Royal College of Paediatrics and Child Health
Annual Report 2006-2007
And a report on the first ten years
RCPCH Presidents
Professor Sir Roy Meadow 1996-1997
Professor David Baum 1997-1999
Professor Richard Cooke 1999-2000
Professor Sir David Hall 2000-2003
Royal College of Paediatrics and Child Health Annual Report 2006-2007 Copyright © 2007 Royal College of Paediatrics and Child Health Further copies available on request – contact publications@rcpch.ac.uk 16
Professor Sir Alan Craft 2003-2006
Dr Patricia Hamilton President 2006-
Contents
President’s introduction
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Chief Executive’s Report 2006
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The first ten years Education, training and assessment
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Quality and standards
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Scholarship, research and information
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Workforce and services
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Advocacy and equality
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International
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Structure
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Treasurer’s Report 2006
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Accounts
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Fund-raising
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Form of Codicil
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From the College’s Royal Charter
The objects of the College shall be: (i) to advance the art and science of Paediatrics; (ii) to raise the standard of medical care provided to children; (iii) to educate and examine those concerned with the health of children; (iv) to advance the education of the public (and in particular medical practitioners) in child health, which means the protection of children, the prevention of illness and disease in children and safeguarding their optimal development.
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President’s introduction “College: A body of persons having a common purpose or shared duties” – OED Dr Patricia Hamilton RCPCH President
This is my first annual report as President and the first thing I must do is to pay tribute to Alan Craft who demitted office in April 2006. He gently and wisely guided us through a year which presented many challenges. Members will have met him and seen him in action but he did an enormous amount of work behind the scenes with politicians, other Colleges, the GMC, disgruntled members, parents and journalists among others. He combined all this with the formal College work, chairmanship of the Academy of Medical Royal Colleges and membership of the GMC and PMETB boards. We owe him a great deal and are very grateful. The format of this report is different from usual in that 2006 marked the 10th anniversary of the College and this report celebrates not just the achievements of one year but of ten. These are outlined in the main body of the report, and Len Tyler our Chief Executive describes the highlights of 2005-06. We are working in a time of immense change in the NHS. Over the past year we have had to negotiate the stormy waters of Modernising Medical Careers and believe we have constructed an excellent competence based curriculum for paediatricians which is flexible enough to accommodate those who wish to progress more quickly or more slowly through the programme, or who wish to work less than full time or who wish to follow an academic career. Transition is always difficult but we believe we are as prepared as we can be for the change and have worked with our trainees to achieve this.
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President’s introduction continued We have been telling politicians that the current configuration of services is not sustainable. The looming reduction of working hours due to the EWTD changes in 2009, the expectation of parents that they will usually see a trained doctor, and increased out of hours attendances mean that consultant services are stretched beyond feasibility. This has now been recognised and reconfiguration is openly on the political agenda. We were prepared early with plans for guidance on remodelling services. Predicting the numbers needed for the future workforce has always been an art rather than a science but we have evidence based our predictions as far as possible. We campaign for more consultant posts to be created citing increasing demands of service, teaching and supervision of trainees and the need for time to prepare for relicensing and recertification. Child Protection has continued to be a real challenge with many paediatricians doing valiant work in the field. We continue to talk with the GMC and the DfES to obtain as much reassurance and security for paediatricians in this work as we can. Our educational courses and the Research Division’s work on evidence base and guidelines will continue to strengthen the service. We have created a new officer post in Child Protection in order to raise its profile within the College and to ensure it is fully integrated into our workplan. It is increasingly difficult to get Trusts to release paediatricians to do work for the wider NHS through the College and we are ever grateful to those Trusts and individuals that do. I hope that the progress and ongoing challenges that are clear in this report will inspire others to take on active College roles.
Dr Patricia Hamilton President
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Chief Executive’s Report 2006 It is not the strongest of the species that survives, nor the most intelligent, but the one most responsive to change. Charles Darwin Elsewhere in this Report we describe ten years of almost uninterrupted growth and change. This year has been no exception. Our training work (led by Vice President Dr Mary McGraw, Dr Claire Smith, Dr Ian Doughty, Ms Alix Clark and Ms Kim Brown) has continued to be dominated by Modernising Medical Careers and consolidating the new working relationship with the Postgraduate Medical Education and Training Board. It typifies the way in which the demands on us (and on paediatricians generally) are constantly changing. The core HST competences were published in October 2005 and PMETB approved our specialty curricula in the autumn of 2006. We also successfully applied to PMETB for Child Mental Health to be recognised as a new sub-specialty. We are currently working on an assessment strategy. A major concern for the coming year is how we balance the number of trainees going into the system with the likely (but only partly knowable) demand for paediatricians when they emerge. We are however improving our knowledge, through the enrolment of trainees, of who is in the system and what their intentions are. For Examinations (led by Dr Tom Lissauer and Mr Graeme Muir) it has been a year of consolidation rather than the spectacular growth of the past. Changing rules for overseas doctors working in the UK has already started to impact on numbers taking the exam; 10,920 doctors sat our exams in 2005-06, only slightly up on the previous year. We looked during the year at whether we could expand the operation significantly overseas but have decided that it would be difficult to do so at present without risk to our running exams to a high standard in the UK. The focus last year and during the coming year therefore is on quality and ensuring that our examinations are fit for purpose – on which we are making good progress. We also reviewed during the year our regulations concerning cheating in examinations. Fortunately we have to apply these only very rarely, though we do have increasingly sophisticated techniques for
detecting irregularities. The highlight of our education programme, and for many the highlight of the College year, remains the Spring Meeting at York, organised by Dr Chris Verity, Dr Alistair Thompson, Miss Rosalind Topping and their team. Numbers attending were slightly down on the previous year but this continues to be an exceptional event, bringing together sub-specialties and delivering education and research of a high standard. We also continued to run courses face to face and by distance learning. Dr Neela Shabde and her team developed Part 1 (and continue to work on Part 2) of the Safeguarding Children training materials. With Southampton University we have continued to develop and run the Diploma in Nutrition course and Dr Avril Washington has led the development of course materials for child mental health training – the Child in Mind Project – which we plan to bring to a successful conclusion during 2007. We have also developed courses in Court Skills for Paediatricians, which will run in 2007. Under Professor Neil McIntosh (Vice President for Science and Research) and Mrs Linda Haines, the College continues to run a range of research programmes. During the year we started a project to develop and implement a national programme of audit for neonatal intensive care. Another major project under way is the production of guidance on the physical signs of child sexual abuse – an interim statement on this was made in early 2007. We also continued our investigation into complaints made about doctors in the context of child protection work. June 2006 saw the BPSU complete 20 years of surveillance. To mark this anniversary, a conference was held on 30 May 2006 at the Institute of Child Health, London, attended by 140 delegates – both College members and members of the International Network of Paediatric Surveillance Units. A major piece of policy work during the year has been the Modelling the Future project (under Vice President Dr Simon Lenton) looking at future configurations of
Len Tyler Chief Executive Officer paediatric services. It was the focus of the 2006 Policy Conference and the results of this will be published in 2007. Health Services is one area in which we have to be aware that we are dealing with not one system but four, and differences between Wales, Scotland, England and Northern Ireland have to be kept constantly in mind. We have also tried, as we reported last year, to involve children more in our work. Ms Sophie Auckland has been appointed as Child Participation Project Manager. She has been focusing on an overall strategy for embedding participation in the work we do but was also able to initiate a painting competition for children around the theme of “Me and my Doctor”. As a result of the above and the activities of other College committees and working parties, a number of important publications were issued during the year. One of the most far-reaching was the British National Formulary for Children, the first edition of which was published in September 2005, at the beginning of the period covered by this report, and the second edition in July 2006 at the end of the reporting year. Another major document, in terms of size and relevance to our work, was the Child Protection Companion, whose creation was overseen by Dr Jean Price, and which appeared in summer 2006. Two other important publications were the Competences framework for Core HST issued in October 2005 and the Workforce Census in July 2006. In some ways the most significant document was however the much slimmer “Vision and Values”, written by Dr Patricia Hamilton as in-coming President, and published in summer 2006. This sets out what we hope to achieve over the next three years. It compares where we are today with where we wish to be in eleven key areas of work, and will form the foundations of future College work plans. A small but significant change during the year was the passing of the Charities Act. With it comes a duty to demonstrate “public benefit” if we are to retain our charitable status. Other charities, such as
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1. Meeting of the RCPCH Executive Committee 2. Photo taken at St George's Hospital, Tooting, London.
