Advocating for our workforce - President's blog

From negotiating preservation of training numbers for Progress+ to questioning birth rate projections used in workforce modelling, Camilla highlights some of the areas where we are advocating for our workforce. The blog also links to some important recent publications.
Dr Camilla Kingdon, RCPCH President

As a College we can have incredibly ambitious plans for our child health advocacy work and we can use the fantastic expertise we have amongst our membership to shine a light on a whole range of important issues, creating headlines and making media appearances. However, if we do not have a child health workforce, all this work becomes almost irrelevant.

Advocating for our workforce

The workforce that cares for children throughout the UK, in hospitals and in the community, in highly specialised services and in district general hospitals, collectively provides the infrastructure to support children and their families to achieve their very best health and wellbeing. In every College committee and in every discussion forum, we always circle back and ask ‘What about the workforce?’

And so, while many members have expressed their frustration with the newly published NHS England Long Term Workforce Plan, we are galvanised to use this opportunity to make a meaningful impact for our patients. Our approach is to think holistically about the needs of children, and so this cannot simply be a conversation about how many paediatricians we need – although that is clearly extremely important. 

We have been negotiating behind the scenes to ensure that the forthcoming implementation of Progress+, with the shortening of our training programme to seven years, does not result in a shrinkage in the total number of training posts. I think it is important to acknowledge that maintaining our ‘training envelope’ was not a foregone conclusion and so it is worth us being clear that it is a significant achievement for the RCPCH that we have received confirmation that our total number of training posts will be unaffected by the shortening of our training programme. So, in effect, each year will become slightly larger. I am very relieved by this news.   

With that said, there is much more work still to do. I don’t suppose any paediatrician in the UK believes their clinical service is adequately staffed and so representing that clinical frontline perspective is part of our job. We also need to challenge some of the birth rate projections that were used in the workforce modelling that fails to take account of population growth and the growing complexity of children’s health needs. Demand for children’s health services has been rising at a faster rate than demand for adult health services, with the elective waiting list growing at double the rate and community service waiting lists growing at three times the rate. We must insist that these issues are factored into the plans for developing the NHS workforce and that children get their fair share of the very significant investment promised by UK Government. As a College this is, as it always has been, our absolute priority and I promise to keep you updated as this work unfolds. Take a look at our members briefing to understand which areas we’ll be focusing on.  

National training survey 2023 results

The publication of the annual GMC National Training Survey this week reveals results that will surprise none of us and strengthens our resolve to undertake the complex negotiations to invest in our workforce. The relentless rise in reported burnout amongst trainees continues to be a real concern. The idea that more than one in ten trainees felt ‘intentionally humiliated’ in front of others is quite extraordinary and profoundly worrying. This speaks to the deep-seated problems that we know exist in the workplace in many parts of the NHS – not all - but enough for this to threaten patient safety and hugely impact retention of doctors in the UK.   

In this year’s report there is also a strong signal that trainers are feeling the pressure, the balancing act between trying to do justice to training and supporting their trainees while trying to fulfil their clinical commitments too. This is a significant finding in the context of the Long Term Workforce Plan that has ambitions to double the number of students by 2031. Please take a look at the survey as it provides a rich source of useful information that gives specific data for each trust and region.    

NHS Race and Health Observatory neonatal report

It was a real honour to be invited to the launch of the NHS Race and Health Observatory’s report into neonatal assessment and practice in Black, Asian and minority ethnic newborns. This important report shows the increasing recognition of the impact of ethnicity on both maternal and neonatal outcomes in the UK, focusing specifically on the Apgar score as well as the early newborn assessment of cyanosis and jaundice. There are some crucial challenges for us to consider in this report. Some of the recommendations relate to the importance of cultural competence and improved communication skills amongst healthcare professionals caring for mothers and babies.  Other recommendations are more specific and focus on the clinical assessment of newborn babies, with potential ideas for how that might be improved. There is a surprising lack of good research in this area internationally, and so there is also a call for specific areas to be looked at more systematically.    

New report from the National Child Mortality Database

The National Child Mortality Database (NCMD) is an extremely important and valuable resource that is unique in the world. The systematic investigation of every single child death in England is a profoundly rich source of learning, and the NCMD’s thematic reports take that one step further and allow us to understand particular specific areas in much more detail. This week, the NCMD published their latest thematic report investigating child deaths due to trauma. I commend this report to you and hope you will read their findings, and join their webinar next week which will be worth attending. My hugest thanks to Professor Karen Luyt and her team at the NCMD for their work.

For those of you working in England I know that next week will be challenging, whether you are taking industrial action or not. Please let’s look out for each other. We have updated our resources with our response to the outcome of the consultant ballot.

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