SUMMER 2015 NEWSLETTER
Fo us focus@rcpch.ac.uk
Facing the Future:
Facing the Future:
@RCPCHtweets
Together for child health
Standards for acute
2015
general paediatric services
Revised 2015
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Fit for the future: new and revised paediatric standards launch At the RCPCH Annual Conference on 29 April, the RCPCH launched the revised Facing the Future: Standards for Acute General Paediatric Services, and the RCPCH, RCN and RCGP launched the new Facing the Future: Together for Child Health standards. First published in 2010, Facing the Future: Standards for Acute General Paediatric Services sets out ten standards for high-quality, safe and sustainable general paediatric services. It was always intended that the standards would remain live and flexible to changes in the health system and, based on the findings of the Back to Facing the Future audit, the RCPCH has revised four of the standards. It is essential that paediatrics is a 24 hours a day, seven days a week specialty, with the most experienced doctors present at the busiest times. As well as improving standards of care in hospital we also need to address the increasing number of emergency
department attendances and admissions. More than a quarter of attendances are under 16s and many of these could be managed more effectively outside the hospital. Facing the Future: Together for Child Health aims to ensure there is high-quality diagnosis and care early in the unscheduled care pathway and to reduce unnecessary attendances and admissions. Where children do need to be cared for in hospital, the standards aim to reduce the length of stay, enabling them to go home as safely and quickly as appropriate. The standards will ensure specialist child health expertise is available directly to general practice, where the needs of the child and their family are known. For more information and to view the new and revised standards visit: www.rcpch.ac.uk/facingthefuture and www.rcpch.ac.uk/togetherforchildhealth ISOBEL HOWE Health Policy Lead
Focus
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1 News for the future: new and revised Fit paediatric standards launch 2 From the President
Child health in a new Government
4 Annual Conference 2015 Post-conference blues Feedback from delegates #RCPCH15
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Your views
From the President
Have you signed into the website lately?
Download the Baby Buddy app
If you’re considering volunteering overseas...
You & Us - ensuring patient voices are at the heart of what we do 8
Your RCPCH
Meds IQ launches to make paediatric prescribing less of a risky business
New website for Medicines for Children
Training matters
This is my first piece for Focus as RCPCH President. I am just a few weeks into the job and, as expected, it’s been pretty hectic. My first task is pleasurable, namely to thank you for all the kind words and good wishes that have been sent my way. I’d also like to set out what I consider our priorities over the next three years. I am hopeful that despite inevitable challenges, together we will be effective advocates for infants, children and young people.
RCPCH Officer for Health Promotion
Improving the evidence base
Publications
10 Training and support New Clinical Lead on board for
ePortfolio integration project
Courses and events 2015
11 Committee news
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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I’ve spent many years leading a research group and am acutely aware that children remain under-represented in discovery science, clinical, and health services research. Research is important because it generates evidence and without reliable evidence the safety and wellbeing of children are put at risk. Since the RCPCH Turning the Tide report of 2012/13 in which we described children’s research in the UK, a new National Institute for Health Research Children Network has been established as a unique platform for the delivery of studies within the NHS. But the bad news is that the 2014 RCPCH workforce census shows a further 8.3% reduction in consultant-level academic staff to the lowest number in over a decade. Children’s research also relies disproportionately on public and charitable funding; for example, for diseases where two-thirds of the burden is carried by children, only 12% of industry-funded research is aimed at them. We need to change the way industry views child health, but most of all child health researchers must up their game. So what are we doing? This year we launched the ‘UK Child Health Research Collaboration’, a forum for research funders,
and other organisations, to optimise the use of available resources. We’re developing a Children’s Research Charter to give a voice to parents, children and young people about how they want to be involved. And we’re working hard to increase opportunities for undergraduates and trainees to gain research experience. We’re committed to improving generic research and evaluation skills and to appraise all paediatric trainees against these competences. We’ve asked consultants and SAS doctors about research involvement in a survey that closed at the end of June; thanks to all those who responded. My aim is to empower paediatricians so that each and every one can contribute to delivering and advancing children’s healthcare. Advocating for child health in a changing world Following last month’s general election, Jeremy Hunt remains Health Secretary and the Shadow Health Team is currently unchanged. But there are also new ministers and MPs, not least from the Scottish National Party, and we’re moving quickly to make sure the RCPCH is at the heart of discussions. We will continue to advocate on issues that our members, young people, and parents tell us are important, from poverty, obesity and health inequalities, to child protection and health services. On some issues we will lead; on others we will collaborate with a range of organisations. You can read our ‘First 100 day challenge’ to the new UK Government on the RCPCH website. See article on the facing page for more information. I’m also acutely aware that many members have grave anxieties about developments within the NHS. There are major changes
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Child health in a new Government Following the General Election which returned a majority Conservative Government, RCPCH will be engaging with parliamentarians and policy makers to keep child health on the agenda. Ministerial appointments include Jeremy Hunt MP as Secretary of State for Health, and Jane Ellison MP will continue in her post as Parliamentary Under Secretary of State for Public Health, with her portfolio now including child health.
