afeguarding children from harm requires early inter- vention to prevent the impairment of a child's health and development, as well as alertness and readiness to act when there are indications that a child is being abused or neglected. A number of studies have demonstrated that general practitioners currently play a relatively peripheral role in the overall child protection process and may be reluctant to act on suspicions of abuse. This is a matter of some concern given the opportunities general practitioners may have to identify not only clinical indicators of abuse in children but also to pick up on parental diculties, such as drug and alcohol abuse, domestic violence and mental health problems, which are associated with child abuse.
Training can play a part in developing awareness, skills and knowledge, but ยฎrst the diculty of engaging general practitioners in the training process has to be overcome. The following papers examine two related aspects of child protection training for general practitioners. The ยฎrst paper describes a study which examined general practitioners' own perceptions of their training needs and argues the case for fresh approaches to the delivery of training. The second paper presents one such innovative approach, characterized by personal contact by credible, known professionals and practice-based training, which had considerable success in engaging general practitioners in Nottinghamshire.
Initiatives such as these oer ways forward; however, these would be assisted by the national introduction of a child protection component into the training of GP registrars and by making child protection a mandatory requirement for all those accredited to carry out child health surveillance.