RCPCH Focus - Winter 2015

WINTER 2015 NEWSLETTER

Fo us focus@rcpch.ac.uk @RCPCHtweets

www.facebook.com/rcpch

New RCPCH e-learning package for paediatricians • Top tips for working with disabled children and young people • Improve your confidence and communication skills • Develop your knowledge of visible and hidden disabilities Basic: bit.ly/1ONeqiA Advanced: bit.ly/1RYPi6d (Estimated three hours learning for each package)

2.5 CPD credits

RCPCH

Annual Conference

26-28 April 2016, Liverpool

Paediatric Care Online launches New for 2016, Paediatric Care Online (PCO UK) is an innovative decision support resource that is a substantial new benefit available through your RCPCH membership.*

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the British National Formulary for Children covering the prescribing, dispensing, monitoring and administration of medicines to children**

PCO UK is designed specifically for child health professionals. It features concise and easy-to-navigate decision support tools and clinically assured advice, facilitating decision making at the point of presentation and offering a ‘roadmap’ for common signs, symptoms and critical care situations.

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links to patient and carer information and resources

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resources and e-learning content for child health professionals to support and enhance their paediatric knowledge and practice

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access to US-based AAP Text Book of Pediatric Care with more than 3,000 pages of content and images.

Available through a range of devices, PCO UK provides instant access to:

Working together across boundaries

See page 7

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over 90 ‘Key Practice Points’ covering the common signs, symptoms and critical care situations

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Public Health England’s ‘Green Book’ Immunisation against infectious diseases in a fully indexed and searchable format

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the Child Protection Companion, an essential resource covering areas ranging from health concerns to social interactions

* Excludes Honorary Fellows and Student Affiliates **BNFC is only available to users in the UK

Through membership subscriptions, you have access to this innovative tool for the heavily discounted annual rate of only £20-£30 (dependent on membership category - see page 4).

Members will be contacted in early 2016 with instructions on how to access their PCO UK account. This information will also be updated at: www.rcpch.ac.uk/pcouk JONATHAN MIALL Director of Business Development

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1 News

New decision support resource for child health professionals 2 From the President

Turbulent times

Quick guide and call for evidence:

Membership subscriptions 2016

Fellowship at RCPCH

Recently published...

Governance reforms

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Education and training

healthcare reforms

4 Your RCPCH

Recruitment soon to open for our

non-UK/EEA postgraduate training scheme

ePortfolio goes live this month

RCPCH Annual Conference 2016

Courses and events 2016

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Your views

Healthcare professionals & Us: add your voice and make a change

Facing the Future: Long-term conditions

RCPCH manifesto proposals

Introducing a new generation of RCPCH global health

In the Twittersphere

11 Committee news

Training matters

Meet SNOMED CT: the clinical terminology solution

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 Turbulent times

The last months have been dominated by the impasse between Government and the British Medical Association over junior doctor contracts. The Secretary of State for Health, Jeremy Hunt, has announced his intention to impose a new contract next year; the British Medical Association has said a return to the negotiating table is not possible without the removal of preconditions. The country has witnessed thousands of junior doctors marching in the streets of London. They are angry and worried, but they have behaved with humour, good grace and maturity.

Government has based its current position on a promise to deliver so-called 24/7 care.

We would all fully support a seven-day health service, but this requires the provision of a complete range of services, not just more doctors. I’ve made our concerns known in respect of several of the proposed changes. I’m glad to have received assurances that pay progression will be maintained for junior doctors undertaking research training but regrettably the proposals continue to disadvantage those taking parental leave, and the precise impact on salaries remains uncertain. It is also difficult to see how the removal of financial penalties for Trusts that breach safeguards designed to prevent employers from requiring trainees to work excessively long hours, replacing this with a complicated process delivered by the Care Quality Commission, can be an advance.

We have urged both sides to get back to the negotiating table and in a recent meeting with the Secretary of State I pointed out that junior doctors, working long and unsociable hours for less pay than their peers in comparable careers, should be valued and respected for their dedication

and commitment. An imposed contract is not an appropriate way to resolve the current dispute. At the time of writing, the results of the BMA ballot have just been announced with 98% of those replying voting in favour of industrial action. The Government has responded by agreeing to start talks with the arbitration service Acas.