The RCPCH will be in touch with, and be meeting relevant ministers as soon as possible to ensure that child health is on their agenda. The RCPCH Challenge The RCPCH is calling on the Government to prioritise children, especially in the first 100 days of government, and have set out what we want all parties to commit to in our document, Child health: A challenge to the new Government. View the document online: www.rcpch.ac.uk/100-day-challenge
“My aim is to empower paediatricians so that each and every one can contribute to delivering and advancing children’s healthcare.” underway, not least the devolution of responsibility for health services to large urban conurbations, of which the so-called ‘Devo-Manc’ affecting Manchester is among the first. Many of you have been telling me that fragmentation of care and bureaucracy are increasing, and a preoccupation with commercialisation is adversely affecting the ability to deliver integrated healthcare. Children are often the first to lose from poorly integrated services and need joined-up systems that preserve their health, and physical, mental and social wellbeing. We shall therefore be monitoring developments closely, especially the impact of the 2012 Health and Social Care Act. The Act has changed lines of accountability by removing the duty of the Secretary of State for Health, in place since 1948, to ‘provide or secure’ healthcare, and left the NHS vulnerable to EU competition law and the Transatlantic Trade and Investment Partnership that make tendering a legal requirement. Let me know what is happening on the
ground so we have an accurate picture and can advocate effectively. Helping you, and working with parents and young people We provide a number of resources to assist paediatricians, including guidance on difficult areas such as research ethics, newborn palliative care, end-of-life decisions and the Facing the Future standards. We also conduct surveillance and audits of children’s health and outcomes in areas such as epilepsy, diabetes and my own specialism, neonatal care. I intend to increase these activities, because without good information and data it’s impossible to know with certainty how children are faring and where we need to target to improve care. Colleagues tell me that they fear the professionalism of doctors and nurses is being damaged by an increasingly boxticking mentality. I am on a working group established as part of the maternity review set up in the wake of the Morecambe Bay
Members – get involved We’re keen to get more members involved in the College’s work lobbying politicians across the four nations to ensure child health is high on the political agenda following the General Election and in the run up to the 2016 elections in Scotland, Wales and Northern Ireland. If you are interested in becoming a member of our Parliamentary Panel, please email public.affairs@rcpch.ac.uk for more information. KARMJIT KAUR Public Affairs Lead
Report where we shall be considering these and related issues. The country has also been outraged by what has happened to NHS whistle-blowers and we will support professionals who speak out when they’re concerned. We’re consulting with members on the Greenaway Shape of Training report. This is a welcome opportunity to influence the future medical training. I’d like the next generation of doctors to have fulfilled careers that grow and develop in keeping with their age, experience and ambition. We also need to be mindful that children need doctors who provide care across a range of settings; there are currently too many barriers between primary, secondary and tertiary care. The traditional model is no longer tenable if we are to do our best for the growing number of children with multiple co-morbidities. Underpinning all our activities is the involvement of parents and young people. The very active and vocal Youth Advisory Panel and Parent and Carer Advisory Group, recently rebranded RCPCH & Us, are core to this (see page 7). I have an ambitious agenda, but you wouldn’t expect less. Please get in touch if you have an idea, a comment, news about how the NHS is functioning, or want to help with the work of your Royal College; my email inbox is always open!
