RCPCH Notes - Spring 2010

SPRING 2010 NEWSLETTER

ROYAL COLLEGE OF PAEDIATRICS AND CHILD HEALTH

Notes

An RCPCH passage to India

“It is impossible not to be astonished by India. Nowhere on the Earth does humanity present itself in such a dizzying, creative burst of cultures…..”

Rough Guide to India

PEDICON provided the opportunity to answer questions from Indian doctors who were considering MRCPCH and / or participation in the newly-invigorated International Paediatric Training Scheme. The immense enthusiasm that characterises the Indian trainee was evident. Graeme Muir, Head of Assessment and Andrew Long, Officer for Assessment, were pinned to the wall by the number of keen questioners. Meanwhile, Ramesh Mehta, Principal Regional Examiner for South Asia and Simon Newell, Officer for Examinations, frantically distributed information leaflets.

The MRCPCH exams will be available to Indian graduates with training in paediatrics.

If applicants are numerous, numbers will be limited on a first come, first served basis to ensure those taking Part 1 will be able to progress to the clinical examination held in India. All details are on our website with the registration for the May 2010 MRCPCH Part 1 going live on the 1st February 2010.

Initially, the written exam will be held in Delhi, Chenai, Mumbai, Kolkata and Bangalore. The clinical examinations will be held initially in two of these centres and then rotate. The first clinicals will be held in 2011.

Much enthusiasm, energy and imagination have been injected into the project. Our College’s examinations have promoted large interest amongst paediatricians and trainees in India and the new joint venture will further strengthen the partnership between IAP and RCPCH.

Last year, around 800 Indian graduates took the Membership examination either in the UK or in our other overseas centres. Against this background, we have worked with the Indian Academy of Pediatrics (IAP) over a number of years and have now agreed the launch of the MRCPCH in India.

The key to this is our partnership with IAP which has grown from an initial agreement made in 2003 leading to previous successes in, for example, the workshops on evidence-based medicine. IAP comprises over 18,000 paediatricians in India and is the representative forum for those caring for over 500 million children in the sub-continent. The Academy has won plaudits and respect from international bodies for major advances in child health in India.

On January 8th 2010 the Memorandum of Understanding for the MRCPCH was signed by our President, Professor Terence Stephenson, and Dr Deepak Ugra, President IAP. The opportunity rose at PEDICON, the conference of IAP with some 6,000 delegates. RCPCH was also pleased to run a joint CME day at the conference.

SIMON NEWELL Officer for Examinations GRAEME MUIR Head of Assessment

Paediatrics and Child Health Annual Conference 2010 20th-22nd April 2010 University of Warwick see page 4 for more details

Notes

Contents 1 An RCPCH passage to India

2 Registrar’s column

3 A message from Terence Stephenson Dr Chris Hanvey

4 Clinical Standards at RCPCH Spring Meeting Warwick 2010

Registrar’s column

Deaths

5 The RCPCH CPD Scheme

6 Media update 2010

7 The Healthy Child Programme Update

8 Reviewing the Palestine programme SASG News

9 Senior Members: 2010 Message from Dr Keith Dodd

10 Investing in our Asset

11 TRAINING MATTERS: The Trainees’ Column

Copy deadline for next issue: 1st May 2010 Managing editor: Graham Sleight Editor: Joanne Ball Email: newsletter@rcpch.ac.uk Editorial services: Work Communications Published by: The Royal College of Paediatrics and Child Health, 5-11 Theobalds Road, London WC1X 8SH. Tel: 020 7092 6000 Fax: 020 7092 6001 Website: www.rcpch.ac.uk Email: enquiries@rcpch.ac.uk The College is a registered charity: no. 1057744 and registered in Scotland as SC038299

2

As I write this in February, we are in the thick of the pre-election season, with all political parties beginning to talk about their plans for reductions in state spending to address the UK financial situation. The recent Budget made it clear that the state sector will not be excluded from the consequences of the global financial crisis. We have become accustomed to generous funding increases, ambitious building programmes, and recruitment of many more nurses, doctors and other staff. It seems clear that this is all about to change. Even if we listen to and believe those promising no cuts to NHS funding, it must be the case that even that scenario will result in real reductions in available spending once the effects of inflation, population growth and shift and the pace of technological advancement are taken into account.

