AUTUMN 2015 NEWSLETTER
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STOP PRESS EGM result At an Extraordinary General Meeting held on 8 September, members approved changes to allow ‘remote voting’ at future General Meetings. Beginning with the 2016 AGM, members who are unable to be physically present will be entitled to vote on items which Council agrees are especially important.
BOOK NOW BPSU 30th Anniversary Rare Disease Conference 23 February 2016 Registration now open www.rcpch.ac.uk /bpsu/rdc16
We need more time for research Three years ago Professor Neena Modi wrote of the ‘need for highquality research to generate evidence to benefit children and ultimately the health of the nation’. Turning the Tide stressed the importance of child health research both to patients and to advancing the science of paediatrics. Since then the UK Child Health Research Collaborative (UKCHRC) has been launched, but we remain concerned about the capacity of the paediatric workforce to undertake research. Our Individual Census in 2011 indicated low levels of research involvement amongst paediatricians and there has been a continued decline in the number of university-funded academic paediatricians. Furthermore, the RCPCH Participation in Child Health Research survey of paediatric consultants and SAS doctors conducted in May 2015 shows that: •
81.6% (80.1% of consultants) have no programmed activities (PAs) for research in their job plans.
•
The average number of PAs in the job plan for research was 0.37 (0.39 for consultants); but respondents spend almost the same amount of time again on research work which is unpaid.
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54.5% (50.8% of consultants) do no research.
•
The stated key barriers to research were a lack of time and lack of support from employers.
•
The survey received 1,924 responses, representing 45.3% of consultants and 21.1% of SAS doctors.
The RCPCH supports members who wish to carry out research by advocating for appropriate supporting professional activity (SPA) time. We will continue to raise awareness of the importance of research to employers, policymakers and the public. Visit www.rcpch.ac.uk/ participation-research to keep informed. PROFESSOR ANNE GREENOUGH Vice President, Science and Research
Focus
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1 News Result of the EGM
BPSU 30th Anniversary Rare Disease Conference
We need more time for research
2 From the President
4 Education and training Making assessment count
Try our free ETAT+ e-learning
Courses and events
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Your views
You said, we acted
In the Twittersphere
New College website - two-year project agreed
Female Genital Mutilation (FGM)
Epilepsy Passport
Launching in early 2016: new decision support system
Opportunities for SAS doctors
8 Your RCPCH
Rethinking postgraduate medical training
11 Committee news
Training matters
A new chapter for the Intercollegiate Committee for Standards for Children and Young People in Emergency Care Settings
Content proposals: Members are invited to submit ideas for content (for planning purposes, please send proposals only) to focus@rcpch.ac.uk Editors: Jo Ball Sarah Quinlan 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 RCPCH is a registered charity: no. 1057744 and registered in Scotland as SC038299
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From the President Simple pleasures, serious issues
Having started my Presidency just before the general election, health service issues are very much on my mind. I’ve realised how much being read to as a child, and reading to one’s own children are the best of simple pleasures and leave an indelible mark. To this day, although my children have long grown up, my mind often subconsciously summarises the essence of a problem in a kind of mental shorthand, by defining it in relation to a fairytale; for example, I find the story of killing the goose that laid the golden eggs constantly in my thoughts these days. Do you remember that tale of the sorry farmer who demanded of the goose that she should lay not one but two golden eggs each day, and killed her when she replied that she couldn’t? The creation of the NHS was one of the greatest acts of humane, egalitarian social engineering of all time, bringing freedom from fear of ill health to all the peoples of the UK - a golden egg if ever there was one. Yet the NHS is in danger of becoming the goose, because too much is being asked of it without it receiving the stability and investment it so badly needs. We are told the NHS is unaffordable. The evidence suggests otherwise. The NHS was founded at a time of great hardship when the nation was on its knees after the great wars. It was affordable then and it is affordable now. Resources could be used more efficiently; for example, renegotiating the Private Finance Initiative, and phasing out the discredited purchaser-provider split that the 2010 Health Select Committee called ‘20 years of costly failure’ would release billions for front-line and preventive care. And few would begrudge a greater contribution from the public purse, given that the UK spends less than 10% of GDP in