Whatever happens, I am confident that paediatricians will place patient safety first.

The threat of industrial action by doctors happens rarely and one cannot help but feel that this point has been reached not only because positions have become entrenched, but also because this is a tipping point for the health service. As all front-line staff know, the NHS is grappling with a harsh financial climate, increasing fragmentation of services, and yet another major re-organisation. Rota vacancies are substantial, leading to greater burden on remaining staff and rising locum costs, all of which feed a vicious cycle. There is a strange discord between the reality on the ground, and the promise to deliver 24/7 services while simultaneously achieving £20 billion in efficiency savings. As I’ve said previously, our health service needs investment, not austerity.

Recently I’ve been asked to give a few lectures about the future of paediatrics and paediatric research. This led me to indulge in a thought experiment. Every young doctor is trained in adult medicine first because that is the way our profession developed down the centuries and paediatrics had to fight hard to be recognised as a distinct speciality. But if medical training were being redesigned today from a completely clean slate, wouldn’t we start at the beginning?

Wouldn’t we give every young medic-to-be

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Quick guide and call for evidence: healthcare reforms On 1 April 2013 the Health and Social Care Act 2012 officially came into effect and introduced radical changes to the way that healthcare in England is organised. We have put together an overview to help members navigate the current system in England (www.rcpch. ac.uk/nhsquickguide) and are developing similar overviews for Wales, Northern Ireland and Scotland.

Key changes under the Act: •

the responsibility for health services as held by the Secretary of State for Health since 1948 was abolished

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a new, arms-length body, the NHS Commissioning Board was created and later renamed NHS England

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Primary Care Trusts and Strategic Health Authorities have been abolished

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GP-led Clinical Commissioning Groups are now responsible for commissioning most hospital, community and mental health services, while NHS England is

responsible for commissioning specialised services •

local authorities are responsible for commissioning public health services, with a new agency, Public Health England, established to oversee the public health system.

Nearly three years on, we are starting to see the real implications of the Act. The RCPCH is monitoring developments closely; please do share with us your examples of what is happening on the ground so we can advocate effectively.

ISOBEL HOWE Head of Health Policy

However, there is a lot more work to be done and decisions around acceptance and implementation of final conclusions are unclear.

There is a third element that is likely to affect the medical training of the future, adding to the uncertainties created by Government’s contract proposals, and the Shape of Training recommendations. This is the creation of Health Education England, established post 2012, to lead health services workforce planning, education and training. Health Education England has a defined budget and delivers its remit through 13 Local Education and Training Boards that have taken over the functions previously carried out by Deaneries. Is this confusing? Yes it is, so we’ll do our best to keep you informed. Other recent changes to the NHS can also be difficult to comprehend so we’ve put together a guide to the new health service to help you navigate a complicated landscape (see above). It is important that doctors understand the implications of the 2012 Act and the arena in which we all now work. a thorough grounding in the early years sciences, and in paediatrics and child health, so that they understand how early exposures in the peri-conceptional, intrauterine and early childhood periods shape a large component of life-long physical and mental health? But medical training is a topsy-turvy legacy from history. Remarkably, only a minority of adult physicians who will go on to care for young people, and less than 50% of those going on to become general practitioners, the first point of contact for a sick child, have opportunity to receive any training in paediatrics.

Ensuring that children receive the care they need, in the location that is best for them, delivered by practitioners who have been appropriately trained, is an important goal, and one of the opportunities offered by the Shape of Training report led by Professor David Greenaway. We have been consulting widely among paediatricians, junior and senior alike, on the recommendations of the report and Council has agreed the principles upon which to proceed. These include achieving greater flexibility in the ways in which paediatricians are able to develop their careers, and clearer points of progression into alternative careers.

In these turbulent times it’s sometimes easy to forget that medicine is a great and wonderful profession of which most of us feel privileged to be part. It’s also worth remembering that doctors are nothing if not able, resolute and resourceful. We can shape change, we can take our destiny into our hands, and we can and should be advocates for child health, and the wellbeing of our patients.

PROFESSOR NEENA MODI president@rcpch.ac.uk

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Membership subscriptions 2016 The College normally aims to keep subscription increases in line with, or below, RPI Inflation. Despite a difficult financial climate, reductions in funding and the introduction of new membership benefits such as the personalised dashboard, the Paediatrician’s Handbook and increased e-learning opportunities, this aim has been achieved in recent years.