We are all aware that ambitious efficiency plans have been proposed. This will result in huge pressure for services to do more work for less money. However, the real problems seem likely to start in 2011, when the next three-year spending period starts. The pressure on state finances will mean overall spending will shrink.

It must be questionable if efficiency programmes will be enough and this suggests that difficult decisions will need to be taken about cutting services and frontline jobs.

What does this all mean for RCPCH and our plans for the future? Many will argue that it is our role to continue to push for further investment in children’s health services, and not to get involved in this political debate. Although to an extent I agree with this, I also think we would be unwise to ignore the political and funding realities. Asking for more investment will only succeed in the new environment if we can demonstrate these requests are made on the back of clear evidence that we are addressing the need to get best value from current investment levels, and have good evidence of unmet need that carries sufficient weight to succeed over other competing requests.

So what are our best arguments? We must continue to have a clear line about improving children’s health. All our cases must rest in the benefits they bring for children, rather than for those delivering the service to them. This is likely to result in the need to support some policies that may, in the short term, be unpopular with either RCPCH members, the public or politicians, or possibly all three. The best example of this is likely to be reconfiguration of services. We know that the current pattern of acute service delivery is unlikely to be supportable in the longer term

without significant further investment to provide sustainable, EWTD compliant rotas. In the new financial climate, this funding is going to be very difficult to secure. In any case, should we divert money to supporting services where a different pattern of service delivery would result in better outcomes for children? Politicians dislike reconfiguration, as there is almost always a significant number of electors who value the current arrangements and do not want to see change. The public like local services and many of those who work within them are also very supportive, and find the idea of loss difficult.

We must be clear that reconfiguration needs to be driven by service improvement, and not by short term financial issues. The coming financial squeeze may well be the catalyst for changes, but any changes should be based on the premise that it delivers a better service, rather than money. Service change to save money usually neither saves it in the long term nor improves services.

An important tool we can use to support a positive approach to this is the development of a range of service standards, to define the basics of a good service. Council considered our first set of these in February, and I hope by the time you read this, we will have begun the process of refining these so we can use them to help local services get to grips with improving in the face of financial reduction. Also, we must continue to develop our work with children and parents. If what we say is supported by the people we work for, it is much more powerful than if we say it alone.

DR DAVID VICKERS Registrar

Notes Paediatrics and Child Health Annual Conference 2010 20th-22nd April 2010 University of Warwick

“Hello, and welcome to the RCPCH Annual Conference 2010.”

A message from Terence Stephenson This is an exciting year for the Annual Conference (formerly the Spring Meeting).

The name change alone gives a clue as to why this is such a big event: we’ve been working to re-shape the Conference using feedback we’ve received from members over the past few years. This, for me, is the start of a long process: the issues surrounding the Annual Conference continue to be debated and considered, and this provides us with an excellent opportunity to help shape the future of the College and the Conference.

The brief we had was to improve the Conference by providing a more focused event, located more centrally than York, in an area with better public transport. Warwick is a natural fit as our location: large enough to hold our delegation, centrally located for everyone in the UK, excellent transport links,

and a renowned socialising capability. (I have to admit, I did notice more and more people ‘networking’ away from the York campus in the past. But with better facilities on site at Warwick that needn’t happen.) Additionally, we’ve shortened the event to just three full days, meaning the Conference should be much more focused and direct than before, and it will take up less time in busy schedules.

However, despite these improvements, we’re still looking for feedback and more improvements and alternatives. I’d like to thank Alistair Thompson, Vice-President of Education; Rosalind Topping, Head of the Education Department; Lois Whittaker, interim Chief Executive; and the Academic Board for shaping the plans for this new event, and for continuing to work towards a better solution.

Personally, I’m also delighted by the choice of Warwick because it was the site of my first ever oral presentation to the British Paediatric Association in April 1994. My topic was ‘Ageing of bruising in children’, and I remember being asked a question from the floor by one David Baum, one of my predecessors as President of the College.

I look forward to meeting as many of you as possible over the three days, and hearing what you have to say. I’m also looking forward to topping up my CPD points at the various guideline and hot-topic sessions.

