My child is unwell: do they need a GP, NHS 111 or A&E?

Your child won't settle. There's a rash you can't read, a fever that has gone on a day longer than you'd like, or a question about growth that keeps nagging at you. You'd like a doctor to look at them properly, soon, and you're weighing up your options.

The short answer: if it can wait until a Monday or Wednesday morning or early afternoon, a paediatric GP visit gives you an unhurried, in-person examination. If it can't wait, NHS 111 or 999 is the faster help.

If you'd rather skip the reading, you can book a paediatric GP consultation with Dr Sheehan online or call 0207 499 1991. The consultation is £200, and a follow-up visit is £150.

When does a child need 999 or A&E?

Call 999 or go to A&E if your child is severely unwell or their life may be at risk. That includes a child who is collapsing, struggling to breathe, having a seizure or bleeding heavily, or who looks so ill you wouldn't put them in a taxi. The same goes for a rash that doesn't fade when you press a glass against it, blue, grey or blotchy skin or lips, a floppy or unresponsive child, very fast or laboured breathing, signs of dehydration, or a baby under 3 months with a temperature of 38°C or more.

Medical Express Clinic has practised at 117a Harley Street since 1984 and is CQC-registered. It runs planned appointments, so a booking later in the week is for everything that can safely wait.

When is NHS 111 the better call?

NHS 111 is the service the NHS points to when symptoms are urgent but not life-threatening, or when you're not sure whether to call 999. You can check symptoms online or call 111, and it runs on evenings, nights and the rest of the week. If the problem can't wait until Monday or Wednesday between 10:00 and 14:00, and it isn't a 999 emergency, 111 is your best next step. You can still book us for a planned examination once your child can come in.

What does the paediatric GP clinic see?

Dr Penny Sheehan, General Practitioner, GMC 6056535, sees children aged 3 months to 15 years on Monday and Wednesday between 10:00 and 14:00. You can walk in during those hours, but booking is safer because it secures a time and usually shortens the wait.

You don't need a diagnosis before you come. Typical reasons include earache, a sore throat, a chest infection or cough, a rash, fever, vomiting or diarrhoea, urinary symptoms and minor injuries. Growth or development can be raised when you book or on the day, and it helps to mention it early so that question is in the room from the start.

This is the visit for when something won't settle, or something new worries you, and you want a doctor who's used to examining children to look in person.

Where to take your child.

Is this a children's specialist?

Dr Sheehan is a GP with a special interest in paediatric assessments and consultations. The word paediatric can sound like a hospital children's ward, so it's worth being clear: this is general practice, done by a doctor who sees a lot of children, rather than a consultant paediatrician department.

If your child needs a consultant paediatrician, the clinic can provide a referral letter when that's clinically indicated. The specialist you're referred to sets their own appointment times, so the clinic can't promise how soon they'll see you.

Planning a trip? Call the clinic to talk through which travel vaccines can be arranged for your child.

What happens at the appointment?

There's no fixed clock, though visits rarely run beyond 30 minutes. Dr Sheehan takes a history from you, examines your child and agrees a plan before you leave. That plan might be advice, a prescription if medicine is needed, a test in clinic, a review, or a referral letter. If anything during the examination feels uncomfortable for your child, say so, and the doctor will pause and explain what's happening.

One parent or legal guardian is enough, and that person stays with the child throughout, because the child is never seen alone. Bring photo ID for both of you. A birth certificate is fine if your child doesn't have a passport, and a copy is kept in your child's medical record.

What does it cost?

The consultation is £200. If the doctor decides medicine is needed and writes a prescription during the paid visit, there's no extra clinic fee for writing it. Pharmacy charges are separate, and a prescription is only written when it's needed.

Blood tests, urine tests and swabs can be done at the clinic when the doctor thinks they'd help. They're charged on top of the consultation, and the cost is discussed before anything goes ahead. Numbing cream is available for blood sampling, which makes it easier for many children, though it doesn't make it painless.

If the doctor asks you to come back, or you want to review the same problem once results are in, contact the clinic to arrange a follow-up. It's available for existing paediatric patients and costs £150.

What about 16-year-olds?

Young people aged 16 and over see a doctor through our standard adult GP consultation, in the same building. A 15-year-old still comes to the paediatric clinic, with a parent or guardian in the room.

Before you set off

• If you can, book rather than walk in, as the list can already be full.
• Bring photo ID for you and your child, or a birth certificate if there's no passport.
• Bring a list of medicines, any allergy details, and letters or results you already hold, so the time goes on your child rather than reconstructing last week.
• If you're asking about travel vaccines, call before you travel.

Related reading: when to see a private GP and choosing an allergy test.