RCPCH Notes - Summer 2010

SUMMER 2010 NEWSLETTER

ROYAL COLLEGE OF PAEDIATRICS AND CHILD HEALTH

Notes

Revalidation pilots underway to test out new systems and processes.

Sarah Fellows, Dr Alistair Thomson

The Revalidation Support Team (RST, Department of Health England), has selected several NHS pilot sites for a series of ‘pathfinder pilots’ in England to test new processes planned for revalidation.

The pilots will run from January 2010 until April 2011 and will test a range of processes, including:

specialty revalidation standards (by selfassessment and appraiser assessment);

revalidation (or not) based on information resulting from appraisals.

• Use of strengthened appraisal forms to record outcomes of appraisals;

Doctors (both appraisers and appraisees) spread of specialties, sectors and different

• Collection of supporting information against GMC and specialty standards for revalidation;

• Use of an online revalidation pilots appraisal toolkit for collection of supporting information and completed appraisal forms;

• Assessment at strengthened appraisals of supporting information against GMC and

• Ability of the Responsible Officer to make a decision to recommend a doctor for

• Strengthened appraisal training for revalidation;

RCPCH Annual Spring Meeting 2010

are being recruited to the pilots to ensure a working patterns.

(Continued on page 7)

From good to great: The role of RCPCH Staff.

Dr Chris Hanvey RCPCH CEO “The whole world stands to gain if children grow up strong and healthy”* and the strength and health enjoyed by many children is in no small part the result of paediatricians within the RCPCH membership. Providing members with support is the task of the 114 College staff who work to ensure that new members are fully integrated, exams are held, national standards set, training provided and the voice of the College is heard in the UK’s four nation legislatures.

(continued on page 7)

In recent years, the tasks and staffing of the College have grown, significantly.

Now, parts of the staffing structure don’t fit together very well and the website needs modernising. If we are to increase our income from fundraising, then we need to improve our branding and we also need to enhance our research, four nations and English regions reach. * Eglantyne Jebb, who is responsible for the first Charter of Children’s Rights

(continued on page 4)

Notes

Contents 1 Revalidation pilots underway to test out new systems and processes

2 Registrar’s column

3 A message from Terence Stephenson

4 Not just a phase From good to great: The role of RCPCH Staff Opera in aid of David Baum International Foundation Remembering Edmund Hey

Registrar’s column

5 Media Update – Summer 2010 Le Nouveau e-Portfolio est arrivé!

6 The Healthy Child Programme Update – RCPCH Summer Newsletter Article Medicines for Children

7 Annual Conference 2010

I write this at a time of great uncertainty, both financial and political. As this article comes to print we have a coalition government and early signs of the direction of health policy. In my last column I wrote about the need to consider service redesign and clinical standards in the context of challenging economic times, and I want to continue with this.

8 British Society for the History of Paediatrics and Child Health Deaths

9 Maintaining and Updating Child Protection Competencies New Style DCH Clinical Exam from April 2011.

10 Can you help increase awareness of childhood disability?

Children's Mental Health in the Community – an intercollegiate conference

We must work to make the health of children a priority, especially in the certain knowledge that the NHS, Education and Children’s Social Care are unlikely to be spared the inevitable cuts in funding to deal with the consequences of the global economic crisis. If the NHS is to continue to improve safety and quality of care in this, RCPCH needs to ensure that children and young people become a key priority, as investment in care at the start of life should result in better outcomes throughout life.

11 Training Matters SSASG NEWS Copy deadline for next issue: 1st August 2010 Managing editor: Graham Sleight Editor: Joanne Ball Email: newsletter@rcpch.ac.uk Editorial services: Work Communications www.workcomms.com 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

To paraphrase our objectives, RCPCH aims to advance the art and science of Paediatrics, raise the standard of medical care provided to children, educate and examine those concerned with the health of children and advance the education of the public in child health.

What can we do to support this agenda? In my view the last of these (education of the public) is possibly the most urgent. This may seem counter intuitive, but if we are to influence the way that services for children are delivered, we need to convince the public that to improve services we must change the way they are delivered. We must be clear about the standards of care we expect to see. We are developing standards, starting with a statement on acute paediatric services including when, and by whom, children should be seen.

We are committed to ensuring that every child or young person with an urgent medical condition is seen by a senior paediatric doctor in a timely manner. Specifically RCPCH will expect all services to ensure that every child or young person with an urgent medical condition:

In order to achieve these standards every service needs sufficient staff available 24 hours a day.

Careful consideration of rotas is needed to ensure that on-call staff are not covering too many patients or clinical areas. Currently there are insufficient staff to meet these standards and to ensure compliance with the Working Time Directive. There is a stark choice: either new consultant posts are created and the number of training posts increased (rather than the planned current reduction) or reconfiguration of children’s services must take place. Service redesign and a reduction in the number of hospitals with inpatient facilities for children would enable more children to be offered consistently high quality care by focusing clinical expertise. This is what we need to educate the public about – the choice between high quality services or the current configuration. I do not believe the option of simply increasing numbers of doctors is politically or financially viable or that our politicians have the courage to lead on service redesign. We need to continue to make a case for expansion, but at the same time use standards as a way of beginning a more open debate on service delivery. Paediatricians, with the public supporting them, are likely to be the way to debate this and achieve change. If we are open to the benefits of doing things differently, then we are likely to carry our patients with us.