independent schools, have been planning for some years how they would meet this test. It has worried us less because we have less to worry about, but we will in future need to keep at the back of our minds that one of our Charter objects is: “to advance the education of the public”. In the meantime the outside world continued to change, whether we liked it or not. Our aim was to ensure that it changed, as far as possible, in the way that our membership wanted. Dr Hamilton and the other senior officers therefore met as often as we could with government ministers and officials – including those in Scotland and Wales – and also with opposition spokesmen and back-benchers of all parties, to explain the College’s position on issues such as child protection, the configuration of services and the European Working Time Directive. Our Registrar, Dr Hilary Cass, and Mr David Ennis coordinated responses to 53 consultations by the Government and other bodies. Particularly important were the consultation on the Family Courts, the CMO’s report “Good Doctors, Safer Patients”, the Healthcare Commission’s review of Children’s Hospital Services and the Nuffield Council on Bio-ethics consultation on the treatment of premature babies. Our responses to all of these can be found on the College web-site. The College also issued statements on the new WHO growth charts, MMR and autism and the transitional arrangements for overseas doctors. And, day-to-day, we receive an ever growing number of press calls and requests for interviews. The President appeared on the radio on several occasions including the Today Programme and Simon Mayo’s show on 5 Live. Dr Harvey Marcovitch stood down as Honorary Press Officer, having occupied that post with great skill and knowledge for many years. Our new Head of Media Affairs, Ms Claire Brunert now fields most of the calls coming in and is working on an overall communications strategy for the College. Once again we must thank those of you who are members of the Press Panel, helping to answer
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journalists technical questions, for your invaluable assistance during the year. International work made progress, sometimes under very difficult conditions. Dr Tony Waterston continues to run the Child Health Development Project in Palestine – the mere fact that it is still operating being a major achievement. We ran two further courses for Iraqi, Palestinian and Jordanian paediatricians in Amman and an evidence based medicine course in India. We are strengthening our links in East Africa. Recognising the growth in work in this area we appointed Overseas Directors during the year to assist Dr Stephen Greene, the new David Baum Fellow; they are: Dr Ezzedin Gouta (Middle East), Dr Stephen Allen (Africa) and Dr Michael Webb (South Asia). Underpinning all of this, we have taken forward our work on structures and governance. We reported last year on how we were trying to give greater focus to EC and Council meetings to ensure that out trustees fulfil their statutory obligations and that our decision making is as efficient as it can be. During the year we restructured the senior management team creating three Director posts – David Ennis becomes Director of Policy and Standards, Mike Poole Director of Internal Services and we welcomed Jacqueline Fitzgerald (previously working with the National Lottery) as the new Director of Operations. Other senior staff changes included the recruitment of Dr Susan Mitchell as Head of Health Services and the departure of two long-serving members of staff – Alix Clark (Head of Training) and Mary Butler (Head of IT and Publications). We wish Mary and Alix well for the future. Ensuring that we have enough office and meeting room space again occupied a great deal of time for officers and staff but, cutting to the chase, I shall simply report that we have taken a lease on the whole of 56 Hallam Street, next door to our main building at 50 Hallam Street. (For those trying to picture it, I should add this is not the imposing GMC building but the more
modest one to the north of the College.) On the IT front, we made excellent progress (under Dr Hilary Cass and Mr Martin McColgan) with the redevelopment of the College web-site. The new web-site should be up and running by the time this report is published, and hopefully you will agree that it is a great improvement on the old one. It will enable us not only to deliver information more efficiently to members and speed up processes such as registration for exams and the Spring Meeting, but it will also help meet our obligation to educate and inform the public. We have also improved communications with our growing offices in Edinburgh and Cardiff. Dr Bernard Valman and Ms Susan Scott have maintained our archives and in particular the database of CVs of College senior and honorary fellows. Dr Valman demits office as archivist during 2007. He will be a hard act to follow and one of the first tasks for his successor will be to start work on the next volume of the history of the BPA and College. Change will not ease up during 2007. We need to re-engineer our processes and are looking at possible tools to use. We are also looking at how we present ourselves to the world and whether we need to re-brand. We need to consider how different areas of work interface with and can contribute to each other. We may end up questioning some cherished assumptions and values. But as the noted American inventor, Charles Kettering, once said: “If you have always done it that way, it is probably wrong”.
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Education, training & assessment The first ten years Education, Training, and Assessment are at the core of the College’s work, both in terms of the statutory obligations it took on when it achieved its new status in 1996, and the additional work it has taken on since. It has always been one of the foundations of the College’s outlook that educating paediatricians to the highest levels possible will result in better child health. Education The College aims to encourage its members, and all concerned with the health of children, to take a life-long approach to their learning, and provides a number of activities to enable this. Its most prominent educational activity, perhaps, is the Annual Spring Meeting, which takes place every year at the University of York. The Meeting to be held in March 2007 will be the College’s eleventh, but in fact is the continuation of a longer tradition stretching back to the BPA’s first meeting in Windermere in 1928, the year of its foundation. The Spring Meeting aims to provide a venue for paediatric specialty groups to discuss issues of specific interest, but also to provide opportunities, though its plenary sessions, to discuss more general topics. A range of fellowships provide those who would otherwise not be able to attend to have the chance to enjoy the meeting. In an era when the pressures on paediatricians’ time are becoming more and more evident, the sustained high attendances at the Spring Meeting are proof of the continued use it has for child health professionals of all kinds. Equally important is the College’s scheme for Continuing Professional Development (CPD). This was established in the first instance as a scheme for Continuing Medical Education (CME) from 1st January 1996, and became progressively more formalised over the years. A range of developments have occurred in CPD, and members of the scheme are now mailed new guidelines and credit records every year, as well as (since 2005) being able to record their credits online. The scheme has been developed in conjunction with other Medical Royal Colleges, and the College is confident that it will be fit for purpose to take on the Chief Medical Officer’s pending requirements for revalidation.
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In addition, the College has in recent years launched a number of individual education projects aimed at improving specific areas of practice: • Child in Mind, a comprehensive training course on mental health issues for SHOs. • Court Skills in Child Protection, a course for England and Wales aimed at giving paediatricians more confidence in the arena of expert witness work. • Diploma in Paediatric Nutrition, a postgraduate course developed in collaboration with the University of Southampton. • Paediatric Educators’ Course, a “training the trainers” course to develop skills in teaching. • Safeguarding Children, a course aiming to “raise awareness of child protection issues and equip doctors in training with the knowledge and skills to enable them to recognise and respond to child protection (CP) situations competently and confidently.” A more advanced training course for Child Protection is currently being developed. Training The British Paediatric Association had no statutory responsibilities with respect to training; these were the responsibility of the Royal College of Physicians. Once formed, the The Royal College of Paediatrics and Child Health took on these responsibilities, and at a time of great change with the Calman reforms of higher specialist training about to be implemented. Since 1996, a number of other major developments have taken place, in particular the creation of the Postgraduate Medical Education Training Board (PMETB), which assumed statutory powers over training on 30th September 2005, and the impending implementation of the Government’s Modernising Medical Careers programme. The College’s ongoing work in the training field has therefore included the inspection of training posts (until this work was taken over by PMETB), the processing of applications for Certificates of Completion of Specialist Training, the creation and administration of the paediatric subspecialty training scheme or 'NTN Grid,’ and processing applications for the new Certificate of Eligibility Route to the specialist register. The College has also fostered links with
training overseas both creating opportunities for doctors overseas to work in the UK with the International Paediatric Training Scheme and for UK trained doctors to work overseas with the RCPCH/VSO fellowship scheme. A major development has been the development and introduction of a new competency based curriculum to underpin Modernising Medical Careers and the run-through grade. This work has been led by Dr Patricia Hamilton and Dr Mary McGraw as successive Vice Presidents for Training and Assessment, officers for training Dr Claire Smith and Dr Ian Doughty and Kim Brown, as the College’s Training and Assessment Advisor. Work is also ongoing to integrate this competence based approach with other aspects of the College’s work, most prominently examinations and other means of workplace-based assessment. Assessment The College took over the former MRCP (UK) and DCH examinations from the Royal Colleges of Physicians in 1999, and since then has developed their syllabi and implementation in accordance with educational thinking and external requirements. In 2004 a new clinical multi-station MRCPCH was launched and in 2006 a similar change was made to the clinical DCH examination. The creation of these new exams, and the management of their expansion, has been one of the largest tasks that the College has taken on. It has been overseen by Dr Graham Clayden and Dr Tom Lissauer as successive Examinations Officers, with Graeme Muir as Head of Examinations. The MRCPCH now consists of four parts: Parts 1A and 1B, which can be taken together, a written Part 2, and the final Clinical examination. It is now usual for over 1000 people to sit the Part 1 exams. A number of pieces of work have been undertaken to ensure that the exams are as rigorous as possible: the move to criterionreferencing pass marks from 2001, a reform of the number and structure of papers in 2004, and the ongoing task of integrating examinations with the College’s competence based syllabi and with training practices more generally. The DCH, intended for trainees who anticipate doing significant amounts of
work with children, though without becoming paediatricians, has also been a significant success. It has proven particularly popular for those intending to take on primary care careers, and it now shares the first part of its exam with the MRCPCH. The College has also led developments in workplace assessment. A major project on the implementation of multi-source feedback using the Sheffield Peer Review Assessment Tool (SPRAT) has shown this to be a reliable and acceptable form of workplace assessment. Another successful project has validated a new instrument to assess consultation skills (Paediatric Consultation Assessment tool, PCAT). Further projects are underway to evaluate further workplace assessment instruments to ensure that all aspects of the curriculum can be assessed.
The education and training of doctors, particularly doctors who work with children, is under scrutiny as never before – due to pressure from both politicians and the public as a whole. The College is confident that the work it has undertaken has helped to equip doctors who have passed through its programmes for their working lives, and that the structures it has created are sufficiently adaptable to continue to do so for many years to come.
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1. Child In Mind, Training the Trainers Workshop held at the RCPCH in London. 2. Sign from St George's Hospital, Tooting, London
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Quality and standards The first ten years From its inception, the College has seen part of its role as being to work towards the highest quality and standards in child health. It addresses this strategic goal in a number of ways, which cut across its departmental and officer structure: Evidence Based Medicine (EBM) The College firmly supports the principle that good paediatric practice should be informed by the strongest research evidence and the responsibility for ensuring that clinical standards are evidence-based lies with the Quality of Practice Committee. In the late 1990s, the growing interest in EBM and the establishment of organisations such as the National Institute for Clinical Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN) saw a rapid growth in the number of clinical guidelines, which still continues. In order to help members evaluate the quality of these guidelines, the QPC established a clinical effectiveness programme and a team to appraise guidelines using accepted quality criteria and to disseminate key recommendations from those meeting the standards. Since that time over thirty guidelines have been appraised and the findings circulated to College members via the newsletter and the website. Key messages from guidelines and the appraisals are also presented to members at RCPCH Spring Meeting sessions. The Clinical Effectiveness team and QPC, also provide advice for those wishing to develop their own clinical guidelines and its publication Standards for Development of Clinical Guidelines in Paediatrics and Child Health is now in its third edition (2006). In addition the work programme is now beginning to focus on implementation of guidelines to ensure that paediatric practice is based on the best available evidence. Outside of the work of the QPC, the College has also developed its own clinical guidelines in areas such as the management of CFS/ME (2004), and Retinopathy of Prematurity (2007). Other work includes a review of the evidence for the differential diagnosis of hypernatremia and a review of the evidence for the Physical Signs of Child Sexual Abuse which, when published later in 2007, will update the Royal College of Physicians 1997 publication of the same name.
