RCPCH Annual Report 2010 by Royal College of Paediatrics and Child Health

ANNUAL REPORT 2010

FROM THE COLLEGE’S ROYAL CHARTER The objectives of the College are: (i)

to advance the art and science of Paediatrics;

(ii)

to raise the standard of medical care provided to children;

(iii)

to educate and examine those concerned with the health of children;

(iv)

to advance the education of the public (and in particular medical practitioners) in child health which means the protection of children, the prevention of illness and disease in children and safeguarding their optimal development.

CONTENTS FROM THE PRESIDENT/CEO

COMMUNICATIONS

RESEARCH AND POLICY

EDUCATION AND TRAINING

CORPORATE SERVICES

INTERNATIONAL WORK

DEVOLVED NATIONS

THE FUTURE

FORM OF CODICIL MAKING A BEQUEST OR DONATION TO THE COLLEGE

MISSION/VISION/VALUES

FROM THE PRESIDENT AND THE CHIEF EXECUTIVE

Dr Chris Hanvey, Chief Executive

Prof Terence Stephenson, President

WE AIM TO SUPPORT PAEDIATRICIANS NOT JUST AT THE BEGINNING OF THEIR CAREERS BUT THROUGHOUT. Professor Terence Stephenson, President

This has been a year of enormous change for the College and for child health. The new Coalition Government wasted no time in setting out its intentions. It published the previously-commissioned Kennedy Report in September 2010, followed by the White Paper ‘Equity and Excellence: Liberating the NHS’. Both will have huge impacts on the way in which children are cared for. The College responded to both, and has continued to engage with policy-makers in the four nations. At the heart of our approach, as always, has been ensuring that children receive the best possible care. Our own Facing the Future report, published in the Spring 2011, argues for significant change in the ways in which the paediatric workforce is configured, and we hope that members will engage fully in the vital issues it raises. Within the College, we have also undertaken major change. A full exercise to assess our staff structure took place in the spring and summer of 2010, and implementation has been undertaken since then. Although, sadly, several long-serving staff left during the process, we are confident that the new staff structure we have as a result will be more robust, more accountable, and more able to deliver our strategic goals. As part of the restructuring, we have also introduced a new People Strategy, whose aim is to allow our staff many more opportunities to develop and grow. We also undertook an exercise to rebrand the College, which was completed on time (in November 2010) and 25% under its budget. The impetus for this was an earlier series of workshops with members and others on the College’s Mission, Vision, and Values. We sought to project an image suitable for a vibrant College while not losing sight of our heritage. The rebranding should also be seen within the context of our other work to raise the profile of the College and of child health. We have instituted a successful series of “policy breakfasts” which have been addressed by – amongst others –

Frank Field, Stephen Dorrell, and Sir Ian Kennedy. It has also been a year when we have sought to make the College more fully a four-nation organisation. Major events have taken place in Scotland, Northern Ireland, and Wales, most recently a major St David’s Day conference on children’s rights, attended by all four of the UK’s Children’s Commissioners. The College’s exams continue to be one of our flagship activities, and the expansion of the MRCPCH exam to India this year has been a major achievement. It represents a great opportunity for the College to help guarantee the standards of child health care in one of the most populous nations in the world. As this is being written, however, the political turmoil in the Middle East means that we have had to postpone some diets of exams held in that region. Our long-term commitment to those countries, and more broadly to expanding the reach of our exams, remains unchanged. Over the coming year, the College’s major priorities are: ■ The launch of a new College website to provide members and others with more accessible and more personalised information. ■ The launch of a major fundraising campaign, to mark fifteen years since the Royal Charter. ■ An expansion in our international activities. ■ Increased levels of support and services to members. ■ Embedding the staff restructuring described above. ■ The establishment of a 2011-14 business plan to guide our future work. It is our hope that members and other stakeholders will see visible improvements in all areas of our work from the foundations we have built this year. Professor Terence Stephenson, President Dr Chris Hanvey, Chief Executive

COMMUNICATIONS

BY COMMUNICATING EFFECTIVELY ABOUT THE COLLEGE'S GOALS AND PRIORITIES, WE CAN RAISE THE PROFILE OF CHILDREN'S AND YOUNG PEOPLE'S HEALTH NEEDS.