The alternative of continued problems with staffing rotas is a recipe to drive down quality of care.

• has their case discussed with, or is seen by a senior paediatric doctor before being sent home • is seen by a senior paediatric doctor within 4 hours of admission

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• is seen by a paediatric consultant within 24 hours of admission

DR DAVID VICKERS Registrar

Notes

A message from Terence Stephenson As I write this, election fever is upon us and all government departments are ‘in purdah’.

However, this does not mean that the College has not been busy. Unlike some other Colleges, we have not issued a manifesto prior to the general election. We did consider this but made a conscious decision not to do so. Rather, we have indeed drawn up a manifesto and will take this to the ministers responsible for health once they are established in post. I will return to the future later in this piece but sadly I must say a few words about the past.

In late April, the College hosted a reception for all those who attended the funeral of David Harvey. David Harvey was a former Honorary Secretary of the British Paediatric Association, an eminent neonatologist and Paediatrician to the Royal Family. He also did a huge amount of work for paediatricians overseas and we are discussing with his family how to recognise this and I will let you know the details once they are available.

April also saw the death of Otto Wolff. Otto was a previous President of the British Paediatric Association and former Nuffield Professor of Child Health at the Institute of Child Health in London. Although in his nineties, he was still attending the Otto Wolff series of guest lectures at the Institute up until the last few months.

In April we had a very successful Annual Conference at Warwick University. This is the first time the College moved away from York University as a venue since the granting of its Royal Charter. Huge thanks to Alistair Thomson and all the conference team at the RCPCH for what turned out to be a fantastic meeting. They even arranged sunshine!

There was good science, a chance to meet colleagues and friends, some Mozart and Vivaldi performed by the scratch Orchestra and Choir, and dinner and dancing that David Baum would have been proud of.

The conference was opened by a rousing call to arms by Richard Horton, Editor of The Lancet. It was not without criticism of our College and there is nothing wrong with that – no one is above criticism.

However, in a review of our conference in The Lancet (volume 375, 1 May 2010, page 1510) he said “quite often in Britain one will hear doctors, with some justification, complain about the Royal Colleges. What are they for?

Aren’t they simply about knighthoods, golden robes, silver plates and good claret? Selfaggrandisement mixed with spectacular vanity. Perhaps some Colleges are like this (one College puts an oil painting of its president on the stage at its annual meeting for lucky delegates to admire). But not the Royal College of Paediatrics and Child Health. Its annual gathering has no robes, no painting, and very little (as far as I could see) claret. The College uses its conference as an opportunity to bring a thousand paediatricians together, from the youngest trainees to the most emeritus of professors. It is a researchdriven event, which gives it edge and attraction.

The speakers are international. Awards recognise professional achievements at all career stages. Paediatric subspecialties are given space to breathe with their own research tracks. But the complete paediatric community also unites around important general themes – at April’s meeting, for example, childhood obesity and international child health. There are lessons to learn from British paediatricians: meeting together regularly strengthens your mission, research makes you relevant, discussing ideas among yourselves keeps you thinking, and mixing young and old binds wisdom to fresh ideas.” I cannot put it better.

At the Annual General Meeting, I had the opportunity to outline some of the College’s achievements of the last year which provides a UK counterbalance to Richard Horton’s view that, globally, children are not on the radar in world politics. I have been to 16 different regional events to listen to the views of members. Children and young people have been placed at the centre of the College and most notably at our celebration of the 20 year anniversary of the UN Convention on the Rights of the Child and also in launching ‘Not Just a Phase – a guide to the participation of children and young people in health services’ at the AGM. We are delivering the European Mastercourse to 27 EU states and in May 2010, for the first time ever, we ran the

MRCPCH examination in India, the country that provides the largest number of overseas candidates for our exam in the UK. We have led the call for a ban on smoking in cars to protect children from the hazards of passive environmental tobacco smoke and we have given advice all over the four devolved countries and to local clinical directors on accessing resources to help with the impact of the European Working Time Directive.

Similarly we have provided written evidence to the enquiry into the impact of EWTD on trainees and on making courts more open.

On a personal note, I put myself forward for appointment to the reconstituted GMC and was appointed by the Appointments Commission taking up the role in 2009. In this role, by law, I have no part to play in individual fitness to practise cases. However, I would note that in the last year, for the first time in its 150 year history, the GMC now has a policy on vexatious complaints, is reviewing the wording of all letters sent to doctors and all 250 members of the fitness to practise panels have been offered child protection training from our College.

I encouraged the GMC to collaborate with the Royal Society of Medicine on a series of articles on high profile cases involving child protection over the last decade. You will have seen in the press, following the judgement from the Appeal Court, that the GMC is to undertake a wide-ranging review of its guidance on child protection for paediatricians in the UK. The RCPCH will be a key player in this review. I stood for appointment to the GMC on the basis that one can best influence and change things from the inside rather than from the outside.

On a final note, one further death since the last newsletter was that of Dr Edmund Hey who has played a huge role in arguing the case with the GMC for paediatricians over the last decade.

I wish you well and hope the sun continues to shine during the summer, as it did in Warwick in April.

PROFESSOR TERENCE STEPHENSON President, Royal College of Paediatrics and Child Health

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Notes

Cont’ from page 1

Professor Terence Stephenson, President of the RCPCH, Launches the new publication Not just a phase 20 April 2010.