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Support for Paediatricians The College provides support for its members in a number of ways, all aimed at helping them deliver the best possible service. These have included the publication of A Charter for Paediatricians (2004), a document outlining the College’s view on minimum standards to be observed by organisations employing paediatricians. The College also acts as a central clearing-house for paediatricians needing support in various ways, and makes resources available in print and online. The College has also seen its role as being to work with other regulatory bodies to set standards for appropriate levels of performance in paediatric work. In 2002, building on the GMC’s guidance Good Medical Practice, it produced its own document Good Medical Practice in Paediatrics and Child Health, explaining in specific terms how the principles in GMP were relevant for its members. In the light of the GMC’s recent update of GMP, the College will also shortly be revising its own document. In addition, the College liaises with the GMC and other regulatory bodies in order to help them ensure the highest levels of service. The College’s work in the media and political spheres also assists its agenda in quality and standards. The President and other Senior Officers regularly meet with Ministers and other officials in order to put forward the case for the needs of children’s services. This work often draws on other strands of the College’s activities, for instance the two-yearly workforce census. Child Protection The College’s Strategy mentions, as one of the Quality and Strategy “Agenda for Action” aims, that it should “improve the status of expert witnesses and the standard of evidence”. This goal is particularly pressing, of course, given the prominence and importance of child protection work as part of paediatric practice, and the range of high-profile cases which have occurred over the last decade. The College has pursued its improvement agenda through a number of avenues. This work has been led by the Standing Committee on Child Protection. Initiatives on Child Protection have included the Court Skills Training programme for England and Wales, as well as supporting
registration of expert witnesses with the Council for the Registration of Forensic Practitioners. In addition, the College has produced a wide range of documents and training materials to assist Child Protection practice, most recently (in 2006) the Child Protection Companion, which was mailed to all members and is also available on the website. As the Education section of this report notes, a number of new courses are also being made available to ensure the highest standards of work in the field. Finally, the College is recognizing the importance of child protection work in general by appointing, for the first time in 2007, a Child Protection Officer. The first holder of this post will be Dr Rosalyn Proops.
Front cover for Good Medical Practice in Paediatrics and Child Health (2002)
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Scholarship, research and information The first ten years When the RCPCH came into existence in 1996, the Research Unit (RU) had already been established for two years, although there had been various research initiatives which dated back to the early 1980s. In fact, it could be said that the impetus for the formation of the RU dated back to 1928 when the British Paediatric Association was founded with one of its objects as “the advancement of the study of Paediatrics”. The original terms of reference for the RCPCH Research Unit,were to: • formulate a research policy for the RCPCH • review paediatric and child health activity within the UK • initiate and facilitate research in paediatrics and child health. Projects must have a national perspective and complement, rather than compete with, research in academic departments • to facilitate research by members, for example by assistance to district paediatricians. Early on in its existence, the discipline of evidence based practice became established in medicine and this area became incorporated into the Unit’s work, with a programme of guideline development and appraisal. The role of Director of the Research Unit is traditionally held by the RCPCH Vice-President for Science and Research. The first director of the unit was Professor David Baum who stepped down after three years in 1997, to be replaced by Professor Richard Cooke. In his final annual report for the unit, Professor Baum described the units early successes. At the time there were a dozen employees, in London, and around the UK working on individual projects with over £500,000 secured in grants for current and future projects, which ensured that the unit was not a financial drain on the College. Three projects had been completed with ten more in the pipeline. Of these, perhaps one of the most important was the production of the first UK paediatric formulary (Medicines for Children) under the auspices of Professor Sir David Hull and the Paediatric Formulary Committee. In 1996 the RU ran its first research clinic at the York meeting, to provide advice to members wishing to undertake their own research and these clinics continued until 2004. Other early projects were the development of a paediatric audit database,
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and the College’s first internet discussion group. Also in 1996 the unit published the BPSU’s annual report, celebrating ten years of activity for the Surveillance Unit, a national conference on Paediatric surveillance, and at least twenty publications and presentations. Although nominally under the auspices of the RU, the BPSU had its own executive committee, and in 1996 Professor Catherine Peckham stepped down as chair, to be replaced by Dr Chris Verity. In 1997 the College moved from Regent’s Park to Hallam Street, which allowed the the Research Division, as it had been renamed, to be co-located with the rest of the College. Work on the paediatric formulary continued, while in the BPSU, a study of nvCJD (new variant CJD) was added to the by now famous orange cards in response to concerns about the possibility of children being affected by “Mad Cow Disease”. By 1998, the BPSU had its own website and the International Network of Paediatric Surveillance Units (INoPSU) was founded. The College’s two yearly workforce census had always been undertaken within this department and in 1998 a workforce information officer was appointed to take forward this area of work. By 1999, the Research Division was flourishing, with the successful publication and distribution of Medicines for Children. A grant from the National Lottery Charities Board was obtained for a three year study of professional attitudes towards children with Chronic Fatigue Syndrome (CFS), work which would eventually culminate in the first RCPCH evidence-based guidelines on the management of CFS/ME. The BPSU continued to be a model for the establishment of other national paediatric surveillance units world-wide. The sudden death in September 1999 of college president Professor David Baum was a tragic loss. David Baum had been a driving force behind the establishment of the BPSU in 1986, and had continued to support and encouragement the Research Division even after stepping down as Director. The Research Division entered the new millennium with several projects nearing completion, including an important project on the health care delivery for children with meningitis, and a five year project on Retinopathy of Prematurity. In addition to its ongoing UK surveillance work, the BPSU was heavily involved in the first INoPSU conferences, in Canada in 2000 and York
in 2001. Preparations were also underway on a new edition of Medicines for Children, but in the meantime, “Pocket Medicines for Children” offered a handy vade mecum for the nation’s doctors and the clinical effectiveness unit within the Division continued its work appraising and endorsing evidence-based guidance. In 2002, both Richard Cooke and Chris Verity stepped down from their respective roles and Neil McIntosh became the new Vice-President for Science and Research, leading the Research Division’s work. Professor Mike Preece took over the chair of the BPSU executive committee. Publications this year included Special Foods for Children, derived from information from Medicines for Children on dietary supplements while under the guideline appraisal programme led by the College’s Quality of Practice committee eight appraisals were published, six of which were presented in popular sessions at the Spring meeting in York. The second edition of Medicines for Children with its companion Pocket Medicines for Children were published in the following year. In 2004 the BPSU awarded the first BPSU/RCPCH Sir Peter Tizard Bursary of £15,000 to Dr Scott Williamson for a study on thyrotoxicosis. Of the many projects in the Research Division at that time, perhaps none was more topical than the survey of UK members about complaints over child protection work. With a response rate of almost 80%, it was clear that this was a matter of great concern to members. The statistics from this survey made striking reading. Over 500 of the nearly 9,000 responders had been subject to a complaint between 1995 and 2003, although only a very small fraction of these complaints had been upheld. Overall complaints had increased from less than 20 in 1995 to over 100 in 2003, with a third of doctors expressing reluctance to become involved in child protection work. This survey prompted a piece of qualitative research to identify common themes in triggering complaints, and a report on the findings of this survey were published in January 2007. In early 2005 the evidence-based guideline,on the management of CFS/ME was launched at the Houses of Parliament with the help of the patient support group AYME, which had also been involved in the previous research on this puzzling illness. A collaboration between the RCPCH, the Neonatal and Paediatric Pharmacists’
Group, and the Indian Academy of Paediatrics, resulted in a special reprint of Medicines for Children for distribution in India. Meanwhile “Medicines” itself became the first “British National Formulary for Children” in a collaboration with the BMA, the Royal Society of Pharmacists of Great Britain and the Neonatal and Paediatric Pharmacists and the BPSU helped to put on the third INoPSU conference, in Lisbon, Portugal. In 2005, the Research Division moved from Hallam Street to Devon House on Great Portland Street. This move was due in part to increasing pressure on office space in the main building but also offered an opportunity for closer working relationships with the NICE Collaborating Centre for Women’s and Children’s Health, led by paediatrician Dr Monica Lakhanpaul, which shared the new office space. While the College, and the Research Division, celebrated their first decade in 2006, for the BPSU this year marked their 20th anniversary. A celebratory one-day conference, at the Institute of Child Health was attended by over 140 delegates from around the world. It is clear that from the outset, paediatricians have been quick to see the value of the orange card system for the surveillance of rare childhood disease, and the response rate has remained consistently over 90%. Since 1986 70 conditions have been studied, over 20,000 cases reported, and over 300 presentations and publications made nationally and internationally. The success of the BPSU has directly inspired the formation of 15 similar
surveillance units abroad, and the unit is now funded by the Department of Health until 2008. The new Chair of the Executive, Professor Allan Colver, in his first foreword for the BPSU Annual Report in 2006 acknowledged the efforts of Richard Lynn, BPSU scientific coordinator for over 15 years, as well as the paediatricians who have regularly and willingly returned their cards over the years to ensure that the data gathered has real meaning. This look back at the last ten years activity of the Research Division can only given a snapshot of this department’s achievements. Unfortunately there is insufficient space to individually acknowledge all those who have leant their support and encouragement to the concept of a College Research unit encompassing research, surveillance, workforce planning and clinical effectiveness. From small beginnings, the Research Division has grown in remit and activity. There is now a staff of fourteen working on collating workforce statistics, the promotion of evidence-based clinical practice, national clinical audit, child protection research and of course the flagship BPSU. Whatever the future of the Research Division may be, it is certain to remain actively involved at the heart of College affairs.
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1-3. Front covers for the 1999, 2002 and 2003 editions of Medicine for Children 4. Front cover for the First edition of the British National Formulary for Children 2005 5. Professor David Baum, RCPCH President 1997-1999
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Workforce and services The first ten years The birth of the RCPCH in 1996 was closely followed by the election of the Labour government under Tony Blair. Given the Government’s focus on the NHS, the College’s work on improving services has had to contribute to a wide range of children’s policy and other NHS management initiatives. These have included the devolution of Scotland and Wales, the creation of the Children’s National Service Framework (NSF), Every Child Matters and the introduction of the European Working Time Directive (EWTD). Children’s National Service Framework During David Hall’s presidency the College developed close working ties with the Department of Health to aid the development and implementation of the Children’s National Service Framework, a document which provides a vision of children and young people’s health services. We have a voice for children at the highest level with the appointment of Al Aynsley-Green as National Clinical Director for Children. Sheila Shribman (College Registrar 20032005) was subsequently appointed to replace Al Aynsley-Green in 2005 when he became Children’s Commissioner for England. RCPCH Publications The college has sought to inform and influence the workforce and health service agenda through the production of various publications. Workforce Census Reports (1998, 2001,2003, 2005 and 2006). The published results of censuses carried out in 1996, 1999, 2001, and 2003 and 2005 along with sustained college representation, informed the debate on workforce requirements and continues to influence DH decision-making in this regard. Consequently, the college is seen as a leading source of information to assist the Department of Health Workforce Review Team on staffing levels and service provision. Accident and Emergency Services for Children (1999). This document made a clear recommendation that children should not be seen in Accident & Emergency Departments unless
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there were inpatient paediatric services on site. This document is currently being revised to reflect the changes in urgent care for children and a revised edition will be published shortly.
there was a 70% rise between 1996 and 2005 (an average of 6% per annum). The number of female consultants rose by 95% in this period compared to a 54% increase in male consultants.
