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RCPCH news Royal College of Paediatrics and Child Health

Leading the way in children’s health

AUTUMN 2008

Modelling the Future II 4 In memoriam: Spence Galbraith 5 ACCEA/SACDA: when and how to apply 6

The RCPCH and the Media 8-9 Education news – upcoming courses 10-11


Editorials In the news

From the Registrar

4 Media Update

“What is a Registrar”, I was asked, by the young person sitting next to me at dinner after an MRCPCH Admission ceremony, “and is it the same as my Mum” (who had earlier received her diploma)?

Modelling the Future II 5 Death of BPSU founding father: Dr Nicol Spence Galbraith NIHR Medicines for Children Research Network – Clinical Studies Groups 6 College Budget 2008/9 and membership Subscriptions 2009 Clinical Excellence Awards (ACCEA/SACDA) – 2009 Round 7 Workforce Census Results International Paediatric Training Sceme (IPTS) Fellowships 8-9 RCPCH and the media – a report 10-11 RCPCH Education News 12 SASG news BPSU Update 14 Trainees column UK Retinopathy of Prematurity Guideline for Screening and Treatment 2008 15 RCPCH meetings

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I had been on surer ground with the earlier question about the College mace, being fairly confident with its function as a symbol of authority. So after a few rather nonspecific comments, I neatly turned the conversation to how she had managed to get off school to come to the ceremony! But it was a good question, and although there is a job description, it is probably best answered by looking at definitions in education, where in the UK the role relates to administration and outside relates to student records entry. My role has an amalgam of both, with a close involvement in the internal running of the College as well as responsibility for Advisory Appointment Committees (AAC). The latter are an important part of the work of the College, and College representation on them helps to ensure that standards are maintained in those appointed by Trusts, both in terms of the person appointed, and the quality of the posts. I am grateful to those of you who make yourselves available to serve on these committees. Sometimes it is difficult to find people for an AAC – we can all help by both volunteering to take part, and most importantly, by ensuring that when we are developing a new post in our own Trust, we advise our medical staffing department of the importance of making early contact with the College when setting up interview panels. The main reason it can be difficult to find people is short notice! Internally, we are looking at how the College structures itself, and in particular how departments work together. The new building, bringing everyone under one roof, supports this, but like most organisations, we need to continue to encourage an approach which takes a broad perspective. Sometimes it is easy to focus on the narrow and specific, rather than seeing wider implications (for example not thinking about how an issue needs to be reflected in all our work, from education for all doctors, to training for future doctors, considering if it has an impact on the way we organise services and whether it generates a research

or clinical effectiveness question). The Registrar, because of the broad remit, also has a role in supporting such thinking. Council, and Regional Advisers, are critical in helping steer the College in this direction. They bring an external and broad perspective, often seeing things not apparent to those more closely involved in the detail. Recently we have begun to consider how these two groups will work in the future, given the development of Heads of Schools (although as ever this does not apply across all parts of the UK), which has resulted in a reduction in the role of Regional Adviser. We are setting up a working party to consider this further, and to ensure that we continue to benefit from the current strong regional representation currently existing in Council and Regional Advisers. Discussion at both meetings has suggested it is an appropriate time to look at this further, not least because of a feeling that the current arrangements may not make best use of precious time, nor result in the clearest relationship between individual members and their representation on College bodies. I also have responsibility for Policy. Thank you to all of you who comment on documents for us. We are asked to provide our thoughts on a huge number of documents, and this is only possible because of your involvement. Our Policy Conference this year was on the issue of first contact care (GP’s, paramedics, emergency departments). The conclusions of this can be found on our website at www.rcpch.ac.uk/Policy/College-PolicyConference-2008. We will continue to work on this, with a particular emphasis on further collaboration with the RCGP. I welcome any comments you have on this topic. And if you have an idea for an important topic we should consider at Policy Conference 2009, please let me know.

Dr David Vickers RCPCH REGISTRAR


RCPCH news

Editorials From the President Once a fortnight, the proverbial Martian looking down at my house will observe me dashing around in a whirl of tidying and cleaning. This is not my daily behaviour and he/she might deduce that an important visitor is coming and he/she would be right. That visitor is of course my cleaning lady. I feel guilty enough about having a cleaning lady at all without the added anguish of having her find the house unclean and untidy – hence the frenzied activity. I suspect that you might think this odd but I would defend myself by saying that having a cleaning lady achieves the desired outcome – once a fortnight my house is tidied and cleaned. You might reasonably enough counter with the observation that this is not the most efficient or indeed cost-effective way of achieving this outcome. I would in turn point out that with the money I pay her, my cleaning lady and I are contributing to the wider economy and fighting the credit crunch; but I recognise that I am not on a strong wicket here. As ever my home life seems not so different from that of our own dear NHS. Lord Darzi’s Next Steps Review has made a welcome shift away from targets expressed in weeks or hours to patient outcomes in terms of quality and improvement. Paediatricians will welcome this as we feel this is more relevant to us as waiting times and payment by results have never served us - or children - well. However there are pitfalls here too as outcomes could still be interpreted along the lines of the “hip operation” model and be defined in easily measured criteria which may return to time based ones such as time in hospital or repeat out patient visits. Whilst these may make sense for orthopaedic surgeons, defining outcome criteria is more of a challenge for paediatricians. However it is possible to define desirable outcome criteria in partnership with parents and children and young people themselves. The College can help by working with the generalists and specialists to define some key indicators that would reflect a good outcome for our patients and hence a good outcome for us. In order to avoid a plethora of goals and an intolerable burden of measurement, we will be asking specialty groups and the general paediatric group to help us identify those measurable factors that are good indicators of wider good practice. That is, if these “marker” outcomes are achieved, it is likely that a good team is practising well and other goals are also likely to be met. We should not fall into the cleaning lady trap which means

that the outcomes are only achieved in ways that are not efficient or depend solely on doctors to achieve them. We should define our outcomes along pathways with multidisciplinary teams each paying their part – each doing what they do best and most efficiently. We need to find outcomes that are measurable - but not fall into the trap of making it important to measure things but to measure those things that are important and are amenable to improvement. One of the issues we are currently working on is the concept of “care bundles” and we are doing a project on this with the National Patient Safety Agency. There is evidence to show that where a pathway for, say, reducing nosocomial infection involves 5 different steps or actions you will only be truly effective if all 5 steps are taken – 3 or 4 is not enough. We are piloting this work in a neonatal context and if this proves to be reliable and feasible we could introduce this as part of one of our index patient outcomes. Our paediatric workforce is already woefully overstretched and we must not add to the administrative burden we already bear. Revalidation will require us to capture more data about our own outcomes but since these will map with patient outcomes this is an opportunity to make sure we do not duplicate effort. The IT challenge has not yet been met but we certainly will need it if we are to carry on practising medicine rather than being data collectors. August and September presented huge challenges to paediatric and child health services with the change-over period and the gaps in rotas. I sent out an email bulletin in August which contained links to various documents which we hope will help those trying to redesign services or be innovative about covering acute services and also routine clinics. I hope you saw these links – if not do check on the website. Some relate to reconfiguration, some to schemes for international medical graduates and some to ways of recruiting to programmes in a way that allows for gaps developing later. Sadly none of these are very helpful for this year but may be for next time. We also were made aware of the problems presented by delays in getting Criminal Record Bureau checks and the difficulty in getting portable checks which enable trainees to move from one part of a training rotation to another without waiting for a repeat check. Portability is difficult under the protection of children act and we are still working on trying to clarify