Visit http://www.rcpch.ac.uk/Policy/Advocacy/ Not-Just-a-Phase-Guide for purchasing details and to download a copy of Not Just a Phase.

I am delighted to be launching Not just a phase – a guide to the participation of children and young people in health services.

I congratulate the authors, all members of our Young People’s Health Special Interest Group: Dr Damian Wood, Dr Gill Turner and Dr Fiona Straw; I congratulate Bharti Mepani, our Children and Young People’s Participation Manager, who has been working closely with the authors to develop this highly informative, inspiring and creative publication.

Not just a phase is a powerful reminder of just how far we have come in relation to child health services, something Sir Harry Platt captured over 50 years ago in the Platt Report. He recognised that the health care of children was so much more than just their medical care but also the holistic care of children, including valuing their perspectives and experiences.

I am confident that the RCPCH’s new publication Not just a phase, a key resource designed to support us (Paediatricians and Service Leads) will ensure the safe, meaningful and ethical participation of children and young people within the delivery of health services.

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Not just a phase has been developed and published by the Young People's Health Special Interest Group of the Royal College of Paediatrics and Child Health. It provides information to ensure the safe, meaningful and ethical participation of children and young people within the delivery of quality child health services and practically demonstrates how we can contribute towards creating a culture of participation.

Who is it for?

Not Just a Phase is designed primarily for paediatricians, senior children's nurses and leaders of organisations which provide general and specialised health services for children and young people.

What is it about?

Not Just a Phase is divided into six sections: • Why paediatricians and service leads need to know about children and young people’s participation • The theory and evidence basis for participation • Key principles of participation • Essential elements of a participation strategy and project • How to create a culture of participation • Examples of participation in practice.

Each member of RCPCH will be receiving a free copy of Not just a phase and it will also be downloadable on our website.

PROFESSOR TERENCE STEPHENSON

Remembering Dr Edmund Hey

Opera in aid of David Baum International Foundation

Many members will remember Dr Edmund Hey, a pioneer in the care of newborn babies, who died in 2009. To mark this, the British Association of Perinatal Medicine (BAPM) produced a publication, The Stoke CNEP Saga: Articles Commissioned by the Journal of the Royal Society of Medicine, collected to honour the memory of Edmund Neville Hey. Copies have been sent to all members of BAPM, but any other College members who would like a copy should contact Lisa Nandi the BAPM Executive Officer, at lisa.nandi@rcpch.ac.uk

The world-renowned Diva Opera will be performing at Manor Farm, Fingest, near Henley in aid of Helen & Douglas House and David Baum International Foundation on 5th and 11th September 2010 with performances of Bizet’s Carmen and Verdi’s Falstaff respectively. Tickets are £50 each, and can be obtained from the organiser, Sylvia Crowther, on 01491 638474 / fingestopera@btconnect.com For more information, please visit www.divaopera.com

President, Royal College of Paediatrics and Child Health

From good to great: The role of RCPCH Staff.

Over the forthcoming months we will be looking at a range of ways in which we can move from “good to great”. Firstly, through our direct service to RCPCH members. Is there more we should be providing for members? What is the experience of the College to a new member and what more can the College do to assist paediatricians in the demanding work they do? And of course as part of this, how can we increase our membership both in the UK and abroad?

A second immediate concern lies in improving the website. No other single issue has been quoted to me so much as a source of frustration or disappointment. It is a portal into the College, fulfils a range of functions and it is an immediate priority that we redesign the website to fulfil the demands not just of 2010 College members, but for all of those who are likely to join in the next few years.

Thirdly, how can the College increase its income in order both to serve members and children and also assist in some of the wider roles the College performs. So, income generation is important, whether this be through the wider hiring of the building, increasing membership and publication sales and eventually fundraising. Our goal here is to create that desirable position when members can then determine where surplus funds should be spent, whether this is, for example in developing further overseas work, increasing research or strengthening our policy work.

Towards this end, the fourth priority is a re-branding exercise to raise the profile of the College which we have embarked upon with the innovative design company FOLD7.

This will build upon the findings of the focus groups, which we undertook in the first part of 2010 and help us to achieve a position where we can go forward and launch a major fundraising campaign for the College.

This is not about rejecting all that has gone before, but ensuring that the College presents itself as facing the demands of the 21st Century.

Fifthly, we are looking at how we can strengthen our research and policy work more effectively, so that the RCPCH is always the default organisation for child health when views are sought by the media.

This will mean some re-alignment of College staff. The College staffing has grown incrementally over the last decade and now is a good time to take stock, look at the arrangement of staff, integrate the English regions and the other three nations and overseas members more fully into the College and achieve a greater clarity in the way in which decisions are made and members are served. The aim of all of this is unashamedly to move the College from good to great and make it an organisation to which both members and staff feel justifiably proud. Your ideas and suggestions as to what more we need to do to achieve this will be warmly welcomed.

DR CHRIS HANVEY Chief Executive

Notes

Media Update – Summer 2010 In early February, the Department of Health launched its Tobacco Strategy and Terence Stephenson was quoted in the Daily Mail welcoming it and the focus on children.

The Audit Commission published a report about health inequalities for the under-fives and Terence Stephenson wrote a commentary piece for Guardian Society in response.

He was also quoted in the Guardian and Daily Express saying “we need to see child health as a priority and improve front-line NHS services.”