Best wishes, TERENCE STEPHENSON President RCPCH

Dr Chris Hanvey In February, the College welcomed Dr Chris Hanvey as its new CEO. Dr Hanvey previously worked as Deputy Chief Executive at Barnardo's where he helped lead the organisation through a period of significant change, growth and modernisation. He has considerable experience in children's services and related organisations, which includes roles as Assistant Director of Children's Services in Leeds, Director of Policy for NCH (now Action for Children) and CEO of both the Thomas Coram Foundation and the John Ellerman Foundation. He has also been an advisor to the Cabinet Office. Dr Hanvey will be attending the Annual Conference in Warwick, where he looks forward to meeting College members. The College is enormously grateful to Lois Whittaker, who served as Interim CEO from September 2009 – February 2010.

3

Notes

RCPCH Register online at www.rcpch.ac.uk/conference-2010

Clinical Standards at RCPCH Annual Conference Warwick 2010

Registration is now open for the UK’s biggest and most exciting Paediatrics and Child Health Conference. All member fees can be found online.

Come visit the RCPCH Clinical Standards team at the RCPCH Annual Conference 2010.

“Getting guidelines into practice” events Wednesday 21st & Thursday 22nd April, 8am and 12pm Listen to experts in the field presenting key messages from NICE guidelines such as: When to Suspect Child Maltreatment; Diarrhoea and Vomiting; and Coeliac Disease. The Head Injury session will focus on implementation. For further information, please see the programme.

“How to audit and implement a guideline” workshop Tuesday 20th April, 2-4pm Once again we will be holding our ever popular annual workshop but this year the focus will be on audit and implementation of guidelines and changing practice. For more details on any of the above events and to book your place on the workshop email clinical.standards@rcpch.ac.uk.

National audit stand Visit us at stand 30 in the main hall where you can find out more about the College’s national audit projects, including the National Neonatal Audit Programme and the forthcoming Epilepsy12 Audit.

Deaths The College notes with sadness the deaths of the following members in late 2009/early 2010.

4

Name

Membership Type

Admission Date

Town

Dr Edmund Neville Hey

Honorary Fellow

1999

KEIGHLEY

Dr Eileen Hill

Senior Fellow

1962

GLOUCESTER

Royal College of Paediatrics and Child Health 5-11 Theobalds Road, London WC1X 8SH Tel: 020 7092 6000 Fax: 020 7092 6001 www.rcpch.ac.uk If you are a retired examiner for the RCPCH and qualify for a free day at the conference (in addition to Wednesday), please contact Amit Kotecha (amit.kotecha@rcpch.ac.uk) at the RCPCH who will then deal with your registration.

Notes

The RCPCH CPD Scheme A Survey of Members' Attitudes to Guidelines, Record Keeping and Audit on the Threshold of Revalidation In order to look at ways of supporting and encouraging RCPCH members with their acquisition and recording of CPD for future revalidation, we set out to investigate the views of members of the College’s CPD scheme. Revalidation implies evolution of minimum levels of CPD from recommendations to requirements; the results of our annual audit are therefore a potential concern (see table 1).

An on-line survey was designed to investigate (a) the proportion of RCPCH members who feel they are able to achieve CPD minimum requirements and the difficulties they are facing with this; (b) the reasons for non-compliance with the requirement to keep adequate, auditable records. Paediatricians were randomly invited via email from the CPD-eligible membership. 377 respondents out of a potential 890 were successfully recruited and came from a range of settings.

Table 1 – 2009 CPD Audit results The headline results are as follows: Total audited:

205

Total passed audit:

137 (67%)

Failed: After assessment:

21 (10 %)

Failed: Nothing submitted:

47 (23%)

Total failed

68 (33%)

Number who failed assessment due to lack of evidence (but recorded adequate CPD in previous 12 months)

20/21 (95%)

Number that were able to fully demonstrate evidence for all points claimed in previous 12 months (to pass the audit, only 50 credits of those claimed need to be evidenced)

44/205 (21.5%)

Number that recorded adequate CPD in previous 5 years

150/205 (73%)

Box 1 – Acceptability of Evidence of CPD – Types of evidence considered appropriate for audit

Sole Evidence:

Further evidence

Certificate of Attendance

Minutes/Handouts of Meetings

Signed Attendance Lists/Register

Receipts/Invoices for Courses

Reflective Notes or other records of learning

Signed Study Leave Forms

Evidence of completed online learning and assessment

Programmes

Own Presentations arising from CPD activities

Handouts/Slides/Course notes

Feedback from others on your lectures/presentations

Personal Diary Entries

Signed PDP as evidence of CPD planning

• 70.5% agreed with a minimum of 50 credits annually; 88.3% were able to comply.