what can be done about this. We have made progress and will let you know when we have a definitive answer and appropriate guidance. Last year the AGM asked us to continue to talk with the GMC about their processes in regard to child protection and expert or professional witnesses. We have been doing so and the GMC has now published guidance on acting as an expert witness. We in turn have developed our court skills training and issued guidance on the conduct of home visits as part of a child death review team. We have talked to the Family Justice Council, to CAFCASS (Children and Family Court Advisory Support Service) and also the GMC about trying to ensure that transcripts of family court proceedings are taken and are available in case of a challenge as to what a witness did or did not say. The problem remains the small number of occasions on which these transcripts will be needed but we have pointed out that paediatricians are not the only witnesses in this position and that social workers, psychiatrists and others might also find this useful if called to account by their regulators. Finally I return to Lord Darzi and the Next Steps Review. The chairs of the Children’s Clinical Pathway groups – one for each Strategic Health Authority – met recently in London to see how implementation is progressing. There is some progress but mainly it seems at SHA level – albeit with some welcome appointments of key people to ensure that the issues facing children and young people are not forgotten in the general schemes being put in place. This is key as we wait with anticipation for the Children’s Health Strategy due to be released soon – hopefully by the time you read this. We hope it will address acute health as well as issues for children and young people with long term conditions, we hope it will address the problems facing the workforce and we hope that, whilst it will address the very important issues of education and social services it will not lose its all important focus on health. We have tried to get this message across, helped as always by our National Clinical Director Sheila Shribman and we await to see if we have succeeded.

Dr Patricia Hamilton RCPCH PRESIDENT

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News Media Update

Modelling the Future II

Expert witnesses and child protection continue to be written about, and the College is always keen to express its views. In May, Terence Stephenson, Vice President for Science and Research, took part in a live discussion on BBC Radio 5 Live with the Minister responsible for Family Courts, Bridget Prentice, and the NSPCC in-house lawyer Barbara Esam. Also that month, Penny Gibson, RCPCH obesity spokesperson, spoke to Chemist and Druggist Magazine about childhood obesity and the difficulties in treating children, saying “it’s not as simple as eating too much or being less active; there is a recognisable genetic tendency, which may influence your metabolism and how you deal with food... even simple obesity is multi-factorial.” In June the College hosted a very successful conference on carbon reduction and health which looked at the role the health sector can play in reducing its impact on the environment. British Satellite News attended the conference. Lord Darzi launched his report High Quality Care for All: Next Stage Review in June too. The College found much to welcome in its response, particularly “the specific references to the need for children’s services to be effectively designed around the needs of children and their families.” In July, we were involved in the launch of the fourth edition of the BNF for Children and launched a joint report with the RCOG – Children’s and Maternity Services in 2009: Working Time Solutions. Also, the National Health Service mark its 60th birthday and Patricia Hamilton said in a statement that “children have benefited greatly from the NHS” and that “routine immunisation and regular screening are particular achievements to be acknowledged.” The Times published a series of articles in mid-July on family justice, by Camilla Cavendish, to which Patricia Hamilton and Rosalyn Proops, Officer for Child Protection, responded with a letter to the newspaper. They raised the issue of the difficulties professionals face when involved in child protection cases and wrote: “Of course child care professionals should be properly accountable for their decisions but some have been pursued by the media in a way which only deters them from welcoming a more transparent process.” The Adolescent Health Project was launched by Health Minister Alan Johnson at the College in July. The project aims to improve the care young people receive by health professionals and attracted a large amount of press interest – it was covered by the Guardian, Evening Standard, Press Association and Telegraph as well as a number of professional publications including HSJ, Nursing in Practice, Management in Practice and Children and Young People Now magazine. In late July, articles in the BMJ about child protection cases and the GMC’s new guidance for expert witnesses led Patricia Hamilton and Rosalyn Proops to respond with a letter. It welcomed the guidance and stressed that paediatricians contribute to the protection of children by following clearly laid out procedures detailed in the Government’s document Working Together to Safeguard Children and “they must feel safe from unnecessary referral to the GMC or from protracted procedures.” To keep up-to-date with news article 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

At the time of writing this article in late July, I am already hearing concerns that a substantial number of middle grade training posts will not be filled over August and September. Both consultants and trainees are concerned about having to do additional night shifts. Trainees worry about the impact that this will have on their training, and consultants are worried about the affect on their daytime work. It feels like a no-win situation. The origins of this problem go back to 2002 when there was an expansion of the number of trainees in order to meet the limitation on doctors hours set by the Working Time Directive (WTD). This led to a mismatch between trainee numbers and consultant numbers, and now almost five years later, we are expecting up to 400 trainees to receive their CCTs each year and yet only around 100 consultant retirements. So we have a dual dilemma - too many trainees for consultant posts available, and too few for the number of rotas that require middle grade trainees. Modelling the Future II is the second of three papers looking at the future configurations and workforce requirements for children’s health services in the UK. It examines the various options that are open to paediatricians and service planners to achieve high quality care with a sustainable medical workforce, whilst meeting WTD requirements. The report proposes that consultant numbers need to expand considerably, and that once this is achieved, trainee numbers will need to be reduced. In addition, it proposes that services need to be reconfigured to improve the quality of care delivered. However, it’s not all bad news! The Department of Health (England) has set aside £100m for consultant expansion in 2008/09 with further substantial allocations planned for 2009/10 and 2010/11. The DH recognises that paediatrics is in a particularly difficult position and that the shortages it faces cannot be covered from adult service middle grade rotas. However, this new money will come with strings attached - improvements in patient experience and outcomes will need to be demonstrated and WTD compliance must be achieved. Exactly how the money will be distributed between specialties is currently under negotiation – as soon as we know, you will know!