Terence Stephenson was interviewed by the Daily Telegraph in February and said that the impact of the European Working Time Directive and NHS savings meant that some children’s in-patient wards may have to close and merge with others. He said there was already a shortfall of consultant paediatricians and top-level trainees before the directive and now the workforce was under “unsustainable pressure”.

Neena Modi, Vice President for Science and Research, was quoted in the Times, Daily Telegraph, Independent and Yorkshire Evening Post about the National Patient Safety Agency’s safety alert over gentamicin being given to babies. She said “it is important that the new gentamicin guidance is implemented by all NHS trusts”.

The new College CEO, Dr Chris Hanvey, started in February and an interview with him appeared in Children & Young People Now in March.

Rosalyn Proops, Child Protection Officer, spoke out about child asylum-seekers being detained in immigration detention centres when the Children’s Commissioner for England published a report on the health of children in the Yarl’s Wood centre. She was quoted in the Guardian and BBC News and said “these children are among the most vulnerable in our communities and detention causes unnecessary harm to their physical and mental health”.

At the end of February Terence Stephenson and the presidents of the Royal College of Surgeons and the British Association of Paediatric Surgeons sent a letter to The Times warning that Criminal Records Bureau checks were forcing paediatric operations to be cancelled.

In mid March the RCPCH and Royal College of Obstetricians and Gynaecologists held a health and climate change conference.

Tony Waterston, Chair of the Advocacy Committee, wrote an article about the impact climate change has on child health for the BBC website and Terence Stephenson co-signed a letter to The Times.

also published in March and he called for fitness tests to be introduced into secondary schools to encourage pupils to be more active. David Vickers, Registrar, responded saying “we recognise that inactivity in adults begins in childhood - an issue on which we have strongly campaigned” and was quoted in the Sun, BBC News, Guardian, Nursing Times and Nursing in Practice.

Iolo Doull, Officer for Wales, appeared on BBC Radio Wales talking about workforce issues in Wales.

At the end of March the Royal College of Physicians launched their Passive Smoking and Children report and Terence Stephenson was quoted in The Independent, Daily Mail, Scotsman, Daily Express, Yorkshire Evening Post and The Times welcoming it.

April was also a busy month which included mentions in the Evening Standard about workforce levels, Guardian Online about smoking in films and the effects on children and the College signed a joint letter with other Royal Colleges, under the Academy umbrella, about reconfiguration and the need for change to be driven by clinical evidence.

Terence Stephenson spoke to the Observer about lack of provisions made by the NHS for the parents of sick children.

He commented that the failure to provide beds for families only adds to the suffering of parents with a child in hospital and that many hospitals relied on charities to supply suitable accommodation.

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

The Chief Medical Officer’s annual report was

Media Affairs Assistant

ELLA WILSON

Le Nouveau e-Portfolio est arrivé!

What is happening?

The Paediatric e-Portfolio was designed with four purposes in mind. It aims to be • a learning portfolio for trainees • a tool to assist with educational supervision • a record of progress through training • a central source of administration for all those involved in training.

The RCPCH e-Portfolio Management Group (e-PMG), which represents all users, has been working on an upgrade to e-Portfolio version 2. Improvements in the upgraded version will include: • Clear Trainee progress relating to training stage, and levels in curriculum.

• A more sophisticated and easier messaging and alerts system.

• The ability to link documents and comments across the e-portfolio, for example to the curriculum, supervision forms or log entries.

• A new personal library for each Trainee, with expanded memory of 40mb.

• Improved section for alerts, courses and seminars.

• Enhanced Skills Log, Development Log and PDP sections with increased editing rights for trainees.

• Good Programme Director access for trainees in posts crossing Deaneries.

• Superior administration functionality.

• More detailed reporting functions.

How does it affect me?

All data will be transferred automatically to the new e-Portfolio. The exact dates of the switchover will be communicated to all users

well in advance via email, e-Portfolio and on the College website. Guidance will be provided prior to the launch and a College hotline will be available for queries and advice.

When will it happen?

The launch for version 2 has been set for early July 2010. A programme of user training will be provided locally and nationally before the launch.

All have worked hard to ensure a smooth transition to this welcome improvement to the innovatory RCPCH e-Portfolio. eportfolio@rcpch.ac.uk www.rcpch.ac.uk/eportfolio DR SIMON NEWELL Vice-President, Training & Assessment IAN O’DONOGHUE Training Coordinator

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Notes

The Healthy Child Programme Project Update Work between the College, e-Learning for Healthcare (e-LfH) and a consortium of Royal Colleges and professional bodies is well underway and we are on track to launch the e-learning resource for the Department of Health’s ‘Healthy Child Programme (HCP)’ in January 2011.

The Healthy Child Programme 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.

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.

Further information can be found at the Department of Health’s website: http://www.dh.gov.uk/en/Healthcare/ Children/Maternity/index.htm To keep up to date with the project, please visit our websites: e-LfH website: www.e-lfh.org.uk/healthychild RCPCH website: www.rcpch.ac.uk/HCP

The programme is also able to focus on changing public health priorities such as obesity, breast feeding, social and emotional development.

