Issuu on Google+

RCPCH news Royal College of Paediatrics and Child Health

Leading the way in children’s health

SUMMER 2008

Spring Meeting highlights 9

7 Workshop on Child Health in Cuba Training Update

Participation Update 6

11 A New Project to Develop Integrated UK/WHO Growth Charts


Editorials In the news

From the Registrar

4 Media Update Child Protection 5 Paediatricians needed in Africa and Asia Derby Community Paediatricians invited to the House of Lords 6 Participation Update RCPCH-HPA developing evidence based guidelines on infectious diseases 7 Child Health Workshop in Cuba Training Update 8 The RCPCH has moved Developing a ‘good’ guideline – how we can help 9 Spring Meeting 10 Achieving Equal Protection for Children 11 Developing Integrated UK/WHO Growth Charts Adolescent Health Project e-learning Safer Practice in Neonatal Care Project Podcasts from Archives in Disease in Childhood 12 SASG news Mainstreaming care for sickle cell and thalassaemia 13 BPSU Activities Online member look-up 14 Trainees column BSHPCH 15 Meetings Allergy and Non-infective Immunological Respiratory Disease Page 2

Welcome to my first column as Registrar (and if you want to read my manifesto go to www.rcpch.ac.uk/Media/News). Hilary Cass, my predecessor, warned me that although this only happens 4 times a year there would be a temptation to leave it to the night before the deadline. Happily I have not done this: I am writing this with 2 nights to spare! It is daunting to take on this role. My predecessors set a hard act to follow. Taking on a new job involves finding out about the many things that you were not quite expecting to have to do and already in the first few weeks in this role I realise its complexity. I was, however, aware that one of the things I would be doing would be contributing a regular column to the Newsletter, so congratulate myself on getting it done so far in advance of the deadline! The College has just moved to impressive new premises which have a much more modern feel and provide more space for meetings and a better working environment for our staff. They also amalgamate the College departments into one building and I hope this will promote a more seamless approach to the way that we work. Increasingly NHS trusts are less willing to support making time available for College activity. I hope that with the new building and its better IT facilities, which include better facilities for video-conferencing and tele-conferencing, we will be able to encourage more of a way of working that does not necessarily involve having to travel to London. Much of what we do can be done electronically and by the use of tele- and video-conferencing. We should ask, “Can this be done electronically or by remote conferencing?” as a routine part of our planning. I enjoyed the Annual Meeting in York. A particular highlight for me was attending the guest lecture given by the RCPCH Youth Advisory Panel at the British Paediatric Mental Health Group. This was an impressive session and made me realise the importance of engaging effectively with young people in thinking about our priorities. They put mental health as a top priority and spoke eloquently about the problems that young people face in accessing support and help, particularly when they have mental health issues. Sophie Auckland, our departing Children and Young People's Participation Manager, has put a huge amount of work into developing this Panel, and the benefits were clear. The day before that meeting the Young People’s Health Special Interest Group was launched. This was a

packed event with huge enthusiasm for thinking about the particular issues faced by adolescents in relation to health services. Locally I have just taken part in a training session for medical students at our Children’s Hospice. The most impressive part of this was the presentation given by a bereaved parent about the life of her child. The messages that the child left behind were powerful and included the importance of listening to young people and understanding their perspectives, their needs and how often what we do may be medically correct but not necessarily the right thing for the individual. His mother also spoke movingly of the dangers of making promises we cannot keep. I was struck while talking to her, and the family support worker who developed the talk with her, how much time was put in to supporting the parent in doing this and the particular benefit created in developing this life story for the family. The medical students were exposed to a very different view of health services by the presentation, the family gained much from the work that was done and the child’s voice was well represented. The participation of Children, Young People and their Families must become more central to the way we think about our work. To do it well, we need to invest time and resources into supporting the people we work with. Participation needs to be seen as a core part of our work and that children and parents are involved in the development of our policy, the direction of our research, the delivery of our educational programmes and our thinking about the best way to deliver services. One of the challenges for an organisation such as the RCPCH is to ensure that the different strands of its work are well integrated. I suspect that by involving families and young people more in what we do is one way to encourage these outcomes. It is my view that if we are going to improve the working lives of Paediatricians we must continue to work on improving the experiences of children and families in our health services. A powerful driver for this will be hearing and acting on their voices. What do you think…?

Dr David Vickers RCPCH REGISTRAR


Editorials

RCPCH news

A Week in the Life of the President Unable to find my car in the street outside my house, I was convinced it had finally been stolen and was about to phone the police when I remembered it was in fact at the hospital where I work. This has happened before. I go to work either at the College or St George’s, and return home sometimes forgetting my car on the way. As I am now also green, I rarely take the car at all and leave it as an accessory outside my house (which I am trying to sell) hoping that a racy little yellow convertible parked outside will entice the last few buyers left in South London. Anyway, the car is on notice as it sulked so much at being abandoned at St George’s that it now refuses to convert on demand. Mind you, this is better than my last car which would spontaneously convert itself whilst in motion leaving me holding up the roof whilst trying to find somewhere to stop. The above is not supposed to illustrate my hopelessness with cars, but the selforganisation required by a President. I am busier than I have ever been – but when people ask me what it is that I am doing, I know I have been busy doing it but can’t always remember what it is. So I have picked a week at random from my diary and thought I would describe it to you.

MONDAY 08.30 Neonatal Consultant meeting at St George’s to discuss the trainees, ideas for the future, coping with EWTD – and plan our own on call rota. I must pay tribute to my colleagues – without their forbearance this job would be impossible. 10.00 Meeting at the College about the Academy of Medical Royal Colleges/NIII Leadership curriculum. The framework is complete and awaiting implementation. 12.30 Meeting with David Shortland, College Workforce officer. We have good data which provides the evidence that means I can ask for 1,000 new consultant posts in paediatrics. Our joint project with the RCOG looks at ideas from trusts identified as being EWTD compliant. Hospital at night, new pathways of care, change of roles and consultant delivered services are described in the final version of the document. 15.00 Bereavement appointment at St George’s. I am meeting parents of a baby who died when I was attending four weeks ago. It takes an hour to get back to SGH and I know the underground like the back of my hand. I am a bit early so just have time to nip into Tooting to buy some essential supplies for my poor deprived refrigerator. Fortunately, I have my non-plastic shopping bag in my briefcase. 16.00 Meeting with trainee for whom I am educational supervisor. We go though her form and I am delighted to find the RCPCH tools for assessment on the Deanery form. She has recorded her DOPs, case based discussion and multisource feedback on line and has an e-portfolio. We arrange for me to do a mini-CEX with her when I am next attending.

WEDNESDAY 09.00 Meeting at College with Chief Executive of the AoMRC to discuss its governance. 10.30 Regular meeting at DH with Sheila Shribman and civil servants. An opportunity to update each other and to plan developments in child health services. 14.30 Meeting with BAPM President about care of babies in midwifery led units. 16.30 Meeting with College senior officers to discuss urgent issues. 18.30 Discussion with facilitator of London children’s clinical pathway group. I chair this and we are finalising the report.

THURSDAY Every meeting today is in a different place… 09.30 Walk around the new College building to finalise plans on office space. 10.30 Academy Education Committee. We discuss the Tooke report and the response of the Secretary of State and the implications for the various specialties. 12.30 Meeting at Audit Commission to discuss inspection and regulation of child health services and aspects of the leadership project. 14.00 Darzi “deliberative event” to discuss the possibility of having an NHS constitution, this takes all afternoon – but after it I have to go back to the College to catch up on paperwork and emails.

