Planning for the future: Brexit, the NHS and the paediatric workforce

In his November blog, Russell reflects on a tumultuous month in politics and looks to the future for the NHS and paediatrics.

As the nights draw in there seems to be only two things in the news. The first one is of course Brexit. Rest assured we are monitoring the situation closely to assess possible impacts on your work, children and young people’s health, our workforce and wider impacts for the College. Most of what we know currently is that we can be certain of little. Once it is clearer what the situation will be after March 2019 we will rapidly share our assessments of the likely impacts on all of our futures. 

The RCPCH, via the Academy of Medical Royal Colleges, is a member of two main coalitions working on Brexit issues – the Brexit Health Alliance and also the Cavendish Coalition, the latter which focuses on workforce. Both coalitions have cautiously welcomed news of an agreement between the UK and European Union. However, there is much work to be done to get this deal through Parliament and finalised. In the meantime, the health sector as a whole continues to express our concerns around the impact of Brexit on workforce, public health, research and cross-border health services between Northern Ireland and the Republic of Ireland. 

Long Term Plan – watch this space! 

...we are doing what we can to keep a strong focus on children

The second item dominating the news, at least in England, is the NHS Long Term Plan, the release of which is imminent.

The promising news is that we are hearing on the grapevines (there are multiple) that the Plan will have a focus on children and young people. We hope that this is indeed the case, as paediatrics has not been a priority in the NHS in England for many years. Unlike in Scotland in particular, where children are a clear priority. This has the potential to be a game changer for many of our services in England, and our ability to maintain and improve the health of our children and young people.

We continue to await the Plan, but in the meantime I can reassure you that we are doing what we can to keep a strong focus on children for the next 10 years – in each of the four nations. 

Getting to grips with workforce pressures

As you read this, winter pressures will be starting to bite for many of you - although I know that in most services it is pressure all year round. The GMC (General Medical Council) trainee survey, just out, makes for somewhat depressing reading in terms of rota gaps and trainee burnout.

Reducing the pressure is unfortunately outside our powers, but I see workforce problems and capacity issues at the heart of pressures over winter. News that the government may be about to expand MTI (Medical Training Initiative) scheme is promising. If expanded, this would enable hospitals to bring more graduates in from overseas for training together with the RCPCH, but by their presence they will also support our services. This news remains uncertain, but if true would be hugely welcome. 

We are working with the Academy of Medical Royal Colleges and all other Colleges on responses to winter pressures. In England, we are part of a Paediatric Intensive Care Review, which may help reduce pressures on PICUs – although we are pushing for more progress on this. But the bottom line is that we need more workforce, more money and more capacity in the system for child health. Which takes us back to the political advocacy and the need to get planning right from the start.


One theme... was how rewarding it is to work with children and young people

Elsewhere this month, if you are a follower of the @RCPCHTweets Twitter account you’re unlikely to have missed the College’s recruitment campaign. Applications for ST1 and ST2 paediatric speciality training were open until 29 November, and to promote this the College has been sharing blogs and social media posts from members highlighting why “paeds rocks”! Our members have shared their reflections this month on everything from balancing family life with training, to being the “last true generalists”, to embracing the opportunities that less than full time working can bring, and even juggling a dual career in paediatrics and playwriting – though the latter may be a slightly less universal experience among paediatricians! 

One theme that ran throughout these blogs, however – and was evident on social media – was how rewarding it is to work with children and young people. From playing with young children who don’t even know they are sick, to helping rebuild paediatric emergency care structures in Sierra Leone, it is clear from our members’ varied experiences that children truly are at the heart of everything we do.