DANIEL RIDDELL Project Manager, RCPCH daniel.riddell@rcpch.ac.uk

Medicines for Children The Medicines for Children: Information for Parents/Carers leaflet project is an exciting initiative which aims to provide accessible and clear information for parents/carers to help them administer drugs at home and to understand their child’s condition. The project was set up because the standard information provided with medicines is often complex and may not always be relevant to children. The leaflets are developed following a standard template which was devised with parent/carer groups to ensure that they provide the information parents/carers need to confidently administer medicines at home, such as the side-effects that can occur and what to do if you forget to give a dose and the support groups available.

The leaflets are freely available to be downloaded from the website http://www.medicinesforchildren.org.uk/ The project is supported by Royal College of Paediatrics and Child Health, the Neonatal and Paediatric Pharmacists Group (NPPG) and the charity WellChild,

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and has also received funding from the Department of Health, England. The project is the responsibility of the RCPCH/NPPG Joint Standing Committee on Medicines which is chaired by Dr William Van't Hoff.

The leaflets are written by volunteer authors and follow a 3-month rigorous checking process involving a consultant paediatric pharmacist, a consultant paediatrician, an editor experienced in writing for the public and the RCPCH/NPPG Joint Standing Committee on Medicines before the leaflets are ready to be published on the website.

We have 108 leaflets either on the website or in development in a wide number of therapeutic areas such as antibiotics and infections, drugs for epilepsy and pain, bedwetting, eczema, constipation, depression, gastro-oesophageal reflux to name a few.

Visit the website http://www.medicinesforchildren.org.uk/ to see the existing leaflets. Please continue to check the site as we frequently upload more and have many more in development.

The leaflets are a really helpful resource for the parents/carers of your patients and we encourage you to use them and to pass on the details of the website to parents/carers so they can use this free resource. You can also use the website to suggest medicines where leaflets are needed or to volunteer to be an author or to give feedback on the leaflets.

Get involved! We are recruiting new volunteer authors. Authoring a leaflet and being involved in this exciting national project can help your professional development and be used as evidence for the RCPCH e-portfolio and CPD schemes.

Ongoing support is provided as well as an easy electronic template to follow.

New authors are given up to 3 weeks to complete an initial draft which has been estimated to take little more than 4 hours.

If you are interested please contact the team by email: medicines.leaflets@rcpch.ac.uk or call Isla-Kate Morris on 020 7092 6165 or complete the contact page on the website.

Notes

Annual Conference 2010

Cont’ from page 1

Revalidation pilots underway to test out new systems and processes Colleges are involved in the pilots in two ways. Firstly, individual Colleges/Faculties are acting as observers on pilot project boards, feeding back key issues and challenges to the Academy of Medical Royal Colleges (AoMRC). Secondly, pilot site participants can contact College representatives directly with queries about individual College/Faculty standards. The RCPCH is available to advise paediatricians in all other pilot sites. The RCPCH is the AoMRC link for the South Central SHA pilot.

Independent evaluation of the pilots will use questionnaires, focus groups and 1-1 interviews to identify what works and what needs improving. A full review of the pilots will be carried out before the next phase of implementation begins.

In addition to current pilots in England, pilots are also underway in Scotland, Wales and Northern Ireland, addressing various aspects of the revalidation process.

In future newsletters we shall bring you more news about revalidation pilots and their implications.

Meanwhile, we urge all paediatricians to prepare for revalidation by: • Collecting supporting information in a folder (portfolio) • including outcome data, incidents, complaints • Keeping up to date with CPD (at least 50 credits each year) • Record “learning points” from all CPD

• Undertaking multisource feedback at least once in five years • Colleague and parent/patient • Completing an audit cycle during the five years

More information Reports and further information on these pilots are available at http://www.gmcuk.org/doctors/licensing/revalidation_projec ts_and_pilots.asp More information on revalidation can be obtained from the RCPCH website at http://www.rcpch.ac.uk/Revalidation or from Dr Alistair Thomson (clinical lead Revalidation) or Sarah Fellows (staff lead Revalidation) at recertification@rcpch.ac.uk

• Undertaking annual appraisals every year

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Notes

Maintaining and Updating Child Protection Competences The aim of the RCPCH is that “children in the UK will be looked after by paediatricians who are the best trained and best supported in the world” The RCPCH has hence undertaken the development of an e-learning training programme that will update its current child protection materials for use by consultants and other career grade paediatricians. This training programme will equate to level 3 competences as described in the Intercollegiate document (Safeguarding Children and Young People: Roles and Competences for Health Care Staff, April 2006).

The aim of the Maintaining and updating competences (MaUC) training programme is to enable paediatricians in the UK to develop and maintain up to date knowledge and skills in order to contribute safely and effectively to interagency working to safeguard and promote the welfare of children and young people.

The RCPCH is working in collaboration with e-Learning for Healthcare (e-LFH) to deliver this distance learning resource. We endeavour to produce an interactive web based programme that has the appropriate links to CPD and Revalidation.

Clinical Lead: Dr Peter Sidebotham is the clinical lead for the maintaining and updating competences project. He is a consultant paediatrician and Associate Professor of child health at the University of Warwick, also the designated doctor for child protection for Warwickshire PCT.

British Society for the History of Paediatrics and Child Health The BSHPCH is holding its Autumn Meeting at Liverpool Medical Institution on Friday 10th and Saturday 11th September 2010.