Claire Brunert HEAD OF MEDIA

Bee Brooke HEAD OF HEALTH SERVICES

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For more information about Modelling the Future, visit www.rcpch.ac.uk/Health-Services/ServiceReconfiguration/Modelling-the-Future RCPCH has produced a number of briefings to help with staff shortages: 1. Solutions for the medical staffing of acute units (www.rcpch.ac.uk/Health-Services) 2. Proposals for Dealing with the Crisis in Filling Short-term Vacancies in Training Programmes (www.rcpch.ac.uk/Training) 3. International Paediatric Training Fellowship Scheme (www.rcpch.ac.uk/Training) 4. Long-term workforce briefing (www.rcpch.ac.uk/Health-Services)


News

RCPCH news

Death of a founding father of the BPSU: Dr Nicol Spence Galbraith As a fellow parent of the BPSU, it was with great sadness that I learned of the death of Spence Galbraith on August 8th. When I joined the Communicable Disease Surveillance Centre of the Public Health Laboratory Service in 1980, Spence was Director. At the time he envisioned the need for clinical reporting schemes to identify and monitor conditions of public health importance, which were possibly, but not necessarily, caused by infection and which might be newly emerging or changing in incidence. In 1980 we were in the shadow of the thalidomide and Spanish toxic oil disasters in which the signs and symptoms first manifested themselves in children. The methodology of the BPSU is based on that used by the National Childhood Encephalopathy Study and it was typical of Spence that, when

approached by the NCES to take on surveillance of Reyes Syndrome (RS), he agreed with enthusiasm, even though it would be a departure from the usual remit of CDSC. Spence was looking for new projects for me to take on, so that was the beginning of my 20 year association with RS for which I am profoundly grateful to “the boss” as we all affectionately called him.. Initially we didn’t have the resources to undertake an “active” monthly card reporting scheme like the NCES used, so decided on a “passive” scheme, recognising that we would need to ascertain cases of RS via paediatricians. Spence and I took the proposal to the (then) British Paediatric Association. It was approved by the BPA Executive and we launched it in August 1981. In 1982 we added Kawasaki disease, haemorrhagic shock encephalopathy syndrome and haemolytic uraemic syndrome. All had appeared as outbreaks in this country during that year and all were thought to be associated with an infection although microbiological

The NIHR Medicines for Children Research Network – Clinical Studies Groups

investigations were inconclusive. They appeared to be new and alarming and fitted with Spence’s notion of the need for a clinical surveillance scheme for emerging new paediatric disorders which might have public health implications. In the early 1980s, there was increasing general interest in studying rare disorders and talk of the need to improve and unify case reporting for rare disease research. After much negotiation between the upper echelons of the BPA and the PHLS in which Spence played a major role, a joint steering committee was set up to take forward a proposal for a British Paediatric Surveillance Unit, whose remit would be the surveillance of less common illness in children. It would use an “active”, monthly, nil return card reporting system. In July 1986 the first card went out and the unit has gone from strength to strength to this day. There were of course other key figures but without the vision, imagination and sheer persistence of Spence Galbraith it is probable that the BPSU would never have happened. In acknowledgement of this, the College awarded him an Honorary Fellowship in 2006. Dr Susan Hall

National Institute for Health Research from charitable bodies (Arthritis Research Campaign; Kids Kidney Research) to support the development and funding of new CSGs (MCRN/ARC Paediatric Rheumatology and MCRN/BAPN Nephrology). We hope to continue to work closely with funding bodies and specialty groups to facilitate the development of more CSGs in the future.

The Medicines for Children Research Network (MCRN) Clinical Studies Groups (CSGs) were established to facilitate the development of a portfolio of high quality randomised controlled trials and other studies of medicines for children.

• General Paediatrics (Chair: Dr Colin Powell) • MCRN/ARC Paediatric Rheumatology (Chair: Dr Michael Beresford) • MCRN/BAPN Nephrology (Chair: Dr Moin Saleem) • Methodology (Chair: Professor Peter Brocklehurst) • Neonatal (Chair: Professor David Field) • Neurosciences (Chair: Dr William Whitehouse) • Pharmacy and Pharmacology (Chair: Professor Ian Wong) • Respiratory and Cystic Fibrosis (Chair: Professor Jonathan Grigg)

At present, 12 MCRN CSGs exist covering most paediatric specialty areas: • Allergy, Infection and Immunity (Chair: Dr Mike Sharland) • Anaesthesia, Intensive Care, Pain and Cardiology (Chair: Dr Robert Tasker) • Diabetes, Endocrinology and Metabolic Medicine (Chair: Professor David Dunger) • Gastroenterology, Hepatology and Nutrition (Chair: Dr Stephen Murphy)

The remit of all CSGs is to: be responsible for developing and overseeing a comprehensive portfolio of studies; propose and support the development of protocols for new trials and other well-designed studies; review study protocols and advise the MCRN Study Adoption Committee; provide robust scientific evaluation, expert advice and support to investigators; ensure consumer involvement in all activities. The MCRN has attracted external funding

ERA-NET PRIOMEDCHILD

Further information on the CSGs can be found at http://www.mcrn.org.uk or by contacting the CSG Administrator at laura.pilkington@liverpool.ac.uk.

During 2008, the MCRN has been conducting the UK work package of the ERA-NET PRIOMEDCHILD Programme on Medicines for Children, in partnership with the MRC. PRIOMEDCHILD is a European research programme, funded through the EU sixth Continued on p15

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News College Budget 2008/9 and Membership Subscriptions 2009 Previous years, Subscription increases compared with RPI and Exam fee increases Subscriptions

RPI

5.0 Increase (%)

Council has set the College’s budget for 2008/9. The budget achieves a £192,000 increase on general funds, which exceeds the break-even recommended by Financial Governance & Audit Committee. As a result there is a small “safety margin” and/or some scope for inclusion of further developments. This is a significant achievement as there was no growth budgeted (compared with the previous year) and this is the first full year following the move to Theobalds Road. It therefore bodes well for the College’s long-term viability in its new headquarters. Membership subscriptions income of £3,134,000 accounts for 36.5% of the total College income of just over £8.5 million. Council agreed that most membership subscriptions would increase by 4% on 1 January 2009. It considered that this increase was essential to maintain the College’s activities. Council was satisfied that such a level of increase was unlikely to exceed the RPI measure of inflation which has already reached 5.0% for the year to 31 July 2008. A £20 reduction from £70 to £50 has been agreed for Senior Fellows and Senior Members so as to encourage them to retain their membership.

4.0 3.0 2.0 1.0 0 2003 2004 2005 2006 2007 2008

Year

The main subscription rates for 2009 will therefore be as follows: Membership Type Fellow UK & Republic of Ireland Fellow rest of EU & Nth America Fellow Elsewhere Ordinary UK & Republic of Ireland Ordinary rest of EU & Nth America Ordinary Elsewhere Junior (UK only) Honorary Fellow Senior Fellow / Member Associate UK, EU & Nth America Associate Elsewhere

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Dr Sue Hobbins HONORARY TREASURER

2009 rate £437* £328 £210 £366* £274 £175 £73 £85 £50 £186* £180

Rate shown includes Archives? Yes Yes Yes Yes Yes Yes No Yes No No No

* as in previous years, those resident in the UK and Ireland pay additional levies. Note also that payment surcharges may apply to those resident in the UK

Clinical Excellence Awards (ACCEA/SACDA) 2009 Round The clinical excellence awards process kicks off a month earlier than usual. ACCEA has announced that the deadline for submission for the 2009 round of awards will be in December rather than in January as in the past. As usual the College has been invited to submit nominations and as usual we will be asking Regional Reps on Council and conveners of specialty groups to send their short-lists for Gold, Silver and Bronze awards to us. Members in England and Wales eligible for awards should therefore expect to hear from their region shortly about local deadlines for submitting CVQs. These will need to be some time in October, in order to allow us to complete our processes and prepare a final College list. The timetable for Scotland is however unchanged, and members in

Members will continue to receive a personalised statement of the amount due in advance of the due date for payment together with details of standard concessions. Members are reminded that those who are in financial difficulty and thus finding it hard to pay their membership subscription can apply for a non - standard concession. For more information on subscriptions please contact the Membership Department on 020 7092 6060 or e-mail membership@rcpch.ac.uk

Scotland should have an extra month. One further change to the ACCEA system this year concerns the submission of supplementary forms. In previous years national applicants have been afforded the opportunity to submit a supplementary option along with their application; they have been able to choose between the Research option and the Teaching/Training option (with the Management option included for Platinum applicants only). For the 2009 round, the Management option has been extended to all national applicants. Under the revised scheme Bronze and Silver applicants may choose to submit one out of the following options: Research, Management, Teaching/Training. Gold applicants may choose to submit up to two of the options. Platinum applicants may submit all three.

