Managing staff wellbeing and paediatric training this winter

With increasing pressure on child health services, even before the usual busy winter period, we must work together to maintain patient safety, look after our colleagues and continue to get the most out of our training, writes our Vice President for Training and Assessment, Cathryn Chadwick.

I am acutely aware of the pressures impacting on paediatric services across the four UK nations. What is usually a chaotic and exhausting few weeks in the height of the winter season has expanded and is threatening to overwhelm us.

There are no easy answers for the coming weeks; working together to maintain patient safety and looking after the wellbeing of our colleagues and ourselves must be the priorities. That seems easy to write, but I do not underestimate how difficult it is to achieve.

The guidance we issued at the start of the COVID-19 pandemic and reviewed earlier this year is still relevant and contains good suggestions for emergency rota planning and wellbeing

While it may be too late for the current pressures, it is timely that consideration of future workforce is a key priority for the College. In these busy times, surveys may be the last of your priorities, but I would urge you to complete the workforce census when it is circulated in November, as it will provide us with much needed data to inform our workforce discussions going forward.


I make no apology for addressing training thirdly after patient safety and staff wellbeing. However, it is not an afterthought and it can be incorporated at the core of our activity. I am certain that there is no shortage of training opportunity in acute and emergency care, and how appropriate that this month’s ‘Principle of the Month’ is Every patient encounter is a learning opportunity. There are some great ideas about how to get the most out of training as we manage our day to day workload.

Nevertheless, I am very aware that there will be lost training opportunities over the next weeks and months. Clinic attendance is likely to be impacted, and formal teaching and time for audit, quality improvement and other management activities will be curtailed.

These parts of training are essential and not just ‘add-ons’. Trainees should use exception reporting to register when they are not able to access these vital opportunities or are doing them in their own time. Exception reporting is not ‘moaning’; it is useful to your local units as it highlights when their service is under so much pressure that managing a rounded training experience suffers. Schools and training units should be looking to mitigate any lost training once service pressures ease.

ARCP derogations

I can reassure all trainees, that Health Education England (HEE) have confirmed that COVID-19 derogations and ‘no-fault’ outcome 10.1 and 10.2 will continue for Annual Reviews of Competence Progression (ARCPs) in 2022 so if vital training opportunities are lost and not made up, this can be reflected with these outcomes. The modified assessment table is largely unchanged, with a reduced requirement for SLEs.


Thanks to a lot of hard work from the Examinats team, all UK candidates who are at career critical points have been able to access the written and clinical exams in a timely fashion. Therefore we have moved the requirement to get the full MRCPCH back to the end of ST4. This means that all trainees will need to have the theory parts of the exam by the end of ST3 and the Clinical by the end of ST4. This brings us into line with the future expectations of Progress+ and with other colleges who have allowed a year;s leeway under their COVID-19 derogations.

Trainees who are experiencing more difficulty with exam progression should expect local support and the possibility of additional training time as per the Gold Guide and normal practice.