In January 2016 we will be introducing Paediatric Care Online (PCO UK) as a major

new benefit for members (see front page).

This means that your Council have agreed that membership subscriptions will need to be increased at above inflation for the first time in over five years.

Discounts will continue to be available to those working part time, those on maternity, paternity or sick leave and members of other Colleges. Additionally, if members are having difficulty in paying their subscription due to financial hardship then they can apply for a

2016 annual subscription £0 £520 £393 £250 £432 £332 £213 £76 £235 £218 £98 £61 £0

Membership type Honorary Fellow Fellow UK* Fellow rest of EU and North America Fellow Elsewhere Ordinary UK* Ordinary rest of EU and North America Ordinary elsewhere Senior Fellow/Member Associate UK, EU and North America Associate elsewhere Junior (UK only) Affiliates Medical Student Affiliates

non-standard concession by contacting the Member Services Team on 0207 092 6060 or via membership@rcpch.ac.uk The main subscription rates for 2016 (excluding training fees) are listed below.

Membership subscriptions are tax deductible for UK tax payers who can claim up to 40% back from the Inland Revenue.

DR LISA KAUFFMANN Honorary Treasurer

Rate shown includes Archives?

No Yes Yes Yes Yes Yes Yes No No No No No No

Rate shown includes PCO UK? No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No

*As in previous years, UK residents pay additional levies and payment surcharges may apply for some payment methods.

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RCPCH Examiner Elect

Associate, Ordinary, Senior, Honorary, Affiliate Associate, Ordinary, Senior, Honorary, norary, Affiliate Associate, Ordinary, Senior, Hono norary or te Associate, Ordinary, Senior, Hon , ffiliatte Associate, Ordinary, Senior, Hon rary, Affiliatte Associate, Ordinary, Seni Senior, ior, Honorary, Affi ffilliate Associate, Ordinary, Sen Senior, nior, H Honorary, onorrary Affiliate Associate, Ordinary, Se Senior, enior, H Honorary, onor Affiliate Associate, Ordinary, Se Senior, enior, H Honorary, onor Affiliate Associate, Odinary, Se Senior, enio eni ior, H Honorary, on no ora ary, A Affiliate Associate, Ordinary, Se S Senior, Honorary, ry, A Affiliate Associate, soc ciate, O Ordinary, rdinary, S Senior, Honorary, ry, A Affiliate Associate, so ociate, O Ordinary, rdinary, S Senior, Honorary, ry, A Affiliate Associate, so ociate, Ordinary, S Senior, ior, Honor Honorary, ry, A Affiliate Associate, so ociate, Ordinary, S Senior, ior, Honor Honorary, ry, A Affiliate Associate, so ociate, Ordinary, S Senior, ior, Honor Honorary, ry, A Affiliate Associate, so ociate, Ordinary, y Se Senior, or, Honor Honorary, ry, A Affiliate Associate, so ociate, O Ordinary, rdinary, S Senior, enior, H Honorary, onorary, A Affiliate Those applying via the election route have to provide letters of support from two RCPCH Fellows, one of whom must be based in the UK or Republic of Ireland.

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previous leadership roles in national services (might include work on medical campaigns or with medical charities)

For more information on the benefits of Fellowship and to apply visit: www.rcpch.ac.uk/apply-membership

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being a named author of several articles in international peerreviewed journals.

DANIEL RADLEY Membership and Marketing Administrator

Fellowship at RCPCH Have you considered upgrading your membership to Fellow? Fellowship is the highest level of membership which you can apply for at the RCPCH. Fellowship recognises and certifies a high standard of education and training and a commitment to the health and welfare of children, enabling you to use the internationally recognised designation FRCPCH. Fellows are also issued with a Fellowship certificate and invited to a Fellowship Ceremony.

Additionally, Fellowship enables you to apply to examine independently for the College and to apply for some RCPCH Senior Officer or College posts.

If you are working in a substantive,

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permanent non-training post and registered with the UK GMC or IMC and on the Specialist Register in Paediatrics, you can apply via our website by completing a simple online form (no proposers are required).

Those not on the UK Specialist Register in Paediatrics but working in substantive non-training posts can apply for Fellowship via election but must have achieved distinction. Examples of distinction could be any of the following:

Apply for Fellowship

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Recently published...

