What is advocacy and why is it relevant to my role?
We all need to speak up.
An advocate is someone who ‘speaks up for, supports, or represents a person or group of people who may need extra help or protection’2 . As child health professionals, we are in a unique position to listen to and speak up for our patients and their families. The importance of our role as advocates is highlighted in Learning Outcome 5 of the Progress+ Core Curriculum:
Utilises local, national and international health information in order to advocate for systems and policies which promote health and reduce inequalities.
Advocacy is also recognised by the GMC as one of the professional responsibilities of a doctor:
Our guidance outlines the expectations for doctors’ professional responsibilities, including their duty of care to their patients. Doctors have a wide range of other professional responsibilities, relating to their roles as an employee, clinician, educator, scientist, scholar, advocate and health champion.
In paediatrics, advocacy enables clinicians to address broader societal issues affecting child health that cannot be solved through day-to-day clinical work. Furthermore, societal, political and environmental issues such as air pollution often disproportionately impact the health of already disadvantaged groups. By advocating for systemic change, paediatricians can play a vital role in tackling health inequalities.
As well as being a foundational component of paediatrics, clinician involvement in child health advocacy is effective. Doctors and nurses are consistently among the most trusted professional groups.3 Our public support can help to reframe divisive or overlooked issues and lead to tangible policy change. For example, after the launch of our 2024 Position statement on air pollution in the UK, The Times newspaper's environment editor wrote on X:
"Woodburning disproportionately affects vulnerable populations, despite being a prevalent activity in wealthier urban households with access to alternative heat sources" - not Friends of the Earth or a green group, but a group of paediatricians.
Barriers to child health advocacy
Getting started with advocacy can feel like stepping into unchartered territory for many healthcare professionals. In this blog, RCPCH Clinical Fellow Dr Emily Parker reflects on her advocacy journey. A 2021 survey of 1000 healthcare professionals from 5 different countries identified 5 common barriers to action on air pollution4 :
- Understanding the problem
- Overcoming helplessness
- Maintaining their standing
- Lack of inspiration on action they could take
- Competing stressors
Despite its challenges, advocacy can provide an outlet for some of the frustrations encountered in clinical work. In this journal article, three US physicians ask Is Patient Advocacy the Solution to Clinician Burnout?*
This guide will equip you with the skills, knowledge and confidence to overcome common barriers and get started on your advocacy journey.
*For further support with clinician wellbeing, visit the Thrive resource hub.
First steps in child health advocacy
1. Listen to children, young people and their families
See below - steps 1 and 2 should be followed simultaneously.
2. Build your knowledge
Steps 1 and 2 go hand-in-hand. Advocacy, in speaking up for others, starts with listening to their experience. However, being able to ask the right questions at the right moment requires some knowledge of the issue. Just the basics are enough – try looking at our start with the basics page or reading our position statement quick read.
Approach patients and families with curiosity, recognising that they may have a deeper knowledge of the issue than you. Visit our talk to patients page to learn more about talking to children and young people.
If you are drawn towards thinking – what can I do, not just in my day job? What could I do to help influence a better system? I would say it starts actually in your day job. The first step, I think, is to step back and think more broadly about the children and families in front of you.
3. Share your knowledge
We've created this infographic for you to share with colleagues and friends to help start a conversation about air pollution and its impact on child health. You could send it to a Whatsapp group, share it on social media, or ask your workplace to include it on waiting room screens or computer screensavers.
Coming soon: we're working on developing some slide sets to support you in delivering teaching sessions on air pollution and child health. You could offer to present at your morning handover or departmental teaching session, at a regional training day, or even at an ICB or local council meeting.
4. Find like-minded colleagues
Sharing your knowledge and raising awareness of the issue is an effective way to build a network of local healthcare professionals interested in advocating for change, enabling you to strengthen your voice and distribute advocacy tasks.
You could also join our national or international networks of child health professionals working together for clean air.
5. Know your sources of support
Change can be uncomfortable, and it is possible that some people will question your advocacy activities. Building a network of colleagues who are working towards the same goals can provide much-needed support:
Emerging evidence suggests…that when individuals realize they are not alone in their beliefs about a contentious issue, they become willing to speak out.
We’ve heard from clinicians working in air pollution advocacy that the RCPCH position statement has helped them when they’ve experienced resistance from employers or colleagues. You can also reference the GMC and Progress + curricula, outlined at the top of this page.
We've prepared a list of answers to difficult questions on air pollution to help you respond.
6. Choose your focus
Advocacy doesn’t have to involve public speaking or media appearances. Start small and build confidence as you go. Watch this video in which Dr Camilla Kingdon describes how air pollution advocacy can change lives:
This diagram, courtesy of Elise Amel et al,6 demonstrates how your influence increases when you go beyond personal choices and start thinking about how to create change at an organisational level. Where do you want to direct your advocacy? Select the largest sphere of influence you are comfortable with, and aim your advocacy at that level.
Think about the relationships you already have and the relationships you want to develop to expand your sphere of influence. And remember, the core skills of child health professionals provide us with a strong basis for advocacy work:
- Listening to patients
- Understanding the evidence base
- Communication skills
- Ability to build trusting relationships
Our build your skills page provides you with further resources to get started with advocacy. If you're unsure of where to start, we’ve collected examples of projects from across the UK to help you find inspiration.
- 1RCPCH (2024), RCPCH &Us Voice Bank, London: RCPCH (unpublished, available via and_us@rcpch.ac.uk)
- 2Cambridge English Dictionary
- 3IPSOS Veracity Index 2023: Trust in Professionals Survey
- 4Clean Air Fund, 2021 'Health Communities Research: How to inspire the health care community to act on air pollution'
- 5RCPCH Podcasts, 2022 'Advocating for child health, now and in the future’
- 6 a b Amel et al, 2017 'Beyond the roots of human inaction: Fostering collective effort torward ecosystem conservation' Science 356: 275-279