FRIDAY 08.30 Connecting for Health Breakfast. We discuss practical and ethical implications of electronic records for children. 10.00 Filming a personal introduction from me to preface the Adolescent Health Project which is an e-learning programme nearing completion. 12.00 Meeting with new Head of Children’s Strategy of the Healthcare Commission 13.00 Catch up on emails again plus time to prepare talks and articles. 16.00 Leave Kings Cross for Cambridge. On the train I have a booked phone call to discuss a proposed article with editor of the BMJ.

17.00 Handover round as I am on call. I try to attend the weekly grand round but this is proving difficult. Still, many patients are familiar to me from last week’s on call.

19.00 Meeting with Cambridge medical students trying to persuade them to take up paediatrics, followed by dinner with them and travel (very late) to Stansted airport.

18.00 Emails, emails and more emails - trying not to print out too many.

SATURDAY

TUESDAY

04.30 Get up to check in for flight to Brussels. My least green thing this week but being in Cambridge meant I could not catch the Eurostar, which is my usual travel mode to Brussels – and the meeting starts too early.

09.00 Meeting with the new officer for examinations, Simon Newell. We had talked a couple of months ago when we were in Hong Kong to sign a Memorandum of Understanding. We discuss ST7 assessment which we hope will give trainees and trainers the confidence to know they are on track to get the CCT the following year.

09.00 European Academy of Paediatrics executive committee meeting all day

10.30 To NHS London in Victoria for the National Commissioning Group. We discuss applications for national commissioning and funding. Excellent CPD on ataxia telangectasia, McArdle’s disease and gender identity disorders to name but a few. I represent paediatrics and did my homework by talking to our specialty group leads.

SUNDAY

15.30 Back to the college for a meeting with President and Chair of Council of RCGP to discuss primary care. One of a series of meetings we are having with them about GP training in acute paediatrics and access to child health services. They are sympathetic – provided we can get their training extended to 5 years.

Look at diary and do emails and paperwork for next week…

09.00 EAP meeting continues. 11.55 Catch Eurostar train for home. Now where did I leave the car?

16.30 General paperwork and catch up with Len Tyler, our Chief Executive. We discuss the move to the new building. 18.00 To nearby wine bar for a drink with the Registrar to celebrate her birthday and catch up on issues she is dealing with. (Work has to be fun occasionally). 19.30 Dinner at the Royal College of Anaesthetists. Sounds frivolous but important networking. I talk child protection to the CMO, to Graeme Catto and to the chair of the BMA.

Dr Patricia Hamilton RCPCH PRESIDENT

Page 3


News Media Update

Child Protection

“Smacking can turn children into criminals” – a headline from The Guardian in February and the first news story the College commented on that month. Rosalyn Proops, Child Protection Officer, responded to the report by the Institute of Public Policy Research, by saying that it was extremely important and “like all people, paediatricians have a variety of opinions. However, the majority believes that all forms of smacking are an assault of a child and should not take place.” Also in February, Simon Lenton, Vice President for Health Services, spoke to BBC online about a story on faulty hospital weighing scales. He expressed the College’s concerns. Terence Stephenson, Vice President for Science and Research, appeared on Panorama about shaken baby syndrome (SBS) in March and was also interviewed by the Telegraph’s Saturday magazine about SBS for an article which marked the anniversary of the death of Sally Clark. The College’s attempt to reduce its carbon footprint made news in Scotland in a Herald article about how doctors can start to “heal the world”. The article stated that ‘The Royal College of Physicians and the Royal College of Paediatrics and Child Health (RCPCH) have adopted policies, dealing with heating, food, travel, use of green energy and improved use of technology, to become carbon neutral. Increasingly, large international conferences at exotic, carbon-expensive locations are being spurned in favour of video-conferencing and the RCPCH has appointed a champion for carbon footprint reduction.” Returning to the subject of child protection, the College worked very closely with the Science Media Centre (SMC) later on in March and invited national health and science journalists to a briefing. The expert panel was Rosalyn Proops, Alison Kemp, Reader in Child Health at the Academic Department of Child Health, University of Cardiff, Paul Davies, Consultant Paediatrician, University of Cardiff and Danya Glaser, Consultant Child and Adolescent Psychiatrist, Great Ormond Street Hospital and President of the International Society for Prevention of Child Abuse and Neglect (ISPCAN). The briefing was a successful attempt to educate and build awareness of the subject – The Times, The Guardian and BBC Online all wrote pieces afterwards. The College launched its new careers booklet towards the end of March. Aimed at 13 to18 year olds, it appeared in Children and Young People Now magazine as a new publication. April saw the publication of the new Physical Signs of Sexual Abuse book. The BMJ reviewed it and although many national health journalists came to the launch, only The Daily Telegraph wrote about it. The Annual Meeting in York attracted widespread attention again this year. The Epicure study’s latest results, new research on the pneumococcal bug and serotype 1 and a BPSU study showing an increase in cases of imported childhood malaria in the UK and the Republic of Ireland. The Annual General Meeting attracted a considerable amount of attention, covered in The Observer, Scotsman, BBC online and the local York press. In a statement afterwards, Patricia Hamilton said, “the proposed vote of no confidence was not supported by the AGM. Instead the wording was amended to read 'the College continues to have grave concerns over the current GMC procedures in child protection.' This amended motion was passed by the AGM, but still has to be taken to Council for a final decision. We look forward to continuing to work with the GMC to resolve these issues.”

We received the following letter in response to the pieces by Finlay Scott and Rosalyn Proops on Child Protection in the last Newsletter. – Ed.

Claire Brunert HEAD OF MEDIA

[A note for clarity: Finlay Scott’s figure of 8,400 complaints and enquiries is across all medical specialties, not just for paediatricians or child protection cases. – Ed.]

Page 4

I came into contact with the notion of Deliberate Harm to children through the work of Henry Kempe in 1968 and his subsequent visit to Christopher Ounsted in Oxford. It had been hard for doctors to accept the long established historical fact that some parents harm their children. There was even a “syndrome” of spontaneous stellate skull fractures. I later wrote against the notion of Non-Accidental Injury as a new sophistry still avoiding the notion of deliberate harm. I have since been in touch with several Children’s Doctors, in various ways, about complaints that have been made to the GMC or the NHS Ombudsman. What is overlooked both by Finlay Scott and Rosalyn Proops and so many others is that Child Protection issues have no close parallel in any other part of Medical Practice. Damage done to a child is an observable matter of medical fact. Who did that damage however is not accessible through the ordinary practice of physic. If anything it is a matter for detective work. Otherwise, who might have done what is a matter of “opinions”; guesses. Paediatricians will be educated guessers and their opinions will be very worthwhile attending to. But anyone can hold an opinion, however worthless it may be, and they may be opposed, in critical situations, to the paediatricians’ very much more informed ones. In one instance of my own experience the “fact” was that the child’s recurrent lapses into unconsciousness, previously referred to as “fits”, were due to the ingestion of sedatives found in the blood. My “opinion” was that it did not occur “accidentally”. The parents naturally gainsaid that opinion. Had they complained to the GMC, outraged at the implication of my “opinion”, how would the truth be better arrived at from the “opinions” of a GMC panel who could have no “clinical sense” of the matter at all? Even if the matter came to a court of law, the court’s findings are still yet another sort of “opinion” which does not alter the truth of the matter in any way at all even though I accept it is possible that I might not have arrived at it. My obligation was only to seek it honestly. What is particularly unnerving about a complaint to the GMC in such cases is that it involves yet another set of “opinions” about the paediatrician’s “opinion” and the parents’ “opinions”. All governance relies finally upon trust. The GMC in a large variety of directives reveal their lack of trust in doctors, in a sense it is their obligation; but they should find it unsurprising if this is reciprocated. Onora O’Neil explained this in her Reith Lectures Finlay Scott writes that the GMC dealt with 8,400 “enquiries and complaints” in a 20 month period. Surely “Complaint” is separable from “Enquiry”? Further, I do not think any complaint made to the GMC is dispassionate. The figures anyway suggest that the system is sorely taxed and perhaps a more local consideration of “enquiries” might save time and reduce the agony that arises from having irritated someone by having tried to do something that is not simply medical but that might yet save the life or better being of a child. Professor David C Taylor MD, FRCP, FRCPSYCH, HON. FRCPCH VISITING PROFESSOR, UCL INSTITUTE OF CHILD HEALTH


