They say that a change is as good as a holiday, and I completely agree! I’ve just returned from a week away with the RCPCH Global Team in Rwanda and I’ve got a real spring in my step. We spent the week visiting a number of hospitals and health facilities in and around Kigali that are participating in the Perinatal Improvement Programme being run there, led by RCPCH Global and the Rwandan Paediatric Association. This is an improvement project underpinned by the concept of improvement via mentorship. Standing in a neonatal unit and hearing about the defined steps that both neonatal and obstetric/midwifery teams are taking to reduce infection in mother and baby, limit the risk of perinatal asphyxia, address the issues of neonatal hypothermia and many other indicators was truly inspiring. Through multiple small improvement steps, the clinical teams, supported by local trained mentors, are making genuine changes to both maternal and neonatal outcomes. We all know how challenging it is to improve care and then sustain that improvement ….. well, in Rwanda, I saw this in multiple settings and am truly inspired.
I have come back from Rwanda with two overriding thoughts. Firstly, genuine improvement can only happen with genuine partnership working. Our partnership with the Rwandan Paediatric Association, led by the indomitable Professor Lisine Tuyisenge, underpins the success of this programme. Working collaboratively has led to insights and learning that mean improvement can happen on the ground. I visited a primary health centre which is the setting where most deliveries take place. The single midwife on duty showed us around. The delivery room was immaculate. The resuscitaire was clean and kitted out, ready for the next baby who may need help. The pack for potential post part haemorrhage was close to hand and the contents had been checked. The midwife had thought about all the problems that might occur and she was as ready as she could be. Improvement in care can only happen when we partner with colleagues who are at the clinical coalface and who understand what needs to happen. I saw that repeatedly in Rwanda and that insight sticks with me.
The other lesson I learnt this week was how invaluable the contributions are of doctors and nurses who volunteer in the programme, particularly after retirement. There is a band of retired paediatricians, nurses, midwives and obstetricians who support the RCPCH Global Team. I was privileged to spend the week with Dr Tom Lissauer who has collaborated with Rwandan paediatricians for over 15 years. As a retired neonatologist from Imperial many of us know Tom from London – but his impact in Rwanda was not just evident but really inspiring! Wherever we went, Tom was greeted as a cherished colleague. He is known for his teaching and his support of a whole range of QI work. It was such a strong reminder to me of how clinicians can continue to contribute meaningfully long past their retirement from the NHS.
Improvement in care can only happen when we partner with colleagues who are at the clinical coalface and who understand what needs to happen
The College’s new Interim Chief Executive Officer
Continuing with the theme of working in partnerships, I am delighted that Rob Okunnu has been appointed to the Interim RCPCH Chief Executive Officer (CEO) role, starting on Monday 17 October. Rob takes over from Jo Revill who leaves the College after four successful years as CEO. I can personally testify to the huge strengths that Rob brings to this position and I am really looking forward to working with him over the next months. The partnership between the College staff and the paediatricians who contribute to RCPCH work is vital and increasingly I believe is how we continue to undertake high quality work and remain relevant and proactive in our advocacy for both the paediatric workforce and children and young people.
Latest GMC report
On 18 October the GMC published its annual report on the state of medical education and practice. The 2022 report focuses on workforce trends and makes for interesting reading. The substantial rise in the number of SAS and Locally Employed (LE) doctors is an important figure to pause and consider, as is the sharp rise in the number of international medical graduates (IMGs) practising in the UK. Most notably, UK graduates joining the workforce rose by just two per cent since 2017, while IMGs rose by 121 per cent. These trends are crucial to consider carefully. We need to be far more thoughtful about induction for doctors coming from abroad. We also need to think much more proactively about how we support the educational needs and career progression for those in SAS and LE posts. There is much to think about in this report which I commend to you.
Kirkup Review of East Kent Hospitals
On 19 October, Dr Bill Kirkup OBE published the findings of the Independent Investigation into East Kent Maternity Services The independent investigation was launched by then Minister for Patient Safety, Nadine Dorries MP, following concerns about the death of a number of babies in recent years. The report outlines a series of terrible consequences, with babies dying in situations that no family should ever have to face. As a Royal College we stand ready to work with others to discuss how we can help ensure teamworking in maternity and neonatal care can be improved across the system, and as the report states “with particular reference to establishing common purpose, objectives and training from the outset”. You can find our response here.
Genomics is an area that many of us are grappling with in our clinical practice. This is going to make more of an impact on all of us as time goes by. To this end we are establishing a Genomics Working Group to be chaired by our Officer for Genomics, Dr Ngozi Edi-Osagie. We are very keen for paediatricians to volunteer to join this group. You do not need extensive genomic knowledge but rather a wider perspective about how innovation can be embedded in clinical practice, perspectives on the ethical and workforce implications, experience of other screening programmes – and so on. Please take a look at the call for applications – closing date is 10:30am, 31 October.
Independent inquiry into child sexual abuse
The much-awaited report from the independent inquiry into child sexual abuse was published on Thursday. We must now consider what this means as a College, for children and for the workforce and we will bring this to our Child Protection Standing Committee in due course. You can read the full report here.
Introducing our new Officer for Workforce
Finally, I am delighted to welcome our new RCPCH Officer for Workforce, Dr Kay Tyerman, to the role. Kay will be known to many of you as she has been working with the College to improve recruitment to our subspecialty Grid programmes. Kay brings a wealth of insight and experience to the role and the Workforce Team. Workforce is one of our key areas of work and so you can expect to see and hear lots from Kay. I’m really looking forward to working with her.
With my best wishes – and take care
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