InnovAiT: Education and inspiration for general practice

Childhood development is the gaining of skills in various aspects of the child's life. It can be monitored using “developmental milestones”; objective targets reached at various stages, generally classified in to four main areas: gross motor, fine motor and vision, speech and hearing, and social and self-help skills. Although each stage of development will be reached at slightly different ages within the normal population, the order that the various skills are obtained by each child remains fairly consistent. Universally agreed ages that a child “should” have reached each skill are well documented, after which the attained skill is classified as being delayed. These milestone ages are important to allow the practitioner to assess if a child has a delay in any or all of the areas of development, and therefore highlight those children needing further assessment. Early intervention is essential for optimising developmental progress in the delayed child. Developmental delay (DD) is a common condition seen regularly by GPs.

Between 20% and 40% of young children suffer a feverish illness each year and many of these will present to their general practitioner. Although the majority of these children have benign, self-limiting illness, infection remains the leading cause of death in children under the age of 5 years. Appropriate assessment, management and referral of the febrile child are important skills to acquire for doctors working in primary care. This article outlines the signs and symptoms of serious infective illness in children under 5 years of age and describes current National Institute for Health and Clinical Excellence (NICE) guidelines for feverish illness in children and the use of the ‘traffic-light’ risk score in the context of face-to-face and remote assessment.

Childhood cancers are uncommon, accounting for only 0.5% of all cancers in the UK. Approximately, 1500 children are diagnosed with cancer in the UK every year. Despite it being a rare occurrence, cancer still remains the largest cause of death in the 1–14 year age group, amongst whom it counts for 20% of all deaths. Although most adult cancers affect the lung, breast, bowel and prostate, the majority of childhood cancers are haematological and central nervous system (CNS) tumours. The primary care physician's role is vital across the disease trajectory, requiring them to recognize the signs and symptoms of childhood cancer, understand treatment, provide support to children and families, and finally consider the issues affecting survivors of childhood cancer.

At a biological level, normal ageing or ‘senescence’ results in limitation of function, increased risk of disease and ultimately death. The pattern, onset and rate vary between individuals and appear not to be the result of a single overarching mechanism but instead that of a complex interplay between intrinsic and extrinsic factors. As such ‘chronological age’ and ‘biological age’ often widely differ. The effects of the ageing process are becoming more important to consider as each generation passes, due to increased life expectancy and other demographic changes.

As the UK population ages and older people retain their natural teeth for longer, the complexity of the oral health needs in older people is becoming more challenging. Older patients are often registered with a GP and will increasingly be likely to require dental care. Older people in particular may benefit from dental care but may not have a dentist or perceive any risk of oral disease. This article therefore provides practical insight into the oral health management of older people to assist in addressing their oral health needs.

Approximately 800 000 people have dementia in the UK and this number is expected to double over the next 30 years. Only 40% of those with dementia receive a formal diagnosis but if dementia is diagnosed early enough, there are lots of things that can be done to help people overcome the problems and to improve their quality of life. The Government has recognised this, and in the past 3 years it has produced a National Dementia Strategy and Prime Minister's Challenge on Dementia with an emphasis on early recognition and diagnosis of dementia. This article aims to highlight when to suspect dementia in primary care and what assessments should be carried out before referral to specialist services.

This article describes how to use the RCGP curriculum for learning and teaching in general practice, explaining why the revised curriculum is designed the way it is and how you can get the most out of it during your training and beyond.