News

RCPCH news

Paediatricians needed in Africa and Asia As a VSO Paediatrician, you’ll directly work to address these challenges, combining clinical, management and teaching work. You’ll help strengthen vital services and build the paediatric expertise of national staff, the future of healthcare delivery in the country you work in. Most VSO Paediatricians work for 12 months to understand the challenges on the ground, build strong relationships, and help bring about long-lasting change. Over 10 million children under the age of five die every year, with 90% of these deaths occurring in just 42 countries. Most children lose their lives to preventable causes such as diarrhoea, acute respiratory infection, and malaria. Poverty underlies malnutrition, inadequate sanitation, and lack of access to clean water. But these factors are compounded by poor preventative care and weak health systems, with access to quality services most difficult for those who bear the greatest disease burden.

Have you got what it takes? VSO Paediatricians come from all phases of their career: registrar, consultant, junior doctor, recently retired. You’ll need to be a registered doctor with at least 3 years’ paediatrics experience. To take on a VSO role you’ll need the confidence and experience to cope with being the most senior clinician in many situations. You’ll have to be passionate about training others, as well as developing services.

Derby Community Paediatricians invited to the House of Lords The Derby community paediatric service was invited to the House of Lords to give evidence to the Narrowing the Gap hearing on 14 April 2008 aimed at identification of best practice in improving outcomes for vulnerable children. Narrowing the Gap is a two-year development and research programme funded by the Department for Children, Schools and Families and the Local Government Association. Launched in June 2007, it seeks to make a significant difference in narrowing the gap in outcomes between vulnerable children and the rest. The first phase included a comprehensive review of the current literature in this area. The next phase aims to gather and analyse validated evidence on what is working locally. A call for evidence resulted in over 120 submissions from a range of agencies and services, six of which were selected to attend a hearing at the House of Lords. The purpose of the hearing was to establish the key characteristics of effective practice from a range of front line children’s

service providers. A seven member panel chaired by Baroness Estelle Morris heard evidence from the selected services, detailing what they are doing locally to make a difference and narrow the gap in outcomes. The Derby community paediatric team, led by Dr Liz Adamson, gave a fifteen minute presentation then fielded thirty minutes of questions from the panel. Dr Adamson’s inspiring presentation outlined the history and development of community paediatrics, the key features of the community paediatric service in Derby, and the ways in which the service was overcoming the barriers to reaching deprived and vulnerable children. The team then answered a range of probing questions from the panel, exploring in depth the key components of the Derby model of care and how this could be disseminated and applied more widely. Key factors were strong clinical leadership, explicit strategic focus on reducing inequalities, and strong multiagency

The Royal College of Paediatrics and Child Health and VSO Year 3 or 4 SpRs, those in ST6 or ST7, can take part in RCPCH’s Fellowship scheme with VSO: allowing one years’ work internationally that may then be accredited towards training by the Royal College. Fellowship opportunities exist for those at ST3/4 level too. VSO and the College are committed to supporting the unique experiences international working can bring to a paediatrician’s career. VSO opportunities are open to paediatricians beyond their specialist training. We welcome the professional and personal experience those closing their career can bring to development work in global paediatrics. If you are interested and would like more information, please contact the VSO Enquiries Team on 020 8780 7500 or visit www.vso.org.uk/doctors

planning processes, all underpinned by a robust and comprehensive information system. The evidence was well received and the panel commented that it was refreshing to see an example of such excellence from the health services in terms of reducing inequalities. Afterwards the panel fed back to us that the work would form a strong basis for what happens next, and that we had left everyone in an optimistic mood about what is possible. A report on the proceedings, with a digest of all the submissions made, will be available in June 2008. Details of the programme can be found on www.lga.gov.uk/lga/core/page.do?pageId=234484

Left to right: Dr Veena Maharaj, Mrs Corinne Clemson, Dr Liz Adamson, Dr Fawzia Rahman.

Page 5


News Participation Update Youth Advisory Panel

Careers

The College now has a Youth Advisory Panel (YAP) with young people from across the UK from ages 11 to 21 years. Their role is to make sure that the College is listening to children and young people and to help us to see things from their point of view. They have already reviewed documents for several organisations, been invited to present at an NCB conference and provided material for the Adolescent Health E-Learning Project. At the first meetings the YAP felt that young people’s mental health needs more attention and resources as it effects more people than is currently known. They recognised the range of mental and emotional conditions that can affect young people and the consequences this can have for adult life. The group presented a guest lecture at the Annual Meeting in York ‘Mental Health: Our Top Priority’ and answered questions on how paediatricians could be more pro-active in helping teenagers with emotional problems. For more information see the Youth Advisory Panel section of the RCPCH website.

A new publication is available to all young people advising them about a career in paediatrics. This has been developed with the input of young people aged 13 to 19 years, paediatricians and medical students. Information includes qualifications required, personal experiences of medical training and facts on employment and career options. Anyone wanting a copy can download a PDF version from www.rcpch.ac.uk/cayp/careers-info/ or request hard copies for use at careers promotion events by emailing joseph.callanan@rcpch.ac.uk

Siblings Project This is a new short report detailing the opinions of siblings of children with disabilities and learning difficulties. Produced in partnership with Barnardo’s, it reveals the importance of siblings’ involvement with the medical aspect of their brother’s or sister’s care. Read it at www.rcpch.ac.uk/Policy

Participation Resource List You can also find a new resource list on the ‘Participation’ web page in the Policy section of the RCPCH website. This details a range of resources you may find useful for developing patient and family participation in your workplace. It also includes reports from previous participation studies and research with families and young people.