Service specification for the clinical evaluation of children and young people who may have been sexually abused

National Neonatal Audit Programme 2015 Annual Report on 2014 data

This document outlines the standards for the provision of a paediatric forensic medical service for children and young people who may have been sexually abused.

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follow-up at two years of age of pre-term babies: no two-year health data was recorded for 46% of babies, a major concern given that developmental delay could be missed

It has been prepared by a working group of the RCPCH Child Protection Standing Committee in partnership with the Faculty of Forensic and Legal Medicine to inform the establishment of these services in the UK.

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consultation with parents: one in ten parents were still not recorded as having had a consultation with a senior member of the neonatal team within 24 hours of their baby’s admission to the neonatal unit.

www.rcpch.ac.uk/cp-pubs

www.rcpch.ac.uk/nnap

Of the report’s key findings, two demand particular attention:

The use of primary and secondary care services by children and young people following contact with NHS 111 – investigating the patient experience and flow for four common conditions The report investigates the NHS 111 service for CYP aged <16 years in North West London with fever, breathlessness, diarrhoea and vomiting, or constipation.

The project aimed to identify patient flow through linking NHS 111 data with GP outof-hours and secondary uses service data, assess parent and carer experience of the service through the development of a PREM and identify what parents, carers and CYP value in a telephone advice service such as NHS 111.

www.rcpch.ac.uk/nhs111

Access our full list of publications: rcpch.adlibhosting.com

Governance reforms As reported in Focus, on 8 September an EGM approved changes to the RCPCH’s governing documents. The changes, now signed off by our regulator, the Privy Council, permits members to vote on selected General Meeting items remotely.

With this in hand, the RCPCH intends to proceed with the main work of reforming its Trustee Board. The proposals to implement this were agreed by Council in the summer and are now undergoing scrutiny from our regulators. All being well, these proposals will be presented to the AGM in April 2016 for approval.

As the AGM approaches, the College will be seeking to ensure that all members are well-informed about the changes: why they are felt to be necessary, how they will work, and what benefits they

will bring. Briefings on these issues will be sent out via the website, and flagged in our email bulletins and social media.

We welcome your comments on these changes. We know that governance issues can be dry and abstract, but they are also vital to delivering a smoothly running organisation for members.

GRAHAM SLEIGHT Head of Governance

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Education and training

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Recruitment soon to open for our non-UK/EEA postgraduate training scheme

Image: Delegates at the MTI induction event in September

The Medical Training Initiative (Paediatrics) scheme enables non-UK/EEA paediatricians, with MRCPCH or other postgraduate qualifications, to undertake high-quality postgraduate training in paediatrics for a maximum of 24 months, before returning to work in their home countries.

On 24 September 2015 the RCPCH hosted its ever-growing annual MTI induction event. We welcomed a diverse group of 40 MTI Fellows who had recently arrived to begin their placements in the UK from countries including Singapore, Burma, Sri Lanka, India, Ghana, Nigeria and Egypt. The event’s aim was to provide attendees with the skills needed to adapt to life in the UK and the environment of the NHS. Apply The RCPCH provides well-qualified, enthusiastic international medical graduates to fill paediatric middlegrade vacancies for a period of 12-24 months. Doctors undergo a robust selection process and are matched to available posts based on their area of interest and experience to date.

If you are interested in getting involved with the MTI Scheme, the next round of recruitment will open to overseas applicants on 1 March 2016 for posts starting in August and September 2016.

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Submit an MTI post In order to ensure we continue to provide suitable training opportunities for these applicants we are now welcoming submission of 2016 posts for the scheme from Trusts nationwide.

All MTI doctors are expected to need 3-6 months on the ‘SHO’ rota in order to adjust to the new system with the remainder of their time spent at ‘middle-grade’ level. We would encourage the inclusion of subspecialty exposure to ensure the post is attractive to prospective Fellows.

The post submission deadline is 15 February 2016 - after this time the posts will be collated and posted on the RCPCH website for applicants to review.

If you would like to submit a post please contact mtip@rcpch.ac.uk If you have any links with centres overseas, do spread the word about the upcoming recruitment round.