• 67.5% agreed with the need to gain at least 25 external CPD credits; 83.6% were able to comply.

• 56.6% agreed with the minimum of 40 clinical credits annually; 90.4% were able to comply.

• 82.3% agreed with the need to maintain a portfolio of evidence of CPD. • 71.6% agreed with the need to submit evidence of CPD credits to RCPCH auditor on request.

Box 1 lists the types of evidence currently accepted for audit purposes according to where a majority of respondents felt each type was adequate as sole evidence of an activity or where further supporting evidence was required.

Reflections and evaluation of reading

• 78.9% agreed with a minimum of 250 credits over 5 yrs; 92.9% were able to comply.

The majority of respondents to this survey supported the RCPCH CPD guidelines and felt able to meet the recommendations. The survey, however, also revealed a significant minority who are reluctant to accept many aspects that have been part of the guidelines since their inception, are common to other medical colleges and are supported by the Academy of Medical Royal Colleges. It could be argued that the respondents to the survey, who represented less than 50% of the original sample, are likely to have been a self-selected group of higher compliers.

Some paediatricians clearly still have difficulties with resources for their CPD. Respondents to the survey appeared to support some tightening up on the standard of acceptable evidence of CPD. The RCPCH must try to accommodate multiple views and is bound by the demands of outside bodies as well as its members. This survey and other forms of evidence such as focus group and informal feedback are invaluable in the development of the guidelines and supporting paediatricians with their CPD; this includes further improvement of the on-line record. The results underline the need to continue publicising the duties required of paediatricians for CPD and revalidation.

ROLLO CLIFFORD, Officer for CPD SARAH FELLOWS, Revalidation and CPD Manager SARAH UDDIN, Revalidation and CPD Administrator January 2010

5

Notes

Media update 2010 In November the NHS launched its Neonatal Toolkit and Terence Stephenson was quoted in numerous national newspapers including The Guardian, Daily Mail and The Independent saying, "Babies should not be denied access to one-to-one nursing care and other support which is already available to children and adults in intensive care".

Also in November – the ‘right to life’ case of Baby RB. Terence Stephenson appeared on Channel 4 News and spoke of the difficulties paediatricians face in these complex cases, and said that “doctors who are in any doubt at all in an emergency situation should always err on the side of saving a child’s life.”

Rosalyn Proops, Child Protection Officer, was quoted in The Guardian about children’s services a year on from Baby Peter. She mentioned the child protection programmes run by the College and work being done with the Department of Health to develop child protection networks.

funding. She said "Children's research funding has always taken second place to adult research funding. Also, research into newborn health has received even less funding. The importance of medical research to benefit infants and children can't be over-emphasised."

Mary McGraw, the former Vice President for Training, spoke to online publication Hospital Dr about the recruitment of overseas doctors and gaps in rotas at training level.

The public consultation on product placement closed at the beginning of this year and David Vickers, RCPCH Registrar, was a signatory on a letter to The Guardian raising concerns about the effect of product placement on child health.

At the beginning of December the College launched Significant Harm – the effects of administration detention on the health of children, young people and their families.

This intercollegiate briefing paper with the Royal Colleges of General Practitioners and Psychiatrists and the UK Faculty of Public Health calls for Government to stop detaining children without delay.

The RCPCH received coverage in over 30 articles and Nick Lessof, RCPCH representative on the working group, also appeared on BBC Radio 4’s Today Programme, BBC Radio Scotland, BBC Radio 5 Live and BBC Radio Wales.

Last summer Terence Stephenson spoke out about adults smoking in cars with children and he appeared on BBC Radio London in December talking about the harmful effects and calling again for a ban.

