An important week for patient safety - President’s blog

Camilla updates on the latest in the world of patient safety with the launch of the national Paediatric Early Warning System (PEWS) and recommendations on Martha’s Rule. There are also opportunities to get involved in service recovery and a reminder to eligible members to vote in our President election.
Dr Camilla Kingdon, RCPCH President

There are times when there is so much bad stuff happening in the world and one has a sense of absolute powerlessness in the face of so many problems. Our recently published report, Preserving the world for future generations, from our RCPCH &Us Climate Changers group of 12 young people articulates the very real sense of anxiety that children and young people feel about the future of our planet. Reading their report, their key messages really struck a chord with me. They have described the problems clearly but what really thrills me is that they focus on solutions too. Our problems can feel insurmountable, but our children and young people often have the solutions – if we can only give them an opportunity to be heard.

New Officer for Climate Change

Our Climate Change work is going from strength to strength. To support this, we have created a new Officer for Climate Change and I am thrilled to announce that our first holder of this position is Dr Helena Clements. Helena is a real inspiration who has a long and proven track record of commitment to sustainability and championing net zero in both her professional and personal life. This is a very exciting appointment and you will hear much more about our College work in the months to come.

We are now regularly asked to speak about these matters and I had my debut appearance on Woman’s Hour this week which was a good opportunity to highlight our #ShiftTheDial work on climate change and health inequalities. 

Supporting families to raise concerns

This is an important week for patient safety, especially for children. NHS England is rolling out a standardised approach for tracking the deterioration of children and young people in all hospitals across England.

The national Paediatric Early Warning System or PEWS will allow clinicians to manage and track deterioration using a standardised chart. ​The ambition is to establish a consistent approach and common language to recognise and respond to acutely ill or deteriorating children or young people and to ensure escalation of care takes place in response to both medical observations, and concerns expressed by a parent or carer.​ This will allow the NHS to operate as a national system in England and help staff working across different hospital sites. ​We’ll continue to signpost you to PEWS information as it becomes available.  

A second key moment in the world of patient safety has been the submission of the Patient Safety Commissioner, Dr Henrietta Hughes, to the Secretary of State of her recommendations for the implementation of Martha’s Rule across all inpatient services in England. Her key recommendation is that all staff should be able to access a rapid review of a patient by a critical care outreach team 24/7, and that patients, their families, and carers should also have access to the same 24/7 rapid review from a critical care outreach team which they can contact via mechanisms advertised around the hospital if they are worried about the patient’s condition. The Commissioner makes a particular point of the need for special consideration to be given to how Martha’s Rule will be implemented in paediatric services, given the lack of access to on site children’s critical care services for most.

We await the response from the Health Secretary and are committed to working with NHS England to ensuring this is implemented in a way that is true to the spirit of Martha’s Rule but is feasible and practical in already over stretched children’s in-patient services.    

Reminder on measles

It's beginning to feel like winter is around the corner as bronchiolitis is starting to rear its ugly head. As we think about the various viruses that circulate during winter, please be reminded that there continues to be real concern about measles. This is particularly the case in London where MMR uptake is low – but we are also seeing outbreaks in Wales, and evidence outside of London shows a high risk of cases linked to overseas travel. There has been a steady rise in the number of cases of measles in the last few months so please use every opportunity to review MMR immunisation status and take the opportunity to encourage families where there are children with missed doses. It is never too late to complete the two-dose programme.   

An opportunity to get involved in service recovery

For many months, the College has been highlighting the increasing number of children waiting for unacceptably long times for elective care (surgery and outpatient clinic visits) across England. I am really pleased that an excellent opportunity has arisen for a general paediatrician to input into the ‘Further Faster’ programme of work which is aiming to improve clinical outcomes and reduce variation between trusts as part of the Getting it Right First Time (GIRFT) programme to address elective recovery, especially focussing on reducing long waits for children. I strongly encourage you to consider this role. We must redouble our efforts to reduce waiting times for elective work. [The application deadline is now past.]

Continuing our advocacy for children seeking refuge and asylum  

I know that many of you are passionate about supporting children seeking refuge and asylum. The College continues to seek every opportunity to advocate for these children and we are doing this in a systematic and methodical way. In October, we provided evidence to the Secondary Legislation Scrutiny Committee in relation to new regulations which would allow the biological age assessment of children seeking asylum and refuge in England.

We have regularly spoken out against this policy, due to the lack of specificity in the outcomes data and the potential harms children may incur as a result of this testing. We were pleased to see our evidence cited in the committee’s response, which rightly highlighted significant gaps in the proposed policy. The committee recommended a number of questions are raised in Parliament in relation to the evidence basis for age assessments, the principles of consent and the risks of subjecting children to unnecessary medical procedures as a part of immigration processing.

We will now focus our efforts on continuing to brief MPs so that they are fully informed and able to raise these questions as the legislation moves through Parliament. If you would like to be involved further in this work, please contact health.policy@rcpch.ac.uk so that we can add you to the communications for our working group.

RCPCH President Election 2023

Our President election is now live! I encourage all eligible members to participate in our election process by casting their vote for one of the five candidates standing for College President. I am also thrilled that our international members are now eligible to vote. Visit our website to learn more about each candidate, the election process and how you can #RCPCHVote online before midday on 11 December. [The election is now past.]


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