Considering paediatrics at home and abroad

Welcome to Russell's latest blog, reflecting on a busy month of travel, meetings and new faces at the College!

At RCPCH Council meeting earlier this month, your Council took a decision to change College policy on relationships with infant formula companies. The Council reiterated that the RCPCH wished to have a good engagement with pharma companies that manufacture specialist infant formula, as these are necessary medicines that paediatricians prescribe. However, Council concluded that this does not require a financial relationship with formula companies – and that, effective immediately, the College will not accept money from companies that make infant formula.

I was very pleased with this outcome - as it acknowledges that working with pharma is an appropriate way to improve health for children, and acknowledges that the majority of our members supported careful engagement with milk industry pharma in the survey we undertook a few years ago.

But it acknowledges as well that financial relationships with infant formula companies are extremely problematic because these companies also manufacture breast-milk substitutes and follow-on formulae for healthy children. I believe we now have a position that allows us to work with companies to improve child health through improving specialist milk formulae (and I do believe that this is part of their motivation) but be free of any appearance of bias that accepting funds from this industry brings.

Concerning workforce

The other thing occupying my mind is workforce. Meaning, for those of you in the UK, you – and the lack of enough of you to fill our rotas and ensure we can deliver safe and high quality care. I am aware that this problem extends well outside the UK – indeed there is a European-wide shortage of paediatricians and an overall global shortage of doctors. This concern has been high in our minds for some time - however, it seems as if we may finally be heading towards some solutions.

Over the last month the Vice Presidents and I have been inundated with invitations to meetings across all the different NHS bodies in England and across Government. It feels as if the NHS and governments across the UK have realised there is a problem (I suspect Brexit has somehow ‘helped’ with this realisation), and have responded by pressing pretty much every button they could find.

I have been very impressed with the sense and commitment shown by some of those leading the process...

In one sense I worry that this furious activity with pretty short timelines, not all of it coordinated, will end up with fragmented solutions. On the other hand, I am really encouraged that this is really been taken seriously. And I have been very impressed with the sense and commitment shown by some of those leading the process. We do know that the Department of Health and Social Care is lobbying other key departments – for example, Home Office to get an immigration policy that will support rather than hinder the NHS, and Treasury to think about flexible pension solutions to the timebomb of senior retirements. However, I’m not sure that other departments are quite so keen as we might hope.

Within the College, you won’t be surprised that we had already prioritised workforce as our one of our key foci for the next couple of years. We already have an excellent workforce team within RCPCH and we will be strengthening this over the coming months. I am also fortunate to have Simon Clark coming in as our new Vice President for Policy who, having been College Officer for Workforce, can take this over seamlessly from his wonderful predecessor, Carol Ewing. We will be focusing on increasing flow into the paediatric ‘pipeline’ – from increasing the numbers of medical students, to attracting more medical students and Foundation Doctors to enter paediatrics, to increasing training numbers for paediatrics in each country and reducing attrition during training.

Supporting consultants across their working lives and keeping our older consultants engaged during retirement will also be key. It is a balance in many ways of actions that will benefit the whole profession – such as making systems safer and supporting NHS staff better – and those that are more focused on our own profession.

Our other new Vice President, Nick Bishop, will also be able to hit the ground running in the key area of ensuring we improve the numbers of paediatricians engaged in science and research, continuing the great work done by his predecessor Anne Greenough in this area.

Trips across the waves

A highlight this month was a trip to Belfast, meeting with paediatricians in both a district hospital and the Belfast Children’s, followed by meetings with the Chief Medical Officer and Children’s Commissioner for Northern Ireland. The central focus for all meetings was thinking about how we preserve children and young people’s health through Brexit as well as longer term. I was very reassured by the CMO’s assurance that the all-Ireland systems that currently exist for some highly specialist work would be maintained at all costs. I did visit the Republic straight afterwards for a great meeting about adolescent health in Dublin. I found myself in the middle of a crisis about the costs of the new Dublin children’s hospital. Never a dull moment!

I was blown away by the warmth and collegiality of our members from across the MENA region

I wanted to quickly mention our highly successful first international conference, where we supported our Egyptian Members Association (College Members and Fellows in Egypt) to welcome over 800 delegates to the RCPCH MENA Conference in Cairo in late January. I was blown away by the warmth and collegiality of our members from across the MENA region and it was very gratifying to see how they held our College in such high regard. Egyptian members emphasised to us how useful the scientific content of the meeting was for them and for broader paediatric practice in the region. It was also great fun – as these things should be - aside from the bad case of ‘smiler’s jaw’ I developed on the first day after two welcome ceremonies, a minister of health, large numbers of ‘meet and greet’ and giving a lecture and a workshop.

I will leave it there, as the sun is out – on an unseasonably warm day in February half-term – and the family are waiting.