We try each year to make our processes more open and to ensure that all eligible members – regardless of their specialty or background - have a fair chance of obtaining an award. Please contact us at the College if you have any questions about the process. More information is available on the College web-site: www.rcpch.ac.uk/About-theCollege/Clinical-Excellence-Awards-2009 ACCEA guidance for 2009 has been published and is available on the ACCEA web-site www.advisorybodies.doh.gov.uk/accea/. The on-line national awards application Information from the Scottish Advisory Committee on Distinction Awards can be found on: www.sacda.scot.nhs.uk/ Len Tyler CHIEF EXECUTIVE


News

RCPCH news

Workforce Census Results A statistical summary of the RCPCH 2007 Workforce Census is now available on the College website www.rcpch.ac.uk/workforce, and the full report will be published later during the autumn. The 2007 census is the 5th biennial census of the paediatric career grade workforce and once again achieved an excellent response rate of 97.9%. The College is extremely grateful to Clinical Directors/Leads and their staff for supplying the data, and mindful of the extra workload this imposes. Although some workforce data is available from other sources, undertaking our own surveys allows the College to be more flexible to produce data reflecting, for example, the introduction of the consultant contract or the WTD. 2007 census information has already been incorporated in the consultation for Modelling the Future and has been shared with DH and NHS Workforce Review Team. The census shows the total number of UK consultants in post growing steadily to 3011 in 2007 with 10.6% (5.2% growth per annum) from 2005. The career grade workforce

overall however, increased by only 4.3% in the same period and the number of SASG doctors continues to fall, by 4.2% per annum. The census also records a fourth successive decline in the size of the paediatric academic workforce and a fall in the community career grade workforce, although consultant numbers rose from 462 to 500 between 2005 and 2007. The numbers and proportions of tertiary specialists increased from 973 (22%) to 1134 (25.4%). 993 of these doctors worked in tertiary centres, an increase of 13.3% since 2005, and a further 141 were recorded in DGHs or other centres working as part of a specialist network. Trainee data were not collected as part of the census, but information gathered from the College’s enrolment process and other sources indicate that, given current trends, the expected number of new CCT holders will outstrip growth in jobs available. The proportion of female consultants grew to 45.8% in 2007 from 43.6% in 2005, although the proportion of women in the total career grade workforce fell marginally.

International Paediatric Training Scheme (IPTS) Fellowships The RCPCH offers the following advice to help overseas doctors to achieve postgraduate training in the UK for a specific period of time. Background All overseas doctors seeking clinical training in the UK are managed by the Royal Colleges. The International Paediatric Training Scheme (IPTS) depends entirely on trust between those involved: the sponsors, the College and the trainees. The scheme enables suitably qualified paediatricians to obtain registration with the GMC. The scheme is of mutual advantage to all parties when it works well. The sponsors from overseas receive good training in UK for their trainees, the UK training scheme can expect trainees of high calibre and motivation, links between UK and overseas institutions are strengthened and the trainee is exposed to a high standard of postgraduate medical education.

Aims IPTS aims to foster links between the United Kingdom (UK) and countries overseas. The IPTS fellowship provides a variety and depth of training and clinical experience in UK which is likely to complement that obtained in the overseas fellow’s home country. Moreover, training in UK provides overseas fellows an opportunity to experience a new culture and to see how cultural differences affect the presentation of illnesses. It also provides exposure to the organisation and management of health care within a National Health Service. IPTS Fellowship We have established a number of fellowships, which are links between various Paediatric departments in UK, overseas institutions (e.g. Sri Lanka, Pakistan, Libya and Myanmar) and the RCPCH. IPTS trainees

53.5% of Community consultants are now aged over 50 years compared to 51.7% in 2005 and to 35.4% in general acute paediatrics. The average number of PAs contracted by all consultants (including those working parttime) was 10.5 per week compared to 10.8 in 2005. 18.3% of consultants for whom PA information is available are contracted for fewer than 10 PAs per week. This compares with 17.5% who worked part time or maximum part time in 2005. Individual consultants were also surveyed and this revealed that they work on average 1.24 PAs more than contracted - the equivalent of the over 370 consultants on a 10 PA contract. Workforce pressures perceived by Clinical Directors and Leads were similar to those recorded in 2005 with staff shortages being the greatest pressure reported by 90 (32%) trusts. Policy issues, especially WTD implementation, excessive workload and an inability to recruit were all also mentioned by at least a quarter of respondents. Issues relating to care, continuity and safety were more noticeably prominent in 2007 than 2005 being raised by 40 clinical directors. Martin McColgan WORKFORCE INFORMATION OFFICER

in these posts will be eligible for 2 years’ sponsorship under the scheme. This time limit is due to the new immigration rules. Overseas doctors wishing to come and train in the UK need TWES (MTI) work permit which is only for up to 2 years. Development of new fellowships The College has been looking at different ways to broaden the scope of the IPTS Fellowship scheme. At the moment we are currently in the process of setting up new fellowships, but are still in the very early stages. The establishment of new fellowships will be mutually beneficial for UK hospitals and the links overseas. For further information and in order to set up IPTS fellowship scheme, please contact: Maria Kirk (IPTS Administrator) at maria.kirk@rcpch.ac.uk or Dr Mansoor Ahmed (IPTS Liaison Officer) at mansoor.ahmed@burtonh-tr.wmids.nhs.uk Dr Mansoor Ahmed and Maria Kirk

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News

RCPCH and the media – a report The RCPCH press office recently carried out an analysis of the College’s media coverage. There is a genuine feeling that the RCPCH is gaining a higher profile in the media and with journalists, both nationally and with the specialist professional press. Increasingly the first port of call for many journalists who are looking for an expert view, quote, and explanation of a condition or issue – the College is also regularly called for background research to inform programmes and articles. It is difficult to measure overall public relations successes. Many calls that come through to the press office don’t result in actual visible coverage. General awareness and column inches have increased over the past few years though and a large part of this also includes educating journalists about paediatrics. In addition, we sometimes successfully keep things out of the media – as well as putting stories out proactively.