PCAG The Patients’ and Carers’ Advisory Group now has a ‘pool’ of 20 parents/carers. RCPCH can use our lay representatives’ knowledge and experience to its best advantage on project boards, committees or by sending items for our attention at our meetings. There is one vacancy for a consultant paediatrician member of PCAG. For more information on this opportunity and any other correspondence please contact pcag@rcpch.ac.uk Sophie Aukland CAYP PARTICIPATION MANAGER

Expert Patients Self Management Workshops Dr Kathy Hawley Expert Patients Self-Management Workshops for 12-18 year olds living with chronic conditions. The Staying Positive Programme consists of 3 structured workshops covering issues like medication adherence, school work, communication and sexual relations. These are delivered by teams of 3 young facilitators (average age 17 years) who also have a condition. Three of the key findings of the evaluation in October 2007 by Oxford University Department of Primary Health Care were: • Facilitators who have a chronic condition are a key factor in achieving the aims of the workshops. • Young people became aware of the importance of self care, medication adherence and of the consequences of poor management. Teenagers with asthma and type 1 diabetes reported positive changes in their attitude to taking their medication in public places. • Workshops helped young people to understand the importance of talking to doctors directly. For further information or copies of the DVD, contact Jim Phillips jim.phillips@eppcic.co.uk telephone 01225 731421

Joint RCPCH-HPA project developing evidence based guidelines on infectious diseases The Royal College of Paediatrics and Child Health and the Health Protection Agency have been awarded a significant grant by the European Centre for Disease Prevention and Control (ECDC) to write evidence based guidance on 56 infectious diseases. Guidance will be developed for professionals and also the public, which will be translated into 23 European languages for publication on the ECDC website. The guidance will be Europewide so it is creditable to have won this

Page 6

tender in competition with other countries. The project has been underway since the start of 2008 and the guidance should be complete by the autumn. The project is being led by Dr Mike Sharland, Dr Jeremy Hawker and Dr Anna Sharma. Other college Fellows on the UK steering committee are Dr Martin Richardson, Dr David Elliman and Dr Helen Bedford. The information sheets aimed at the public will be developed so that they are

accessible to a younger audience. The RCPCH Youth Advisory Panel and a group of young parents will be asked to comment on the appropriateness of language, format and overall usefulness of the information sheets and their recommendations will be fed back for producing the final public documents. Those interested in the project are welcome to contact Dr Mike Sharland: mike.sharland@stgeorges.nhs.uk or Dr Anna Sharma: anna.sharma@hpa.org.uk. Susan Mitchell RCPCH HEAD OF HEALTH SERVICES


RCPCH news

News

Workshop on Child Health in Cuba The Third International Workshop on Child Health in Cuba was held in Camaguey on 3-5 March 2008. The three day event involved health professionals from overseas who learnt about health care of children in Camaguey in Cuba. The workshop also involved a scientific exchange of ideas between Cuban doctors and speakers from overseas. Two British paediatric trainees (Dr AnnaLouise Nichols and Dr Rima Al-Saffar) attended the workshop. On the first day they visited a family doctor’s surgery and a newly built polyclinic. Both are key components of the primary health care system with a strong focus on prevention of illnesses. In the afternoon the group visited the Children’s Hospital in Camaguey where the new Director, Dr Deybis Sánchez Miranda gave a presentation. There were also several posters highlighting both research and case reports from the doctors in Camaguey. The themes of the second day were ‘Infections and antibiotics’, ‘Treatment of epilepsy’ and ‘Paediatric oncology’. Each session involved a speaker from Cuba alongside an international speaker. The Children’s Hospital in Camaguey has an active Therapeutics Committee which has developed antibiotic guidelines for use in

different clinical settings. Dr Yoicet Ruiz de Villa Martinez described the work that was undertaken in primary care to ensure that antibiotics were not used indiscriminately. One of the Cuban speakers, Dr Angel Escobedo from Havana, described how he worked with a Cuban children’s TV programme to highlight the importance of children washing their hands to prevent gastrointestinal infections. The final day focused on ‘Pain and sedation in neonates and critically ill children’. The management of sedation in critically ill children in Camaguey was very similar to that in the UK. The final session focused on ‘Child health in Latin America’ and Dr Deybis Sánchez Miranda described his work in Venezuela in the three year period prior to his appointment as Director of the Children’s Hospital. Dr Juan Carlos from Peru explained how he, like many other Latin American students from deprived communities, had received free medical education in Cuba on the understanding that he would return home to provide medical care for deprived communities. He is continuing his education in Cuba and wishes to go back to Peru as a qualified paediatrician. There were international speakers from

Training Update The past year in the Training Department reminds me of bright winter and spring days spent watching farmers work in the fields. They worked many long hours preparing the ground before they could sow their new crops, so that those crops had the best chance of success. The training environment has changed so much and in such a short space of time that much preparation time has been required, and many hours have been spent by all those involved in the wider training department – the Officers for Training and Assessment, the many committee members and not least the College staff. All have contributed to enable us to fulfil our new obligations to our trainees, trainers and regulators. Not all of that work is visible but gaining a successful outcome depends upon it. So are we progressing towards a successful outcome? Well, it is not always as speedy as I would like, but we are progressing, slowly but surely! We now have a register of our trainees, which is reasonably accurate, though some have left it rather late in the day to enrol – if you are late, send in your form NOW! (If you were one of the earlier enrollers, thank you and could you please update your details via

the website, to ensure that we have the latest and most accurate information). To help us build a more structured and ordered process for the future, we have scheduled three “seasons” each year for enrolment – the first of which will be in June and we would ask all those recently appointed to posts beginning in August/September to enrol during this time. In this way, your assessment account and your e-Portfolio account should be ready for the start of your training year. To all SpRs: please complete an enrolment form and send it in to us. Although you may be in membership already, there is other information on the enrolment form not collected through membership. You may take up workplace assessments and e-Portfolio if you wish (or if your deanery wish you to) but you can indicate your preference on the form. We have also been processing assessments via HcAT, though not as many as we expected. There have been glitches in the system (mostly corrected now) but there are many assessments yet to be completed and a number of trainees may well appear before their ARCP without having completed all their required assessments.

Canada, Italy, the United States of America as well as the United Kingdom. It is anticipated that several collaborative research projects will be undertaken following the workshop. The workshop concluded with a salsa evening where the Cuban doctors tried to teach the doctors from overseas how to salsa. Both British trainees managed this interactive part of the workshop exceptionally well! There will be a further workshop in March 2009 and individuals interested in attending should contact Imti Choonara (Email: imti.choonara@nottingham.ac.uk).

For the late enrollers, we are trying to arrange for a late round of e-SPRAT and we need all who have not yet enrolled to do so as a matter of urgency (see enrolment page on RCPCH website). For assessors, you will find two CDs included with this newsletter. One contains the presentations given at the Training the Trainers days in June last year and the other is particularly geared towards feedback. We are grateful to Dr Simon Frazer and colleagues who have spent much time on the content of our e-Portfolio and we hope to roll this out to all trainees by the end of the summer. Champions for each region are being trained over the next few weeks and I am hoping that rollout will begin in mid July. We will be staging this process over a number of weeks, and we will notify your regional representatives of the timetable for your region as we come closer to the date. Do keep an eye on the Training section of the website, and do take a look at the Trainees Committee page on which you will find details of your Trainee Representatives. I feel sure they will be happy to hear from you. Christine Cooper HEAD OF TRAINING

Page 7


News The RCPCH has moved! As noted in the last Newsletter, the College’s London offices moved over the Easter weekend. Thanks to the efforts of the project group and our Facilities and IT Departments, everything was seamlessly in place when staff returned after the long weekend. The new offices offer space for us to have all staff on one site, as well as more meeting rooms, a social area, and a new larger members’ room with computers for use. Some of these facilities are pictured here, and a fuller virtual tour can be found on the website.

Reception.

Exterior of the new building.

Meeting room.