Children’s Attendance at a Minor Injury/Illness Service (MIS) (2002). Guidance for those responsible for setting up and running minor injury and illness services for children. This document followed on from Accident and Emergency Services for Children document to provide guidance for sites without inpatient paediatric services and to assist the delivery of a national standard for MIS.
UK Consultants by gender 1996-2005 3000 2500 2000 1500
607
784
1000 500
The Next Ten Years: Educating Paediatricians for new roles in the 21st Century (2002). A report assessing the skills, training and workforce requirements needed for future paediatric health care delivery. This document was produced in recognition of the need for a radical reform of health services provision. Strengthening the Care of Children in the Community (2002). A review of the changing needs of Community Child care services. This publication was published in parallel with the Health Services Committee report The Next Ten Years: Educating Paediatricians for new roles in the 21st Century (2002) A guide to Understanding Pathways and Implementing Networks (2006). Guidance for paediatricians on the subject of managed networks in response to the new agendas set out in Every Child Matters and the National Service Framework by the DH. Paediatric Workforce information The RCPCH workforce graph below illustrates the growth in consultant numbers for the last 10 years. Overall
1030
1186
1149
1304
1489
1537
998
1996
1999
2001
2003
2005
0
Female consultant
Old problems, New Solutions: 21st Century Children’s Healthcare (2002). A review of new patterns of paediatric practice for service delivery. This document was followed up by College assessments of out-of-hours and emergency care, the hospital at night project and clinical directors and members surveys.
880
Male consultant
RCPCH and Health Services Devolution The College has kept pace with the impact of the Government’s de-centralisation of the Health Service into 4 services for Northern Ireland, Scotland Wales and England. Along with the establishment of Scottish, Welsh and Irish Committees in 1999, the College created new RCPCH offices in Edinburgh and Cardiff in 2003. The existence of the Scottish and Welsh offices and the all-Ireland Committee have enabled the RCPCH to strengthen its regional presence for workforce planning and health service delivery. In addition we have witnessed, in recent years, the transfer of a large part of the responsibilities for children from the Department of Health to the Department of Education and Skills (where the new Minister for Children post sits) to provide better joined up thinking and policy at the social, health and educational interface. The RCPCH has kept pace with the resulting outcomes for children’s service delivery through regular meetings with ministers for children and children’s commissioners for all four UK strategic health regions.
Working together In the last 10 years, the College has successfully endorsed and protected member’s interests by developing a range of tools and bodies. The activities of the Clinical Directors Special Interest group, the Informatics group and the Health Services Committee have helped to inform and advise the DH on the needs of children and their services. The consistent input by these bodies has been particularly apparent with the implementation of the European Working Time Directive and the Children’s National Service Framework. Examples include: European Working Time Directive Questionnaire – Autumn 2003: Survey Results (2004) Showed that only 35 trusts in the UK (17.3% of responders) reported that their medical rotas were fully compliant to meet the EWTD requirements of August 2004.
Follow Up Survey of Paediatric Clinical Directors New Contract Job Plans: Survey Results (May 2005) Reported that 87% of consultants in directorates responding to the survey had accepted the new contract and that 11.54 programmed activities on average, are allocated to consultants. It also showed that Consultants workload was greater than recognised under the contract and this was a major difficulty encountered by Clinical Directors. The college has developed a consistent and productive dialogue concerning the Government’s drive for a service provided by trained doctors and the provision of more consultants to this effect. It is thanks to the combined work and continued efforts of Clinical Directors, Regional Advisers, specialty groups, colleagues and College staff over the last ten years that has enabled the RCPCH to develop as a leading advocate for the paediatric medical workforce and the related health services.
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1. RCPCH Publication: Strengthening the Care of Children in the Community: A review of Community Child Health in 2001 (2002) 2. RCPCH Publication: Children's attendance at A Minor Injury and Illness Services (2002) 3. Child at play, St George's Hospital, Tooting, London 2006 4. RCPCH Publication: The Next Ten Years: Educating Paediatricians for new roles in the 21st Century (2002) 5. RCPCH Publication: A guide to Understanding Pathways and Implementing Networks (2006) 6. RCPCH Publication: Old Problems, New Solutions: 21st Century Children’s Healthcare (2002)
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Advocacy and equality The first ten years Throughout the last decade, the College has been actively involved in advocating the rights of children and young people (CAYP), both in the UK and internationally. The UN Convention on the Rights of the Child (UNCRC) was ratified by the UK in 1991 and the RCPCH has been committed to implementing the principles and provisions of the convention. The College officially endorsed the principles of the UNCRC as a fundamental requirement of its strategy and activity in 2002. The College has promoted children and young people’s health needs and services by developing specialist groups, partnerships and representation with other organisations, UK and international support programmes, training, media communication, staff resourcing, special events, and publications. RCPCH working groups and representatives for advocacy and equality The UNCRC and the National Service Framework (with its differing incarnations in England, Wales, Scotland and Northern Ireland) are the basis for the College’s engagement with children and young people. The work of the Advocacy Committee has covered a wide range of topics both internationally and in the UK, some of which are detailed below. In order to fulfill the College’s advocacy awareness remit, the RCPCH introduced the role of ‘Children’s Champion’ on every Committee. The College has also successfully introduced the awareness of advocacy as a specific competence to be demonstrated by trainees as part of the new competencybased training. The establishment of the Patient and Carer Liaison Group in1999 (subsequently the Patients’ and Carers’ Advisory Group) has driven increased lay involvement into the work of the College and paediatric practice, such as the assessment of direct consultation with children. The Children and Young Persons’ Advisory Group were invited to Council in 2004 to join in debates on best practice and international topics, such as children in Iraq and the issue of cluster munitions. Following the publication of its 2004 report Coming Out of the Shadows, the College also created a new staff position of CAYP Participation Manager, currently held by Sophie Auckland, to oversee College activities with children and young people. Working closely with the Advocacy
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Committee and the PPCAG, the CAYP Participation Manager has ensured that the RCPCH has mechanisms to involve CAYP throughout its policy and practice. This work has been particularly driven by Article 12 of the UNCRC – that every child has the right to be listened to on matters that concern them. Subsequently, the college has extended its work with CAYP participation to paediatric service delivery. For example, research has recently been undertaken for a proposed Communications Toolkit for paediatricians based on young patients’ experiences. The encouragement of all involved with the RCPCH to take responsibility for child advocacy awareness has been furthered with the creation of half-day training sessions for staff and UNCRC training day programmes for members at the College. It is vital that the College continues to build on the good work already achieved for child advocacy awareness in strategy and practice. Therefore, a number of proposals are in the pipeline, such as consultations with children and young people on issues such as paediatric practice, service design and the best way to talk about sexual health. There are also plans for further staff training about the ways in which children can be involved in decisionmaking for healthcare. Media Communication and advocacy Providing information for the press and the public has been important to the College throughout its work on the advancement of child advocacy and equality. The College has worked closely with Government, and with a range of different media outlets, from national broadcast and print to specialist outlets such as Hospital Doctor and Children Now. The RCPCH has continuously promoted advocacy-aware projects to the media, such as press releases for new publications and training programmes like ‘Safeguarding Children’ and the recent Palestine Training Scheme. Over the last decade the RCPCH has supplied position statements offering expert advice in the wake of controversial and international topics relating to the rights of children – obesity, child protection, welfare of children in war-torn countries, fabricated and induced illness, SARS, MMR and autism – to name but a few. The Press Panel has become an important College resource for providing such specialist responses. A dedicated CAYP area has also been
incorporated into the new RCPCH website. These activities serve to demonstrate the RCPCH’s recognition of the importance of communicating child advocacy issues and activities to the public at large. Partnerships with other organisations The College has been involved with a large number of external organisations in relation to child advocacy and equality. Here are just some examples of joint activity over the years: • Supporting the work of advocacy-based organisations such as: - MEDACT: a UK-based charity highlighting the health implications of environmental degradation - Contact A Family: support for parents and children with long-term conditions. - WellChild: an organisation dedicated to supporting sick children, whatever their illness and finding ways to prevent and cure childhood disease and illness and to improve the treatment and care of sick children. • Representation on a wide range of advocacy groups: - Children’s Rights Alliance - Child Advocacy Network - Refugee Health Consortium - Intercollegiate Forum on Poverty and Health • Campaign support for child advocacy issues, such as the Children’s Food bill, the writing-off of Third World debt and non-violent discipline. • Inter-collegiate activities including Conferences, seminars and documents examining issues such as obesity, child protection, FII and HIV. • Strengthened relationships between RCPCH and BACCH. Formalised associations with BACCH-affiliated subspecialist groups dealing with children’s public health and child protection. • Working with CAYP organisations such as AYME (Association of Young people with ME) to develop proposals for primary research into CFS/ME. • A joint RCPCH & American Academy of Paediatrics Equity project is currently under way, a report of which is to be published on both sides of the Atlantic in 2007. Such projects demonstrate the importance to the College of sharing knowledge – in this case – to improve the equity of children’s health outcomes.
RCPCH Publications and advocacy Outlined below is a selection of some College publications from the last ten years dedicated to the advocacy of children and young people: • The Health of Refugee Children (1999). Part of RCPCH strategy is to ‘publicise the special needs of asylum seekers, looked after children and other disadvantaged groups’. The last ten years has seen Government-driven dispersion of refuges throughout the UK. The RCPCH published The Health of Refugee Children (1999), in conjunction with the Kings Fund, to assist in improving the health care and education received by refugees from health professionals and others while in this country. This document provided timely advice on the physical, psychological and cultural needs of refugee children in the UK, and explains their entitlements and rights under law here. • Advocating for Children (2000) Advice for paediatricians on how to be an effective advocate for children, providing specific case histories and useful ways of implementing advocacy. • Helpful Parenting (2002) A College review of the evidence on good parenting. This publication examines the interactions between parents and children within the family setting and also the wider social and political context in which this occurs. • Bridging the gaps: health care of Adolescents (2003). An overview of the health care of
adolescents in the UK at the start of the 21st century, assessing adolescent needs, service development and paediatric training. • Coming out of the Shadows: A Strategy to Promote Participation of Children and Young People in RCPCH activity (2005). This publication led to the creation of the College CAYP Participation Manager staff post. Funding the future Nobody can underestimate the importance of child advocacy awareness for the College in the past, as the illustrated examples in this report have shown. The necessity of funding for advocacy and developmental work, both in the UK and abroad, has proved vital. This was recognised in 2001 when the RCPCH agreed to raise the member subscription levy to fund international work in areas where children are under threat. (for more information on College international work see the ‘International’ section on page 20). Following the achievements of the last decade, there is no doubt that the RCPCH will continue to see CAYP participation and the promotion of child advocacy awareness as fundamental to future College strategy and practice.