Support MTI Fellows To ensure adequate levels of support is available for MTI Fellows new to the NHS system, we ask the Trust to provide MTI Buddies for each Fellow they employ. If you are interested in becoming a MTI Buddy, please get in touch with us.

We are also able to assist you all year round with overseas doctors you have selected directly via the MTI trust route.

Contact mtip@rcpch.ac.uk for more details.

MONIKA FILASIEWICZ MTI Coordinator

ePortfolio goes live Jan 2016 The new RCPCH ePortfolio has been rolled out in Scotland and the West Midlands before going live for the whole country later this month.

We’re working in collaboration with Fry IT to produce a system that can be improved and refined. Added functionality will be coming over the next year.

The system will integrate data and forms from ePortfolio and ASSET into one place with the added benefits of being optimised for mobile devices, with an offline mode and single sign on from the College website. We will be working to improve the content too, including supervision reports, reporting and trainee goals functionality.

The RCPCH ePortfolio and assessment pages will be updated to reflect the changes, along with manuals and videos to help you understand the new system better. The ePortfolio news page will continue to be updated with support, information and future developments www.rcpch.ac.uk/eportfolio-news PIPPA ASHTON Project Manager, ePortfolio Integration Project

RCPCH ePortfolio

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Education and training

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RCPCH

Annual Conference

26-28 April 2016, Liverpool

In association with the RCN Children and Young People Nursing Conference

Book your discounted early bird place The UK’s biggest paediatric and child health event boasts a top line-up of speakers, great networking opportunities and a wide range of sessions to choose from.

Visit: www.rcpch.ac.uk/conf16 Facebook “f ” Logo

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Facebook “f ” Logo

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facebook.com/RCPCHAnnualConference

RCPCH Annual General Meeting The College’s Annual General Meeting will take place on 27 April 2016 as part of the Annual Conference. In accordance with Bye-Law 6 vii e, the meeting will consider any motion ‘submitted in writing to the College not less than 10 weeks before the date of the meeting, accompanied by the signature of 15 persons being Ordinary Members or Fellows’.

#RCPCH16

The 10-week deadline for motions falls on 17 February 2016.

For further enquiries or to submit a motion, please email: graham.sleight@rcpch.ac.uk

RCPCH courses and events 2016 email: events@rcpch.ac.uk

tel: 020 7092 6000

web: www.rcpch.ac.uk/courses

RCPCH Wales St David’s Day Conference 2016 26 February 2016 Wrexham

Safeguarding: Statement and Report Writing (Level 3) 23 March 2016 RCPCH London

Working Together to Improve the Diagnosis, Treatment and Management of Asthma in Children and Young People 3 March 2016 RCPCH London

Effective Educational Supervision 24 March 2016 Bradford

How to Manage: End of Life Care and Bereavement 15 March 2016 RCPCH London Dates correct at time of going to press.

Limited places available.

Promoting and enhancing quality and evidence-based care for our children and neonates

FGM in Children: Overcoming Challenges Faced by Healthcare Professionals 10 May 2016 RCPCH London Join the conversation on Twitter #RCPCHcourses

REGISTER TODAY! www.arabpaediatriccongress.com 7

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®

Healthcare professionals & Us: add your voice and make a change Since the launch of the & Us voices network at our Annual Conference in April 2015, we have been making strong progress in our children and young people’s participation and engagement at the RCPCH.

The & Us network is expanding its reach to ensure it is truly representative of our service users with different health and healthcare experiences, as well as encouraging those from a range of socio economic and ethnic/cultural backgrounds to get involved.

In addition, to harness the enthusiasm of members with an interest in patient and public engagement, we have developed a new Children and Young People’s Engagement Collaborative. This will be in the form of an online portal bringing together engagement leads and professionals from health, as well as those working in social care, education,

government, voluntary sector and professional bodies to: •

provide mutual support and partnership learning

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share best practice (through a quality improvement (QI) site)

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collaborate on consultation responses

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work together for quality improvement

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encourage & Us membership

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help channel extensive and inclusive CYP, parent and carer engagement.

Interested in getting involved?

To find out more or to register your interest in the new Collaborative, please visit www.rcpch.ac.uk/and_us and complete our short online application form.

