGP), leading children's charity NSPCC and researchers from UCL and the University of Surrey.
The report 'The GP's role in responding to child maltreatment' claims that giving family doctors the time, support and autonomy to work with vulnerable families in the community - as well as referring cases to social care services - could benefit children and families in the short and long term.
Children's health accounts for a significant proportion of a GP's entire workload and GPs follow strict guidelines and procedures on child safeguarding. But children's experts say that GPs' skills in building and maintaining a relationship with patients and treating the 'whole person' - rather than a single condition - and their families mean that they are ideally placed to take more of a leading role in addressing social and emotional issues relevant to health.
According to the NSPCC there is a large gap between cases of child maltreatment in the community and the proportion of cases receiving attention from children's social care.
For every child who is subject to a child protection plan, they estimate that there are another eight not receiving services, and that this could be even higher.
The report suggests that GPs, as a first and on-going point of contact for parents and their children, are well-placed to work with other front-line professionals to act on concerns about issues such as child neglect and emotional abuse.
This could include providing long-term support and monitoring of children and wider family members, as well as advocating for parents to help them find their way through the health and social care systems and advising and coaching parents about their own health issues, which affect their children, such as alcohol use or mental health problems. GPs can do this by building relationships with families and using their skills and expertise, as well as those of the wider community health team, such as health visitors.
Drawing on a comprehensive analysis of policy, practice guidance and research evidence, the report calls on governments and policy makers to re-think the role of GPs and maximise the potential of the crucial doctor-parent and doctor-child relationships to create a public health approach of early intervention to reduce child maltreatment.
The RCGP has previously worked with the NSPCC to develop an innovative child safeguarding toolkit for GPs, which is currently being updated for release later this year.
Dr Maureen Baker, Chair of the Royal College of GPs (RCGP), said: "Caring for children and their families is a major part of a GP's work and we are pleased that today's report acknowledges the unique skills and expertise of family doctors in this crucial area.
"GPs do the best they can to ensure that children are kept safe and well. By recognising early signs of strain in children and their families, which may involve physical or emotional symptoms, GPs can be of real help and in some cases help prevent situations or conditions getting worse.
"The health of our young patients is a priority for the RCGP, yet only half of our trainee GPs currently get the opportunity to undertake a specialist paediatric placement during their training.
"This is not acceptable and we are currently campaigning to extend GP training from three to four years, with a particular focus on child health and mental health.
"General practice itself is in a state of crisis with GPs heaving under the pressures of ballooning workloads and plummeting funding. Over 90% of all NHS patient contacts are dealt with in general practice for only 8.39% of the overall budget - an all time low.
"There are 40m more consultations in general practice every year than there were five years ago and the most GPs are routinely working 11-hour days, seeing between 40-60 patients a day to try and cope with demand.
"We are calling on the four governments of the UK to ensure that general practice receives 11% of the NHS budget by 2017. This would allow us to recruit more GPs and offer more services and appointments for patients of all ages.
"Today's report strengthens our case and we hope it will prove to be a turning point in how society approaches and cares for our children and young people and their families in the future."
Jenny Woodman of the UCL-Institute of Child Health and lead author of the report, said: "The findings from our research are positive. The evidence tells us that GPs know about many vulnerable families and can use their professional position and expertise to help these children and their parents in the community.
"Policy and guidelines focus on the GP's role in referring children to social care services - but this is only a small part of what GPs can do. Policy makers should look at what is already happening in some GP practices and think about the policy and other services that can support GPs to use their skills as family doctors to help maltreated children and their parents."
Chris Cuthbert, NSPCC head of strategy and development, said: "This report highlights an opportunity for GPs to contribute to a new public health approach to child maltreatment, by using their skills to provide children and parents with direct support. Their unique position within the local community means they can often get to know families better than many other professionals.
"By spotting opportunities to help families face to face, and to intervene before problems become chronic, GPs could ultimately reduce the number of children needing to enter the child protection system. For example, they could monitor a parent who is struggling to care for their children, give them advice and support at appointments and check-ups, and advocate for the family with children's services.
"This innovative approach calls for changes in the perception of the GP role within the health service, by acknowledging GPs' unique insight into family life and encouraging them to take personal action to protect children from abuse and neglect."
Professor Simon de Lusignan, University of Surrey, said: "As a practising GP involved in this research I understand how front-line pressures prevent GPs from having the time to fully explore complex social and family issues that impact on a child's health and wellbeing.
"Reorganising care so that there is more time given to those who need it - in this context, children who are at risk or who are maltreated - can only improve general care and help keep families together and children safe from harm.
"GPs are the first service many families in this position encounter and without the right support and investment they will fall at the first hurdle. I urge policy makers and senior managers to make the necessary changes so that the recommendations put forward by the RCGP and NSPCC are put into practice."