Opportunistic surveillance in primary care

Abstract

There are many unscheduled contacts between children and clinicians, and therefore many opportunities for clinicians to identify previously unsuspected problems that parents may not already have suspected. There are three distinct foci during assessment, namely the child, the parent(s), and the parent–child relationship. Any of these can alert the practitioner to potential concerns, regardless of the presenting issue. Practitioners need to be aware of, and alert to, concerns about physical and social/emotional development, as well as signs of maltreatment and neglect. In addition, it is important to be able to evaluate the quality of parenting a child experiences, as this is a strong predictor of future mental and physical health. While this is an area in which clinicians may feel less confident or skilled, there is evidence to suggest that continuity of care and a trusting parent–clinician relationship provide an arena in which problems can be raised, aired, and more satisfactorily addressed.