These last three years have been “interesting times”. COVID-19 has shaped much of what has been done during this period, but both despite and because of the pandemic, I’ve learnt a lot and been privileged to see and be part of what the College has done for children and their families, as well as for paediatricians.
Until I started in the role, I have to confess that I was largely ignorant of the scope of what the College undertakes in the research and quality improvement area - guideline production and endorsement, nationally-funded audits and QI, the QI Central microsite, the British Paediatric Surveillance Unit (BPSU), systematic reviews, support for the Trainee-led networks and partnership support of the Academic Toolkit. All this continued through the pandemic.
In addition, there are committees such as the Research Consultation Committee that brings together the specialty and special interest groups; the Academic Training Committee that scrutinises academic job descriptions and whose members can help support or signpost to regional mentorship for trainees developing their research and teaching interests; and the UK Child Health Research Collaboration that engages stakeholders such as Newlife, who with the College co-funded a research Fellowship. That all this not only continued but flourished is a reflection of what everyone contributed , both members and College staff. We now have four Officers in the Division – Jan Dudley, Raj Krishnan, May Ng and Will Carroll - who have put in many hours of hard work.
As I “pass on the baton”, I wanted to let you know about the activity that has occupied much of my non-COVID work over these last 18 months, and that forms part of the College’s overall strategy for the next three years.
We are good at doing research in rare diseases, not so good at dealing with the more common health issues that blight children’s lives and persist into adult years... there is no quick fix, but we have made a start...
We lack capability and capacity in child health to undertake research, particularly in “intractable areas”. The total UK research spend in the five years to 2018 was around £10 billion; the amount spent on child health research was around £300 million – just 3%. The NHS spend on children’s health is around 11% of the total, and children make up not just 20% of the population but 100% of the future. We are good at doing research in rare diseases, not so good at dealing with the more common health issues that blight children’s lives and persist into adult years – the intractable areas of learning disability, mental health, obesity and safeguarding. Some of these elements join together and create the paediatric multi-morbidity that we all recognise as extremely challenging.
There is a mismatch both in terms of the scale of the problems and the amount of funding directed to those areas, and in terms of our capacity and capability to undertake such work. There is no quick fix, but we have made a start, and we have a plan.
Encouraged by major research funders, we have drawn together a group that spans the health, education and social care sectors to scope what has been done and could easily be implemented; what is currently being done, where and whether it is reaching across all children; and then what still needs to be done. The ambition is to ensure that in the future there is funding that rebuilds the capability and capacity to undertake research, reaching all children, which has impact for the whole of children’s lives. So, not just health outcomes, but education and social impact, too. We anticipate that we will take our proposals back to funders later this year.
What can you do? Support trainees and colleagues - not just medical colleagues - to engage in research. The NIHR Associate PI scheme is open to all of us. Support the Trainee-led Research Network in your region, and if there isn’t one, try and encourage one to develop. Talk to your Trust about the importance of research and QI in improving standards (it’s scientifically proven!), the need to invest in it – time in job plans – and the positive effect that such involvement has on staff morale and retention. If everyone does a little, together we can do a huge amount, and a research-positive culture across all staff is a key part of all of this.
Finally, my thanks to all of you who have offered help, advice, and cups of coffee. I wish Paul Dimitri every success as he takes the baton for the next stage, and hope that he will enjoy the role as much as I have.
Best wishes,
Nick