Media

Events

During the last twelve months, our media work has focused on the major policy statements that have been developed (see overleaf). The College has also gained high prominence for its responses to external policy documents, such as the Kennedy Report on Child care and the Government’s proposed NHS health reforms in the Health and Social Care Bill.

The College’s flagship event is its Annual Conference, which in 2010 was held at the University of Warwick after many years in York. Despite taking place during the Icelandic volcano eruption that grounded UK air flights, attendance was up on the previous year, as were delegates’ responses in their feedback questionnaires. Other courses this year included the Court Skills in Child Protection, which gives the opportunity for paediatricians to work with lawyers to understand the particular stresses of giving evidence in child protection cases.

Rebranding

OUR GOALS: TO RECRUIT 255 NEW FELLOWS BY 31 AUGUST, 2011 TO GO LIVE WITH OUR NEW WEBSITE, ON A NEW PLATFORM, BY AUGUST 2011 TO ACHIEVE A 10% INCREASE (ON 2009/10) IN POSITIVE MEDIA COVERAGE AND PRESENCE IN A WIDER RANGE OF MEDIA OUTLETS.

This year, we’ve been developing a new College Mission, Vision & Values statement, following consultations with members throughout the UK. The Council agreed to a rebranding project. This was delivered in November 2010, 25% under budget, and can now be seen on our publications, website and buildings.

Membership Importantly, we needed to develop the level of service we provide to our members (without increasing fees). Membership numbers have continued to grow over the last few years, with new services such as the online ASSET and E-Portfolio being provided to trainees. Total College membership now exceeds 12,000. A new category of Student Membership allows medical students who’ve not yet embarked on paediatric training to become affiliated to the College. Nearly 400 students have taken this up so far.

Publications Our flagship journal ‘Archives of Disease in Childhood’ (co-owned with the BMJ) continues to flourish under the editorship of Professor Howard Bauchner. It has expanded its reach to countries such as Brazil and extended its web presence. The British National Formulary for Children, published with the BMJ and the Royal Pharmaceutical Society, celebrated its 5th anniversary with a reception at the Houses of Parliament. Other new publications included a joint venture with the European Academy of Paediatrics to produce a new edition of the popular “Mastercourse”. Dovetailing paediatric curricula across Europe, the book was edited by Malcolm Levene and Alfredo Tenore, and published by Elsevier in October 2010.

RESEARCH AND POLICY THE COLLEGE DEVELOPS HIGH QUALITY PIECES OF RESEARCH TO DRIVE POLICY FORMATION. IN TURN, WE USE OUR POLICIES TO LOBBY FOR HIGHER QUALITY TREATMENT OF CHILDREN AND YOUNG PEOPLE – BOTH IN THE UK AND ABROAD.

■ The creation of National Care Pathways for childhood allergies ■ A major piece of work on understanding parents’ information needs and experiences when professional concerns of non-accidental injury were not substantiated ■ A national survey to ascertain the number of children with diabetes ■ Care bundles aimed at providing safer practice in neonatal care

CENTRAL TO OUR RESEARCH PROFILE IS A RIGOROUS, EVIDENCE-BASED APPROACH TO HEALTH CARE. AS AN EXAMPLE OF THIS, OUR CLINICAL STANDARDS UNIT WORKS TO EVALUATE GUIDELINES PRODUCED BY OTHER BODIES (THESE ARE PUBLISHED ONLINE AT WWW.RCPCH.AC.UK/RESEARCH/CE WE ALSO HOST THE BRITISH PAEDIATRIC SURVEILLANCE UNIT (BPSU) – A JOINT VENTURE WITH THE HEALTH PROTECTION AGENCY AND THE INSTITUTE OF CHILD HEALTH – WHICH FACILITATES RESEARCH INTO RARE CHILDHOOD CONDITIONS. WE TAKE ON A WIDE RANGE OF RESEARCH PROJECTS ON SPECIFIC ISSUES, OFTEN AT THE REQUEST OF GOVERNMENTAL BODIES. PROJECTS IN 2009-10 HAVE INCLUDED:

■ The creation of a series of ‘Medicines for Children’ leaflets providing clear and accessible information on commonly prescribed drugs for both parents and children ■ The continued roll-out of the College’s new growth charts for children aged 0-18, with accompanying educational material In our recent work, we have been encouraging more and more children and young people to discuss their experiences of the health system. Examples will be showcased at a major conference that we’re running in Cardiff in March 2011. A new series of policy breakfasts was initiated in 2010 (and will continue on into 2011), at which policymakers meet to discuss topical issues in an informal setting. The results of the biennial RCPCH Workforce Census, last undertaken in 2009, were published in 2010. The Census provides a detailed breakdown of the paediatric workforce across the UK, analysed by area, specialty and job type. Over many years, it has become established as a central planning tool in its field. The next one will be carried out in the summer of 2011. 2010 also saw a number of major changes in the field of UK child health. The new, government-issued Kennedy Report on child health was followed by a White Paper proposing a radical reorganisation of the NHS commissioning structure. We published a

response to both of these, as well as to more than 50 consultations on other issues from governmental and other bodies. Our major policy work of the year was the creation of ‘Facing the Future’. This report, which is to be launched in the spring of 2011, recommends a radical reconfiguration of paediatric services and the workforce to address the changing conditions in the NHS. A ‘Facing the Future’ follow-up, also to be published in 2011, will address the separate issues raised in our Community Child Health work. Finally, the College has developed a number of major education packages to support the goals set out by our research and policy. These are increasingly being delivered via eLearning, which is both more cost-effective and more flexible than traditional routes, as it allows learners to work at their own pace. Our current elearning projects include: ■ The Healthy Child Programme: an elearning resource in support of the Department of Health’s ‘Healthy Child Programme’ ■ Safeguarding Children and Young People: a suite of programmes for doctors at various stages of training in paediatrics, providing the essential competences required in child protection practice ■ Maintaining and Updating Competences in Child Protection: a detailed training in child protection competences for consultants and career-grade doctors, delivered via eLearning for Healthcare ■ The Adolescent Health Project: a Department of Health-sponsored programme supporting the delivery of quality care to young people (aged 11-19), delivered via eLearning for Healthcare

OUR GOALS: TO DEVELOP ‘POLICY BRIEFINGS’ ON A MINIMUM OF FIVE KEY ISSUES OVER A 12-MONTH PERIOD

EDUCATION AND TRAINING

THE COLLEGE HAS A STATUTORY RESPONSIBILITY FOR THE OVERSIGHT OF PAEDIATRICS TRAINING IN THE UK.

Training In the last year, we launched a major new initiative to encourage more doctors to choose paediatrics as a career. This embraced a ‘Careers Fair’, which was held at the College, a new section on our website giving information about the specialty, and a range of leaflets and other publications. Those who enter paediatric training have their progress monitored through ePortfolio, the College’s online learning tool. This enables trainees to track their progress by monitoring the skills and knowledge they gain. Supervisors can use ePortfolio to measure the progress of their trainees, as well as record meetings and complete assessments.

OUR GOALS: TO ACHIEVE A 5% INCREASE IN NET INCOME ACROSS ALL EDUCATION, TRAINING AND ASSESSMENT AND RESEARCH ACTIVITIES TO SET AND MONITOR THE STANDARDS AND TRAINING FOR CLINICAL PRACTICE OF THE PAEDIATRIC WORKFORCE

The trainees’ progress is measured against the College’s curriculum, in which the competences are mapped to the skills tested in the various levels of our exams. Our Trainees’ Committee, currently chaired by Dr Damian Roland, represents the interests of trainees at all levels in the decision-making process, including representation on Council, the College’s governing body.