Developing a ‘good’ guideline – how we can help Developing a guideline isn’t easy and developing a ‘good’ guideline is even harder as anyone who has ever tried will tell you! Clinical guidelines are increasingly being developed to help improve health outcomes for children and to help reduce unacceptable variations in clinical practice. However, guidelines can only be effective if they are developed to the highest standards and are based upon the best available evidence. The Clinical Effectiveness team, overseen by the Quality of Practice Committee, provides support and methodological advice to paediatricians seeking to develop guidelines to help ensure that it meets the College’s standards for guideline development and to help it through the appraisal and endorsement process. As a minimum, a guideline should include information on, and meet, all the key criteria of the AGREE instrument which is an assessment tool for the quality of a guideline. The team uses the instrument when working with guideline developers to ensure rigour of development and explicit and transparent reporting of the processes used to develop the

Page 8

guideline by for example, ensuring that systematic methods were used to search for the evidence, that the criteria for selecting the evidence are clearly described or that there is an explicit link between the recommendations and the supporting evidence. A good guideline should be externally reviewed by experts prior to its publication. The team can help with this by drawing upon the expertise of the RCPCH Consultation Panel, identifying those who are likely to be users of the guideline to comment on its clinical content and how easily it can be used in practice. Recently the team have supported groups developing guidelines on Sleep Disorders and The Diagnosis of Brain Tumours and feedback so far on the support we have provided has been positive. The team can also recommend useful resources where you can find out more about developing guidelines and how to make sure it is a ‘good’ guideline. So contact us if you are planning on or have already begun developing a guideline and you would like help to ensure it meets College standards.

“The Gallery”.

Further support with guideline development is available by attending our “Developing a Good Guideline” workshop which is held each year at York. This includes small group work facilitated by an expert to learn more about key aspects of guideline development such as identifying and selecting the evidence using specific examples. Contact us to book a place for 2009. The College also holds guideline events each year at York where developers of College-endorsed guidelines including NICE and SIGN are invited to present the guideline including methods used, key messages and information about how to implement it. In addition, a joint RSM/RCPCH guidelines day is being planned for October 2008 to present and discuss a range of NICE/SIGN guidelines relevant to child health. If you would like more information about any of the above then please contact Katie Jones/ Helen Booth by phone on 020 7092 6165/6 or by email at clinical.effectiveness@rcpch.ac.uk or visit our website www.rcpch.ac.uk/research/ce. Rita Ranmal CLINICAL EFFECTIVENESS CO-ORDINATOR


RCPCH news

News

Spring Meeting The 12th Annual Spring Meeting took place on 14-17 April 2008 in York. The University campus displayed its usual April delights in the form of flowers and wild life. Despite a piercing cold snap, participants enjoyed a warm and convivial ambience throughout the week. The scientific programme was rich and varied. Professor Gregory Holmes from Lebanon, New Hampshire gave the 2008 Windermere Lecture on ‘Developmental consequences of early seizures’. There were symposia on breastfeeding and medicines for children. The ‘5 x 5 hot topics’ symposium proved a particularly successful format, The Princess Royal attended the Wednesday plenary session, during which she presented the James Spence medal to Sir Alan Craft and certificates to this year’s Honorary Fellows. Highlights of the meeting, including all of the plenary keynote lectures, will be displayed on the College website. The 13th Spring Meeting will be in York 30 March-2 April 2009. Aiming for content of the highest quality, the Academic Board is planning a rejuvenated programme. The meeting will open with a ‘3 x 5 hot topics’ CPD session on Monday afternoon. By popular demand, the plenary sessions will move to mornings on Tuesday, Wednesday and Thursday rather than the afternoon. Other changes include more parallel sessions organised jointly between specialty groups, more posters and a clearly signposted CPD pathway through the week. The Annual Dinner will be held on Wednesday rather than Thursday evening, with black-tie optional, to encourage as many fellows, members and guests as possible to attend. The programme will be displayed on the College website in due course; registration will open in early December. Put the dates in your own diary now and encourage your colleagues to attend! Rosalind Topping HEAD OF EDUCATION

Admissions Ceremony Monday evening 14 April.

Alistair Tompson VICE PRESIDENT, EDUCATION RCPCH/VSO Group.

Central Hall, University of York.

HRH The Princess Royal and RCPCH President Patricia Hamilton.

Admissions Ceremony attendees.

Professor Sir Alan Craft receiving the James Spence Medal from HRH The Princess Royal.

Professor Sir Graeme Catto, GMC President.

Medical Student Prize Winners.

Page 9


News Achieving Equal Protection for Children

‘Parliament passes bill to outlaw all corporal punishment of children in England.’ If you saw this headline would you be pleased that paediatricians had been part of the movement to bring about this change? The Royal College has been signed up in support of the Children are Unbeatable! Alliance (CAU!) for many years. The Alliance brings together more than 400 organisations, including the NSPCC and all the major children’s organisations, seeking a change in the law to give children the same protection as adults from being “smacked” or hit. There is still majority public opinion in the UK against banning smacking – but surely paediatricians should now be in the forefront of campaigning for this reform, which is speeding fast across Europe? In the EU, now only five of the 27 member-states, the UK among them, have not either completely banned all corporal punishment or publicly committed themselves to doing so in the near future. We hope you will become part of a paediatric movement to help sway Parliament to vote in favour of equal protection for children: there will be an opportunity for MPs and Peers to vote on the issue this summer. In Sweden, which was the first country to legislate against smacking back in 1979, paediatricians were part of the movement which influenced public opinion by mounting an exhibition in Stockholm to illustrate graphically the physical effects of corporal punishment. So the Royal College’s Advocacy and Child Protection Committees are asking all paediatricians who care about the continuing high prevalence of violence against children (www.cardiff.ac.uk/news/articles/violenceinjuries-fall-12-per-cent.html) to stand up and speak out, as our influence

Page 10

at this critical time could make the difference. The last Parliamentary vote on this issue was in 2004. Then, the Government refused to allow a free (conscience) vote on providing children with equal protection from being hit. Instead, section 58 of the Children Act 2004 was introduced. This allows parents and some other carers to continue to justify common assault as “reasonable punishment”. This defence can no longer be used by those charged with actual or grievous bodily harm or wounding. But it fails to satisfy children’s equal human right to respect and fails to provide a clear and logical basis for child protection and the promotion of non-violent child-rearing. This summer, Parliament will be asked again to accept that children – the smallest and most vulnerable of citizens – deserve at least equal protection from assault. This is a fundamental issue of equality and human rights. No government would defend any level of violence against any other population group – so why children? The UK is under considerable European and international human rights pressure to change the law, and in 2006 the UN Secretary-General’s Study on violence against children called for universal prohibition of violence against children including all corporal punishment, setting a deadline of 2009. This will also be an issue likely to receive adverse comment from the UN Committee on the Rights of the Child in its report later this year on the UK’s progress in implementing the UN Convention. For the RCPCH and for most paediatricians in the UK, this is a basic issue that speaks to whether or not we are a child friendly country, putting children’s best interests first. Smacking is invariably an attack on a child’s human dignity and physical integrity, can lead on to serious abuse, and teaches children nothing about how we want them to behave. In fact, it’s a lesson in bad behaviour. The aim of this legal reform is not of course to send more parents to prison. The purpose is to change attitudes and actions. The Royal College has agreed with the other organisations involved actively in child protection that equal protection can and must be implemented ion the best interests of children. Law reform will need to be accompanied by widespread education on children’s right to protection and on positive, non-violent parenting – not well understood by many members of the British public, but well evidenced and covered in the RCPCH publication, ‘Helpful Parenting’ (RCPCH, May 2002). If you agree with us, please help. The following actions will make you part of the solution rather than part of the problem: • Join CAU!; you can sign up to the campaign at www.childrenareunbeatable.co.uk. • Sign the letter which is on the Advocacy website (www.rcpch.ac.uk/ advocacy) and send it to your MP as soon as possible. If possible, personalise this letter with your own views, and send a copy to info@endcorporalpunishment.org. • Encourage friends, family or work colleagues to send a campaign postcard to their MP. Go to www.childrenareunbeatable.org.uk/postcard-request.php or call 0207 713 0569. Tony Waterston, CHAIR OF ADVOCACY COMMITTEE Rosalyn Proops, OFFICER FOR CHILD PROTECTION Peter Newell, COORDINATOR, CHILDREN ARE UNBEATABLE! ALLIANCE