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1. Dr Christine Ronald in the Children's Hospital, Kampala, Uganda. (photo courtesy of CAI) 2. Winners and Judges of the RCPCH 10th Anniversary Drawing Competition for Children 2006 3. Picture by Alanah Davies-Brown, winner – age 5 to 11 age category, RCPCH 10th Anniversary Drawing Competition for Children, 2006 4. RCPCH Publication: Bridging the Gaps: Health Care of Adolescents (2003) 5. RCPCH Publication: Coming out of the Shadows: A Strategy to Promote Participation of Children and Young People in RCPCH activity (2005) 6. RCPCH Publication: Helpful Parenting (2002)
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International The first ten years A College strategy proposal in 1997 set out the following aim for the newly-formed RCPCH: to contribute to international paediatrics and child health with clearly defined programmes in advantaged and disadvantaged countries. The last decade has seen the College recognise its responsibility to make a positive contribution to child health across the world. The College has progressively expanded and strengthened its activities abroad, under the auspices of its successive International Officers. This has been achieved in a number of ways that include individual and joint projects, training and support programmes, voluntary work schemes, visits to war-torn countries and the creation of representatives and bodies to facilitate international strategy and ensuing activity. Following the 1997 Spring Meeting special lecture on International Child Health, attended by HRH Princess Anne, an International Task Force was established to examine the role RCPCH could play internationally in helping children under threat. Subsequently, Her Royal Highness encouraged the establishment of a register of paediatricians wishing to give service overseas, so the College could respond to aid agencies searching for paediatricians. This register came to fruition in 1999 with the information being held by the International Health Exchange, which recruits for aid agencies. The Task Force continued to explore collaborations between the Royal Colleges, non-governmental organisations and the military to improve the plight of children in war torn countries. This also included the creation of training programmes and a network of advisors. For example, a pilot summer school was developed in 1999 by IHE/Child Advocacy International and hosted by the College for those wishing to work in complex humanitarian situations. The RCPCH International Board was established in 1998, comprising chairs of all Committees relating to overseas matters: including advocacy, education and training, membership and examinations. This Board managed initiatives developed by the Task Force. In the same year the Royal Colleges International Forum was created to provide the opportunity to liaise with international officers and administrators of the Medical Royal Colleges on matters relating to training, examinations and workforce issues. A delegation led by the then RCPCH president, David Baum, visited Gaza in 1998
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to establish the prospects of a training programme for local paediatricians: its goals were to improve post-basic training, develop a CME programme for senior paediatricians advance sub-specialty training, and to fast-track academic sub-specialties to create a focused research-base with international collaboration. Working jointly with Medical Aid for Palestinians and the Department for International Development, the RCPCH has continued working to improve education and training for doctors in the Palestinian. In the same year, the College took responsibility for the International Paediatric Training Scheme to assist UK paediatricians training in other countries, especially in the developing world. The scheme was assisted by a formalised double sponsorship initiated jointly by the DoH and the Royal Colleges. Some of the countries currently involved with the IPTS are Sri Lanka, Pakistan, Nigeria, Myanmar, India, Libya, the West Indies, Egypt, the Philippines, and Sudan. David Baum’s Legacy: The death of David Baum on 5th September 1999, while undertaking a sponsored cycle ride in aid of College work in Kosovo and Gaza, was a tragic event in the history of the College. He brought an international perspective to his presidency. He conceived and chaired the International Task Force mentioned earlier. The David Baum International Foundation (DBIF) and the post of David Baum Fellow were created in memory of David in order to carry on his work and dedication to international affairs. The role of David Baum Fellow, created in 2000, encompassed chairing the International Board and offering management and strategic direction to the College’s international affairs. Peter Sullivan held the post until 2006. Stephen Greene is currently the holder. The DBIF was formally launched on January 30th 2001. A new Professorship of International Child Health was also set up at Bristol University and formed part of a joint fund raising activity for the DBIF. Activities included the development of sustainable training programmes to further education and training overseas. This foundation continues to work independently of the College but both are closely linked. Some of the DBIF-supported projects are: • A training-the-trainers course in Tanzania to update medical educators with modern educational techniques. • Workshops in Dar Es Salaam on current ‘best practice’ for child health practitioners
working in Tanzania and Kenya. • A project in the Kilimanjaro region of Tanzania training occupational therapists in art techniques that can be used locally to the advantage of children with disabilities. • Training programmes in evidence-based medicine designed to enhance the skills of paediatricians in India and the North-east of Brazil. • An initiative to create a catalogue of teaching resources that are available free or at low cost to medical schools and schools of nursing in less developed countries. • A pilot course in basic child health for primary care doctors and nurses in the Palestinian territories. Overseas Linkages Programme The College’s Overseas Linkages Programme commenced in 2002 to encourage international paediatric partnerships for the exchange of ideas and information. The programme also aimed to provide a means of sharing practice and policy documents, facilitate training programmes for junior paediatricians and to assist with setting up administrative structures. Some of the created and planned linkages schemes are: South Africa Red Cross Hospital, (DoH, RCN): To provide nurse-led training and consultancy. Iraq & Jordan: A 4-day course, which consisted of 2 days of paediatric life support and 2 days of training the trainers. Kenyan Medical Research Institute and the Wellcome Trust: A course on best practice. Kosovan Paediatric Association: Assisted with the formation of the first Paediatric association. University of West Indies: Memorandum of Understanding signed by the RCPCH and the UWI. College of Physicians, West Africa: Memorandum of Understanding signed by the RCPCH and the CPWA. Malawi College of Medicine and Birmingham Children’s Hospital: Supporting lead paediatricians in setting up an exchange programme and assisted with the development of their post-graduate paediatric training programme by RCPCH assessors. East Africa World Health Organisation: RCPCH will work collaboratively with WHO on a programme to reduce child mortality in the case of severe malnutrition.
RCPCH VSO Scheme and International Scholarships The VSO scheme, launched in 2000, gives paediatricians in training the opportunity to work overseas for a year. Participation on the scheme is recognised as contributing towards the completion of specialist training. The College also waives subscription fees for members on the scheme whilst they are abroad. Many paediatricians have participated, working in countries such as Malawi, Uganda, Namibia, the Gambia and Indonesia. The Heinz and Donald Court visiting fellowships, the Ashok Nathwani Fellowship and Douglas Hubble Travel Bursary enable overseas paediatricians to gain experience of paediatrics in the UK. Overseas RCPCH Examinations The international take-up of RCPCH examinations has expanded rapidly in recent years. The Exams Department now oversees the running of examinations in 20 countries throughout the world: Abu Dhabi, Bahrain, Dubai, Egypt, Ghana, Hong Kong, Jordan, Kuwait, Malaysia, Malawi, Malta, Myanmar, Nepal, Oman, Qatar, Saudi Arabia, Singapore, Sudan, West Indies and Zimbabwe. The World Wide Web The growing importance of the internet in relation to RCPCH international provision is reflected in College website development and expansion in the last decade. A newlook RCPCH website has just been launched this year (see ‘Structure’ section page 22). In addition, the provision of an online version of Archives of Disease in Childhood,
free of charge, was first piloted on 2000 to disadvantaged areas such as the Balkans, Eastern Europe and Bangladesh. A Global Child Health Section for Archives of Disease in Childhood was also launched in the Spring of 2003, with articles commissioned by the David Baum Fellow. International Representation RCPCH visits to colleges and paediatric centres in other countries, and the welcoming of overseas visitors to the College, are also a vital activity for the creation of international links and sharing of knowledge. For example, there have been presidential delegations to Kosovo, Gaza, India, Oman and Sri Lanka. Official overseas visits to the College have included, amongst others, the Bangladesh College of Physicians and Surgeons and a delegation from the Ukraine in 2006. The RCPCH has an established representation on several international bodies, such as the Confederation of European Specialists in Paediatrics (CESP), the Union of National European Paediatric Societies and Associations (UNESPA), the International Paediatric Association (IPA) and the International Network of Paediatric Surveillance Units (INOPSU). The College has recently created three posts for Overseas Directors for Africa, Middle East and South Asia. Their role is to support the David Baum Fellow in specific geographical regions: the Middle East, South Asia and Africa. The establishment of these posts reflects the continuing expansion of international activity conducted by the College.