PROFESSOR NEENA MODI president@rcpch.ac.uk
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Focus
RCPCH
Annual Conference Annual Conference
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28-30 April 2015 Birmingham
Annual Conference 2015 Post-conference blues This year was another highlight in the RCPCH calendar. For the first time ever, numbers attending approached 2,000, with delegates arriving keen to learn and exchange information as well as contribute to the energy of the meeting. We had a thematic approach to Conference with an overall theme of ‘advocating for children in a rapidly changing world’ - each day being streamed around a particular facet of advocacy. For the first two conference days we were joined by colleagues from the Royal College of Nursing who provided expertise, balance and powerful advocacy themselves for the child/family unit. The first day focused on the critical role of UK health services in advocating for children and their carers, and day two was devoted to international health advocacy. It was a privilege to welcome our Patron, HRH The Princess Royal, who has been a powerful advocate for children internationally as well as in the UK. The final day provided an opportunity for the high-quality research and science that is, at least in part, facilitated by the close working relationship with the
National Institute of Health Research to be demonstrated in action.
Plenary Q&A session
Delegates were invited to use the new Conference app, which provided access to the programme, abstracts, speaker biographies and instantaneous feedback. So why the ‘post-conference blues’? I always come away from conferences full of energy and excitement. However, I also have that feeling of missed opportunities – the people that I didn’t have enough time to talk to, the sessions that I missed because of the richness of experiences on offer and the challenge of putting new knowledge into practice. So I have to wait another year – in this case until Liverpool 2016 – when the theme of the conference will be ‘working together across interfaces’.
Workshop
DR ANDREW LONG Vice President for Education
We asked you how you would describe this year’s conference to a colleague. Here are some of your responses…
“A smorgasbord of paediatric topics to delight the curious clinician” Consultant Paediatrician
“Very useful. Great way to update on general paediatrics as I work in a specialist area. Lots of different areas updated in one day” Associate Specialist
“Relevant. Diverse. Interesting. Stimulating. Great venue” ST6 Trainee
Princess Anne meeting delegates
“Brilliant conference for paediatric trainees covering a broad range of paediatric clinical areas” FY1 Doctor Skills and simulations in paediatric emergencies session
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Focus
RCPCH
Annual Conference Annual Conference
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28-30 April 2015 Birmingham
Annual Conference 2015 Leading the way in children’s health… #RCPCH15 On the three days of Annual Conference, #RCPCH15 was trending on Twitter – a first for the College! With over 8,000 tweets including comments, questions and challenges from a range of sessions (and photos of food and RCPCH teddy bears!), it proved to be the most social media dominated RCPCH conference yet.
Delegates heading to sessions
Poster viewing
A snapshot of the most shared posts based on the number of retweets can be found: storify.com/Damian_Roland/rcpch15 The conversation online highlighted that listening to children and young people was at the core of discussions and through your knowledge, innovation and expertise, we can be powerful advocates for child health. Don’t forget you can follow the RCPCH on Twitter (@rcpchtweets) as well as through our dedicated @rcpchScotland @rcpchWales @rcpchIreland and @rcpch_trainees accounts. For those of you at Conference, you’ll have seen the rebrand of the College’s Youth Advisory Panel - RCPCH & Us (see page 7). You can follow them on Twitter, Facebook, Google+, LinkedIn, Instagram and YouTube. For more pictures from Conference: uk.pinterest.com/rcpch
Exhibition hall
Save the date
RCPCH
Annual Conference
26-28 April 2016, Liverpool
Register for updates: www.rcpch.ac.uk/conference16 5
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Have you signed in to the website lately? When logged in to RCPCH, you can see your member dashboard. This is your personalised ‘home’ screen with news and opportunities for learning and getting involved – based around your interests and career. From your dashboard you can access College resources without needing to sign in again. These include links to Compass online classroom, ASSET, CPD Diary and Archives of Disease in Childhood. Log in to see and customise your dashboard, update your details and tell us what you think: www.rcpch.ac.uk/user
Download the Baby Buddy app Baby Buddy is a free mobile phone app for parents and parents-to-be to use from pregnancy through to the first six months after birth. The personalised content is approved by a multiprofessional editorial board to ensure it is both evidence based and user friendly. It’s proving hugely popular with parents and healthcare professionals, with over 18,000 downloads since it launched in November 2014. I would highly recommend that colleagues working with new and expectant parents download and use the Baby Buddy app so you’re well placed to recommend the app and its content and features to families and use it effectively during appointments. Download Baby Buddy on Google Play and in App Store. Feedback and suggestions for additional content is welcomed via the app. DR JANE RITCHIE Best Beginnings RCPCH Representative