RCPCH news

News

A New Project to Develop Integrated UK/WHO Growth Charts The RCPCH has been commissioned by the Department of Health to undertake a project to develop new growth charts for weight, height and head circumference (and BMI) from birth to 5 years with all supporting educational materials. This exciting project, which is being run within the RCPCH Research Department, is being led by Professor Charlotte Wright from Glasgow University. The new growth charts will follow the recommendations made by Scientific Advisory Committee on Nutrition and

combine the WHO data on breastfed babies from two weeks to two years with the UK 1990 growth charts currently in use. The project team has already started working on a prototype for a new chart which will be evaluated by both professional and parental groups during the early summer. It is anticipated that the final prototypes will include a new A3 community chart and preterm chart as well as charts for the Personal Child Health Record.

The process will also inform the development of training materials which will also be rigorously field tested via various educational settings before they are published in the form of a toolkit of training materials for PCTs directed at the relevant health professions, parents and carers. The aim is that the new integrated charts and the educational packages will be ready for full implementation across the UK in March 2009. For further information please contact: Catriona Macintyre-Beon, Project Co-ordinator RCPCH Email: Catriona.Macintyre-Beon@RCPCH.ac.uk

Adolescent Health Project e-learning

Safer Practice in Neonatal Care Project

Many thanks to all who came to visit us in the Exhibition Hall at the College Spring Meeting in April. We were sincerely enthused by your encouraging support and confirmation that there is a dire need for training resources focused on young people’s health. The project is in budget and on target to be launched in June, and will provide e-learning training materials to health professionals at all levels and across all professions. The materials will be free of charge to all registered users. Registration will be through a managed process on a secure website accessible via the College website www.rcpch.ac.uk/AHP. The curriculum for the Adolescent Health Project maps across the competences for all relevant Royal Colleges and consists of 14 modules covering 30 topics ranging from health promotion and youth friendly services to self-harm and obesity. As well as trainee focused pathways, learners and educators will have the ability to create individual learning pathways through the materials. If you would like to be informed when these exciting resources become available to you, then please send an email to ahp@rcpch.ac.uk. Updates will also appear on the project’s website www.rcpch.ac.uk/AHP.

Main objectives: to develop and test specific neonatal care bundles and improve analysis, sharing and learning from patient safety incidents, working with the NRLS to improve this process.

Newborn babies who require hospital care are among the most vulnerable of all patient groups. This two-year project is being undertaken by the Research Division in partnership with relevant royal colleges, healthcare professionals, advocacy groups and families.

Care Bundle definition: “A group of evidence based interventions related to a disease or care process that, when executed together, result in better outcomes than when implemented individually”. Methodology: Three expert working groups have been established to develop bundles in Transport, Medication errors (gentamicin specifically) and Blood borne infection. Full teaching will be provided to those participating sites prior to implementation. The bundles are designed to be part of day to day care and will run for 3-4 months. Feedback will be given throughout the study, and the project completion is due in February 2009. Project Lead: Prof Neena Modi, Imperial College, London Contacts for further information: Clare Litherland, RCPCH (clare.litherland@rcpch.ac.uk), Anita Dougall, NPSA (anita.dougall@npsa.nhs.uk)

Podcasts from Archives in Disease in Childhood We are delighted to offer you our first podcast. Harry Baumer, a consultant paediatrician from Plymouth, UK who writes about guidelines for ADC and Ian Balfour-Lynn, an associate editor in paediatric respiratory medicine at the Royal Brompton in London, discuss the new National Institute of Health asthma guidelines, comparing these recommendations to those of the British Thoracic Society. In the podcast they discuss: 1. Use of inhaled cortical steroids in infants 2. What are the side-effects of ICS

Managing editor: Graham Sleight

RCPCH news

Editor: Joanne Ball Email: newsletter@rcpch.ac.uk

Copy deadline for next issue:

Editorial services: Chamberlain Dunn Associates

1 August 2008

Advertisements: British Medical Journal

3. Are long-acting beta agonists safe in children 4. What are the differences between the NIH and BTS recommendation regarding environmental approaches to asthma. We have posted both a short (18 minutes) and long version (28 minutes) of their discussion www.adc.bmj.com/podcasts/podcasts.dtl Please email us your thoughts about this podcast (howard.bauchner@bmc.org) and suggestions for future ones. Janet O’Flaherty PUBLISHER, ADC

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 © 2008 Royal College of Paediatrics and Child Health. The views expressed in this newsletter do not necessarily reflect the official positions of the RCPCH.

Page 11


News SASG news

Thank-you to all those who attended the SASG business lunch at the RCPCH annual scientific meeting in April. There was a lively debate, and we are trying to identify speakers to tell us more about the topics you raised at our annual SASG information day in our new College buildings in London on November 14th. More information and an application form are on the flyer sent with this newsletter. Please can I suggest you put this date in your diaries? It will be a chance to find out more about how to make the most of our grade, as well as an opportunity to visit the new RCPCH building.

In April, our College hosted a meeting for the Chairs of SASG groups from the other Royal Colleges. The aim was to explore what each College does to support its SASG doctors so we can learn from each other. I will keep you informed of the progress we make. I see this as an exciting project.

Mainstreaming care for sickle cell and thalassaemia

the Programme has published a parent’s handbook consistent with these standards. These were developed with the support of a wide range of clinical and patient stakeholders. They complement existing guidelines for the management of children with thalassaemia developed in 2005 by the UK Thalassaemia Society, and the RCP guidelines for the diagnosis and management of acute stroke in Childhood. The Programme is asking that the RCPCH formally endorse the standards for both conditions and use them as the model for developing awareness and skills.

Things seem to moving quite quickly for our group of doctors. Finally we have been offered our new contract: whether to accept it is for individual doctors to decide on. All doctors who accept the contract will have at least one PA (pro rata) for supporting activities. As a College, we are committed to the importance of continuing professional development, audit and appraisal, so it feels positive that our group of doctors will now have proper time to carry out these activities.