healthcare, almost half that spent by the United States and less than our European neighbours. Our health service needs investment, not austerity. Of course, money isn’t everything. The 2014 Mirror, Mirror on the Wall (yes, Snow White!) report from the Commonwealth Fund shows that the UK ranks first in healthcare performance whilst the United States spends the most on healthcare in the world and yet underperforms relative to all eleven countries studied (Australia, Canada, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland, United States, UK). This is a testament to the commitment and dedication of all who work in the NHS despite increasingly difficult conditions, so it is particularly worrying that a King’s Fund Report (July 2015) shows that low staff morale is the greatest cause for concern. It also indicates that the way a health system functions is a national ethical benchmark. Indeed the United States has now taken tentative steps towards universal healthcare with the ‘Obamacare’ reforms. Elsewhere in this edition of Focus you will read about activities at the RCPCH. There is a lot going on! We are working hard to influence national strategies to reduce childhood obesity. Recent member surveys will inform our workforce recommendations. We have a number of plans underway to grow child health research capacity. A pilot research training day will be delivered in the autumn with a view to equipping all paediatricians with solid skills to help them evaluate the care they provide. Our Global Health Team has an ambitious programme that will strengthen activity in Africa, the Middle East and Asia. We know there are ‘Cinderella’ areas where child health measures are not as good as they should be,
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Workforce and service design
Following on from discussion at RCPCH Council and the CEO member roadshows earlier this year, our three-year plan is now up and running. The priorities wheel above illustrates the main areas of work. We’ve started from the premise that infants, children and young people are at our core, and we are reinvigorating our advocacy work though the & Us network and a new ‘engagement collaborative’ with children and young people in relation to shaping health services. Your expertise is crucial
Child rights
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Public information and political influence
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Evidence-based policy and practice
ic Educ ate the publ because collectively we are a powerful voice to take to policy makers and Government. The RCPCH has a responsibility to speak for the wellbeing of infants, children and young people; therefore we are opposing proposals to cut £200m in public health funding. We don’t consider a sick child a ‘client’ and if a ‘business case’ is really needed for every sensible development,
“Your expertise is crucial because collectively we are a powerful voice to take to policy makers and Government.”
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why is there a cap on the Quality Adjusted Life Year and other metrics applied to judge the value of innovation; surely much better to recognise the true worth of a child’s lifelong health? We want the NHS to modernise, we deplore bureaucracy, waste and inefficiency, but also the language and ethos of the marketplace; healthcare is a service, not a business. We will continue to call for restoration of Government responsibility and accountability for the NHS through Parliament, one of the magnificent founding principles of the NHS, envied and admired around the world, that have served as a beacon against social injustice for over six decades; children will bear the brunt of their continuing erosion.
in
If you’d like to help your Royal College to do more, please contact me; my inbox is always open!
PROFESSOR NEENA MODI president@rcpch.ac.uk
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Making assessment count David Evans, Officer for Assessment David Evans, a neonatologist from Bristol, has recently taken over as Officer for Assessment, with responsibility for workplace-based assessments (WPBAs), as well as overseeing other assessments within training (eg START and recruitment). Here he outlines proposed future developments. What is the purpose of assessment? The assessment strategy has to serve many purposes: • • • •
protecting the patient satisfying the GMC assessing the quality of training providing feedback to inform trainees’ development and learning.
No individual assessment tool can satisfy all these requirements but we often forget this and attempt to use WPBAs to fulfil both summative and formative objectives simultaneously. For example, requiring trainees to complete set numbers of satisfactory mini-CEX (a summative objective), when the assessment was designed to be formative. How can we promote the formative element of WPBAs? Well, several steps have already been taken. The formative WPBAs (miniCEX, CBD) have been re-launched as Supervised Learning Events (SLEs) in 2013, with greater emphasis on feedback (scoring matrices removed) and three new SLEs were introduced (HAT – handover, ACAT – acute take, and LEADER). The pilot evaluation showed increased numbers of SLEs being undertaken year on year with less of a peak before ARCPs. The GMC recently approved the pilot and so the changes have been incorporated into the assessment strategy. What are your future plans? The key thing for me is that the WPBAs shouldn’t get in the way of the clinical work - because that is precisely what it is trying to assess. So I would like to reduce the barriers to assessment: •
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uncertainty in how to use the different SLEs
• •
difficulty in recording the assessment devaluing assessments by viewing them solely as objectives, rather than as means to learn.