If you’re considering volunteering overseas... There are opportunities to become involved with RCPCH’s new global programmes in Kenya, Uganda, Sierra Leone and Myanmar. The programmes look to build on the impact RCPCH members have already had, and strengthen health partnerships that deliver essential services to some of the world’s least privileged children. If you are interested in contributing to the improvement of child health in these countries in a sustainable, coordinated way, please visit the RCPCH website to find out more: www.rcpch.ac.uk/global If you have any queries contact: •
peter.nash@rcpch.ac.uk / 020 7092 6016
•
andrew.fryer@rcpch.ac.uk / 020 7092 6017 Patient and carer in Ola During Children’s Hospital, Sierra Leone
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You & Us - ensuring patient voices are at the heart of what we do “& Us builds a wider foundation so that a larger audience can get involved in different ways and will get a chance to influence decisions about our healthcare.” Thines Ganeshmoorty, RCPCH Young Person & Us member Expanding on the excellent work of our Youth Advisory Panel (YAP) and Parents and Carers Group (PCG), we are pleased to announce the launch of our new platform for children, young people and families called & Us. & Us was co-designed with our YAP and PCG to embody the patient voice. It will provide flexible ways for as wide a variety of people as possible to get involved with our work - from short surveys and focus groups to longer-term roles - as we recognise that being part of a panel does not suit everyone. Our flexible opportunities will allow us to broaden our reach and reflect the full spectrum of patient voices. We’ll be working with children, young people, families, teachers and healthcare professionals to promote the importance of involvement in order to improve healthcare.
You
Help make the NHS a better place
You can help by promoting & Us in your local area
&Us works with children, young people and families across the UK to improve child health.
Share our poster (pictured) in your local area to help recruit people to join & Us, or sign up to become one of our Child Health Champions and promote better participation across the UK.
Add your voice and make a change.
PARTICIPATION AND ADVOCACY TEAM
www.rcpch.ac.uk/and_us and_us@rcpch.ac.uk
Quote ‘all of us’ when you get in touch The Royal College of Paediatrics and Child Health (RCPCH), 5-11 Theobalds Road, London, WC1X 8SH, is a registered charity in England and Wales (1057744) and in Scotland (SC038299). © 2015
Download the poster and find out more: www.rcpch.ac.uk/and_us 7
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Your RCPCH
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Meds IQ launches to make paediatric prescribing less of a risky business If you happened to be at this year’s RCPCH Annual Conference, you might have caught a glimpse of a short film telling a story of a little boy who, having lost his hearing due to a prescribing error, is scared before his next visit to hospital in case something equally terrible befalls him again.
www.medsiq.org
Meds IQ is a new project at RCPCH, funded by the Department of Health, which aims to improve medication safety for children through a simple approach: rather than create new solutions, make the best of those already there. In response to some key challenges in medication safety – prescribing errors, medication error under-reporting, medicine reconciliation, communicating with patients and families – there have been numerous innovative quality improvement projects developed in local settings, matching the real need and resourcing available in dayto-day clinical practice. These small-scale initiatives could often be a real gamechanger for clinicians struggling with similar challenges in other locations, yet many remain unknown to a larger audience.
Unfortunately, his fear appears well grounded as paediatric medication errors are relatively common and can cause serious harm.
Meds IQ aims to bring together the abundance of existing QI initiatives in a
single website, which clinicians can access to improve knowledge, seek solutions and share their experiences in improving paediatric medication safety. Our vision is that Meds IQ will become a comprehensive library of resources – ranging from low-cost local strategies to nationwide projects – which will be disseminated more widely to enable a more systematic, larger-scale approach to improving medication safety. Our next step is to build a nationwide network of child healthcare specialists ready to pilot new medication safety projects and shout out about the work they do. For more information, contact kasia.muszynska@rcpch.ac.uk KASIA MUSZYNSKA Meds IQ Project Manager
New website for Medicines for Children Providing practical, reliable, accessible information, Medicines for Children empowers parents and carers to confidently administer medicines to children and young people. www.medicinesforchildren.org.uk Our vision is to ensure any parent or carer, wherever they are, has trusted information on their child’s medicines. We have worked hard to develop a wide library of resources and are proud to be endorsed by RCGP, RCN and the Royal Pharmaceutical Society, with our information leaflets carrying The Information Standard kitemark. The launch of our upgraded website brings a range of improvements to make the site more user friendly. You can still find our bank of: •
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Medicine information leaflets - developed and regularly reviewed by clinicians, we have
over 190 leaflets covering many of the medicines prescribed or recommended to children. Addressing how and when to give medicine, what to do if someone forgets to give the medicine or gives it twice, and any possible side effects. •
Tutorials and videos demonstrating how to give different medicines, including tablets, capsules, liquid medicine, injections, suppositories and enemas, eye drops/ointment and ear drops.
