As I near the end of my tenure as College President I am giving some thought to the rich lessons over the last three years. I think that one of the most important is the power of collaboration and how we can deliver a much stronger and clearer message about child health when we work with others who are like minded. I have learnt that one of the key roles of a College President is to build those alliances and develop relationships with groups and individuals who can amplify our messages or, even better, act independently but use their influence to develop the advocacy and make the case for children and the importance of a healthy childhood.
It was therefore a real delight to read this BMJ editorial earlier this month, authored by the Editor in Chief, Kamran Abbasi. He very elegantly made the case for why children and their health must be viewed in a multisectoral and multidimensional way, and how failing to do that in the UK is betraying our children and leads inevitably to the rapid decline we are currently witnessing in children’s mental and physical health. The importance of this message, written in a widely read journal and articulated by someone outside the immediate child health fraternity, cannot be overstated.
Likewise, the Academy of Medical Sciences (AMS) have published their report on the importance of early childhood, making the case for why investment in those early years reaps rewards for both health and prosperity nationally. The report is certainly worth a read and chimes very closely with our own analysis and the RCPCH manifesto for the next UK general election. It highlights the concerning trends in childhood obesity, tooth decay and mental health, while flagging the importance of investment in the child health workforce, better data collection and research. Crucially, the AMS is also calling for a unifying vision across UK Government for the early years to coordinate policies and resources.
Implementing Martha’s Rule
I have written previously about how the College has engaged with the work led by the Patient Safety Commissioner, Dr Henrietta Hughes, on what is known as Martha’s Rule. There is no doubt whatsoever that any initiative focussed on improving the safety of children and young people in our hospitals deserves our total support.
And so, we welcome the announcement of the rollout of Martha’s Rule from April 2024 to 100 sites which have 24/7 adult critical care outreach. We are also clear that a great deal of work, underpinned by adequate resources, needs to be made available in the next phase of this initiative if we want to see this functioning effectively across all inpatient children’s services where only a small minority currently have access to onsite paediatric critical care outreach. We are totally committed to working with NHS England to understand the challenges to a full rollout and will play our part in addressing the current service gaps.
Whooping cough and RSV
I realise I risk being boring and repetitive! But I make no apology for mentioning our concerns about current immunisation rates again. You will be aware that pregnant people are offered a pertussis vaccination in pregnancy and recent data shows how disappointing the uptake is, even as low as 23% in north London. Sadly, we are seeing cases of pertussis this winter and at least one neonatal death. Maternal immunisation programmes obviously fall out of our remit and are largely delivered by midwives.
However, we do have a responsibility to use every opportunity to make the case for why these infectious diseases are so worrying and therefore why we want pregnant people to be furnished with all the relevant advice and information so they can make as well informed a decision as possible. This is going to be even more important once the RSV immunisation programme is launched (hopefully later this year) as the maternal RSV vaccine is one of the possible routes of administration. We are working with the Royal Colleges of Obstetrics and Gynaecology and of Midwives so we can better understand how we can help and support these vital programmes.
Remembering Gordon Denney
As Merope and Paul Mills have campaigned tirelessly after the tragic death of their daughter Martha, so too did Gordon Denney campaign tirelessly for the link between aspirin administration in children and Reye’s Syndrome. Gordon’s son Jonathan sadly died of Reye’s Syndrome in 1984 and his parents set out to understand better what happened to their son. They linked up with another family where the same tragedy had occurred, and this spurred an inspiring collaboration which eventually led to the Committee on Safety of Medicines in the UK requiring labelling on all aspirin containing products and a warning to all children under 12 to avoid these. This was later extended to under 16 years and almost certainly many lives were saved as a result.
Gordon devoted his life to the study of Reye’s Syndrome and a number of inherited metabolic conditions that mimic Reye’s. In recognition of this, he was awarded an Honorary Fellowship of the College in 2012. Gordon died in January this year and leaves a legacy of research and understanding of Reye’s Syndrome, as well as generations of paediatricians and parents who are indebted to him. You can read the College tribute to Gordon.
With my best wishes to you – and take care,
Camilla
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