I have an analogy: if buying crisps were like completing an SLE, manufacturers would have gone out of business. View this analogy: http://bit.ly/1EF5ojU So, the plan is to support trainers and trainees by providing updated guidance in using SLEs to promote feedback, reflection and learning. The RCPCH is in the process of integrating ASSET and ePortfolio; this should ease the process
of undertaking assessments. The new ePortfolio should also enable us to move away from merely counting numbers of assessments undertaken and look at quality measures, such as how they map to the curriculum and what learning has arisen as a result. Where to get more information The assessment section of the RCPCH website contains the latest updates and guidance: www.rcpch.ac.uk/assessment There is also a new assessment Twitter feed @RCPCH_Assess
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Try our free ETAT+ e-learning modules The new RCPCH e-learning in Emergency Triage And Treatment of African Children + admission care (ETAT+) is now available on the RCPCH website. www.rcpch.ac.uk/etat-e-learning This is an excellent opportunity to familiarise yourself with World Health Organisation (WHO) paediatric guidelines and gain experience of the ETAT+ resuscitation course free of charge, particularly for those interested in working in paediatrics in the developing world. The six modules have been created using video footage of paediatric inpatients from multiple African sites, by Dr Natalie Prevatt MRCPCH DTMH DPID (London Paediatric Registrar, pictured) on behalf of the RCPCH. The modules were reviewed by a Clinical Review team of Professor Mike English (Kemri Wellcome Trust), Dr John Wachira (RCPCH East Africa Project Manager) and Professor Steve Allen (RCPCH International Officer). We would like to thank the review team
and in particular Dr Natalie Prevatt who has sacrificed large amounts of her time and worked tirelessly to provide content and to help produce a really impressive online ETAT+ course that will significantly help support healthcare workers and students interested in emergency care in low-resource settings.
Above: Dr Natalie Prevatt with Benedict Otii (Ugandan clinical officer). Below: e-learning screen shot
The ETAT+ e-learning platform was funded as part of the DFID/THET MultiCountry Partnership that was delivered in 18 hospitals in East Africa and will be used for future RCPCH ETAT+ projects in Rwanda, Uganda, Sierra Leone and Myanmar. If you are interested in learning more, contact andrew.fryer@rcpch.ac.uk ANDREW FRYER ETAT+ Operations Manager
RCPCH courses and events 2015 EVENTS TEAM
email: events@rcpch.ac.uk
tel: 020 7092 6000
web: www.rcpch.ac.uk/courses
How to Manage: End of Life Care and Bereavement 12 November 2015 York
How to Manage: Gastroenterology 17 November 2015 RCPCH London
How to Manage: Benign Haematological Problems 26 November 2015 RCPCH London
Introduction to Quality Improvement and Patient Safety 13 November 2015 RCPCH London
Paediatric Educators Programme 19-20 November 2015 RCPCH London
How to Manage: Oncology 8 December 2015 RCPCH London
Dates correct at time of going to press.
Save the dateLimited places available.
Join the conversation on Twitter #RCPCHcourses
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You said, we acted: In 2012, we surveyed members and asked you what you thought was good about the College and what needed to be improved. Here’s a snapshot of progress:
“We’re frustrated at the website’s lack of functionality and can’t sign up to updates in the membership area”
• Member dashboard launched (www.rcpch.ac.uk/user) • Opt-in functionality for events bulletins, daily cuttings and other services • Online booking for courses and events • Exam registration and results now online • See opposite page for our website update
only London? “The College is too London centric when it comes to events and training, and general communication”
• Significant number of e-learning courses run by the RCPCH including safeguarding, paediatric prescribing, spotting the sick child, clinical audits and vitamin D deficiency • Online e-portals MindEd, Disability Matters and the award-winning Healthy Child Programme
• 59 courses and events held outside London since October 2012 • RCPCH hosted a series of roadshows in 10 locations across the UK to inform the College plan • Free media training for members held in NI and Scotland with Wales session planned for November 2015 • Why Children Die nation-specific reports launched in Scottish Parliament, Welsh Assembly and NI Assembly
In the Twittersphere
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“We’d like to see more online education courses and resources”
With over 7,000 Twitter followers, @RCPCHtweets presence is growing. Now we’re keen to make use of the large audience and expand the College’s reach.