In January Neena Modi, Vice President for Science and Research, was quoted in The Observer talking about children’s research

6

William Van’t Hoff, Chair of the Medicines Committee, was quoted on the BBC News website talking about the high rate of drug errors in hospital. He said that the high error rate reflected the complexity of treating children and that there is a need for “more research into the causes of these errors and training to prevent mistakes being made”.

Terence Stephenson appeared on ITV News at the end of January talking about fabricated or induced illness (FII) after a mother was convicted of fabricating her son’s illness.

To keep up-to-date with news articles that mention or quote the RCPCH, or to stay informed about what is going on within paediatrics and child health, visit the website for a regular summary of articles – www.rcpch.ac.uk/media ELLA WILSON Media Affairs Assistant

Notes

The Healthy Child Programme Update Project Update

The Healthy Child Programme

The College is continuing to work with e-Learning for Healthcare (e-LfH) and a consortium of Royal Colleges and Professional Bodies to produce an e-learning resource for the Department of Health’s ‘Healthy Child Programme’ (HCP).

The HCP provides preventative services tailored to the individual needs of children and families and also acts as a best practice guide for children’s services.

Writing content for the resource is now underway. We are still seeking additional content authors, so if you would like to be involved, please get in touch. We are particularly encouraging volunteers who are trainees or studying and who could contribute an educational perspective to writing.

You can express an interest in being involved by visiting the e-LfH Healthy Child Programme homepage – www.e-lfh.org.uk/healthychild or email healthychild@e-lfh.org.uk.

The programme focuses on the health and well-being of children in the early stages – pregnancy and the first five years of life.

Based on a model of progressive universalism, the HCP seeks to provide a core programme of scheduled reviews for all children, with additional services for children and families with particular needs and risks. The programme is also able to focus on changing public health priorities such as obesity, breast feeding, social and emotional development.

Further information can be found at the Department of Health’s website: http://www.dh.gov.uk/en/Healthcare/Children/Maternity/index.htm

Updated Curriculum Communication, Record Keeping and Inter-professional working

The HCP curriculum has been updated.

Family Health Safeguarding Positive Parenting & Parenting Issues

HEALTHY CHILD PROGRAMME

Development & Behaviour

OVERVIEW

Speech, Language & Communication Needs Growth & Nutrition Immunisation Health Promotion Screening

For more information, or to download the HCP curriculum, please visit our websites: e-LfH website: www.e-lfh.org.uk/healthychild RCPCH website: www.rcpch.ac.uk/HCP Daniel Riddell, Project Manager, RCPCH daniel.riddell@rcpch.ac.uk

7

Notes

SASG News

Reviewing the Palestine programme Just before Christmas 2009, the RCPCH President, Professor Terence Stephenson, attended the second full graduation of 20 Palestinian diploma candidates in Ramallah, including three nurses. All those who had completed the course were successful in the exam, which was a gruelling OSCE overseen by our external examiner Dr Tom Lissauer. The students have also completed an assignment for each of the 11 modules and have maintained portfolios throughout the course – a new concept for Palestinians but one that has shown its benefit in offering reflection on generally high standard practice.

Changes, Changes...

It is all change at the SASG Committee! In her Autumn SASG Newsletter Column, Natalie Lyth mentioned that the SASG Committee was going through some changes with two Members – Drs Ned Rowlands and Melanie Pollitzer – leaving the Committee for pastures new. As you will see from the photo and name at the end of this Column, these changes have continued as Natalie has now moved on from her role as SASG Committee Chair to take up a Consultant post. Under Natalie’s leadership, the SASG Committee has seen its numbers increase and the voice of SASGs at College strengthened.

We remain indebted to her for all her hard work and wish her well for the future.

A New Face And so….I should introduce myself! I am an Associate Specialist working in acute tertiary Paediatrics in Glasgow. I was a SASG Regional Representative from 2004, joining the SASG Committee as a Member in 2005. I was Deputy Chair of the SASG Committee from 2007 and was elected to the new SASG Seat on College Council in December 2009 – which includes being Chair of the SASG Committee.