For any specific questions and for more information, please contact the Participation and Advocacy Team: and_us@rcpch.ac.uk HANA NAJSROVA CYP Participation and Advocacy Coordinator

Facing the Future: long-term conditions In 2015, the RCPCH published the revised Facing the Future: Standards for Acute General Paediatric Services and the new Facing the Future: Together for Child Health standards.

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making outpatient and GP contacts more valuable and effective for the ICYP

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providing high-quality and responsive networks of care (across health, education, social care)

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improving the transition from children’s to adult services.

This new project, the third in the Facing the Future series, focuses on infants, children and young people (ICYP) with long-term conditions (with one in seven 11 to 15 year olds now having a long-term condition), including their transition from children’s to adult services. Together with four other Colleges, the RCPCH is developing key standards to improve the health outcomes and quality of life for ICYP with long-term conditions by:

As part of the evidence-gathering stage of the project, we would like to hear about new ways of working and innovative service models that have made a difference to patient outcomes.

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empowering ICYP and their parents/ carers to manage their long-term conditions

Please share your examples with us by contributing to our call for evidence: www.rcpch.ac.uk/longtermconditions (closes 19 February).

DR DAVID SHORTLAND Clinical Lead ISOBEL HOWE Head of Health Policy

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Your views

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RCPCH manifesto proposals Next May, voters in Scotland, Wales and Northern Ireland will take to the polls in the 2016 devolved elections.

We are urging all political parties contesting next year’s elections to commit to the key policy asks as outlined in our Vision 2016 manifestos to make child health across the UK comparable to the best in the world.

Vision 2016 Visit our website to read our full Vision 2016 manifestos for Scotland, Wales and Northern Ireland.

Our calls for action include:

Scottish Government • develop and implement a crossdepartmental child health strategy • introduce 20mph speed limits in built-up areas to create safer environments for physical activity • restrict access to alcohol by young people and introduce minimum pricing.

Read more: bit.ly/1Ipcfzs

• establish a Child Deaths Overview Panel to ensure that lessons are learned from childhood deaths

If you are in the devolved nations and would like to contact your local election candidates to support our manifesto proposals, why not get involved with our Parliamentary Panel?

• establish a Northern Ireland paediatric network, headed by a children’s clinical lead

For information, contact: public.affairs@rcpch.ac.uk

Northern Ireland Assembly

• commission a regular survey to identify the prevalence of mental health problems.

Read more: bit.ly/1QU8c0K

Welsh Government • appoint a Welsh Minister for Children with lead responsibility for all policies affecting children, child rights and child health • in public health, introduce levies on food and drinks high in fat, sugar and salt, and set and monitor new targets for reducing smoking rates in pregnancy and early childhood • work collaboratively to develop a strategic workforce plan, which should include measures to address the child health and paediatric workforce.

Read more: bit.ly/1l84X93 (Welsh), bit.ly/1l853gX (English)

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Focus

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Introducing a new generation of RCPCH global health RCPCH is now entering a new epoch in global child health.

With an established track record bringing members’ world-class skills to some of the most deprived parts of the globe, we have developed a new strategy to guide future work, and to enhance our ability to engage members seeking the opportunity to get involved internationally.

RCPCH works to improve the lives of infants, children and young people in the UK, but also around the world. Working internationally is written into our name and mission statement. This makes us unique among Medical Royal Colleges.

Our geographical focus is in East and West Africa (the latter, primarily postEbola Sierra Leone); in the middle-east (continuing our historical support to the children of Palestine); and new initiatives in southeast Asia (currently in Myanmar but looking also to Cambodia).

Our programmes focus on building the capacity of health workers, from senior clinicians and policy-makers to primarylevel facility staff and community-based

volunteers. Our training focuses on lifesaving protocols such as Emergency Triage, Assessment and Treatment (ETAT) and ETAT+, but also on the development of new protocols that advance facility-based care for neonates as well as wider work on child survival, development and safeguarding.

what works to save lives and enhance childhood even in the poorest settings.

We are a leader among the Royal Colleges on global health, leading inter-college collaboration, speaking for global child health at the top of government in the UK and overseas, and developing new research collaborations to build, and teach, best evidence on

If you would like to hear more about our current and emerging programmes, please get in touch: global@rcpch.ac.uk

In all this, our ability to engage and work with you is key. We believe members support the principle of global child health working; we want to work with you to turn that principle into practice.