through to how best to tackle the obesity crisis or sharing ideas for how to involve young people, parents and carers in their healthcare. If you’d like to take part, or have an idea, contact melissa.milner@rcpch.ac.uk
We’re looking for ideas and volunteers to host ‘Twitter chats’ on topics that you feel would be of interest to those who have an interest, or work in, the child health sector. It could be on anything from debating the impact of the budget on child health,
@rcpch_trainees
Don’t forget to follow the other RCPCH Twitter feeds: @rcpchWales @rcpchIreland @rcpchScotland @rcpch_and_us
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Child Protection
“Junior members are keen for the College to have a stronger presence on social media”
• The College’s Twitter followers have increased by over 150% since October 2013 • Dedicated Twitter accounts for Trainees, Wales, Scotland, Northern Ireland and & Us • Dedicated social accounts for College-led projects such as MindEd, Disability Matters and S.A.F.E If you are not already following us, visit www.rcpch.ac.uk/social-media for links
“Child protection is an important topic – we want to be updated with the latest information, support and training” Dedicated website area for updated information on the College’s child protection work: www.rcpch.ac.uk/ child-protection
Since 2012 we have led campaigns on:
“The RCPCH should be leading campaigns to advocate for child health, as well as supporting existing campaigns”
• Tackling vitamin D deficiency • Reducing childhood obesity (on behalf of the Academy of Medical Royal Colleges) • Reducing child mortality • Ensuring child health is a political priority in the 2015 General Election …as well supporting a range of other successful campaigns including standardised cigarette packaging and not smoking in cars when children are present
New College website - two-year project agreed Council agreed on 1 July that a project to rebuild the College website* will be started this autumn. The project will take approximately two years, and will deliver a significantly improved experience for members.
Both the work of the College and website design has moved on since the site launched in 2011. Though lots of content and functionality (see above) has been added since launch, there are a number of pressing reasons for the project: •
the navigation and search are underperforming
•
the design doesn’t benefit from current practice including optimising for mobile
•
the underlying software needs upgrading.
Lisa Kauffman, Honorary Treasurer, will be representing members on the project board, and we will also be looking for member involvement with our research and testing throughout the project. If you are interested in being involved and are not already on our members web panel, please email website@rcpch.ac.uk
*the website is content held in www.rcpch.ac.uk only
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Female Genital Mutilation (FGM) FGM continues to be a top government priority and with changes to legislation for reporting FGM under the Serious Crime Act 2015, Dr Deborah Hodes (pictured) provides answers to some key questions and details of an exciting new research project at RCPCH. What are the new requirements to report FGM?
Children at risk of FGM should also have this documented in their health record.
examine children with suspicion of child sexual abuse (CSA) using a colposcope.
As of October 2015 regulated professionals in England and Wales, in addition to following existing safeguarding procedures, must report known cases of FGM in under 18s directly to the police. Professionals in Scotland and Northern Ireland should continue to follow existing safeguarding procedures.
Where can I learn more about FGM?
New RCPCH research
Both the RCPCH and Health Education England have produced e-learning packages for FGM.
Commencing in late 2015, FGM will be included in the list of conditions on the British Paediatric Surveillance Unit (BPSU) card. Information collected as part of the study will be used to inform policy and practice guidance, as well as service provision for children and young people.
What should be recorded in the patient notes? FGM must be recorded in a patient’s healthcare notes whenever identified.
What can I do if I am unsure about a case? Speak with your named or designated professional (or equivalent) for safeguarding. Depending on the degree of suspicion the child may need to be examined. This is best done by someone with specific skills and competencies to
More information and resources Visit www.rcpch.ac.uk/fgm
Epilepsy Passport Under the leadership of Dr Richard Appleton and Dr Amit Bali, the RCPCH has followed up on a key recommendation from the 2013 Child Health Review UK into Epilepsy and created an ‘Epilepsy Passport’ aimed at improving communication and clarity between parents, children and young people and healthcare and other professionals. Caring for children with epilepsy is complex and often challenging, testing every part of the healthcare system. It is paramount that clear partnership and effective communication exists between healthcare providers and children with epilepsy and their families to ensure they receive the best treatment. With this goal in mind, the Epilepsy Passport was
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launched at the House of Commons on 18 September 2015. The Epilepsy Passport contains essential information about a child’s epilepsy, including an emergency care plan, medication history and key professional contacts. It is available to download from www.epilepsypassport.org.uk and will be completed by paediatricians/paediatric neurologists or specialist epilepsy nurses at epilepsy clinic appointments. A copy will be saved locally for future updates and printed off and given to each child and parent/carer to carry and present to healthcare professionals as and when
needed. It is designed to be folded to wallet size making it convenient to carry in a small plastic wallet. Our vision is that the Epilepsy Passport will become a universal and ubiquitous resource in epilepsy care and, together with other initiatives, will help to ensure that children with epilepsy receive the best integrated healthcare possible. For more information, contact ian.odonoghue@rcpch.ac.uk or visit www.epilepsypassport.org.uk IAN O’DONOGHUE Epilepsy Passport Project Manager
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Launching in early 2016: new decision support system Paediatric Care Online (PCO UK) is an innovative decision support system for all child health professionals. Designed to help health practitioners manage childhood illnesses, PCO UK will offer immediate, evidence-based information to support decision making at the point of care, together with quick links to NICE and SIGN guidance and patient information. PCO UK received start-up funding from the Department of Health but will require support to source ongoing development and maintenance costs. It is intended that PCO UK will become the single
point of reference for any child health professional practicing in the UK. PCO UK has been developed by the RCPCH, working in partnership with the Royal College of General Practitioners, the Royal College of Nursing, other UK professional bodies, and the American Academy of Pediatrics.