Now that the second course is over, the planning group of UK and Palestinian paediatricians are carrying out their own reflection. Medical Aid to the Palestinians, who support the work in the occupied territories, have funded an evaluation which has so far shown how popular the course is with the students – comments include: We are now more oriented to eating & feeding disorders, we better use the growth chart, and Autism is very relevant to our work at a secondary health care setting. For example, the FTT has two main causes, first, organic and functional, and second nutritional due to social status of the family. We were neglecting the second cause although we knew it, but now we are more alert to it.

From the Makassed group (paediatric trainees) I feel now I can respond better to the changes in health care services and can deal with new cases effectively.

– I know now the importance of the Primary Health Care, and have started to engage in different activities such as: – I do more health education for the patients and their families.

– I have participated in establishing a Health Committee at the camp level From a nurse in the Ramallah (primary care) group The evaluation is not yet complete but will be made available on the RCPCH website during the coming weeks.

8

In further innovation aimed at learning lessons from the course, a video conference was held in late January between the UK and Palestinian tutors (ten at each end). This was to reduce the need for air travel and to allow full discussion over a three and a half hour meeting.

Despite initial problems with slide presentations, the meeting was a great success and as well as business, we exchanged presents, told jokes, sang a song together and enjoyed a bagpipe recital (perhaps a first in the RCPCH building?). There was an effective exchange of views and planning is well underway for the next course to start in March, with increasingly greater Palestinian involvement in the course organisation. There will be a greater emphasis on how to effect change in the primary care clinics as a result of the training, and clinic supervisors will be included in a further training of trainers to be held in Ramallah in February.

Presently only being run in the West Bank, we hope that the course may extend to Gaza during the coming year (it was after all in Gaza that the course was planned by David Baum back in 1998). It will be appropriate for our first pilot module there to be on child mental health.

We continuously admire our Palestinian colleagues and Juzoor, the NGO with who we work in the oPt and are pleased to work with Medical Aid to the Palestinians who are doing remarkable work in both the West Bank and Gaza.

Dr Tony Waterston Prof Mary Rudolf Dr Jean Bowyer

Recent years have brought some new and welcome opportunities for SASG Paediatricians – as well as some challenges. The SASG Committee remain committed to taking forward the issues which are important to SASG Paediatricians within College and to ensuring that the needs of SASG Paediatricians are fully considered when decisions are being made.

New Committee Name?

As we know, there is a new Contract and new title for many SASGs. To recognise this, the SASG Committee has requested a change of name to SSASG – Staff, Specialty and Associate Specialist Grade Committee. This request will be considered for ratification at College Council in February 2010.

RCPCH Annual Conference 2010 – SASG Update Meeting I hope to see many of you at the College Annual Conference Meeting in Warwick.

There will be a “SASG Update Meeting” on Thursday 22nd April at 1230 – 1330 – lunch provided. We plan to have a presentation with open discussion on the roles of SASG Paediatricians in relation to current RCPCH Workforce Planning. We also hope to hear your views on what issues are important to you and what matters you would like to see the SASG Committee taking forward this year.

SASG Vacancies As you will see from the College Website Nominations Page www.rcpch.ac.uk/Aboutthe-College/RCPCH-Officers/nominations the SASG Committee is seeking new Members and also new SASG Regional Representatives.

Please have a think about applying for these posts – it is very important that SASGs working in Paediatrics have a strong, representative voice at College.

DR JANE WILKINSON Chair, SASG Committee

Notes

Senior Members: 2010 Message from Dr Keith Dodd Seniors’

Web Pages

A cold bright winter’s day in central London sees a small group of paediatricians poring over a recent set of Part 2 Membership papers. Fortified by a mound of bacon sandwiches they struggle with the question “What percentage of borderline candidates should pass each item?” The group includes three bright young things who recently passed the exam, a couple of practising paediatricians and two retired consultants, each bringing their own expertise to the standard setting session. It works well.

The social programme for seniors continues with the President’s lunch held in June and December, usually at the college. However, after a successful event in Edinburgh in 2008 we plan to hold the lunch in Cardiff this summer, and I would like to find a venue in the north west of England for another year.

The free day for seniors at the Annual Conference this year will be Wednesday and will link up with the History group’s session as it did last year.