The meeting will run from lunchtime on Friday until lunchtime on Saturday, with four sessions, including the William Cadogan Lecture, and the conference dinner on Friday evening. The meeting is open to both members and non-members who are interested in the history of paediatrics and child health, including paediatricians, historians, and students. Spouses and partners are welcome. On Saturday afternoon there are optional tours of the Liverpool Medical Institution (with its fine library), or the Anglican and Roman Catholic Cathedrals, both near the LMI. For full details of registration including accommodation and costs, please contact Karyn Cooper k.cooper@clinmed.gla.ac.uk (tel: 0141 201 0235). The closing date for registration is 1st September 2010.

If you have a paper on a topic of historical medical interest that you think might be suitable for presentation, please submit an abstract for consideration (250 words, including title of paper, name and address of author) to the Hon Secretary, Lawrence Weaver lweaver@clinmed.gla.ac.uk. The final date for submissions is 5th July 2010.

Deaths The College notes with sadness the deaths of the following members since the last edition of the Newsletter.

Admission Date

Town

Dr Marilyn Moore Black Senior Fellow

1988

WIMBORNE MINSTER

Dr John Emery Ellis

Senior Fellow

1978

BOLTON

Dr Irina Gennadyevna Gourlo

Ordinary Member

2004

LONDON

Consortium Members:

Dr (Sir) Albert Cecil Graham

Honorary Fellow

1985

ST JAMES, Barbados

• National Society for the Prevention of Cruelty to Children (NSPCC)

Dr Joan Gray

Senior Fellow

1990

AMERSHAM

Dr Catherine Margaret Hall

Fellow

2001

STOCKPORT

Dr Sidebotham has lead on the development of a range of training materials and courses including national training on child death review, safeguarding training for dentists, court skills for paediatricians and the University of Warwick MSc in child health. He is on the editorial boards for Child Abuse and Neglect and Child Abuse Review.

Name

• The Royal College of Obstetricians and Gynaecologists (RCOG) • The Royal College of General Practitioners (RCGP) • Child Protection Special Interest Group (CPSIG)

Professor David Harvey Honorary Fellow

1971

LONDON

• National Safeguarding Delivery Unit (NSDU)

Emeritus Professor Ralph Hendrickse

Honorary Fellow

1970

WIRRAL

Dr Margaret Bryce Mearns

Honorary Fellow

1971

LONDON

Dr Edward S Mucklow

Senior Fellow

1970

CARISBROOKE

Dr Alan Charles Parsons Senior Fellow

1975

NEW PLYMOUTH, New Zealand

Dr Edward Tempany

Senior Fellow

1975

DUBLIN

Dr Vivien V Tracey

Senior Member

1979

NORWICH

Professor Richard West Senior Fellow

1974

OXFORD

Professor Otto Wolff

1959

LONDON

• Promoting Inter-Agency Training (PIAT) • Family Justice Council (FJC)

Access and Registration: This online resource will be made freely available to consultants and career grade paediatricians in the UK to facilitate in maintaining and updating their competencies with regard to safeguarding children.

The training programme is planned to launch late summer 2010 and will be available from the e-LfH website: www.e-lfh.org.uk/projects/safeguarding For more information please contact: ELIZABETH ALUKO Child Protection Project Manager, RCPCH elizabeth.aluko@rcpch.ac.uk

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Membership Type

Honorary Fellow

Notes

New Style DCH Clinical Exam from April 2011.

The current clinical examination of the DCH is set to change from April 2011. Approval to roll out this exam was obtained from the Examinations Executive of the RCPCH in March following its successful pilot in January 2010.

tool in assessing competence in clinical skills.

Other key drivers were the need to include assessments on “safe prescribing”, ease capacity pressures due to high demand and making the exam more attractive for hosts and host centres.

focus group and the DCH Board. Feedback from the pilot of the new circuit in January 2010 resulted in 95% approval from trainees, minor issues of timing and other feedback from examiners in the pilot incorporated.

Background:

Outcome from the DCH Development Group:

What are the main changes to the exam?

A new DCH Clinical Syllabus was created as a basis for the assessment of candidates and this is now available on the RCPCH website.

The new circuit has 8 stations with 12 clinical skills assessed including the new “safe prescribing” and “data interpretation” stations.

The current DCH exam is the most popular diploma exam offered by the Royal Colleges in the UK. Demand for the current exam is high, with three written exams feeding two clinical sittings a year. The College routinely experiences a shortage of host centres and examiners. Reducing the number of patients recruited in each centre makes the logistics of preparation more attractive for hosts.

The need for innovation of the current DCH Clinical Exam was proposed by the RCPCH in 2008. Consideration was needed to assess the practicality of utilizing workplace based assessments (WPBA) as a possible

The use of workplace-based assessment (WPBA) towards competency for the diploma was abandoned through difficulties with assuring standardisation across the UK, monitoring, and its exclusion of candidates from abroad.

A proposed Clinical circuit incorporating two new stations, “safe prescribing” and “data interpretation” was approved by a trainee

The timings of all stations have been adjusted with a mix of 6 and 9 minutes per station.

The clinical assessment station now tests any system e.g.: cardiovascular, abdomen, respiratory etc.

The child development station now incorporates any relevant neurodisability discussion.

CIRCUIT A: 6 MINUTE STATIONS X 2

Communication 1 6 minutes

Communication 2 6 minutes

Data Interpretation 6 minutes

Structured Oral 6 minutes

Total time 36 mins Double cycle (X2) 8 candidates 2 cycles 16 candidates/72 minutes Examiners should stay in same stations for the 2 x double cycle.