other resources for health professionals and families. Available online, PCO UK has been optimised for desktop, tablet and smartphone devices and will be the first site to gather existing resources in the UK on one searchable platform.
Featuring concise and easy-to-navigate decision support tools, ‘Key Practice Points’, PCO UK will cover common signs and symptoms and critical care situations, facilitating decision making from the point of presentation. Each ‘Key Practice Point’ will include red flags and referral indicators, offering a clinically assured ‘roadmap’ for diagnosis and linking to NICE and SIGN guidance where available.
We will continue to invest in the development of PCO UK following the launch of the first edition in January 2016, with new resources and enhanced content becoming available with the launch of the second edition at the Annual Conference in April 2016.
PCO UK will also incorporate the BNF for Children and the Public Health England Green Book, as well as a vast number of
MARK HANNIGAN PCO UK Clinical Content Programme Manager
For the latest information, and to register for updates, please visit: www.rcpch.ac.uk/pcouk
Opportunities for SAS doctors Over the last 50 years middle grade doctors have transformed from unsung heroes to the wellrecognised brand of ‘SAS doctors’. At RCPCH, staff, committee members and Officers are on hand to continue to help champion the voices of SAS doctors in an ever-changing NHS climate. It couldn’t be a better time for us to take advantage of a variety of opportunities on offer.
As an associate member of RCPCH, a range of support is available to you: •
career guidance
•
mentoring training tools
•
SAS education, training and assessment support tools
•
committee representation
If you’d like the chance to strengthen
College work and have your say on the things that matter to you as a SAS doctor, why not consider applying for a College post? Vacancies for SAS committee and regional representative vacancies are advertised regularly online (www.rcpch.ac.uk/nominations). Other benefits available to you include discounted fees for events and Annual Conference and representation on Council.
Visit www.rcpch.ac.uk/sas for a reminder of these benefits, support and information about how to take advantage of them. RCPCH associate membership may also be of interest to those of your SAS doctor colleagues who work with children. DR MALLA R H V NARASIMHAMURTY SAS Chair
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Rethinking postgraduate medical training There has been much discussion about the proposals and recommendations in the Shape of Training (SoT) report (www.shapeoftraining.co.uk). For doctors to be able to provide care in broad specialties across a range of different settings requires a rethink of how postgraduate medical training is undertaken. As a College we have actively engaged in the proposals with our Council to set out our position on the future structure of paediatric specialty training.
There are still many uncertainties around the processes and timescales for the adoption of the SoT recommendations and the mechanisms for funding and maintenance of standards. RCPCH Council has considered different options for a model of training that will meet service requirements, including a workforce with general paediatric competences at consultant level, maintenance of on-call rotas, outpatient clinics and complex care provision, and an ability to cover maternity services safely with paediatricians trained to deliver emergency neonatal care. Council’s position is that the current three-level training pathway leading to a Certificate of Specialty Training (CST) replacing the Certificate of Completion of Training (CCT) should be retained. Whilst the programme can be completed
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in five years, most trainees take approximately eight years to gain CCT and a consultant post. However, further consideration of the structure and content is required to include more flexibility, different options for career pathways and increased exposure to primary care. The RCPCH has a responsibility to train a fit-for-purpose workforce in the context of very likely service transformation to enhance care out of hospital and refine models of acute care and specialist care. The rationale for maintaining this model is due to the limited experience in paediatrics of those doctors starting specialty training. Most undergraduate paediatric training experience is normally limited to five weeks within the fiveyear programme and most foundation programmes do not include paediatrics. Therefore, doctors coming into paediatric specialty training do so from a lower
knowledge base than adult medicine. We are committed to reviewing the current training structure to ensure CCT/ CST paediatricians have the appropriate skills, knowledge and competences for the best outcomes for children. Further consideration will take place in the coming months to explore career pathway options to move into primary care, to explore integrated training models, increase flexibility and transferability and increase exposure to community paediatrics and mental health. Council will confirm the RCPCH position paper in response to the SoT review at its next meeting on 4 November 2015. It will be published on the RCPCH website and member dashboard in mid-November. JULIA O’SULLIVAN Director of Education and Training
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Training matters I am now a few months into my new role as Chair of the Trainees’ Committee and thought it would be a good time to share my thoughts on priorities for trainees over the next three years. It’s going to be a fascinating couple of years and I look forward to working with you all to ensure that child health training in the UK continues to evolve and develop to give children the doctors they need and us the careers we want. Continue the evolution in training and assessment The College has already led the way in revolutionising assessment with formative Supervised Learning Events (SLEs), START and Computer Based Training (CBT). We need to push on towards technology-enhanced assessment and learning that is truly integrated into our busy lives and jobs. It’s all about child health How we train as paediatricians is not the whole story. Sick and injured children and young people meet many different
professionals and specialties. Working with the other Colleges and groups, our curriculum review provides a fantastic opportunity to set standards in training and to evolve assessment for those outside of paediatrics. Training doesn’t finish when you CCT We are all used to the concept of lifelong learning but how about more lifelong support? We need to get better at supporting new consultants as they make the often daunting step up. Peer mentoring, shared learning - let’s get people together and feeling supported.