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1. Photo of two children in Northern Malawi taken by a paediatrician on VSO placement in 2003 2. Iraqi and Palestinian doctors in a small group meeting 3-4. RCPCH Examinations visit to New Delhi and Chennai, India, 2006 5. RCPCH Education and Training visit to Jordan, Summer 2004
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Structure The first ten years Since its foundation as a College in 1996, the RCPCH’s membership has grown dramatically, and so have the demands placed on its internal structures and governance processes. Graph of RCPCH Membership 9000 8000 7000 6000 5000 4000 3000 2000 1000 0 1997
2000
2002
2004
2006
Junior Member
Member
Associate Member
Fellow
Senior Member
Honorary Fellow
Senior Fellow
Governance and Planning The creation of the College entailed setting up a framework of governance, only some of which was inherited from the structures of the old BPA. Collegiate status necessitated a new Charter and new Bye-laws. The long negotiations for a Royal Charter have been described in The Royal College of Paediatrics and Child Health at the Millennium, but its granting on 23 August 1996 marked the birth of the College. We consciously opted for a large governing body of trustees, directly elected by the Fellows and Members. Accountability to the membership is therefore taken seriously and Council remains the democratic cornerstone of the College. In practice, however, many operational responsibilities have to be delegated by Council to other bodies, such as Executive Committee (EC), Exams Committee, Academic Board and Child Protection Committee. The College’s Annual General Meeting has a number of specific functions: it receives reports from the President and Treasurer, and approves changes to the College’s Charter and Bye-Laws. Contrary to popular belief, however, its informative and sometimes heated debates on resolutions proposed by members are only advisory until endorsed by Council. College governance was reviewed during 2005-06 in an attempt to streamline
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decision-making. EC was slimmed down and the agendas of Council and EC were refocused. Reviews of other committees are under way. In 1998, the then Honorary Secretary, Dr Patricia Hamilton, led the drafting process of the College’s first five-year strategy. The intention was that the College should be able to plan its goals on a longer time-horizon than a single presidential term; a second strategy, covering the years 2003-8, followed, with Dr Hamilton’s successor Sheila Shribman leading its production. These strategies are approved by Council, which remains the RCPCH’s governing body, and which also approves the annual Work Plan and budget. In 2006 Dr Hamilton, now as President, produced the Vision and Values document. Vision and Values foresees a growth in the College’s education work, a more structured research programme, a greater emphasis on communication with the outside world, and a matching growth in underpinning activities. All of these will be necessary for the College to build on its first ten years’ work leading the way in children’s health. External Affairs The College has increasingly needed to represent the views of the membership and the needs and rights of children to a wider public. This has never been the responsibility of a single Officer or department but is a facet of almost all our operational work. The President and senior officers have generally taken the lead in dealings with parliament and we now have regular meetings with relevant Ministers, officials, opposition spokesmen and back-benchers on issues such as child protection, the configuration of services and the paediatric workforce. Perhaps one of the greatest changes of the past ten years has been our increased access to Ministers and the frequency of our meetings with them. At the same time we continue to maintain contact with the other medical royal colleges through various forums, including the Academy of Medical Royal Colleges, and with other bodies advocating for children such as the NSPCC and NCB. As the College has become a more high-profile organisation, this has been reflected in the greater interest shown by the media in its affairs and in questions of child health generally. Not all of this
interest has been positive, but one of the College’s most important tasks has been to present consistently the point of view of its members and of child health generally. This work was led for many years by Dr Harvey Marcovitch, assisted in recent years by a staff member – currently Claire Brunert – in the role of Head of Media. In 2006, Council approved a new Communications Strategy, which should produce a more structured and uniform approach to all the College’s work in putting its message across. Another key aspect of external affairs, our international work, is dealt with separately in this report. Building As a result of the College’s expansion, its London offices relocated in November 1997 from 5 St Andrew’s Place – for many years home of the BPA – to premises in 50 Hallam Street, which had previously been owned by the General Dental Council and the Medical Defence Union. As staffing levels increased, particularly in Training and Examinations, it became clear that further space was needed, and so, from 2003, the College began renting space in the adjoining building at 56 Hallam Street and later at Devon House in Great Portland Street. This provides a set of premises that are sufficient for current needs and for several years in the future. Longer-term efforts to create a purpose-built headquarters for the College continue. In order to recognise the changes brought by devolution, College offices opened in Edinburgh and Cardiff in 2003, and both now embrace a wide range of activities – from administering their respective committees and subcommittees to liaising with devolved governments and facilitating research. The Scottish Office is co-located within the Royal College of Physicians of Edinburgh and the Welsh Office, having been launched under the umbrella of Children in Wales, now has its own premises near Cardiff Bay. Staff The growth in the College’s work described elsewhere in this report has necessitated an expansion in College staffing levels, from 29 in 1997 to 52 in 2000 and 98 in 2007. Staffing expenditure has, however, broadly been kept at the same level as a proportion of total College expenditure.
Website One development that has coincided with the College’s life is the growth of the Internet. The College has had a website from the start of its existence, and this has grown in scope and sophistication over the years. Major redesigns took place in 2000 and 2002, and an entirely new website was launched in early 2007. The new website includes a member-only area with an online version of the College Handbook, as well as copies of College consultations in which members can participate. Future developments being considered include online registration for exams and other activities, and interactive functionality for e-learning. The College’s website has, since 2002, been the top hit for “Paediatrics” on Google and other search engines. IT/Database More generally, the College’s IT requirements have become increasingly complicated and demanding over the last decade. All staff (including those in Scotland and Wales) now have access to the College network and intranet, as well as recently added features such as remote access to email and files. We have moved in ten years from an organisation working mainly with paper to one working mainly electronically. The project to install an updated and fit-for-purpose contacts database was one of the largest that the College has undertaken. The database, supplied by CARE, was finally installed in early 2003, and has greatly expedited work for the College’s Membership Section. A review of the College’s database requirements is currently underway, along with a
redevelopment of the internal intranet to make it a more useful resource for staff. Archives The College’s history – both in its present incarnation and before that as the BPA – stretches back continuously to 1928, and the College has a role in preserving that record and making it available to scholars. Dr Bernard Valman, who retires in 2007 as the College’s Honorary Archivist, has spent many years cataloguing and recording this history, most recently with the assistance of the College’s staff Archivist, Susan Scott. This work has generated, amongst other things, video records of recent Spring Meetings, the digital preservation of footage of early BPA meetings held at Windermere, and the preservation of Council minutes and other records of importance in the College’s history. The next major project is to undertake a new volume of the College’s history covering the twenty years to 2008; this will be led by Dr Valman’s successor, Professor Sir Alan Craft.
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1. RCPCH 5 St Andrews Place, London NW1 (1985-1997) 2. RCPCH 50 Hallam Street Loondon W1W (1997-present)
Vision and Values The College’s current planning is governed by its Strategy 2003-8 and by the President’s Vision and Values document, approved by Council in 2006 and circulated to all members. Vision and Values foresees a growth in the College’s education work, a more structured research programme, a greater emphasis on communication with the outside world, and a matching growth in underpinning activities. All of these will be necessary for the College to build on its first ten years’ work leading the way in children’s health.
rcpch.ac.uk
RCPCH Website over the last 10 years
1997
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2001
2002
2007 23
Senior management team
Chief Executive Officer Len Tyler Director of Internal Services Mike Poole Director of Operations Jacqueline Fitzgerald Director of Policy and Standards David Ennis
2005/2006 College Boards and Committees The governing body of the College is its Council, which consists of the Trustees of the College. Trustees are elected by members and fellows of the College and comprise honorary officers, representatives from each of the College regions in the UK and the Republic of Ireland, paediatricians in the training grades, associate specialists, honorary and senior fellows and specialty paediatrics. The College’s primary functions are co-ordinated by a number of boards and committees, which are in turn supported by sub-committees and working parties, which report their activities to Council. The officers of the College meet formally and informally with representatives from other Royal Colleges, and with government and external organisations allied to child health. The College also participates fully in consultation exercises and wider discussions on paediatric health care issues at national level. Regional representatives, Regional Advisers, paediatric tutors and specialty advisers work on behalf of the membership across the UK and Republic of Ireland. Regional committees have been established to improve communication at all levels. The College’s national network is managed through its Scottish, Welsh and Irish committees. These provide a powerful voice for fellows and members, and also ensure effective communication with the four UK Departments of Health. The College is in regular touch with its members through the monthly publication of its scientific, peer-reviewed journal, Archives of Disease in Childhood, and quarterly newsletter which contains general news and information.
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Executive Committee Reviewing College activities, offering strategic direction to College activities and advice to Council Chair: President, Dr Patricia Hamilton Finance Committee Responsible for ensuring the proper management of the finances of the College Chair: Honorary Treasurer, Dr Sue Hobbins Specialty Board Coordinating the work of College specialties Chair: Vice President, Dr Mary McGraw Training Board Setting, delivery and maintaining the standards of paediatric training and examinations throughout the UK and Republic of Ireland Chair: Vice President, Dr Mary McGraw Research Division Executive Committee Reviewing research activity and offering strategic direction in the areas of research, surveillance and data collection Chair: Vice President, Professor Neil McIntosh Health Services Committee Provision of child health services and service configuration Chair: Vice President, Dr Simon Lenton International Board Coordinating the international activities of the College Chair: David Baum Fellow, Dr Steve Greene Academic Board Managing conferences, scientific meetings and CPD Chair: Vice President, Dr Chris Verity Secretary: Dr Alistair Thomson Examinations Committee Setting and conducting the MRCPCH and DCH examinations Chair: Officer for Examinations, Dr Tom Lissauer Publications Board Strategic management of College publications Chair: Honorary Editor, Dr Rashmin Tahmne
Patron: Her Royal Highness The Princess Royal Trustees 2005-2006: The Officers of the College and members of Council are as follows: Officers of the College
Dr Ramesh Mehta
Eastern
President Dr Patricia Hamilton
Dr Sian Snelling
Mersey
Dr Geoffrey Lawson
Northern
Vice Presidents Dr Simon Lenton (Health Services) Dr Mary McGraw (Training & Assessment) Professor Neil McIntosh (Science & Research) Dr Chris Verity (Education)
Dr Russell Viner
North East Thames
Dr Ruby Schwartz
North West Thames
Dr Ian Swann
North Western
Dr Nicholas Mann
Oxford
Dr Andrew Evans
South East Thames
Honorary Treasurer Dr Sue Hobbins
Dr Ruth Charlton
South West Thames
Dr Michael Webb
South Western
Registrar Dr Hilary Cass
Dr Peter Macfarlane
Trent
Dr Edward Wozniak
Wessex
Dr Steve Bennett Britton
West Midlands
Wales Dr Gwyneth Owen
Dr David Beverley
Yorkshire
Dr Iolo Doull
Wales
Ireland Professor Denis Gill
Dr Stephen Greene
N, NE, E Scotland
Dr Sepideh Taheri
South Eastern Scotland
Examinations Dr Tom Lissauer
Dr Jack Beattie
Western Scotland
Dr Moira Stewart
Northern Ireland
David Baum Fellow (International Affairs) Dr Steve Greene
Vacant
Republic of Ireland
Dr Martha Wyles and Paul Dimitri
Trainees
Dr Natalie Lyth
Associate Member
Prof. Richard Olver
Association of Clinical
Scotland Dr Adrian Margerison
Donald Court Fellow Dr Claire Smith Higher Specialist Training Dr Ian Doughty Continuing Professional Development Dr Alistair Thomson Workforce Planning Dr David Shortland
Professors of Paediatrics Dr Margaret Mearns
Senior Members
Dr Richard Newton and Dr Helen Venning
Paediatric Specialities
Details correct as of 31 August 2006.