Feedback from journalists A number of journalists were asked for feedback on the ‘service’ we provide, with most commenting favourably. Some did say that the College could be more outspoken. Many commented on the swift response to queries and that College spokespeople were accessible. The BBC health team said specifically that they appreciate our ongoing advice on topical issues and that they get an informative response to their queries. Building relationships with journalists is very important to us. We recently invited BBC Social Affairs correspondent, Alison Holt, into the College to meet some of the Officers and representatives. Child protection, MMR, end of life decisions and educating the public about science were covered and feedback afterwards was very positive from both sides. Collaborative working is also a major part of our media strategy. A recent example is the child protection briefing earlier this year with the Science Media Centre (SMC). Held at the SMC, a panel of paediatricians and child psychiatrists took a range of questions from national health and social affairs journalists about this area of work, resulting in national newspaper articles the following day.

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RCPCH Press Panel If the College does not have a position or policy on a particular subject or childhood illness for example, then the Press Office has a Press Panel to field these types of media enquiries to. The Press Panel is made up of over a hundred paediatricians and the Press Office puts them in direct contact with journalists to provide ‘independent’ expert comment and advice. If you would like more information on the Press Panel, please email press.office@rcpch.ac.uk The future The College is clearly getting more publicity, especially with the national press. It is also clear that increases in media activity are linked to specific news, events, and topical issues of the time. Working closely with the President and Officers, the Press Office will continue to promote College work where it can and scope out opportunities to be proactive as well as reactive. We need to continue to recognise the increasing need to be more outspoken, but only where we feel we have the expertise and are the best - and most appropriate organisation to give it. The regularity of our press releases and statements is in line with most similar organisations, so we feel that the balance is right here. We will carry on assessing risk and becoming more opportunistic where possible.

Broadcast Interviews There has also been a significant increase in the number of broadcast interviews. The numbers below are for television and radio interviews with the President, Patricia Hamilton, Officers or College representatives – such as the Officer for Child Protection, Rosalyn Proops. Interviews April 2006 - March 2007 = 12 interviews April 2007- March 2008 = 29 interviews Claire Brunert HEAD OF MEDIA AFFAIRS Ella Wilson MEDIA AFFAIRS ASSISTANT


RCPCH news October 2007 to March 2008

Media coverage - overview We looked at a six month period, from October 2007 to March 2008 – and compared this with the same period the previous year to see what paediatric and child health related stories and topics we were commenting on – but also other paediatrics stories that were in the media at that time, which we did not comment on. Summary of main stories October 2006 to March 2007 Month

RCPCH stories

Paediatrics stories

October

Childhood obesity IVF guidelines

Hospital care of premature babies GMC case - paediatrician IVF guidelines

November Premature baby survival rates

Premature baby survival rates

December Expert witness work Paediatric services

GMC case - paediatrician Maternity unit shakeup Vaccinations

January

A&E reform Child protection work Interview with RCPCH President

Children’s medicines Child protection work

February

Child asylum seekers & x-rays to determine age Hospitals failing children

Breastfeeding Child protection work MMR Childhood obesity Premature babies GMC case - paediatrician

Child asylum seekers & x-rays Children’s surgery A&E reform BPSU study – early onset eating disorders

Teenage health Junior doctors and MMC Expert witnesses

March

Month

RCPCH stories

Paediatrics stories

October

NHS maternity services Childhood obesity Bringing up Baby (Channel 4 programme)

Childhood obesity NHS maternity services Breastfeeding Child protection work

November Bringing up Baby Chickenpox vaccine Child asylum seekers & x-rays RCPCH in Middle East Neonatal care Formula milk Childhood obesity

Chickenpox vaccine GMC case - paediatrician Childhood obesity Breastfeeding MMR Child protection work

December GMC case - paediatrician Child protection work Neonatal care

GMC case - paediatrician MMR Child protection work Cot death Shaken baby syndrome Premature babies (BAPM)

January

Shortage of paediatric pathologists Prescription of children’s medicines Bringing up Baby GMC case - paediatrician Child protection work

Vitamin D deficiency Children’s cough medicines Abortion debate Neonatal units

February

Bringing up Baby Faulty hospital scales Child protection Smacking

Premature babies survival rates (BAPM) Child protection MMR Childhood obesity

March

Child protection New RCPCH careers booklet Premature babies

Childhood obesity MMR Foetal alcohol syndrome Premature babies – long term effects Children’s cough medicines

Articles printed and online We also looked at how many times the RCPCH was mentioned in print and online articles for both periods and how many times paediatrics was in the news. Comparison of “RCPCH” mentions in media

Comparison of “Paediatrics” mentions in media

80

80 2006/2007

2006/2007

70

70 2007/2008 Number of articles

Number of articles

2007/2008 60 50 40 30 20 10

60 50 40 30 20 10

0

0 Oct

Nov

Dec

Jan Month

Feb

Mar

TOTAL

Oct

Nov

Dec

Jan

Feb

Mar

TOTAL

Month

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Education

RCPCH Education Update 1. Spring Meeting 2009 13th Spring Meeting 30 March -2 April 2009 University of York New format for 2009 Have you not been to the Spring Meeting before? If not, why not give us a try in 2009? The Spring Meeting is the College’s main forum for the presentation of basic and clinical science, together with updates in clinical practice. It is attended by over 1800 participants, including paediatricians, trainees and those involved in child health. Do you have some research work to submit to the RCPCH Spring Meeting? We will be accepting abstracts from September 2008. Submissions will be accepted via our website www.rcpch.ac.uk

2. Paediatric Educators Programme (PEP) 27-28 November 2008 PEP has been designed by paediatricians who have an active interest in education, many of whom hold appointments with educational components. This course is intended for paediatricians who have either been on a generic/basic teaching course and/or those with a reasonable level of experience who teach on the job. The programme has 3 compulsory components: 1. Two-day “core” delivered centrally (RCPCH London) for all participants on November 27 -28 November 2008. 2. Two locally based Learning Group meetings to follow in January and March 2009. 3. A Learning Development Portfolio, which is designed to facilitate personal development as an educator through work for each meeting, and provide a wide range of resources both for use in the programme and your future educational practice. Website: www.rcpch.ac.uk/Education/Education-Courses-and-Programmes/Paediatric-Educators-Programme

3. Child in Mind Workshops The ‘Child in Mind’ project is funded by the RCPCH, and the Department of Health, to design training materials for paediatricians in child mental health as it relates to paediatrics (paediatric mental health). Whilst the workshops were designed for paediatric trainers and child mental health co-trainers (e.g. child psychiatrists, senior nurses and psychologists), the course materials are aimed at SHOs (STs 1-3) and are designed to be run alongside, or be integrated into, your regular departmental teaching programme. ‘Child in Mind’ London Stages 1 & 2

Thursday, 13 November 2008

Stage 3

Wednesday, 19 November 2008

‘Child in Mind’ Liverpool Stage 1 & 2

Thursday, 6 November 2008

Stage 3

Friday, 7 November 2008

Website: www.rcpch.ac.uk/cim for more information

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RCPCH news 4. Other Courses Adolescent Health Project This project aims to improve the health outcomes of the UK’s young people by providing e-learning materials to health professionals at all levels and across all health professions. The initiative is funded by the DH and supported by e-learning for healthcare. The project was launched on the 14th of July this summer and is free to all registered users. The curriculum for the Adolescent Health Project maps across the competences for all the relevant Royal Colleges and consists of 14 modules covering a broad spectrum of key topics. Topics range from health promotion and youth friendly services to self-harm and obesity. As well as trainee focused pathways, learners and educators have the ability to create individual learning pathways through the materials. The resources include high resolution images and video clips capturing the voices and opinions of young people and health professionals. This project is now launched and is available via the project’s website www.rcpch.ac.uk/AHP

Court Skills in Child Protection A two-day course about family and criminal law in England and Wales, evidence gathering, receiving instructions, report writing and preparing for court. Dates for the next course will be advertised on our website soon.