3 minute intervals between each station

CIRCUIT B: 9 MINUTE STATIONS

Clinical Assessment 9 minutes

Focused History & Management Planning 9 minutes

Child Development 9 minutes

Safe Prescribing 9 minutes

Total time 48 mins Double cycle (X2) 8 candidates 2 cycles 16 candidates/96 minutes Examiners should stay in same stations for the 2 x double cycle.

What are the benefits from this new exam?

Fewer patients need to be recruited, easing the pressure on host centres.

Capacity issues have been addressed; this circuit allows 32 candidates to be examined per day.

Overall, fewer centres will need to host the exam in the future.

The circuit has been adjusted without increasing the length of the examining day.

No candidate meets the same examiner twice.

Examiner training for the new Clinical DCH: Examiner Training dates for the new DCH format have been set for Wednesday 24th November 2010 & Wednesday 16th

3 minute intervals between each station

February 2011 before the exam is rolled out in April 2011. We would encourage all present active DCH examiners to enrol in one of these dates as soon as possible.

We also welcome feedback about these changes.

DR ANNA MATHEW Lead for Examiner Training and Recruitment, DCH Board

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Notes Can you help increase awareness of childhood disability?

Children’s Mental Health in the Community – an intercollegiate conference

Contact a Family is looking for your expertise to help update our renowned Directory – the essential guide to medical conditions, disabilities and support.

RCPCH recently hosted a joint conference with RCN, RCPsych and RCGP to discuss the current challenges facing children’s mental health services in the community. An invited group of 50 professionals representing a range of services and professional organisations attended the all day conference.

Key note presentations from Lord Layard, Dr Sheila Shribman and Dr Lesley Hewson provided an overview of the key national policies and findings from the recent CAMHS review. These were followed by a series of facilitated workshops covering a range of cross cutting themes.

The Contact a Family Directory is a vital resource for those working with disabled children or those with additional support needs. The 430 medical conditions included are updated by specialists as part of a rolling programme. Each entry is a short overview of the condition written in plain language and requires only a few hours of your time to update.

If you would like to offer your expertise please email Cheryl Lenny at cheryl_lenny@cafamily.org.uk stating your specialist medical discipline.

Contact a Family is a UK charity that supports the families of disabled children regardless of the child’s disability or additional need. Last year we helped over 300,000 families by providing support, advice and information and by campaigning to increase investment in essential services. For more information on Contact a Family’s work visit www.cafamily.org.uk

Key issues identified by the conference included: • Clarity on the roles and responsibilities of health professionals, to ensure consistency between services.

• The need for strategic vision and clinical leadership to ensure consensus on the definition and delivery of high quality services.

• Improving communication, joint working and a common language between professional groups.

• Resource and capacity issues, particularly with an ageing workforce increasing workload and potential public sector cuts in funding.

Professor Otto Herbert Wolff Otto Wolff who recently died at the age of 90 years was President of the British Paediatric Association from 1976 to 1979.

He was a medical scientist and paediatrician who was at the forefront of the post-war development of the care of children in the UK. He was born in Hamburg in 1920; his father served as a doctor with the German army in the Great War. Otto came to London in 1936 so that he could matriculate and go to Cambridge to read medicine with clinical studies at UCH. Following army service he returned to Birmingham to train as a paediatrician under Sir Leonard Parsons.

He developed his interests in the scientific aspects of medicine and learnt biochemical techniques in the laboratory of Harold Salt.

He discovered the disorder of fat metabolism, abetaliporoteinaemia, and developed special diets for phenylketonuria.

In 1965, he was appointed as Nuffield Professor of Child Health at the Institute

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of Child Health and GOSH. He was the first trained scientist to be appointed to a clinical chair and he used this position well to push forward understanding of the scientific basis of the care of babies and children.

He was very aware of psychosocial needs of children and families and regularly undertook ward rounds with Lionel Herzov, a child psychiatrist. In 1960 he was the senior author on the Lancet paper describing Edwards syndrome.

He was an excellent, thoughtful clinician and feelings were as important to him as signs.

In 1976 he was elected President of the BPA and spent much of his time developing the case for the formation of a separate College.

He was very disappointed when the members turned down his plans but he had laid the groundwork for a College, and was delighted when it came to fruition in 1996.

Music was a very important part of his life, and he had two grand pianos. He would play for 20 minutes every morning before leaving for work.

• Increasing the input from children, young people and their families, particularly given that services users often cannot or are not given the opportunity to voice their needs.

• Ongoing concerns around the commissioning and regulation of children's mental services, that do not currently ensure the consistent delivery of high quality children’s mental health services.

• Variation in the quality and consistency of training both for specialists and all health professionals that work with children and young people.

At the end of the conference there was agreement to encouraging working between the professional groups, and supporting clinical leadership and consensus on the delivery of high quality children's mental health services. There was a recognised need to educate politicians on the issues associated with children’s mental health and for all the professions to advocate for children, young people and their families.

The conference represented the start of a process and work is underway to further develop joint commitments and recommendations for policy makers and the government.

He was a gracious man, slightly austere, precise and very intelligent.

He was always a poor sleeper and at night he had to have a flask of coffee and marmalade sandwiches on his bedside table. He would also take this sustenance on his travels and would cause great amusement when he opened his brief case and took out his neatly cut finger sandwiches. In 1985 he was awarded the CBE and in 1988 the James Spence medal of the British Paediatric Association.