Honorary Editor Dr Rashmin Tahmne
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Treasurer’s Report 2006 Dr Sue Hobbins Honorary Treasurer As I take over the onerous task of Honorary Treasurer from Dr Alun Elias Jones who has established a legacy of sound financial management, it is important for the membership of valued members and fellows of the College to understand and be aware of how their fees are allocated and utilised. This report aims to explain and put into context the figures for the College’s financial year to 31 August 2006, which are summarised on pages 28 to 30. It includes an update on the current financial health of the College. The College by virtue of its constitution undertakes a wide variety of activities, which are described within the other reports in this document and explains why income and expenditure vary from year-to-year. Reporting year 2005-2006 Overall, the “bottom line” for this reporting year is a substantial net increase in funds of over £1.2million. The resulting £1.5million increase in the General Fund is welcome and timely given the potential effect of current uncertainties, the demands on the College and the related requirement for premises in the medium-term. Other headlines include: • Total incoming resources of £8.3m, an increase of 5.7% • Total resources expended of £7.6m, an increase of 13.2% • Membership subscription income of £2.4m, an increase of 9.8%, reflecting the real growth in membership by 5.5% from 8,479 to 8,946 members • Membership subscription rates increased by 2% on 1 January 2006 for those resident in UK, Ireland the rest of the European Union and North America. For members in resource-poor countries, no increase was levied meaning that for over 1,100 members their 2006 membership subscription remained at 2005 levels. This principle has been agreed for 2007. • Gains on investments of £399,943, which is a return of 12.1% (2005 - £592,468; 19.5%) • Successful launch of the British National Formulary for Children (BNF-C), two editions published, resulted in Publications income of £548,896 (2005 - £Nil) • Publications income also includes £333,358 (2005 - £260,029) in respect of the surplus due to the College from
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the joint venture to publish Archives of Disease in Childhood (ADC) • A one-off donation of £150,000 has been designated to create the Paul Polani fund which shall be used to encourage work in neuro-disability, and is included in unrestricted Voluntary income • Unexpectedly low attendance at the 2006 Spring Meeting reduced the College’s net income by £41,173 compared with 2005 (the figures disclosed as “Spring Meeting” do not include the trade exhibition which had a similar financial performance in both years). The increase in total resources expended reflects a significant expansion across all of the College’s work and particularly in Training, Research and Other Professional Activities (principally initiatives surrounding children’s participation and child protection). There has been increased expenditure to support activities to develop the examination and improve its quality and robustness. Meeting the requirements set by PMETB for training, assessment and examinations have impacted on costs and will continue to do so for the foreseeable future. The College has continued to use the Everley Jones fund towards Education, Training and Research initiatives, which have been unable to attract external funding. The balance on the Everley Jones fund at 31 August 2006 is £870,204 of which over £200,000 has been committed to underwrite such activities. The increase in expenditure has been kept to a minimum by continuing to carefully monitor and control costs. The changes to the structure of governance and investment in senior management (the latter from September 2006) are expected to yield efficiencies. Current year 2006-2007 These factors are important as the College matures. The rate of growth cannot continue and be sustainable as activities reach the limits of income. The current financial year to 31 August 2007 is budgeted to potentially yield an overall deficit and the increase in the General Fund is expected to be closer to “only” achieving the target increase of £250,000. Significant reasons for this include:
• Expenditure in the current financial year on activities for which monies were received previously (and were held in restricted funds) • Full-year effect of 2005/6 developments • BNF-C to be published at rate of one edition per year (2005/6 had the first two editions). External influences such as PMETB, changes to immigration rules (which may eventually affect the number of examination candidates and ultimately growth in membership) and the potential move to recertification, may present adverse financial pressures for the future. These factors will be kept under close review and opportunities for income generation will be explored. Achieving sustainability for a number of current education initiatives has already been identified as a challenge. Electronic publishing remains a potential threat to the ADC and BNF-C income streams. This effect may be mitigated however as both ventures are actively engaging in electronic initiatives themselves. The General Fund at 31 August 2006 stands at £7.3million, which is a sound financial base to enable the College to respond appropriately to most eventualities. However, to put this in perspective, the requirement is nearer to £16million if new premises as currently specified are acquired. The importance of achieving the continued increase in the General Fund from general College activities is therefore well understood. A principle of “better use of resources” is paramount. The current expenditure on IT to enhance communication and productivity in general and the website in particular is one such example that is expected to improve and expand College services. The resultant open-ness is expected to improve as a result and being able to publish the Annual Report and the full financial statements on the website for the first time is welcomed. In that spirit of transparency, if you have any queries about the finances of the College, please direct them to either myself (sue.hobbins@bromleyhospitals.nhs.uk) or Mike Poole (mike.poole@rcpch.ac.uk), Director of Internal Services at the College.
Dr Sue Hobbins Honorary Treasurer
Accompanying Statement by the Council of the Royal College of Paediatrics and Child Health These summarised financial statements on pages 28 to 30 have been derived from the full statutory Council report and financial statements for the year ended 31 August 2006 which have been audited by Sargent & Co who gave an unqualified audit opinion on 7 February 2007. The auditors have confirmed to Council that the summarised financial statements are consistent with the full financial statements for the year ended 31 August 2006.
The full statutory Council report and financial statements were approved by Council on 7 February 2007 and signed on their behalf by Dr P Hamilton and Dr S M Hobbins. They will be submitted to the Charity Commission by 30 June 2007. These summarised financial statements may not contain sufficient information to allow for a full understanding of the financial affairs of the College. The full statutory Council report and financial statements can be obtained from: The Chief Executive, Royal College of Paediatrics and Child Health, 50 Hallam Street, London, W1W 6DE On behalf of Council, 7 February 2007 Dr Sue Hobbins Honorary Treasurer
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Accounts Summarised Financial Statements for the Year Ended 31 August 2006
Consolidated Statement of Financial Activities for the Year Ended 31 August 2006 Unrestricted Funds £
Restricted Funds £
Endowment Funds £
2006 Total £
2005 Total £
Incoming Resources Incoming Resources from Generated Funds Voluntary income Activities for generating funds Investment income Incoming Resources from Charitable Activities Examinations Spring Meeting Education Training Research Members subscriptions Publications Other income
164,617 165,347 395,660
97,721 21,809
-
262,338 165,347 417,469
194,522 166,511 378,409
2,527,769 432,916 74,055 49,066 186,699 2,396,048 896,401 320,471
500 79,984 247,342 227,125 -
-
2,527,769 433,416 154,039 296,408 413,824 2,396,048 896,401 320,471
2,512,767 523,941 373,617 424,642 494,867 2,183,063 293,009 289,122
TOTAL INCOMING RESOURCES (see note 3)
7,609,049
674,481
-
8,283,530
7,834,470
-
-
35,269 36,131
38,982 27,807
500 307,179 783,544 379,420 85,247 -
-
1,923,486 487,821 643,050 874,837 1,020,676 2,514,401 45,196
1,705,443 537,173 633,412 754,904 855,440 2,097,318 43,857
1,555,890
-
7,580,867
6,694,336
Resources Expended Cost of Generating Funds Costs of generating voluntary income 35,269 36,131 Fundraising Trading: Cost of goods sold and other costs Charitable activities Examinations 1,923,486 Spring Meeting 487,321 335,871 Education Training 91,293 Research 641,256 Other professional activities & standards 2,429,154 Governance costs 45,196 TOTAL RESOURCES EXPENDED (see note 1)
6,024,977
Net Incoming / (Outgoing) Resources Before Interest in Associate and Transfers Interest in result of Associated Undertaking Transfer between Funds
1,584,072 98,049 (491,128)
(881,409) 491,128
-
702,663 98,049 -
1,140,134 (98,049) -
Net Incoming Resources Before Other Recognised Gains and Losses Gains on revaluation of fixed assets Gains and losses on investment assets
1,190,993 10,140 399,943
(390,281) -
-
800,712 10,140 399,943
1,042,085 592,468
Net Movement in Funds Fund balances brought forward
1,601,076 9,535,892
(390,281) 1,386,428
14,855
1,210,795 10,937,175
1,634,553 9,302,622
£996,147
£14,855
£12,147,970
£10,937,175
TOTAL FUNDS CARRIED FORWARD
£11,136,968
There were no recognised gains and losses for the period other than those included in the Statement of Financial Activities.
28
Consolidated Balance Sheet as at 31 August 2006 Group 2006 £
Group 2005 £
Fixed Assets Tangible Assets
2,306,705
2,361,645
Investments
5,190,881
4,732,580
7,497,586
7,094,225
Current Assets Stock of Publications and Merchandise Debtors Cash at bank and in hand
1,209 1,278,106 5,289,272
1,147 734,303 5,256,766
Creditors: Amounts Falling Due Within One Year
6,568,587 (1,918,203)
5,992,216 (2,148,266)
NET CURRENT ASSETS
4,650,384
3,843,950
12,147,970
10,938,175
-
(1,000)
£12,147,970
£10,937,175
3,796,227 4 7,340,737
3,833,441 4 (98,049) 5,800,496
Total Unrestricted Funds
11,136,968
9,535,892
Restricted Funds Permanent Endowments
996,147 14,855
1,386,428 14,855
£12,147,970
£10,937,175
Total Assets Less Current Liabilities Creditors: Amounts Falling Due After More Than One Year NET ASSETS Represented by: Unrestricted Funds: Designated Funds Charitable Trading Subsidiary Fund Charitable Trading Associate Fund General Funds
TOTAL FUNDS OF THE COLLEGE (see note 2)
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Accounts Notes to the Summarised Financial Statements for the Year Ended 31 August 2006 1. TOTAL RESOURCES EXPENDED Other Direct Costs £
Other Allocated Costs £
15,367
12,801
7,101
35,269
38,982
-
36,131
-
36,131
27,807
660,600
971,547
291,339
1,923,486
1,705,443
74,776
388,864
24,181
487,821
537,173
Staff Costs £ Costs of generating voluntary income Fundraising trading: cost of goods sold and other costs Examinations Spring Meeting
2006 Total £
2005 Total £
Education
169,632
411,959
61,459
643,050
633,412
Training
489,718
209,967
175,152
874,837
754,904
534,702
312,242
173,732
1,020,676
855,440
1,015,971
1,148,855
349,575
2,514,401
2,097,318
Research Other professional activities and standards Governance costs TOTAL RESOURCES EXPENDED
-
45,196
-
45,196
43,857
2,960,766
3,537,562
1,082,539
7,580,867
6,694,336
Other allocated costs in 2005-2006 can be further analysed by activity as follows: Premises & Facilities £
Human Resources £
Information Technology £
Finance £
Total Other Allocated Costs £
3,108
847
1,925
1,221
7,101
-
-
-
-
-
Costs of generating voluntary income Fundraising trading: cost of goods sold and other costs Examinations
114,483
31,180
100,701
44,975
291,339
Spring Meeting
10,584
2,883
6,556
4,158
24,181
Education
26,902
7,327
16,662
10,568
61,459
Training
76,668
20,881
47,485
30,118
175,152
Research
76,046
20,711
47,100
29,875
173,732
150,091
40,878
99,644
58,962
349,575
-
-
-
-
-
457,882
124,707
320,073
179,877
1,082,539
Other professional activities and standards Governance costs TOTAL ALLOCATED COSTS
Costs of generating voluntary income are those incurred in seeking voluntary contributions and do not include the costs of disseminating information in support of the charitable activities. Governance costs include the costs associated with the meetings of the Council, Executive Committee and Finance Committee and those incurred in connection with the statutory external audit. All costs have been allocated on the basis of the headcount except £57,795 of the Information Technology cost which has been directly attributed.
