How do we respond to workforce challenges? - President's blog

In this edition Camilla explores workforce challenges and the recent reports and surveys on this issue. She also congratulates our new Chair of the Trainee Oversight Committee and settles down to listen to our new podcast on advocating for child health.
Dr Camilla Kingdon

There doesn’t seem to be any sign of a gentle wind down to summer holidays just yet! How many of you remember the days when paediatricians used the summer to catch up on all their unfinished quality improvement projects and undertook some useful CPD, knowing full well that it would be far too busy to do any of it from September onwards? Those days seem a distant memory and whether you are catching up on lengthy waiting lists or crisis managing your overflowing A&E department and acute wards, I know that summer currently feels as overwhelming as a cold November day. The enormity of the workload and the pressure on our workforce seems enormous.


I know that none of the headlines in the GMC National Training Survey and the Westminster Health and Social Care Committee Workforce report will have surprised any of you. Both describe the same depressing themes – increasing workload, more staff reporting burnout, more days lost due to staff ill-health, barriers to recruiting and supporting international medical graduates, eye-watering locum and agency spend and a recurring theme of poor facilities for staff across the whole NHS. We have heard all of this described in many previous reports – nothing is new, it simply is getting worse. There is no single or easy solution. There are some obvious quick wins – the most obvious being to swiftly overhaul the NHS Pension Scheme to remove the financial penalties incurred by senior doctors, many of whom wish to continue to work but are forced into early retirement due to punitive pension rules.

The other decision that should be made quickly is to mandate that trusts need to adopt an explicitly more flexible approach to senior clinicians who wish to continue working but want to reduce their out of hours commitments. It is unacceptable that we are losing experienced senior paediatricians to early retirement simply because they are unable to step off the on call rota. Fundamentally though, we need a coherent Workforce Plan that describes the vision for the future, has a grip on the numbers of health and social care staff needed to deliver a safe clinical service and is then funded to deliver that plan. This plan must take into account the need for flexibility and specifically factor in the increasing demand for less than fulltime working. As paediatricians we have discovered to our cost that the failure to account for part-time working in our workforce numbers is something that has been very challenging to manage and so must be acknowledged.

I refuse to feel defeated or cynical about the dire conclusions from both these reports. As a College we are focused on all these issues and have a number of initiatives to address many of the most concerning ones. We cannot solve all the problems of the paediatric workforce – arguably our contribution is only a small part of a much wider piece of work. However, we are absolutely resolved to embed career and training flexibility in our Progress+ curriculum and training pathway. Through our Lifelong Careers work we have some exciting and innovative plans to develop sustainable working practices and also to network paediatricians regionally to allow for greater local networking and sharing of good working practices as the Integrated Care Systems (ICSs) develop in England for example. Also, our Workforce Team is working away looking at modelling and numbers and giving us important trends and data to help us advocate more effectively for paediatricians and the wider child health workforce. So please rest assured that we are determined to play our part in speaking up on your behalf. There is no single or quick fix and for many of us change won’t happen meaningfully during our working lives, but change has to happen and we are committed to being part of it.

Latest from the Cass Review

Yesterday, Dr Hilary Cass wrote to NHS England with further advice from her independent review of gender identity services for children and young people. Her letter set out the key components of the new regional service model, as described in the Review’s interim report – you can read both the letter and the interim report on the Cass Review website. The College published a statement in response to the latest recommendations from the Cass Review.

The votes are in

Our trainee workforce are an enormously important part of our membership and I personally value the insights and ideas that trainees bring to our various committees and our work. The Chair of the Trainee Oversight Committee is therefore a very important person in my working life and so I am truly delighted to welcome and congratulate Emma Dyer who has just been elected as Laura Kelly’s successor in this role. Emma will take over in September and I am thrilled at the idea of what we are going to achieve together. I have loved working with Laura and I want to record my thanks and very best wishes to her. She’s done an outstanding job over the last three years which are arguably the most challenging we’ve ever faced in terms of engaging with our colleagues and supporting them.

New RCPCH podcast series

I love podcasts and holidays are the perfect time to listen to them! We have a new series of podcasts being launched discussing the progress we are making with our RCPCH Strategy. Our first in the series is now available to listen to. You can hear Mike McKean, our Vice President for Health Policy, chatting to Rob Okunnu, our Director for Membership, Policy and External Affairs, about advocating for child health. I can really recommend this as a perfect companion for a walk in the countryside or time on the sun lounger!

Extreme heat

The extreme heat we experienced last week is a sobering reminder that climate change is not an issue impacting our futures but very much an issue for now. We won’t know how many excess deaths occurred as a result of the high temperatures, but the fact that 1,600 excess deaths occurred in the heat last year spells out to me what a real and present danger this is – and almost invariably impacting the more vulnerable members of society. To declare our heightened concern and the threat to human health, we produced a statement in conjunction with the UK Health Alliance on Climate Change and the Lancet Countdown. It remains my firm belief that paediatricians must amplify the messages about climate change and so I hope you will read our statement.

I don’t think I can sign off my message this week on such a gloomy note... and so I hope that you are all basking in the reflected glory of England’s women’s football team. What a stunning and truly inspiring performance they gave in the Women’s Euros semi-finals! We’ll all be cheering for them in the final on Sunday!

With my very best wishes – and take care,


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