SEBASTIAN TAYLOR Head of International Operations

In the Twittersphere A big welcome to our new followers on Twitter. We’re now nearing the 8,000 mark and it’s proving a great way for members to share their views and opinions, pass on examples of best practice, and see what others are talking about in the field of child health!

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We’ve had a look at some of our most popular posts and topics on Twitter and Facebook, which over the last few months have included: •

junior doctors’ contracts, RCPCH statements

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Epilepsy Passport

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comments on the refugee crisis

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applications for the 2016 RCPCH Visiting Fellowship programme.

The RCPCH’s & Us network (@rcpch_ and_Us) hosted a Twitter chat for World

Mental Health Day in October. Don’t forget to follow them for the latest news and updates.

We’re always interested in topics that you feel we should highlight on social media, particularly in the form of Twitter chats. Do get in touch with your ideas.

And finally…some of you will have noticed that we’re highlighting a different paediatric sub-speciality each month on Facebook and Twitter. Keep checking the RCPCH’s social media channels for updates!

Focus

Committee news

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Training matters Thank you. Do we say it enough? We have all watched as the junior doctor body has poured its heart out over the last few months in response to the threat of an imposed new contract. We have heard the voices that speak up that we don’t see enough of our friends, our families or our children due to often long and antisocial hours.

Whilst the threatened new contract has elements that have been described as unsafe and unfair, the problems of long and antisocial hours are not new.

How then, we may ask, have we found ourselves in a position in which morale is amongst the lowest seen since the dawn of our much-loved NHS?

by those who employ them and the good will that has been the glue that has maintained this quite remarkable public institution is beginning to come unstuck. This also spreads much wider than our junior doctors to our senior colleagues and those in nursing and allied professions.

I would argue that one large contributing factor is a lack of appreciation. The very staff who maintain the front line of the NHS no longer feel valued or appreciated

So what can we do? Well, firstly we must do all we can to secure a contract that is safe to our patients, fair to us and sustainable for the NHS. We can also do more ourselves. Let’s start a grass roots

appreciation campaign. If we all say thank you to each other, our nursing or allied health professional colleagues just that little more, we may start to turn the tide on this sea of lowering morale.

It is an enormous privilege to serve the public and to have the opportunity to help other people’s children get better.

Who knows, maybe an epidemic of appreciation could be so contagious that it even reaches those in Whitehall.

DAVID JAMES Chair, Trainees’ Committee

Meet SNOMED CT: the clinical terminology solution Dr Andy Spencer has recently taken over as Chair of the Informatics for Quality Committee. Having broad experience of informatics, he hopes to encourage members to get involved in the committee’s work on SNOMED CT, which will be implemented across secondary care by 2020.

The data collection process is changing.

Clinical data is currently extracted from paper notes and coded using classification systems by expert coding staff. However, data coded in this way is not usually appropriate for QI, so independent data collections, national audits and disease registers are used to supplement this information.

The introduction of electronic patient records means that clinical data will be recorded at the point of care, using SNOMED CT, a clinical terminology. Any condition, complication or treatment can be accurately described using SNOMED CT and it is structured to facilitate data analysis. It uses parent terms for more general or higher-level descriptions and child terms for more detailed descriptions. This data will be

used for direct patient management and secondary uses, such as administration and QI. Clinicians will be responsible for accurately and consistently recording these clinical details into the records.

Unfortunately, medicine is not entirely consistent in the way that conditions are described in paper notes, with many outdated and overlapping terms in use.

Often the meaning is clear from the context, but in order to analyse electronic records to compare outcomes for QI we need to do better.

Specialty groups need to look at the terminology they use for common conditions and to agree on appropriate terms and their definition, just as one would do with a specialist database.

These can then be incorporated into SNOMED CT as a subset ready to be used across the specialty nationally. Provision for regular updating is also required.

Using the whole of SNOMED CT can be very unwieldy so Trusts may choose to develop their own short lists of favourite terms. Developing specialty subsets would remove the need and ensure the language used for inpatients and outpatients is consistent.

Primary care will be using SNOMED CT by 2018 and secondary care by 2020.

There is a time window available; we need to ensure it is used wisely. You can read more here: bit.ly/1Q7Zme6 (ADC access required). Please contact me if you’re interested in being involved with this work: s.a.spencer@icloud.com

11

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