Once the preserve of a few inner city specialists, sickle cell disease is now arguably the most common genetic condition in the UK. Increasingly, both screening and care for haemoglobinopathies are becoming part of the mainstream within the NHS. The parents of every newborn in England are now offered screening for sickle cell as part of the Newborn Bloodspot test. Each year this has meant that a cohort of more than 300 affected children have been referred to paediatric services for follow-up and about 9,000 newborn carriers are also identified. As screening achieves this mainstream status within the NHS, we are working with the Department of Health to develop quality care throughout England. We strongly believe that an ethical antenatal screening programme should offer genuine choice to parents. If parents choose to have a child with sickle cell or thalassaemia, they should be able to count on quality care wherever they live in England. This remains a particular challenge because knowledge and expertise that has traditionally been concentrated in urban areas. Paediatricians and child health professionals are vital contributors to effectively developing a model for a managed clinical network. The Programme is currently working on this process with key stakeholders. The RCPCH is represented on the DH stakeholder group, that is leading on these changes, is Dr Olu Wilkey. There are two key areas where the Screening Programme is asking for support from the RCPCH: training and a formal endorsement of the established guidelines for care.

Page 12

Call for members to comment on competencies Dr. Olu Wilkey has put out a call for College members to comment on the proposed competency framework. Once agreed, these competencies will become part of the college’s core training offering. Key suggested additions are listed here. Members should contact Dr Wilkey at Olu.Wilkey@nmh.nhs.uk to give feedback

Proposed competency framework additions: • Aware of the other acute presentations and complications of sickle cell disease including acute stroke, priapism, splenic sequestration and acute chest syndrome • Able to manage these complications and know when to transfer to specialist hospitals • Able to understand the principles and practice of stroke prevention in sickle cell disease • Aware of the chronic complications of sickle cell disease, thalassaemia and iron overload • Be competent in the management of these conditions in a day unit and outpatient setting. Clinical standards In October 2006, the UK Forum on Haemoglobin Disorders published standards and guidelines for the clinical management of children with sickle cell and, more recently,

So I hope to see you in November! Dr Nataile Lyth CHAIR OF THE RCPCH SASG COMMITTEE

Further information • Clinical standards for management of children with sickle cell; parents guide and other support materials can be viewed and downloaded at: www.sct.screening.nhs.uk • View the clinical standards for the care of adults and children with thalassaemia at: www.ukts.org. An updated version will be available in June 2008. • Find out more about the work of the UK Forum on Haemoglobin Disorders at: www.haemoglobin.org.uk/ • Sickle Cell Society: www.sicklecellsociety.org • Information and professional development resources across the antenatal and newborn screening programmes can be found at: www.screening.nhs.uk/cpd/home.htm

Dr Allison Streetly DIRECTOR, NHS SICKLE CELL AND THALASSAEMIA SCREENING PROGRAMME


News BPSU Activities

RCPCH news Online member look-up

Call for Sir Peter Tizard Bursary Applications The RCPCH is once again inviting applications for the Sir Peter Tizard Research Bursary from paediatricians wishing to undertake an epidemiological surveillance study through the British Paediatric Surveillance Unit. The successful applicant will receive up to £15,000 towards the costs of a surveillance study. Details on eligibility and an application form are available from aaron.barham@rcpch.ac.uk or via the web at www.bpsu.inopsu.com/home/tizard_bursary.html Closing date is 13 June. This will be the 6th year that this bursary has been offered the 2007 bursary being awarded at the RCPCH meeting in York (inset) to Dr Beth Chessbrugh for her application on Glutaryl-Coenzyme A dehydrogenase deficiency (GDD).

Dr Beth Chessbrugh receiving the Sir Peter Tizard Bursary Award.

Evaluation of the units activities The BPSU is currently in the processes of evaluating its activies. Following Communicable Disease Surveillance – Atalanta guidelines on surveillance evaluation we will identify areas within the BPSU process that may require adjustment, development or change. Part of the process is to ask a selected sample of those who return the orange card or are investigators for their opinions. If you have been one of those selected please take time to complete the short proforma. Results of the evaluation will be used in preparing future grant applications. Richard Lynn BPSU SCIENTIFIC COORDINATOR

When the new College website was launched in 2007, one of the extra features provided was an online facility to look up the contact details of another member. This facility is only available to College members, who need to sign up for a user-name and password via the page at www.rcpch.ac.uk/membership/create-account/ . Once that has been done, the member search can be used at www.rcpch.ac.uk/Membership/search. Members can also use the website to update their contact details when they move. As of June 2008, we are very pleased that more than 4,500 members (that is, almost half of all members) have signed up for user-names and passwords. The search facility is being well-used, and the range of member-only content on the website is also expanding. Related to this in 2008, for the first time, the College will not be producing a print version of the Handbook listing all members’ contact details. This is partly a response to escalating print and postage costs, and partly to those members who have raised the question of the environmental impact of producing such a large volume every year. However, we are aware that a number of members – especially senior members – may not have internet access, and so may not be able to use the online look-up facility. For those members, the following RCPCH Membership Department phone numbers are available to call with any queries as to the address details of other members: 020 7092 6061/2/3. For security reasons, members using this service will be required to provide information (eg GMC number) to help verify their idenity.

RCPCH Call for nominations All job descriptions along with application forms can be downloaded from the College website at:

www.rcpch.ac.uk/nominations Applications deadline for the current round of nominations is Friday 25th July 2008

Page 13


Trainees The RCPCH is already thinking about innovative ways to facilitate training for IMGs.

Trainees’ column

ST7 assessments The Trainees Committee continues to play an important and active role in the discussion and decisions made at the College. We advocate for all Paediatric trainees and we are keen to hear trainees’ views and questions. Contact details of the regional representatives, Chair and Vice Chair are available on the RCPCH website

Spring Meeting The RCPCH meeting has once again been both enjoyable and successful with a touch of controversy at the AGM. The Trainees’ meeting on the Wednesday was unfortunately poorly attended this year. However, despite the more intimate nature of this meeting it was still a success with excellent and informative presentations on Education from Dr Chris Verity, E-portfolios by Dr Simon Frazer and an MMC and Training update by Dr Mary McGraw. The trainees who attended raised some important issues regarding staffing and training, which has prompted further discussion and action by the Trainees Committee. We are hoping that next year trainees will use this open forum to present any issues they have to the Trainees Committee and our senior colleagues.

MMC Feedback on the current system of recruitment in Paediatrics for 2008 has been positive with a high appointment rate to Specialty training posts. A number of FTSTA posts remain unfilled. There will be no second round and recruitment to remaining posts will be locally led. Four stakeholder events are being held around the country by the MMC team. These are in London, Leeds, Birmingham and Bristol. This is with a view to planning MMC for 2009 and beyond. This is a chance for any trainee at any level to voice their opinion. Details of these events are on the MMC website. The MMC programme board continues to work towards to improving the recruitment process and training in the future.

IMG issues Two years ago, the Department of Health issued guidance to the NHS to control access to postgraduate training places for doctors graduating outside the European Economic Area (EEA). Following protracted litigation, the House of Lords ruled on Wednesday 30 April 2008 that this guidance was unlawful. The Department of Health are considering this ruling carefully as there are a consultations and complex issues outstanding. We hope that this may provide a basis for the DH to expand IMG placements within the UK workforce.

British Society for History of Paediatrics and Child Health Founded in 2002, the BSHPCH is a wellestablished and thriving society dedicated to the history of paediatrics and child health. Recognised as a special interest group of the RCPCH, it meets biannually, at the spring meeting in York, and in the autumn elsewhere in the UK. The spring meeting is the venue for the George Armstrong Lecture, which was given this year by Dr Morrice McCrae, on ‘Childhood rickets: two medical traditions’. In 2007 it was delivered by Professor John Pearn from the University of Queensland, Australia, who spoke about Armstrong’s struggle to establish the first dispensary for children in London in 1769.

