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Can we apply more generalism in child health?
  1. Stephen W Turner1,
  2. Rupal Shah2,
  3. Kate Dharmarajah3,
  4. Hannah Jacob4
  1. 1 Division of Women and Children, NHS Grampian, Aberdeen, UK
  2. 2 Health Education England, London, UK
  3. 3 General Paediatrics, Evelina London Children's Hospital, London, UK
  4. 4 Department of Paediatrics, University College London Hospitals NHS Foundation Trust, London, UK
  1. Correspondence to Dr Stephen W Turner, NHS Grampian, Aberdeen, UK; s.w.turner{at}

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Introduction to generalism

Generalism has been defined as ‘an approach to the delivery of health care, be it to individuals, families, groups or to communities. Its principles apply wherever and whenever people receive care and advice about their health and well-being. The generalist approach applies equally to individuals and to clinical teams. It is one facet of medical professionalism’.1 Generalism has been advocated by numerous bodies including the Royal College of Physicians,2 the Academy of Medical Royal Colleges3 and Health Education England.4 Generalism is part care provision for children and young people, but we are not aware of any publications which describe generalism in the context of child health or highlight the benefits and limitations of generalism to paediatricians.

Central to generalism is the understanding that connecting children, young people and their families to the correct activities and services in their community can help mental and physical health and address social needs. Social prescribing is a term used to describe this process of connection.

The aims of this article are to (i) raise generalism in the mind of the reader, (ii) use case studies to identify how healthcare staff can improve child health and well being and (iii) provide examples of social prescribing. The reader is encouraged to identify local social prescribing options and consider becoming involved in local health and social care partnerships.

Case presentation

A workshop at the 2022 meeting of the Royal College of Paediatrics and Child Health used the fictitious case of Shelly (box 1) to highlight how generalism could help a single child at different ages, and potentially nudge their health and well-being trajectory towards a different destination. There were two contrasting ‘destinations’ for Shelly.

Box 1

Shelly aged 7

Shelly is a 7-year-old girl who attends your clinic following a recent asthma admission. She is prescribed low-dose beclomethasone …

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  • Contributors RS and SWT conceived the idea. All authors contributed to the design of the workshop. SWT wrote the first draft of the paper. All authors made contributions to and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.