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A-Z of Children’s Services (Paediatrics) guidelines for GPs

Here you can find some useful information and guidelines that can assist you in your everyday practice.

One of the challenges of general practice is delivering optimal care in a limited consultation time. We recognise that this might be even more challenging when it comes to paediatric patients. Here you can find some useful information and guidelines that can assist you in your everyday practice. They are listed alphabetically as a quick reference.

Information also includes interpretation of abnormal results and urine tests.

We will continue to add to this list going forward. If you would like more topics to be covered, please contact our GP Liaison Officer team.

A:

B:

C:

All referrals for Community Paediatrics are sent in via paper request to the contact centre with the associated questionnaires and these are then logged on Lorenzo.

The Community Paediatric service is only available for children who live within the East and North Hertfordshire catchment area.

  • Cow’s Milk Protein Allergy
    Primary Care Pathway
    • Local pathway – Please see uploaded document
    • List of EHF and Amino Based Formula milks Hertfordshire – document to be uploaded

D:

  • Dermatological complaints
    Viral exanthemas
    Useful pictures of various dermatological conditions
    Common rashes/educational module
    • Paediatric Dermatology Referrals
    • Please use HCT trust – skin health for non-urgent, routine dermatology referrals.
    • Children with moles should be referred directly to Pediatric Dermatology and not to Paediatrics.
    • There is no 2-week wait referral pathway for paediatric dermatology. The rationale is the chances of melanoma in children is exceedingly low, apart from large congenital melanocytic naevi etc. If you have any concerns re: urgent dermatological problems, follow the pathway above and mark the referral as urgent. Alternative pathway is through A&G, which might be slightly quicker.

E:

F:

G:

H:

  • Hand Foot and Mouth
    Skin deep(useful pictures)

L:

  • Laryngomalacia

REFERRAL PATHWAY FOR PRIMARY CARE:

  • If there are any acute concerns about the child such as desaturations, increased work of breathing or poor feeding/failure to thrive, the child to be referred urgently to the Paediatric team for assessment in children’s assessment unit and then referred to ENT team as an inpatient.
  • If the child is not showing any of the acute symptoms and signs mentioned above, to be referred as an outpatient to ENT within 2-4 weeks-time.

N:

O:

P:

R:    

S:

T:

U:

  • Undescended Testes pathway
    If undescended testis was picked up during the 6 weeks check:
    • ​If the child is already under Paediatrics for any reason, then please review at 6 months and refer to Urology if still undescended. If there is no further paediatric problem, they can be referred directly to Urology once it has been confirmed that the child has an undescended testis.
  • Is an USS needed before referring?
  • No need for imaging, in-fact the new trust guidelines will reject any request for US unless they have been seen by urology.
  • When to Refer?

Refer as soon as they have been diagnosed as they will need an operation at age 1.

  • How is the referral done?

Please refer via ERS. If the child is close to 1 year, please email urology secretaries as well as the child will need a more urgent review.

If you pick up any child with diagnosis of Antenatal Hydronephrosis, VUR or Hypospadias not already under paediatric team please refer to urology. Local team at Lister will operate on children from 1 year of age if needed. If under 1 year of age, urology team will arrange the necessary as not all of them will need surgery. Lister Hospital has a very good Paediatric Nephrology and Urology joint clinic set up, 4 times a year for some children who need this approach.

V:

W:

Page last updated: 30 March 2023