The college now has over 800 retired members (senior members, fellows and honorary fellows), many of whom continue to help with college exams in a variety of ways such as setting questions, examining and criterion referencing as above. Others have helped to develop parts of the new clinical exam, especially the Communication, History Taking and Development stations.

Last year college council agreed guidance allowing seniors to continue this work.

It is likely that seniors’ numbers will increase steadily in the next few years, and many may wish to remain involved in child health in various ways, such as research, teaching, overseas work, or helping a charity.

The college believes that senior members are a valuable and currently under-used resource, and is keen to make better use of their skills, experience and judgement.

If you would like to be involved please get in touch with me.

www.rcpch.ac.uk/Membership/ Senior-Members The new web pages are now up to date with new information.

Please take a moment to view the new pages on the President’s lunches; you can watch a presentation by Dr Nicholas Barnes, which took place in July 2009, and a presentation from Dr James Aidan MacFarlane in December 2009.

The members’ forum page is open to you to contribute any notice or communication you wish other seniors to be aware of or to become involved with.

If you wish to post anything in the forums / web pages, please contact Pardeep below.

Keith Dodd, February 2010 Email: keith@dodd394.fsnet.co.uk Phone: 01332 557249 Post: 394 Duffield Rd, Derby DE22 1ES Pardeep Bhakar PA to Directors of Internal Services / Support to Dr Keith Dodd Email: pardeep.bhakar@rcpch.ac.uk Phone: 020 7092 6016

One of my aims as your representative on council is to improve links between senior members and the college, and to this end we set up a web-page a couple of years ago.

However communication with retired colleagues is not easy and in order to improve this we’ve redesigned the seniors’ web-page and tried to make it more accessible, as Pardeep explains below. Please note the site now has a notice board where members may seek support for child health related projects, such as Alison Earley’s current request for help with MCAI, an international child and maternal health charity. Please contact me if you have something you would like posted there.

I have now served for 3 years as seniors’ representative and will be standing down at the end of next year. If you might be interested in taking over from me I will be very happy to talk to you.

9

Notes

Assessment News 2009 saw some major changes in the approach that the RCPCH is taking towards assessment.

The loss of HcAT will be mourned by very few. However the implementation of Asset has led to some new issues that have already been corrected in part, but which will require version 2 to iron out all the creases. The long term benefits of Asset will be significant and should soon become apparent as doctors in training demonstrate progression to meet PMETB standards for award of their CCT.

Investing in our Asset We have listened carefully to the problems that have been experienced:

Time-out – we recognise the frustration when the system ‘times out’ before completion, causing data loss. We have now installed a clock which provides a countdown to remind assessor and assessee to save the data.

User-name – we are only too aware of the multiple usernames and passwords that are required in daily life. The system now contains an automatic username and password reminder.

Trust firewalls – it has quickly become apparent that the degree of firewall security varies significantly between trusts causing certain functions to be blocked. We have written instructions which have allowed most trust IT departments to resolve conflicts and have had an active dialogue with some departments. However, in absolute crisis, we have enabled the use of printed forms to be faxed to the RCPCH for entry on to the system.

Assessor email

– there is still a

problem over some trusts refusing to allow access to non-nhs.net email accounts. With version 2 of Asset (hopefully due sometime during the spring of 2010) we intend to allow assessors to have multiple email accounts registered with Assets which will resolve this issue.

ePaedMSF – for the next stage of the tool’s development we are intending to extend the response period (although allow enough time for completion before ARCPs).

We have made some simple changes to the self-assessment form to make it more relevant and the forms will be sent out automatically to those taking part with regular reminders for completion.

10

We have also observed some other problems arising in use of ePaedMSF. It is recognised that the validity of this tool rests in the correct number of assessments being received from assessors that have enough expertise to make a valid judgement about the individual.

In the future we will only allow a minimum of 7 assessors and will expect responses from 11 assessors to produce a valid report.

It will also be expected that half of the assessors will be non-training grade doctors.

This is designed to ensure that the report provides an accurate and rounded view of the individual to help them to progress in their training.

It is our intention to review all the assessment tools in 2010. We know that they are not yet achieving what we would wish them to accomplish and so we have asked users to help us refine the tools to make them more effective. If there are any trainees who would like to help please let us know.