Examinations The College runs two examinations: the MRCPCH (the membership exam), and the DCH (the Diploma in Child Health, intended for those who don’t work solely in paediatrics but who make it a significant part of their practice).

must be completed for the candidate to proceed to the next. On completion of all three, the candidate is admitted to membership of the College. The DCH consists of an initial written paper (shared with MRCPCH Part 1a) and a clinical exam. The MRCPCH is internationally recognised as a rigorous qualification in paediatrics. Accordingly, the exams have been held in a range of countries outside the UK (including India, where a major initiative recently paved the way for the launch of Part 1 of MRCPCH).

Continuing Professional Development Continuing Professional Development has long been an integral part of the College’s approach to the education of doctors. Participants in the CPD scheme are expected to perform 50 hours’ worth of educational/development activity each year. They can record these credits online via a web interface, and so are able to keep a continually updated record of their CPD. The major development in the future of CPD is the introduction of Revalidation, the process by which doctors will be formally assessed on their competence to practice every five years. This process was recommended by Dame Janet Smith’s inquiry into Harold Shipman’s practice, and its development has involved extensive cooperation between the Medical Royal Colleges and the General Medical Council. It is hoped that College members will be provided with an online Revalidation tool that builds on the ones that currently exist for CPD online.

The MRCPCH consists of a written exam, Part 1 (comprising two papers, 1a and 1b); a written Part 2, and a final clinical examination. Each of these parts

CORPORATE SERVICES THE COLLEGE'S CORPORATE SERVICES PROVIDE THE INFRASTRUCTURE THAT ALLOWS OUR OTHER WORK TO BE CARRIED OUT EFFICIENTLY AND EFFECTIVELY.

Our overall financial position remains solid, despite the difficult circumstances in the global economy. The College’s income in 2009-10 was £10.20m against expenditure of £10.33m, resulting in a small deficit of £0.13m

Income 2009-10 Total = £10.2m Annual Meeting 3%

OUR GOALS:

Publications 9%

TO EVALUATE THE CURRENT STAFFING STRUCTURE AND MAKE ANY NECESSARY CHANGES IN 2010/11 TO ACHIEVE 100% RETURN ON APPRAISALS, MID + END OF PROBATION REVIEWS OF NEW STAFF TO EVALUATE ALL EXISTING CONTRACTS HELD BY THE COLLEGE AND ESTABLISH A ROBUST AND CONSISTENT PROCESS TO DEAL WITH FUTURE CONTRACTS, BY DECEMBER 2010

Dr Sue Hobbins stands down as the College’s Hon Treasurer in April 2011; she will be succeeded by Dr David Vickers.

Research 7% Education 8%

Training 7% Member Subscriptions 32% Other 6%

Assessment 28%

Expenditure 2009-10 Total = £10.3m

Overall, this has been another year of growth for the College. We remain financially sound with substantial assets, and have a strong cash-flow to fund operations for the foreseeable future. Our overall reserves position remains good, and membership growth has stayed strong. Given the predicted decline in research and education grants over the next few years, the challenge will be to create and sustain new sources of income. Our financial plans for the future include a targeted budget surplus of £0.5m in 2010-11. This is based on the assumption that membership, together with income from assessments, will continue to grow. This figure also envisages development of commercial income, consistent results from publications, and expenditure held close to 2010 levels. Moreover, our plans assume that government grants will decline over the coming years, but that those already committed will be honoured. A major reorganisation of College staff has taken place over 2010-11. The aims of this are to provide a staff structure that is better suited to the tasks at hand, and to remove unnecessary layers of management. Although the process has carried one-off costs, the types of new posts it has opened up (for instance, in Fundraising, Public Affairs and IT) should enable us to operate more efficiently. Other one-off projects should bring long-term benefits. Aside from the rebranding project (see p6-7), the most important of these has been to develop a new College website. The current site is too difficult to navigate, and doesn’t provide the degree of personalisation that members require. The development process for the new site began in 2010, and it will launch in the spring of 2011.