MEDICINES FOR CHILDREN TEAM
“Just wanted to thank you for your website. My 10-year-old daughter may have complex regional pain syndrome (CRPS) and your leaflet on amitriptyline and gabapentin, specifically for neuropathic pain relief in children, is very much appreciated while we are in the learning and researching phase.” Parent feedback
Focus
Your RCPCH
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Publications The physical signs of child sexual abuse
Diagnosis of death by neurological criteria
RCPCH annual review 2014
Second edition provides an update of the evidence-based review and also includes three new reviews: anogenital signs of accidental injuries in girls and boys, genital bleeding in prepubertal girls and healing in anogenital injuries.
Published in April 2015, this report provides recommendations on the diagnosis of death by neurological criteria (DNC) in infants from 37 weeks corrected gestation (post menstrual) to two months (post term) of age. Aimed at UK paediatric and neonatal healthcare staff.
The review reflects the financial year 01 September 2013 - 31 August 2014. It outlines the College’s key performance indicators against our strategic aims. CEO Judith Ellis says “Looking back over 2014 the RCPCH is in a strong position to move forward.”
www.rcpch.ac.uk/csa
www.rcpch.ac.uk/dnc
www.rcpch.ac.uk/ar2014
NHS 111 service evaluation
Looked after children
MRCPCH Theory and Science
This pilot service evaluation reviews the flow of paediatric patients (<5 years) with fever through the NHS with NHS 111 as an entry point. View the recommendations and conclusions online.
This document, developed in partnership with the RCN and RCGP, provides a framework for healthcare staff to understand their role and responsibilities for meeting the needs of looked after children.
The official resource tool for MRCPCH Theory and Science theory examination, edited by RCPCH Chair of Written Examination Papers, Dr Will Carroll.
www.rcpch.ac.uk/nhs111
www.rcpch.ac.uk/lac
www.rcpch.ac.uk/clinicalcases-mrcpch 9
Focus
Training and support
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New Clinical Lead on board for ePortfolio integration project We reported in the spring edition of Focus that we are developing a brand new standalone ePortfolio platform to integrate RCPCH assessment tools. We’re pleased to announce that Dr Sanjeev Deshpande has now joined us as the Clinical Lead for this project. Dr Deshpande has worked as a supervisor for 20 years and as a training programme director. He has developed a strong interest in ePortfolio, having worked for many years as the ePortfolio Champion in the West Midlands. He says:
with a quick, graphical overview of their progress and an easy-tonavigate list of events. This system will enable trainees to populate the competences in the curricula directly with evidence from SLEs.
“I am delighted to be involved with this project. The integration of ePortfolio and ASSET into one system will meet a long-standing demand.
ePortfolio is an essential part of training; the more user involvement we have in the development stage, from trainees, supervisors and assessors, the better the final product.
The new ePortfolio is mobile friendly, enabling capture of learning activities on mobile devices, even without wifi. New features will provide trainees
Please do volunteer for testing by emailing ePortfolio@rcpch.ac.uk and keep an eye on the College website, newsletters and social media for regular updates.”
RCPCH courses and events 2015 EVENTS TEAM
email: events@rcpch.ac.uk
Evening of Evidence: iTeen the Paediatrician’s Guide to Common Presentations During Adolescence 28 July 2015 RCPCH London Expert Witnesses in Child Protection: Developing Excellence 14-15 September 2015 RCPCH London How to Manage: Common Cardiac Problems in Paediatrics 16 September 2015 RCPCH, London 10
tel: 020 7092 6000
web: www.rcpch.ac.uk/courses
Effective Educational Supervision 22 September 2015 Newcastle
Paediatric Educators’ Programme 19-20 November 2015 RCPCH London
Introduction to Quality Improvement and Patient Safety 13 November 2015 RCPCH London
How to Manage: Children with Benign Haematological Problems 26 November 2015 RCPCH London
How to Manage: Gastroenterology 17 November 2015 RCPCH London
Effective Educational Supervision 27 November 2015 Liverpool
Dates correct at time of going to press. Limited places available.