2. FUNDS Unrestricted Funds The General Funds of £7,340,737 (2005 £5,800,496) represent the “free” funds of the College which are not designated for particular purposes or restricted in any way; they are essentially the College’s reserves. Such funds need to be held as reserves to permit a responsible reaction to uncertainties. During the year the College reviewed the level of reserves it requires and set the requirement at one year’s expenditure, which is currently in excess of £7 million. In addition, it is estimated that a further £9 million will be necessary to enable the College to acquire the type of premises it has identified as being appropriate in the long-term.
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Designated funds comprise unrestricted funds that have been set aside by Council for particular purposes. They include the Fixed Assets Fund £2,235,268 (2005 - £2,293,790) and the balance of the Everley Jones Bequest £870,204 (2005 - £1,038,353).
Permanent Endowments Permanent Endowments are monies which have been given to the College in trust with the restriction that they are held as capital with the income generated from them to be used for specific awards.
Restricted Funds Restricted funds are funds which are to be used in accordance with specific restrictions imposed by donors or which have been raised by the College for particular purposes and comprise funds for the WellChild Fellowships, David Baum International Foundation, Education & Training, Research, Overseas Levy and Awards & Prizes.
3. INCOME FROM COMMERCIAL COMPANIES A list of commercial companies who pay for a presence at the Spring Meeting and similar events organised by the College is available on request from the Director of Internal Services at the College. Any commercial companies who have made significant financial contributions to the College in the calendar year 2006 are included in the Fund-raising report within this Annual Report.
Fund-raising
Dr Ben Ko Assistant Treasurer In the last 12 months, the College has seen important developments in its operation, with new work plans and new visions clearly defined. These new directions reflect both the College’s commitment to the Royal Charter, and the priorities of Members and Fellows. Certain objectives of the College, such as training assessments and some research projects, are met with funding from statutory sources. However, other areas in which the College wishes to progress, are not well-placed to attract statutory funds, such as certain aspects of child protection work, and international education initiatives. Hence there is a need to generate additional income in order to fulfil the College’s visions and ambitions. Voluntary donations make up an important part of this income. The College has done well in attracting donations during 2006-07. These help the College to invest more in research, education and training. The main donations and fund raising activities are reported in the following paragraphs. Paul Polani Fund The largest single donation this year came from an anonymous donor. £150,000 was received to set up the Paul Polani Fund, which aims to bring about improvements to the lives and health of children with neurodisabilities. Professor Paul Polani (1914 – 2006) was amongst the early specialists in childhood disabilities, and had long associations with Guy’s Hospital and the National Spastics Society (now ‘Scope’). He was particularly known for his pioneering research in chromosomal anomalies and abnormalities, and in cerebral palsy. The utilisation of this fund will be led by the British Academy of Childhood Disability (BACD). It will be used in the first instance to support a Paul Polani keynote lecture at the annual BACD meeting, and the occasion will also be used to launch a Paul Polani Bursary to support young researchers in the field.
David Baum International Foundation Active fund-raising for the Foundation continued over the last 12 months. The most notable event was the barn opera event organised by Mr Charles Crowther, a friend of the Baum family. This took place on 2nd September 2006, with a performance of Donizetti’s L’elisir d’amore by Opera Diva in Fingest, Oxfordshire. Dr Patricia Hamilton, College President attended as did Rosalind Topping, College Head of Education, who remarked, ‘It was a most enjoyable evening. Over 250 people came. The performance was superb, and it was a wonderful setting to have our picnics in between the Acts. Everybody had a great time, for a worthwhile course.’ Mr Crowther’s efforts have been rewarded by warm support and participation from friends, family and colleagues of the College. An excess over direct costs of £5,000 was raised. This represents a generous addition to a healthy Foundation, which is now funding a growing number of educational projects in developing countries in Africa and Asia as well as in Gaza and the West Bank. Legacy fund raising In comparison with the more established charitable organisations, with one notable exception, the RCPCH has received relatively little in the way of legacies from its members and others. Other Royal Medical Colleges have well-established mechanisms encouraging their members to include them as beneficiaries in their wills. It is this area of fund-raising that the College would wish to develop and benefit from. Following a number of initiatives in the last two years in encouraging legacy donations to the college, some progress has been made, although the very nature of this activity is for the longer-term of course. In 2006 one legacy was notified to the College, it is for the sum of £10,000. It is hoped that in future this area will provide a source of income that other organisations are already benefiting from.
A gift in your Will The College is a charity and a gift in your Will can help reduce your inheritance tax burden. Such gifts are often referred to as legacies or bequests. There is a standard codicil form (an appendix to your Will) that can be sent you to forward to your professional adviser. And if you have not yet written a Will and need a solicitor the College can help with that too. Guidance on making a legacy in favour of the College is given on the College website. To add a legacy to an existing will please use the form of codicil on page 34 of this Annual Report, where you will also find some relevant notes. Other ways of making donation include: • regular donations by direct debit. • single donations by cheque or credit card • gifts of shares • gifts of dividend income. • support by payroll giving through your workplace. • taking part in an event such as a marathon Further information Please visit our website at www.rcpch.ac.uk The new website is being finalised as I write and the fund-raising section will be much easier to find than before. Alternatively please contact Pardeep Bhakar, PA to the Director of Internal Services, at The Royal College of Paediatrics and Child Health, 50 Hallam Street, London, W1W 6DE. Email: pardeep.bhakar@rcpch.ac.uk Telephone: 020 7307 5622.
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Major donations, grants and gifts
We would especially like to thank the following who have helped to further the College’s vision towards better child health by supporting our activities in 2006 through major donations, grants, gifts and gifts in kind (including consultancy services and advice): The estate of the late Dr Anthony Jackson deceased Charles Crowther (David Baum International Foundation) Dr Kan Fai Poon Dr Peter Corry (David Baum International Foundation) Clinical Directors Special Interest Group Department of Health G M Morrison Charitable Trust Health Protection Agency Institute of Child Health
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Neonatal care following premature birth, St George's Hospital, Tooting, London
Bequests Bequests to the Royal College of Paediatrics and Child Health The health and well being of children has always been the concern of paediatricians. The enormous advances made by the medical profession have cut a swathe through previously fatal diseases, and better nutrition and living conditions have produced a healthier child population. However, other dangers, social and medical, continue to threaten, and in today’s market-oriented climate, money is always needed to enable us to fight for children’s welfare, to fund research and to provide better education for paediatricians in whose hands lies the health of the nation’s children. A bequest to the RCPCH in your Will would help the College to continue its important work. Overleaf you will find a printed form which, duly signed and witnessed, would become a codicil to your exiting Will. It can be simply filled in, detached and sent to your solicitor. If you intend to do this, will you please note the following points: 1. Please read the document to ensure that it accords with your wishes. Any alterations must be made before you sign.
2. Then date the document where indicated. 3. Then in the presence of two witnesses sign your name at the end of the document where indicated. 4. The witnesses must sign their names and write their addresses where indicated. Two witnesses are needed in England, Wales and Northern Ireland; one witness in Scotland. 5. You and the witnesses must all be present together when you sign, and the witnesses must see you sign. 6. No person taking benefit under the document or the husband or wife of any such person should be a witness, otherwise such person will not be able to take any benefit under the document. 7. All alterations should be initialled by you and the witnesses in the margin opposite the alteration. 8. On no account should anything be pinned, stapled, paper-clipped or fastened in any way whatsoever to the document. Members wishing to contribute in this way are asked to contact the fund-raising section of the College (e-mail fundraising@rcpch.ac.uk), especially if they wish any bequest to be used for a specific purpose.
33
Form of Codicil Please complete this form, detach and send to your solicitor. I (name in block capitals) of
(address)
Declare this to be a Codicil which I make this
day of
20
To my Will which bears the date
day of
20
(1) I bequeath to the ROYAL COLLEGE OF PAEDIATRICS AND CHILD HEALTH (‘The College’) or to any successor body carrying out the same or similar charitable work the sum of
£
amount in words
free of all taxes whether payable in the United Kingdom or in countries overseas for the general purposes of the College and I declare that the receipt of the – Honorary Treasurer for the time being of the College shall be sufficient discharge for the same. (2) In all other respects I confirm my said Will. In witness thereof I have here unto set my hand the day and year first above written. Signed by the said Testor/rix (Signature) Date as a Codicil to his/her last Will in our joint presence and by us in his/hers.
Witness (name in block capitals)
(Signature)
of (address)
Witness (name in block capitals)
(Signature)
of (address)
Royal College of Paediatrics and Child Health
34
Registered Charity 1057744
Photo credits Front cover; p15 photo 1; p27 (Shutterstock) p13 (Nigel Bradford) Acknowledgements We are very grateful to St George's Hospital, Tooting, for their help in providing photographs for this Report. Appropriate consent was sought from all those featured.
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50 Hallam Street, London W1W 6DE Tel: 020 7307 5600, Fax: 020 7307 5601 e-mail: enquiries@rcpch.ac.uk Website: http//www.rcpch.ac.uk Registered Charity 1057744
Designed and produced by Chamberlain Dunn Associates
Royal College of Paediatrics and Child Health