Member Services

Assessment

Training

Education 2010 2009

Research

Annual Meeting 0

500

1000

1500 2000 2500 3000 3500 4000

In addition, we are looking to adopt a more commercial approach to the use of our facilities. As part of the staff review, several facilities functions were outsourced. As a next step, we are looking to hire out our meeting rooms to outside organisations and so generate a new income stream. Details of this new venture will soon be available on our website.

INTERNATIONAL WORK THE FINANCIAL CONTRIBUTION EACH MEMBER MAKES DEMONSTRATES OUR TOTAL COMMITMENT TO INTERNATIONAL WORK.

There have been a number of international achievements over the last year: ■ The ETAT-Plus course, a partnership project which provides training in Emergency Triage Assessment and Treatment. Following a successful roll-out in East Africa, the College is actively seeking other areas where it can be used. ■ The Diploma in Palestinian Child Health (DPCH) where UK paediatricians could share their knowledge and skills with Palestinian colleagues. The clinical leaders of this course are Dr Tony Waterston, Dr Jean Bowyer and Prof. Mary Rudolf.

THIS YEAR, DR STEPHEN GREEN WAS SUCCEEDED AS THE DAVID BAUM FELLOW BY PROFESSOR STEVE ALLEN. WE’VE ALSO CREATED A NEW ‘HEAD OF INTERNATIONAL OPERATIONS’ ROLE, TO WHICH DR JUSTIN THACKER HAS BEEN APPOINTED.

■ A training course for Iraqi paediatricians held in Irbil, with tutors including the College’s Vice President for Education, Alistair Thomson. ■ The continuing VSO scheme to allow paediatricians from the UK to do placements in the developing world. ■ The continuing International Paediatric Training Scheme (IPTS), which helps to bring paediatricians from outside the EU to complete part of their training in the UK. Sadly, owing to government funding cuts, the College was forced to suspend this scheme in early 2011.

DEVOLVED NATIONS Wales

Scotland

In Wales, the RCPCH is represented by the Wales Executive Committee and the Wales Administrative Office in Cardiff Bay. The Officer for Wales is Dr Iolo Doull.

Our Officer for Scotland is Dr Jim Beattie, who leads our Scottish Committee with the support of our Edinburgh Office team. In the last year, meetings have been held with Dr Harry Burns (Scottish CMO) and Ms Shona Robson, the Scottish Government Minister with responsibility for Child Health. Issues raised in the meetings have included the continuing pressure on medical workforce and the College’s Equity and Excellence Outcomes Framework.

RCPCH Wales supports the organisation of the bi-annual Welsh Paediatric Society’s Spring and Autumn meetings (in association with the College), and the St David’s Day Lecture and Study Afternoon. RCPCH Wales is also hosting ‘My Right to a Better Health’, a major conference on children’s rights, in Spring 2011. Representatives of RCPCH Wales have met with Ministers and Officials of the Welsh Government on various occasions this year. Issues of particular concern have included workforce numbers and how we can provide specialist services.

Ireland Historically, we’ve appointed an officer with responsibility for both Northern Ireland and the Republic of Ireland, given the close cross-border links between the two health services. The current incumbent is Dr Moira Stewart. Issues dealt with this year include the continuing impact of the European Working-time Directive and, therefore, the difficulties in filling rotas across Northern Ireland. In addition, the reduction of in-patient beds in Belfast, has created serious knock-on effects for paediatric services. In the Republic of Ireland, negotiations continue around plans for a new dedicated paediatric hospital in Dublin, scheduled to open in 2016. What’s more, our plans to have office support in Ireland will hopefully be moved forward in the coming year.

The Scottish Office has been involved in organising a number of conferences this year, including their Annual Conference, a new Paediatric Lecture Series, and the regular St Andrew’s day Symposium. Dr Peter Fowlie will take over as the Officer for Scotland in 2011.