Join the conversation on Twitter #RCPCHcourses
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Committee news
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Training matters David James replaces Dan Lumsden as Chair of the Trainees’ Committee at the beginning of July. He’s currently working as an ST6 in General Paediatrics at Musgrove Park Hospital in Taunton and starts Grid training in Paediatric Emergency Medicine at Bristol Children’s Hospital from September. What three things do you hope to achieve in the role?
At work I am always learning that...
Championing the voice of trainees Why have you taken up this role?
•
Improve child health training for all trainees, not just in paediatrics
around you
•
Improve support to new consultants
•
Improve academic training for clinical trainees
Describe your new role in five words
How could you not? Paediatric trainees are a hard working, innovative and passionate bunch and it is such a privilege to represent their voice and to channel some of that innovation towards improving the health of children and young people. Why did you want to work in paediatrics? I loved it as a medical student and I still love it today. What’s not to love about a specialty that tests you on a daily basis on physiology, communication, teamwork and the plot and characters of Disney’s Frozen.
Complete these sentences: My proudest achievement at work was... surviving tertiary neonates
you are only as good as the team
If I could go back 10 years and meet my former self I’d tell them... to give up supporting Swindon Town Football Club, it would have saved a lot of frustration! What makes you smile?
The most difficult thing I’ve dealt with at work is... anything involving small babies and fiddly lines, not my strong point!
Anything by Armando Iannucci
Sometimes people think that I... am far older than I am
The bleep! Night shifts always seem to
What keeps you awake at night?
come round too often…
RCPCH Officer for Health Promotion Professor Russell Viner takes up the post of Officer for Health Promotion at the beginning of July. He works as Professor of Adolescent Health, UCL Institute of Child Health, London. Public health issues regularly dominate the media and public debate – whether it’s smoking, alcohol or obesity. For the RCPCH, ensuring that public health policies are implemented to protect child health is an absolutely priority. There’s been much progress over the last few years, not least legislation for England and Wales on banning smoking in cars with children present, standardised cigarette packaging and, most recently, a commitment from the new government to develop a childhood obesity strategy. As Officer for Heath Promotion, I am keen to continue and grow the excellent work of my predecessor Professor Mitch Blair to ensure that the RCPCH has a
strong voice on public health in the national arena. I want to embed health promotion within the day-to-day clinical practice of all paediatricians and child health professionals, regardless of their specialty. Concepts of promoting healthy behaviours and ‘making every contact count’ are as relevant to clinical practice as to public health. I also want to focus on promoting further development of public health research and health service research for children and young people, linking with the development of the UK Child Health Research Collaboration. I’m highly engaged in regional and national policy work for children and young people. I am a member of the
Children’s Health Outcomes Forum and co-lead the Public Health subgroup and the Outcomes theme group. I was one of the chapter authors of the CMO’s Report on children and young people (2012) and a co-author on the recent report Why Children Die by RCPCH and NCB on mortality in children in the UK. My own research underpins much of my work in health promotion, and I work across key RCPCH priority areas of obesity and nutrition, wellbeing, injury prevention and comparative mortality in children and young people. Do get in touch with your ideas and comments: health.policy@rcpch.ac.uk I look forward to working with you.
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BNF for Children 2015-2016 Guiding health professionals on all aspects of paediatric drug therapy
NEW
PUBLICATION DATE The new BNF for Children will be published on 15 September 2015.
SEPTEMBER
This change in publication date will bring all the updates in line with those in the BNF and the Nurse Prescribers’ Formulary, achieving clinical consistency between the products. Fully revised and packed with the latest updates, new coverage in BNFC includes: • Domperidone for the treatment of gastrooesophageal reflux disease (GORD) • Updated information on adverse drug reactions (ADRs) in children • Tramadol dosage updates • New advice on self-administration of adrenaline for anaphylaxis
www.pharmpress.com
Watch this space for further news!