Research isn’t just for researchers We have a great opportunity to harness the passion of our new President for child health research, but it isn’t just about those at the cutting edge. We all need to get better, not just at telling a P value from a confidence interval but at interpreting evidence into our everyday practice. The College undoubtedly has a training role here. DAVID JAMES Chair, Trainees’ Committee
A new chapter for the Intercollegiate Committee for Standards for Children and Young People in Emergency Care Settings Dr John Criddle has been working as a Consultant Paediatrician in the children’s emergency department at the Evelina, Guy’s and St Thomas’ Hospital since 2004. In June 2015 I was appointed as the new Chair of the Intercollegiate Committee for Standards for Children and Young People in Emergency Care Settings after serving as the Association of Paediatric Emergency Medicine (APEM) representative on the Committee for the last three years. The Committee is an expert advisory group on the emergency care of infants, children and young people; supporting health professionals, service planners and inspectorates in the improvement of services by developing and supporting the implementation of standards.
This is an exciting time for me to be taking over as Chair of the Committee as we will be focusing on two key pieces of work over the next twelve months. The first will be a revision of the Short Stay Paediatric Assessment Units; Advice for Commissioner and Providers that was originally published by the committee in 2009. The second essential item of work will be to revise the Standards for Children and Young People in Emergency Care Settings. Both are available online: www.rcpch.ac.uk/emergencycare
We are currently gathering feedback on the 2012 version of the Standards – please do let us know your views by completing our short survey (www.rcpch.ac.uk/standards-survey) to help inform us as we review the Standards in 2016. I must thank Stephanie Smith for her leadership during her term as chair – her enthusiasm, support and guidance has been greatly appreciated by all committee members over the last five years. We have a lot of work to do, but I look forward to the challenge!
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BNF for Children 2015-2016
Guiding health professionals on all aspects of paediatric drug therapy Improved format – easier access To make it even easier to find the information you need, the content in the new BNF for Children has been restructured. You’ll find improved consistency and clarity in the print version, and purposedesigned online content through our MedicinesComplete platform. See www. bnf.org to find out more, along with sample pages and a clear guide on how to use the improved BNF for Children.
Significant new content updates to BNF for Children 2015-2016 include: ■ Updated monographs with links to ‘Medicines for children’ leaflets, which provide parents and carers with information about how to use certain medicines in children ■ New safety information about reducing the risk of QT interval prolongation and Torsade de Pointes for hydroxyzine ■ Further guidance on the restricted use of codeine for cough and cold symptoms in children ■ Updated dosing information for the use of tramadol in the treatment of acute and chronic pain ■ Update on the scheduling of sodium oxybate under the Misuse of Drugs Regulation 2001 ■ Guidance on the use of domperidone for the treatment of gastrooesophageal reflux disease in children ■ Updated dosing information on the use of nifedipine for the treatment of hypertensive crisis, acute angina and Kawasaki disease or progeria ■ Advice about the risk of hepatotoxicity and phototoxicity with voriconazole treatment Book: 978 0 85711 164 7 • September 2015 • £39.99
Online: For pricing information contact our sales team at pharmpress@rpharms.com Order your print copy now at www.pharmpress.com/bnfc
www.bnf.org