Discussion
autism
RECRUITMENT
A number of factors emerged regarding GPs’ perceptions and experiences about feasibility after they had participated and implemented the program’s developmental surveillance assessments with families of children potentially on the autism spectrum. The findings from this study highlighted a number of enablers, barriers, and improvements in both the digital universal developmental surveillance and the routine care pathways. Although GPs in both groups identified overlapping barriers and facilitators, GPs encountered greater challenges than enablers in both the current and ASP settings while also providing their encouragements/suggestions for improvement to the overall surveillance program.Indeed, the themes and subthemes reported in this paper are similar and complimentary to the findings that emerged from our parent/caregiver cohort [GPs tended reported that the quality of their healthcare delivery towards patients is grounded in mutual trust and positive relationships, thereby improving the patient’s overall healthcare experience and wellbeing. In this regard, previous studies have shown the critical role of trust in the doctor-patient relationship through open communication, engagement, and shared decision-making [Implementing a digital developmental surveillance system within the primary healthcare setting is another innovative pathway for GPs to engage with and deliver care for their patients, in a systematic manner using standardised tools. One such program developed by our team, the ‘Watch Me Grow-Electronic’ platform (WMG-E), empowers parents/caregivers to engage in developmental surveillance using opportunistic contacts such as vaccination visits to complete developmental checks digitally and for this to be done in the family home or in the community [Several electronic or web-based screening tools have been used in various healthcare settings, including mental health services and hospital/ambulatory care settings [Despite facilitating factors and positive experiences, GPs also highlighted barriers including the language and cultural beliefs about developmental screening, socioeconomic situations of the families, lack of availability of health specialists’, and the complexity of the health system. These findings were echoed by a similar, qualitative study conducted in NSW which also highlighted the practical challenges such as limited knowledge and uptake of the use of the recommended screening tools as part of child developmental surveillance by service providers [Another key barrier GPs encountered was in relation to the COVID-19 pandemic lockdowns/restrictions, which affected routine patient care. Changes in practice management and in consultation strategies included a major switch towards telephone triage/consultations and/or patient care occurring in carparks; however, acute/chronic care delivery was mostly postponed and recruitment of patients to the study was decreased substantially during the pandemic. Other primary health research studies confirmed these same issues [General practice is a relatively busy space, with GPs often having to manage multiple processes and tasks to get routine patient care completed [Additionally, this study identified several health system barriers, such as long waiting times, service fragmentation and lack of specialist resources, particularly in the SaU pathway. These barriers have also been reported in recent studies about clinician perspectives about the care of children and adolescents with mental health conditions [The GPs in our study observed that parental/caregiver understanding of child developmental milestones is an important factor contributing to a smooth, streamlined pathway of developmental surveillance and better patient care. According to the Australian Commission on Safety and Quality in Health Care, [In the current study, GPs also emphasised the need for further training and education around child development. As alluded by Price and Rechert, [