Page 14

It is a PMETB requirement that all trainees in every specialty are assessed prior to CCT. Work is ongoing to provide a fair and appropriate method of assessing trainees at this level. Volunteers will be required during the pilot stage.

Recruitment Survey At the recent Trainees meeting, one of the main problems identified was recruitment shortages. The Trainees Committee is about to issue a short online questionnaire to regional trainees asking about specific issues in this area. Your help is vital for us to try and alleviate some of the current problems

Vacancies for the Trainees Committee Posts for Vice Chair of the Trainees Committee and South Western deputy will be shortly advertised. I would encourage interested trainees to apply. Some committee experience is desirable for the post of Vice Chair.

Dr Paul Dimitri Chair, Trainees Committee pauldimitri@hotmail.com

Autumn Meeting September 2008 and William Cadogan Prize The Autumn meeting will be on 12th and 13th September 2008, hosted by Professor Euan Ross at the Courtauld Institute in the Strand, London, with a dinner at the Athenaeum Club. It is the venue for the William Cadogan Lecture, given by the winner of the eponymous prize. Sister Societies of Medical History The BSHPCH is affiliated with the British Society for the History of Medicine (www.bshm.org.uk), whose website includes details of the activities of other societies in the UK. The BSHPCH is keen to attract new and young members, including students of the history of medicine and science related to paediatrics and child health, as well as paediatricians. Those who wish to attend the Autumn meeting and/or submit a paper, join the BSHPCH, or obtain details of the William Cadogan essay prize, should contact the honorary secretary, Professor Lawrence Weaver at lweaver@clinmed.gla.ac.uk Professor Dan Young PRESIDENT OF BSHPCH


RCPCH news

Meetings RCPCH meetings UK meetings and courses 2008 2 July 2008 Investigating Infants with Suspected Child Abuse Venue: Cardiff Contact: Elen Evans Tel: 02920 743141 Email: EvansEM5@cardiff.ac.uk Website: www.bacch.org.uk/downloads/conferences/ investigating-infants_info.doc 2-3 July 2008 Middlesbrough Developmental Paediatric Symposium Venue: James Cook University Hospital, Middlesbrough Contact: Nicky Skippon Tel : 01642 282534 Email: Nicky.Skippon@stees.nhs.uk Website: www.conferencessouthtees.co.uk/paediatricsymposium-c100009.html 3 July 2008 Non accidental head injury in children: the evidence base Event Organiser: Radha Singh Tel: 0207 825 2760 rsingh@nspcc.org.uk 3-4 July 2008 3rd Neonatal and Paediatric Cardiac Intensive Care Course Venue: London Website: www.ich.ucl.ac.uk/education/short_cou rses/courses/2T27 4th July 2008 Care of the Critically Sick Child in the District General Hospital Venue: John Innes Centre, Norfolk & Norwich University Hospital, Norwich Contact: Dr Mary-Anne Morris Tel: 01603 289936

4 July 2008 Nutritional models of the Developmental Origins of Adult Health and Disease Venue: University Hospital, Nottingham Contact: Professor Michael Symonds Email: Michael.symonds@nottingham.ac.uk 7-11 July 2008 Parenting and Child Health – determinants, interventions and outcomes Venue: Warwick Medical School, Coventry Contact: Annette Finn Tel: 024 7652 2035 Email: cpdenquiries@warwick.ac.uk Website: www.warwick.ac.uk/go/childhealth 7-8 July 2008 Paediatric and Infant Critical Care Transport Course (PICCTS) Venue: Glenfield Hospital, Leicester Contact: Sam Thurlow Telephone: 0116 2502305 Email: sam.thurlow@uhl-tr.nhs.uk 14-17 July 2007 Techniques & Applications of Molecular Biology Venue: University of Warwick, Coventry Contact: Dr Charlotte Moonan Tel: 024 7652 3540 Email: Charlotte.Moonan@warwick.ac.uk Website: www.warwick.ac.uk/go/bioscienceshort courses 14 July 2008 RCPCH The Physical Signs of Child Sexual Abuse Venue: University Hospital, Cardiff Contact: BASPCAN Tel: 01904 613605 Email: conferences@baspcan.org.uk Website: www.baspcan.org.uk/events.html 21 July 2008 RCPCH The Physical Signs of Child Sexual Abuse Venue: RCPCH, London Contact: BASPCAN Tel: 01904 613605 Email: conferences@baspcan.org.uk Web: www.baspcan.org.uk/events.html

Allergy & Non-Infective Immunological Respiratory Disease The 10th Annual Summer Symposium in Paediatric Respiratory Disease will be held at the Sheffield Conference Centre Thursday 3rd and Friday 4th July. It is aimed at Respiratory Specialists and trainees, but the theme this year may well be attractive to those specialising in allergy and immunology. This meeting has an outstanding reputation for the quality of its faculty and the quality of discussion. The meeting has an international faculty, and seeks to promote discussion and debate focusing on a single thematic area. Key to the on going success of the meeting is that it aims

28 July 2008 RCPCH The Physical Signs of Child Sexual Abuse Venue: St James’ Hospital, Leeds Contact: BASPCAN Tel: 01904 613605 Email: conferences@baspcan.org.uk Website: www.baspcan.org.uk/events.html 1 September 2008 Clinical Audit and Improvement: Monitoring and Improving Clinical Practice and Outcomes Venue: Manchester Conference Centre, Manchester Contact: Hannah Parker Tel: 020 8541 1399 Email: hannah@healthcare-events.co.uk Website: www.healthcare-events.co.uk 1 September 2008 Lean and Six Sigma Venue: Manchester Conference Centre, Manchester Contact: Hannah Parker Telephone: 020 8541 1399 Email: hannah@healthcare-events.co.uk Website: www.healthcare-events.co.uk

Worldwide meetings and courses 2008 24-28 October 2008 The 2nd Congress of the European Academy of Paediatrics KENES International 1-3, Rue de Chantepoulet PO Box 1726, CH-1211 Geneva 1, Tel: +41 22 908 0488 Fax: +41 22 732 2850 Email: paediatrics@kenes.com Website: www.kenes.com/paediatrics

to involve the participants in discussing areas that are challenging and at time controversial. The format has always been short, focused lectures by experts in the field, followed by plenty of time for discussion. The meeting is at Sheffield Conference Centre, a comfortable modern venue with single en suite accommodation. There is a conference dinner on the Thursday evening, which is included in the conference fee of £230. For further details please contact Dr Jayesh Bhatt or Wendy Appell, Department of Paediatrics, City Campus Nottingham Tel: 0115 969 1169 ext 39396 wendy.appell@nuh.nhs.uk or visit the BPRS website www.bprs.co.uk.

Page 15


Want to keep up to date with the BNF and BNF for Children? Sign up to our free e-newsletter designed to alert you to the latest changes that are influencing clinical practice.

Newsletters will be sent to you by email, several times a year, and will include: • • • •

Details of significant updates Tips for using the BNF and BNFC effectively Latest developments on BNF publications Links to examples of prescribing excellence and case studies

If you would like to receive this essential information, please register now at bnfc.org or bnf.org


RCPCH Newsletter 08 Summer