Primary care

Information for families in England and Wales

Primary care is the local healthcare that we receive from General Practitioner (GP) practices, NHS walk-in centres, dentists, pharmacists and opticians. Primary health care provides the first point of contact in the healthcare system.

It is the route by which we most commonly access other parts of the NHS, for example, hospital care.

GP practices (GPs)

Your GP is often the first doctor you talk to if you have any concerns about your child. GPs usually work in GP practices as part of a team, which can include:

  • Nurses.
  • Healthcare assistants.
  • Practice managers.
  • Receptionists and other staff.

Your GP practice can provide a wide range of services including:

  • Advice on health problems.
  • Examinations.
  • Treatment for common ailments.
  • Prescriptions for medicine.
  • Health checks.
  • Vaccinations.

They might refer your child to be seen by other health professionals if more specialist knowledge is needed.

GP practices keep a medical record for all their patients, which includes information about any medical conditions, tests and prescribed medicines. If your child is seen by other specialists, they should keep your GP informed about the results of any tests they carried out and any recommended treatment.

You can find out how to register with a GP by going to the NHS Choices website www.nhs.uk

Why your GP is important

Children with disabilities are just like any other children and can get all the usual childhood illnesses and infections. However, normal childhood illness can have different and sometimes greater impacts on a child with an existing medical condition or disability. In these instances, you may be tempted to first seek advice from a paediatrician (specialist children's consultants) when your child is ill.

In fact, often your GP can be a vital point of contact, no matter your child's condition, disability or illness. GPs are 'general' practitioners, and while they may not have a wide knowledge of all childhood disabilities, they will know about general childhood illnesses. They are also the one medical professional that is sent every letter, report or result that relates to your child.

They will have a good knowledge of all the appointments that your child attends. It is also likely that you and any other children you have are registered at the same GP practice, so they will have a good understanding of your whole family, not just your child.

So getting to know your GP and encouraging them to get to know your child can be a worthwhile venture. They can then provide holistic support to your whole family as well as supporting you to navigate the heathcare system with your disabled child.

Building a relationship with your GP

It can be daunting building a relationship with your GP. Here are some tips that can help:

  • Make sure the practice is aware of your child's disability and any specific needs they might have in order to attend the surgery.
  • If there is a particular GP who you or your child feel more comfortable with, ask to see them specifically (The NHS Constitution gives you the right to ask to see the same person and surgeries need to do their best to comply). You  may need to explain why you wish to see the same person, but you can tell the reception staff that you want the GP to get to know your child and their condition/disability.
  • You could also ask the reception staff to put a note on your child's records that you wish to see the same GP and why, so that new staff understand why you are requesting a specific person
  • Take your child to see the GP when they are well, not just when they are ill. You could use it as an introduction, both for your child and the GP. If they know your child's 'normal' they will be better at understanding them when they are ill.
  • Some surgeries may allow you to book a 'double appointment' so you do not feel that you have to rush your child, although this will only be for routine rather than 'emergency' appointments.
  • Even if you are booking an 'emergency' appointment, it is worth asking whether you can see the same GP, though it may be more difficult in these circumstances.

It may take you a few attendances in order for the wider practice staff to get to know you and your child, but it is worth the effort. A supportive GP and practice staff can reduce the stress of managing your child when they are unwell.

If you find that you are not being accommodated in your requests, you can always change your GP practice.

Can I change my GP?

You can change your GP at any time without having to give a reason to the new surgery or to your old GP. If you are in a practice you may be able to see another GP at that surgery.

If you are unhappy about the service provided by your GP practice, or disagree with the way your GP wants to treat a health problem, it is best to try to speak to them about it before deciding to change GP. If you feel uncomfortable about this you can always ask to speak to the GP practice manager instead.

What if my local GP practice refuses to register my child?

A surgery can refuse an application to register you or your child if you don't live in the surgery area or if it is not accepting new patients. If they do, they must have reasonable grounds and you must be given reasons in writing.  If this happens, you can try registering with a different GP, or you can complain to NHS England, who are responsible for ensuring you are able to register with a GP.

Health visitors and the Healthy Child programme

Shortly after having a baby you will receive a visit from a member of the Healthy Child team, usually a health visitor. A health visitor is a nurse who has undertaken extra training to work with families in the community.

The Healthy Child team, led by a health visitor, includes people with different skills and experience, such as nursery nurses, children's nurses and early years support staff. They will work closely with your GP and local children's centre.

The team delivers the Healthy Child programme to all children between the ages of 0 to five. The programme includes a series of appointments where your child's development will be reviewed, and they will be given vaccinations. The reviews are also an opportunity for you to ask questions and discuss any concerns you may have, and the team can also give practical advice on day-to-day matters such as feeding, sleep and teething.

Either your GP surgery, local clinic or children's centre will offer you an appointment. Some reviews may be done in your home.

Dentists

To find information about dentists in your area, you can search online at www.nhs.uk/dentists. Dental practices can take private and NHS patients, and most take both.

To get NHS dental treatment, contact a practice providing NHS dentistry and ask for an NHS appointment. When you have been accepted for treatment by an NHS dentist you will then be a patient of that provider (a practice of one or more dentists working under contract to NHS England) for the duration of your course of treatment. You can then choose either to use the same dentist or to use another dentist under the same provider, or even another provider on future occasions, if you prefer.

Urgent and out-of-hours dental treatment

If you think your child might need urgent treatment and you have a dentist, you should contact your dentist on the usual number. They will usually have an answerphone message telling you where to go.

You could also call the NHS non-emergency number on 111.

Community Dental Service (CDS)

The Community Dental Service (CDS) provides treatment for disabled people including those with learning disabilities, mental health needs or other conditions that may prevent them from visiting a local dental practice.

Some CDS will accept a self referral; others will only accept a referral from your GP or a General Dental Practitioner. To find out how to access your nearest CDS, contact your GP or local dentist. More information about NHS dentist services can be found by going to the NHS Choices website at www.nhs.uk and selecting 'dental services'.

Opticians (also known as optometrists)

Ophthalmic practitioners carry out eye tests to check the quality of their patient's vision and eye health. They can also prescribe and fit glasses and contact lenses. They are trained to recognise abnormalities and signs of any eye disease, and if necessary they will refer patients onto a specialist doctor or eye surgeon for further advice and treatment.

All children's sight tests are free under the NHS. More information about NHS optician services can be found by going to the NHS Choices website at www.nhs.uk and selecting 'eye care services'.

Children can consider their own visual experience to be 'normal', so might not complain about visual symptoms such as blurred vision or eye strain. It may not be possible for a disabled child to express that something is wrong with their vision due to language difficulties, so it's important they have regular eye tests.

Instead of going to an optician, your child might be able to have their eyes tested at the local eye hospital, depending on their needs and the services in your local area. Talk to your optometrist, optician, GP or paediatrician who can advise you about the most appropriate arrangement for an eye test.

Information for families in Northern Ireland and Scotland

We also support Northern Ireland and Scotland. Give our helpline a call on 0808 808 3555 for information and advice on any aspect of raising a disabled child, or call your local contact. Find out our details in the In your area section.