Diploma in Paediatric Nutrition The aim of the Diploma is to help paediatricians develop an understanding of what nutrition is and how it impacts on their work. Dates for the 2009 course will be advertised on our website soon.

Safeguarding Children: Recognition and Response in Child Protecction An educational programme, for doctors in training, to, “raise awareness of child protection issues and equip doctors in training with the knowledge and skills to enable them to recognise and respond to child protection (CP) situations competently and confidently at a level appropriate to their stage of training”. Website: www.rcpch.ac.uk/Education/Education-Courses-and-Programmes/Safeguarding-Children

Palestine Child Health Diploma A new programme aimed at GPs and nurses working in primary care was established, in collaboration with paediatricians in the West Bank and using a pilot site in Ramallah where a group of 10 is currently undergoing a year long child health course which will lead (for those successful) to a Palestinian Certificate in Child Health. Website: www.rcpch.ac.uk/Education/Education-Courses-and-Programmes/Teaching-Child-Health-in-Palestine

Iraq For 5 years now the College has run an educational programme for paediatricians in Iraq. This programme is run in collaboration with The Jordan Paediatric Society. The programme is held in Jordan and includes doctors from Jordan, the West Bank and Iraq. For more information on this programme please contact rosalind.topping@rcpch.ac.uk.

Fellowships The College is very proud of its Fellowships. They have enabled many colleagues from overseas to visit the UK to learn some techniques and methods from UK paediatricians. We have always had excellent feedback from those visiting the UK and are told time and time again how much the programme helps to shape services and save lives back home. If you have any contact overseas who would be interested in our Fellowships, please pass the details of our website onto them. If you are interested in hosting a Fellow, please contact aaron.barham@rcpch.ac.uk. All Fellowships cover all associated costs, including economy travel and subsistence whilst in the UK. The College also administers and organises the entire visit for each Fellow.

5. Continuing Professional Development (CPD) Still sending in your returns by card? You can save time, paper and money by making your submissions online at: www.cpd.rcpch.ac.uk (you can, of course, continue to send your returns in the mail if you wish, but please do not do both!) All you need to register for the online system is your surname, GMC number and an email address. You can register at: www.cpd.rcpch.ac.uk/register.php Did you know... If you use the online system, you can print an up-to-date certificate at anytime. An update to the system will be coming soon – adding new features and making it even more interactive. Effectiveness of CPD Questionnaire We would be grateful if as many paediatricians as possible could complete the questionnaire at the following link: Website: www.xeoxeo.com/cpdsurvey/ This is a GMC funded project to evaluate the perception of CPD.

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News SASG news Well, I’m writing this just prior to going on holiday. Over the last couple of weeks, the SASG committee has had more direct contact from SASG members of RCPCH than we have had throughout the year. Many of the questions are around terms and conditions of service, and official advice should be sought from the BMA or other trade unions. The most asked question is different versions of “I’ve heard this is a funded contract but my trust doesn’t know how to get the money to implement the contract?” NHS Employers have explained that the sum of money for the implementation was in the general uplift that trusts receive rather

than a ring-fenced pot of money. So the message to feed back to your trust is that they have received the money already. The next question is around the PA allocation for supporting activities. Some SASG doctors were under the impression that we would all be paid an additional PA on top of what we currently receive to do clinical governance activities and CPD. It’s correct that we are entitled to an SPA for these activities but if this can be incorporated within your job plan within existing hours this is acceptable. As I’ve said previously, I feel it is really good news that the importance of time to carry out these professional activities has been

BPSU Update

BPSU Annual Report 2008.

BPSU annual report September sees the publication of the 2007-08 BPSU annual report. In attempt to reduce our carbon footprint we are only circulating copies to those currently receiving the orange card. However, the report can be found in PDF form on the College’s website at www.rcpch.ac.uk/publications or via the BPSU website at www.bpsu.inopsu.com Also we do have a limited number of copies available in the office so if you would prefer to receive this please contact the BPSU office at helen.friend@rcpch.ac.uk. The report highlights the current studies undertaken including data on MRSA, an update on the newer studies idiopathic intracranial hypertension and genital herpes as well as the status of long term studies such as HIV, congenital rubella and PIND. As always a big thank you for all those who have returned your cards, over 94% in 2007, and completed questionnaires after reporting a case.

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 November 2008

Advertisements: British Medical Journal

Page 12

recognised. Lets just make sure we use the SPA productively for these activities and keep good records of the outcomes we achieve from this, rather than letting the time get swallowed up by clinical administration, which should be done in a clinical PA. We are trying to refresh our network of Regional SASG representatives. Several positions are advertised with this newsletter. Why not see if there is a vacancy in your region? Don’t forget our SASG information day at the College on 14th November 2008 – it’s such a good opportunity to find out what the College offers to support us. I look forward to meeting you then. Dr Nataile Lyth CHAIR OF THE RCPCH SASG COMMITTEE

Call for nomination Professor Adam Finn and Dr Donal Manning have recently stepped down from the BPSU Executive. The BPSU is therefore seeking nominations for their replacement. If you are interested in contributing to this national and internationally respected activity please visit www.rcpch.ac.uk/About-the-College/RCPCHOfficers/nominations and complete a nomination form. In the meantime, if you wish to know more, do not hesitate to email the chairman Professor Allan Colver at allan.colver@ncl.ac.uk or Richard Lynn, scientific coordinator at bpsu@rcpch.ac.uk. BPSU Scientific meeting An early notice of a conference that BPSU will be holding on the 3rd March 2009 at the Royal Institute of British Architecture. The day will consist of presentations around the themes of infectious disease; informing policy and practice; and developing partnerships. If you are interested in knowing more or wish to pre-reserve a place contact the BPSU office or visit www.rcpch.ac.uk/Education/Events Richard Lynn BPSU SCIENTIFIC COORDINATOR

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.


Y #U S T IME &PI1EN

DELIVERS A RAPID SINGLE DOSE OF INT RAMUSCULAR ADRENALINE FOR FAST PHYSIOLOGICAL EFFECTS 1,2 ®

Y #U S MORE T I ME

"VAILABLE IN A 5WIN 1ACK –

BECAUSE ANAPHYLACTIC REACTIONS CAN BE BIPHASIC 3

TWIN PACK

TWIN PACK

References: 1. Simons FER, Roberts JR, Gu X, Simons KJ. Epinephrine absorption in children with a history of anaphylaxis. J Allergy Clin Immunol 1998; 101: 33–7. 2. Simons FER, Gu X, Simons KJ. Intramuscular (IM) injection of epinephrine in adults. What is the optimal interval between doses? J Allergy Clin Immunol 2004; 113: S259. 3. Lee JM, Greenes DS. Biphasic anaphylactic reactions in pediatrics. Pediatrics 2000; 160: 762–6.