Otto Herbert Wolff b January 20 1920, d April 27 2010.

Notes

Training Matters Attendance at the National Trainees Meeting at the Warwick Paediatric and Child Health conference was good; many thanks to those who contributed and asked questions. I hope those who attended felt the session was useful even if there are no easy solutions to some persistent problems. The format was a series of short lectures followed by a question and answer session to a panel including a number of senior college officials.

There was one question which stood out: Q: I am a final year general paediatric trainee who is struggling to get to any clinics, let alone specialty ones. We have been raising this issue locally for some time but nothing seems to change.

The recruitment crisis, which has been an issue in paediatrics for over two years, continues to cause problems. The lack of staff on middle grade rotas means trainees are often pulled off scheduled activities to cover admission units and wards (which have limited educational value for trainees late in training programmes.) A number of local initiatives were mentioned including one unit which covered registrar slots with consultants on a regular basis. However this is not pragmatic in all areas and may not make daytime activities any easier to attend.

It was noted the college has set standards for training and these can be found at: http://www.rcpch.ac.uk/Training/Qualityof-Training Training is a two way process as, in the process of being trained, doctors provide an essential clinical service. Trainees must

SSASG News You will notice that we have a new Committee name – Staff, Specialty and Associate Specialist Grade Committee. A small change, but one which acknowledges RCPCH SSASG Committee representation of doctors working in paediatrics in the newly created Specialty Doctor Grade. The SSASG Committee is now up to full membership with the appointment of 3 newly elected Members- Dr Carol Roberts, Dr Naeem Ashraf and Dr Virendra Puri.

Although the SSASG Committee membership is now complete, there are still a number of SSASG Regional Representative vacancies – please take a look at the College Website http://www.rcpch.ac.uk/Policy/SASG-Doctors SSASG Conferences Joint royal colleges SAS Conference 29th Jan 2010.

This inaugural Conference was hosted by the Royal College of Surgeons of England. It was a huge success – fully booked well in advance with almost 200 Delegates. There were presentations on a range of topics including the current DOH view of the future of the SSAS

be as proactive about their training needs as the NHS is in expecting this service to be delivered. If you are unable to attend clinics through no fault of your own you must identify this to your educational supervisor and then to your head of school quoting the RCPCH standards. However there is a difference between having the opportunity to attend clinics but missing them because you become tied up with something else and not having an opportunity to attend in the first place. Time management and team working are vital. Unfortunately it may be that the on call SpR bears the brunt of other registrars not being available for ward cover while attending clinics. However, there should ultimately be equity in a process which allows all to attend the training they deserve. If rotas are not flexible or fair enough to support this then this must be discussed with the head of department. The need for doctors to be involved in management at all levels is increasingly recognised as a pre-requisite for the delivery of a high quality service. This applies to trainees as well and the formation of junior doctor medical management committees with the involvement of clinical directors is something

I will be championing. I would be grateful to hear of any successful systems you may have been involved in.

Grade, Clinical Leadership and CPD/Training for SSAS Doctors. RCPCH had a Poster and Stand outlining SSASG projects and initiatives, which generated a great deal of interest from Delegates. A very big “thank you” to all those who made this such a success. Please have a look at the Poster which is currently on the SSASG pages of the RCPCH Website.

“RCPCH Service Standards”, and further information on SSASG Workforce planning.

The afternoon Workshop Sessions are planned to include topics involving CPD for SSASGs and Article 14 / CESR routes.

Further information on registration etc will appear on the RCPCH Website soon.

SSASG Update Meeting, Warwick 2010.

This year, we had 3 excellent speakers at our SSASG Update Meeting at the College Spring Conference. Dr Nicola Balch, SSASG Committee BMA Rep. and Dr Carol Ewing, RCPCH Workforce Officer, gave a joint presentation on the SSASG Contract and Workforce planning followed by Dr Alastair Thomson speaking on Revalidation for SSASG Paediatricians. The SSASG Committee is very grateful to all Speakers for delivering such informative talks and also to the Senior College Officers who attended the Meeting.

Next RCPCH SSASG Information Day Thursday October 21st 2010, 10.30am.

We are currently putting together the Programme for our next SSASG Information Day. We plan to have a Morning Session covering topics on “Revalidation – Update,”

In next article: What is a resident consultant and do I want to be one?

There was an unfortunate typo in my last article - a sentence in the last paragraph should have read: “I do, however, have some concerns about the delivery of the extra training to those who do NOT 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” Contacting the Trainees’ Committee Please e-mail trainees.committee@rcpch.ac.uk for any training queries you may have. Your regional representative may be found at www.deaneries.rcpch.ac.uk and will be able to assist with local issues.

DR DAMIAN ROLAND Chair, Trainees’ Committee

Get in touch The SSASG Committee would like to hear from you. The date of the next RCPCH SSASG Committee Meeting is 17th June 2010 and the next RCPCH SSASG Regional Representatives Meeting is on 21st October 2010. If you have any questions for the SSASG Committee or any matters which you would like to have raised at College, please contact either your SSASG Regional Rep. or Serean Williamson, RCPCH SSASG Committee Administrator. Email addresses can be found on the SSASG pages of the College website.

DR JANE WILKINSON Chair, RCPCH SSASG Committee

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