THE FUTURE International

Developing College Buildings

Prizes and Fellowships

The College already has ambitious overseas programmes in Africa, Asia, and the Palestinian Territories, and has plans to do much more.

We have plans to turn the public space of the College headquarters into an innovative new education centre.

Your support can enable paediatricians from the developing world to attend College events and conferences. With increased finances we can reach out to more children and young people, not only in the UK but in other areas of the world.

Education and Courses The College has developed ground-breaking e-learning programmes, often made freely available within the UK.

FORM OF CODICIL

(Please complete this form, detach and send to you solicitor.)

(2) In all other respects I confirm my said Will. In witness thereof I have here unto set my hand the day and year first above written.

Signed by the said Testor/rix

(name in block capitals)

(Signature)

of as a Codicil to his/her last Will in our joint presence and by us in his/hers.

Witness 1 (name in block capitals) (address) (Signature)

of Declare this to be a Codicil which I make this day of

(address)

To my Will which bears the date Witness 2 day of

(name in block capitals)

(Signature)

(1) I bequeath to the ROYAL COLLEGE OF PAEDIATRICS AND CHILD HEALTH (‘The College’) or to any successor body carrying out the same or similar charitable work the sum of £

(address)

amount in words

free of all taxes whether payable in the United Kingdom or in countries overseas for the general purposes of the College and I declare that the receipt of the – Honorary Treasurer for the time being of the College shall be sufficient discharge for the same.

The Royal College of Paediatrics and Child Health (RCPCH) is a registered charity in England and Wales (1057744) and in Scotland (SC038299).

MAKING A BEQUEST OR DONATION THE HEALTH AND WELL BEING OF CHILDREN HAS ALWAYS BEEN THE CONCERN OF PAEDIATRICIANS.

The enormous advances made by the medical profession have cut a swathe through previously fatal diseases, and better nutrition and living conditions have produced a healthier child population. However, other dangers, social and medical, continue to threaten, and in today’s market-oriented climate, money is always needed to enable us to fight for children’s welfare, to fund research and to provide better education for paediatricians in whose hands lies the health of the nation’s children. A bequest to the RCPCH in your Will would help the College to continue its important work. On the opposite page you will find a printed form which, duly signed and witnessed, would become a codicil to your exiting Will. It can be simply filled in, detached and sent to your solicitor.

If you intend to do this, will you please note the following points: 1. Please read the document to ensure that it accords with your wishes. Any alterations must be made before you sign. 2. Then date the document where indicated. 3. Then in the presence of two witnesses sign your name at the end of the document where indicated. 4. The witnesses must sign their names and write their addresses where indicated. The witnesses are needed in England, Wales and Northern Ireland; one witness in Scotland. 5. You and the witnesses must all be present together when you sign, and the witnesses must see you sign. 6. No person taking benefit under the document or the husband or wife of any such person should be a witness, otherwise such person will not be able to take any benefit under the document. 7. All alterations should be initialed by you and the witnesses in the margin opposite the alteration. 8. On no account should anything be pinned, stapled, paper-clipped or fastened in anyway whatsoever to the document. Members wishing to contribute in this way are asked to contact the fund-raising section of the College (e-mail fundraising@rcpch.ac.uk), especially if they wish any bequest to be used for a specific purpose.

MISSION: To transform child health through knowledge, innovation and expertise. VISION: A healthier future for children and young people across the world. VALUES: • AUTHORITATIVE Recognised and respected as the authority on child health. • MODERN Committed to leading the way in paediatric research and training. • INFLUENTIAL Champions of the best health outcomes for children and young people. • PROFESSIONAL The standard bearer of child health within the medical profession.

Royal College of Paediatrics and Child Health 5-11 Theobalds Road, London WC1X 8SH, Tel: 020 7092 6000 Fax: 020 7092 6001, email: enquiries@rcpch.ac.uk

www.rcpch.ac.uk The Royal College of Paediatrics and Child Health (RCPCH) is a registered charity in England and Wales (1057744) and in Scotland (SCO38299)