EpiPen® Auto-Injector abbreviated prescribing information. Please refer to the Summary of Product Characteristics before prescribing. Presentation: EpiPen delivers a single dose of 0.3mg of adrenaline BP 1:1000 (0.3ml) in a sterile solution. EpiPen Jr. delivers a single dose of 0.15mg adrenaline BP 1:2000 (0.3ml) in a sterile solution. 1.7ml of adrenaline remains in the auto-injector after activation. Uses: Intramuscular adrenaline is considered the first-line drug of choice for allergic emergencies. Adrenaline effectively reverses the symptoms of rhinitis, urticaria, bronchospasm and hypotension. The strong vasoconstrictor action of adrenaline, through its effect on alpha adrenergic receptors, acts quickly to counter vasodilation and increased vascular permeability which can lead to loss of intravascular fluid volume and hypotension during anaphylactic reactions. Adrenaline, through its action on beta receptors on bronchial smooth muscles, causes relaxation which alleviates wheezing and dyspnoea. Adrenaline also alleviates pruritus, urticaria and angioedema and may be effective in relieving gastrointestinal and genitourinary symptoms associated with anaphylaxis. Indication: EpiPen is intended for immediate self administration in the emergency treatment of allergic anaphylactic reactions. Anaphylaxis may be caused by insect stings or bites, foods, drugs and other allergens as well as idiopathic or exercise-induced anaphylaxis. Reactions may

occur within minutes of exposure and consist of flushing, syncope, tachycardia, faint or unobtainable pulse associated with a fall in blood pressure, convulsions, vomiting, diarrhoea and abdominal cramps, involuntary voiding, wheezing, dyspnoea due to laryngeal spasm, pruritus, rashes, urticaria or angioedema. Dosage and Administration: ADULTS: Self administration of 0.3mg adrenaline (EpiPen ) intramuscularly. CHILDREN: The appropriate dosage may be 0.15mg (EpiPen Jr.) for children 15-30kg body weight and 0.3mg (EpiPen) adrenaline for children >30kg body weight, or at the discretion of the physician. EpiPen should only be injected into the anterolateral aspect of the thigh through clothing if necessary. In the absence of clinical improvement or if deterioration occurs after the initial treatment, a second injection with an additional EpiPen Auto-Injector may be necessary. The repeated injection may be administered after about 5 – 15 minutes. As EpiPen is designed for emergency treatment, the patient should always seek immediate medical attention even if symptoms have disappeared. Contra-indications: There are no absolute contra-indications to the use of adrenaline in a life threatening situation. Warnings: Avoid the risk of inadvertent intravascular injection. DO NOT INJECT INTO THE BUTTOCKS. Accidental injection into the hands or feet may result in loss of blood flow to the affected areas. Precautions: Patients must be instructed

in the proper use of EpiPen. Use with extreme caution in patients with heart disease and those taking digitalis, mercurial diuretic or quinidine. The effects of adrenaline may be potentiated by tricyclic antidepressants and monoamine oxidase inhibitors. Adrenaline should be used in pregnancy only if the potential benefit justifies any potential risk to the foetus. Adverse events: May include palpitations, tachycardia, sweating, nausea and vomiting, respiratory difficulty, pallor, dizziness, nervousness and anxiety. Cardiac arrhythmias may follow administration of adrenaline. Overdoses of adrenaline may cause cerebral haemorrhage or arrhythmias. Legal Category: POM. Basic NHS Cost: EpiPen and EpiPen Jr. are available as single unit doses at £28.05 each. EpiPen and EpiPen Jr. are also available as twin packs; two single unit doses at £56.10. Marketing Authorisation Numbers: EpiPen Auto Injector 10085/0012. EpiPen Jr. Auto-Injector 10085/0013. Marketing Authorisation holder: ALK-Abelló A/S, Bøge Alle 6-8, DK-2970, Hørsholm, Denmark. Telephone: (+45) 45 74 74 45 Date of last revision: March 2008. Item code 196E. Customer contact: ALK-Abelló Ltd, 1 Tealgate, Hungerford, Berkshire, RG17 0YT, United Kingdom. Telephone: (01488) 686016 Website www.epipen.co.uk

www.epipen.co.uk www.alk-abello.co.uk

Information about adverse event reporting can be found at www.yellowcard.gov.uk Adverse events should also be reported to ALK-Abelló Ltd. (tel: 01488 686016)

Date of preparation: March 2008. Code No. 197E


Trainees Trainees’ column Over the last few months, a number of contentious issues have kept the Trainees’ Committee very busy.

Funding for Assessments The issue of charging trainees for assessment has been the subject that has dominated discussions within the Trainees’ Committee over the last few months. Following a suspension of this levy last year, we have remained strongly opposed to the introduction of a new charge for assessments. However, our case of opposition was overruled by College Council in June 2008. The Trainees’ Committee is not opposed to the introduction of the assessments process, but to the tariff attached. The Committee has raised significant concerns that the assessments system remains inequitable around the country despite the imminent introduction of this charge. Furthermore, given that PMETB currently governs training and assessments, the Committee feels that there should be some degree of financial support from PMETB for this mandatory process. Trainees in specialty training are required to enrol for training and pay a cost of £70 to undergo assessments and receive the e-portfolio. Current SpRs may enrol with the College and either choose to receive the whole package or to undergo e-sprat at a reduced cost. I would encourage Trainees to write to me at pauldimitri@hotmail.com with your opinions regarding this issue.

MMC and Recruitment Following the MTAS debacle of 2007, the newly introduced national recruitment system for Paediatrics has been more successful. Recruitment to ST posts has been in excess of 80%. Any remaining posts will have been advertised locally. The future of the FTSTA is currently the subject of discussion at the RCPCH and MMC programme board. Progression from FTSTA to ST posts is becoming increasingly restricted. The Trainees’ Committee are currently in favour of a reduction in the number of FTSTAs in favour of an increase in ST posts to provide a progressive pathway for UK paediatric trainees. Four MMC roadshows have taken place in June and July in England. The MMC programme board is keen to seek the views of all stakeholders including trainees on how MMC progresses in 2009 and beyond.

Recruitment Concerns Following issues raised at the Spring Meeting over recruitment difficulties in some regions leading to low morale, the Trainees’ Committee has performed a survey to identify key concerns. 450 trainees followed the survey from start to finish. Over 50% of trainees responded that there were gaps on their current rota with 10% of respondents stating the rota was more than three doctors short. Trainees in subspecialties are often supporting general rotas. This issue has been taken very seriously and our President is currently discussing these issues with Ministers to try and resolve these problems.