DR ANDREW LONG Officer for Assessment wpba@rcpch.ac.uk

Notes

TRAINING MATTERS: The Trainees’ Column At the Trainees’ Committee in January, we discussed which issues trainees would most like to hear about in this article. The ST7 assessment was frequently mentioned and I will devote the column to this. I am supportive of the ST7 assessment although I have not always been and it is only by seeing how it has developed over time I have become increasingly confident it will be a constructive exercise.

Numerous trainees have been involved in its development and feedback has been considered and acted on. Many thanks to all those who took part in the pilot last summer – your comments and feedback have been very useful. There is still a further pilot this summer that will include stations applicable to GRID trainees as well. The process is still developing and firm decisions will only be made after all the data from the pilots has been analysed.

Q: How much work will I have to do?

Q: Why do we need an ST7 assessment?

Q: What if I fail?

The Post Graduate Medical Education and Training Board have been clear that they wish colleges to supply evidence that all competencies are being adequately assessed.

Colleges were not given an option as to whether they did this or not.

The assessment is being extensively validated (and the assessors also closely assessed!) so that individual competencies or curriculum areas can be identified as being below a set standard. About 10-15% trainees may have individual issues that need attention. For example there may be a particular problem with prescribing that can be reviewed with the educational supervisor and remedied. It is envisaged only 1% will perform so poorly a re-assessment will be necessary.

The current membership exam provides a way of testing clinical skills and ability to communicate in clinically related scenarios.

There are a number of other competencies though which are not tested. These range from management and leadership skills to prescribing practice. A decision was taken from an early stage to avoid this assessment becoming an “exit exam”.

It is felt you should be able to achieve the required standard with no revision. I suspect it is unlikely trainees will go in cold although the feedback from the pilot was very little preparatory work was necessary. It is hoped that the assessment will drive training standards in deaneries and especially for some of the management competencies specific training not currently delivered will be developed.

Q: I’m an SpR, will I need to take the assessment?

No.

Q: But it’s a test we take before becoming a consultant. Isn’t that an exit exam?

In the sense there will be some candidates who will perform below the expected standard to the extent they will need to repeat the assessment, then it fits the criteria for an exam. However, it is hoped over 80% of those taking it will achieve the required standard (compare with 30% for some other ‘exit’ exams and 50-60% for the MRCPCH). A proportion will have certain defined competencies identified as being in need of improvement. These can be dealt with at a local level. It is envisaged the trainees’ educational supervisor can sign off on these.

Q: Well if everyone gets through why do we need this in the first place?

As stated above PMETB are requiring this evidence. The vast majority of trainees pass NLS and APLS – that doesn’t mean that setting a standard isn’t necessary.

Please feel free to contact me if you have any further questions (damos@doctors.net.uk).

There have been few assessments which have been piloted as well as the ST7 assessment.

I do, however, have some concerns about the delivery of the extra training to those who do reach required standards in some areas and I will be working hard with the College to ensure trainees are not left struggling to achieve the required training. Ultimately engagement with the process is to the benefit of all and alternatives such as a clinically based, highly competitive barrier to consultant progression as seen in the surgical specialties are not desirable.

DR DAMIAN ROLAND Chair of the RCPCH Trainees’ Committee

College Courses 4-5 May Court Skills in Child Protection Venue: RCPCH, London Fee: £300 Members, £375 Non Members Who should attend?

Court Skills in Child Protection is an invaluable and enjoyable two day course held in May of each year, hosted by the College and purposefully developed for Consultants and Trainees.

Contact : Saheeda Rahman on events@rcpch.ac.uk or 020 7092 6106.

11-12 November Paediatric Educators Programme (PEP) Venue: RCPCH, London Fee: £450 Who should attend?

PEP has been designed by paediatricians who have an active interest in education, many of whom hold appointments with educational components.

This course is intended for paediatricians who have either been on a generic/basic teaching course and/or those with a reasonable level of experience teach on the job.

Application to this course is by completion of a portfolio, which will need to be submitted. Forms available at: www.rcpch.ac.uk/Education/Events_ and_Courses/RCPCH-Events

11