UK Retinopathy of Prematurity Guideline for Screening and Treatment 2008 The new UK Retinopathy of Prematurity Guideline for Screening and Treatment was published in May. This is a joint publication by the RCPCH, RCOphth, BAPM and the charity BLISS and was produced according to the RCPCH standards for guideline development. Professors Andrew Wilkinson (RCPCH) and Alistair Fielder (RCOphth) were the joint chairs of the Guideline Development

Page 14

Group. The 23 members gave wide representation that contributed to the document which has now been endorsed by the Council of all the organisations involved. A copy has been sent to the Lead clinician in every Neonatal Unit and Network. The Executive Summary has gone to every Medical Director and Chief Executive. Of particular relevance to them will be the

National Trainees Meeting A working group has been established within the Trainees’ Committee to establish a National Trainees Meeting in York for 2009. We are hoping to provide a new forum for Trainees to voice opinions and discuss current training issues. We are also planning to have keynote speakers. I would encourage all trainees interested in the way their training is developed to contact us with ideas they have for this forum and to attend in 2009.

Vice Chair of the Trainees’ Committee Nominations have been received and we currently have two candidates running for the post of Vice Chair. I would encourage all trainees to use their vote. Members of the Trainees’ Committee represent your voice in political matters, consultation with other stakeholders and in the decisions that are made in training and education.

Your Opinion Counts! We are a body established to represent trainees. The Trainees’ Committee always values your views. Please contact the Chair, Vice Chair or your regional representatives if you have any issue you would like to discuss. Contact details are available on the Trainees section of the website.

Dr Paul Dimitri CHAIR, TRAINEES’ COMMITTEE pauldimitri@hotmail.com

recommendations with respect to the organisation of services and the work commitment of screening consultant ophthalmologists. The executive summary has also been published in Early Human Development. Wilkinson AR, Haines L, Head K, Fielder AR. UK Retinopathy of Prematurity Guideline. 2008; 84:71-74. and the full guideline and appendices is available at www.rcpch.ac.uk/ROP. Linda Haines HEAD OF RESEARCH


RCPCH news

Meetings RCPCH meetings UK meetings and courses 2008 25-27 September 2008 RCPCH/RCPE joint symposium New Approcahes to Paediatric Epilepsy Venue: Royal College of Physicians of Edinburgh Contact: Eileen Strawn Tel: 0131 225 7324 Email: e.strawn@rcpe.ac.uk Website: www.rcpe.ac.uk/education/events/ paediatric-epilepsy-sep-08.php 26 September 2008 Nutrition in Childhood - Meeting the Challenge - CPD conference Venue: The Newton Hotel, Nairn, Scotland Contact: Fiona O’Fee Tel: 01463 258837 Email: admin@fabresearch.org Website: www.fabresearch.org 29 September 2008 (5 days) Annual Scottish Advanced Paediatric Dermatology Course Venue: Ninewells Hospital, Dundee, Scotland Contact: Jill Lamont Tel: 01382 632821 Email: jill.lamont@nhs.net Website: www.dundee.ac.uk/dermatology/derm/ dermintro_files/dermintro.htm 30 September 2008 Ronnie MacKeith: his contribution to paediatrics yesterday and today Venue: RCPCH, 5-11 Theobalds Road, London Tel: 020 7092 6105 Email: aaron.barham@rcpch.ac.uk Website: rcpch.ac.uk 1-2 October 2008 Brazelton Centre in Great Britain Venue: The Royal Free Hospital, London Contact: Helen Wells Telephone: 01223 245791 Email: info@brazelton.co.uk Website: www.brazelton.co.uk 1 October 2008 Gender Identity Disorder in Adolescents Venue: The Royal Society of Medicine, London Contact: Chandni Kohar Telephone: 020 7290 2965 Email: chandni.kohar@rsm.ac.uk Website: www.rsm.ac.uk/academ/gid08.php 2 October 2008 The Safety of Birth - new and emerging evidence Organised by the NPEU Venue: Martin Wood Lecture Theatre, University of Oxford Contact: Lynne Roberts Tel: 01865 289719 Email: lynne.roberts@npeu.ox.ac.uk Website: www.npeu.ox.ac.uk/conference

2-3 October 2008 Gastroenterology for General Paediatrics 2008 Venue: Institute of Child Health, London Contact: Colin D'Cruz Tel: 020 7829 8692 Email: info@ichevents.com Website: www.ichevents.com 3 October 2008 GSF ADHD Study Day: A NICE Awakening Venue: RCPCH, London Contact: Dr Somnath Banerjee Tel: 07941156519 Email: somnath.b@doctors.org.uk Website: www.georgestillforum.co.uk 3-5 October 2008 Omega-3 for behaviour, learning and mood; science, policy and practice - CPD conference Venue: Said Business School, Oxford Contact: Fiona O’Fee Tel: 01463 258837 Email: admin@fabresearch.org Website: www.fabresearch.org 6 October 2008 Family health legacy - Ethical dilemmas in promoting health for children separated from their genetic roots Venue: London Telephone: 020 7421 2637 Website: www.baaf.org.uk 6 October 2008 RCPCH Annual Tutors Meeting Venue: Wellcome Collection, Euston Rd, London Contact: Aaron Barham Tel: 020 7092 6105 Email: aaron.barham@rcpch.ac.uk Website: rcpch.ac.uk 8 October 2008 Immunisation and Vaccination Study Day Venue: Stockport Medical Education Centre, Pinewood House, Cheshire Tel: 0161 419 4684 9-10 October 2007 Young People’s Health Special Interest Group Conference: Improving paediatric practice in young people’s health Venue: Harborne Hall, Birmingham Contact: Diane Burgess Telephone: 01661867749 Email: diane.burgess@northumberlandcaretrust.nhs.uk Website: www.yphsig.org.uk 13-14 October 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 October 2008 Do you use or abuse NICE guidelines in your clinical practice? Joint Meeting of the Paediatrics and Child Health section, RSM and the RCPCH Venue: Royal Society of Medicine, London Contact: Andrea Török Telephone: 020 7290 2986 Email: paediatrics@rsm.ac.uk

22-23 January 2009 Paediatric and Adolescent Obesity Course for Paediatricians Venue: RCPCH Office, London Contact: Aaron Barham Tel: 020 7092 6105 Email: aaron.barham@rcpch.ac.uk Website: www.rcpch.ac.uk

Continued from p5 Framework and aims to improve the coordination of paediatric research across Europe by fostering trans-national research cooperation, establishing best practice and identifying barriers for children’s medicines research and developing European research priority setting and funding strategies in cooperation with stakeholder groups. The UK work package focuses on conducting a pan-European priority setting exercise to inform the common research agenda, and identifying key medicines for children research priorities to be fed into a subsequent funding call. Results of PRIOMEDCHILD will be presented at a European Conference in November and will be published in a report at the end of the year. For more information, contact the UK PRIOMEDCHILD Programme Manager at Jennifer.Blakeburn@mcrn.org.uk or visit www.priomedchild.eu (The NIHR Medicines for Children Research Network is part of the National Institute for Health Research and the UK Clinical Research Network)

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RCPCH Newsletter 08 Autumn