Scoring change in 2019

Its only 25 days into the New Year (happy new year by the way) and it feels like 25 months have passed. We’ve seen the launch of the NHS Long Term Plan (England), launched our own screen time guidance and hosted a roundtable with three CMOs on social media use, launched our State of Child Health 2019 scorecards in all four UK parliaments/assemblies and participated in a Parliamentary inquiry.

Plus there’s been the usual College and clinical day to day work. So apologies for a long blog this month!

And before you ask, I discussed dry January with an eminent paediatric hepatologist over a glass of wine at the British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) dinner in Oxford last night. We concluded it was our parliamentarians who need drying out! Thanks to BSPGHAN for a lovely night. 

Long Term Plan

I enjoyed seeing the NHS in England and the Prime Minister launch the long-awaited Long Term Plan at Alder Hey Children’s Hospital in Liverpool (thank you Alder Hey for your great hospitality). As you know, I have been working closely with NHS England and other sector stakeholders since last summer to ensure that children and young people were at the heart of the Long Term Plan – and we are hugely delighted at the outcome.

There’s a lot in the Plan – from improved neonatal care, targeted weight management support for children struggling with obesity, support for young people with long term conditions, to support for moving towards a 0-25 service to improve children and young people’s experience of care. We have summarised the Plan’s child health proposals so you can read them all in one place. 

The Plan makes children and young people a priority in the NHS in England for the first time in over a decade – and this priority will come with a central strategy board (Children’s Transformation Board) which will be the key vehicle to drive change nationally linked with local system change. Of course the proof of the pudding will be in the eating, and there is a lot to be done to ensure that the Plan’s proposals are fully implemented.

...the best way to improve the working lives of paediatricians is to get more money into and focus on child health services

Welcome as all these developments are, I have raised concerns about the difficulty of achieving these ambitious commitments without adequate investment in the child health workforce and in public health services. NHS England has acknowledged the workforce issues affecting us all, and have pledged to establish a National Workforce Group tasked with developing a Workforce Implementation Plan. Children’s workforce representation on this group is essential to ensure that we are a key part of this plan, which must be produced without delay to keep up the fantastic momentum we have seen for child health in recent months. As I’ve said before, I believe that the best way to improve the working lives of paediatricians is to get more money into and focus on child health services – and the Long Term Plan should bring real benefits for members in England as well as for our children and young people.

Progress and threats to progress

There may be great momentum in some countries, but threats on the horizon pose significant risks to progress made. Our State of Child Health: Two Years On scorecards – which assess progress made against the policy recommendations in our landmark State of Child Health 2017 report – reveal a varied picture for child health across the UK. In England, lack of action on child poverty, cuts to vital public health services and persistent inequalities make the delivery of a truly preventive health service hugely difficult. 

In Wales and Scotland, many policies that will make a meaningful difference to child health have not yet been fully implemented or enforced. And in Northern Ireland, the ongoing political deadlock means, sadly, very little has been achieved for child health in the past two years. And it goes without saying that the ongoing uncertainty caused by the ‘B-word’ – Brexit – continues to loom large, raising concerns about recruiting enough children’s doctors and nurses, and access to medicines, cross-border services between Northern Ireland and Ireland and European Union funding for vital child health research.

But threats aside, there is much to celebrate for child health across the four nations of the UK, and we marked this progress in events at the four parliaments/assemblies this week. You can see more on Twitter #ChildHealthMatters. And, children and young people from England, Scotland, Wales and Northern Ireland joined us to develop creative and inspiring art projects highlighting their priorities for child health, such as the below.

Elections and diversity

The deadline for voting in the elections for our new Vice Presidents for Research and Policy was 12 noon today (25 January). I hope you have made your voice heard at the ballot box! 

Some of you have expressed concern to me about the lack of diversity on the candidate lists – a concern I share. This is not to take away from some really good people on those panels, who if elected will make great VPs.

I firmly believe that those who lead the College must reflect the diversity of our membership

If we look back, I think we’ve generally done well in the College to get a gender balance in our senior officer positions – three of the last five  presidents have been women, women are currently four of six senior officers at VP level and our last three senior appointments/elections have brought us superb female colleagues: Camilla Kingdon as VP Education, Liz Marder as Treasurer, and our incoming Chair of Trainees Committee, Hannah Jacob. Yet many of us were surprised to see all-male candidate panels (manels, I’m told they’re called) for the two current elections. This may have been a random event, given our recent history. But we need to ensure that members from all backgrounds feel they have an opportunity to contribute to the College, and that they can nominate for and win a College election. I firmly believe that those who lead the College must reflect the diversity of our membership and am therefore keen to examine what more we can do to encourage more women and members from BAME backgrounds to apply for positions on Council and Committees.

I will be establishing a panel to look into this issue and equality and diversity more broadly across the College. Please watch this space for more info. 

Screen time

If you’re reading this on a screen, relax! We recently launched our screen time guidance, which produced a very high level of interest not just nationally but also internationally. We hope they will be helpful to you and your patients to deal with this great modern dilemma for parents and health professionals.

We followed this up by hosting a roundtable on screens and social media with the ‘three CMOs’ – Chief Medical Officers from Scotland, England and Northern Ireland. 

Outside London

Lastly, I wanted to let you know that for 2019, one third of our educational offerings (meetings, seminars, etc.) will be outside London. We are working on building this up to over 50% to make sure members across all countries can access face to face events more locally – as well as building up our electronic offer. 

I will leave you this month with another photo of children and young people's contributions at our State of Child Health: Two Years On events across the nations. As ever, if you have any issue you’d like to raise with me, don’t hesitate to get in touch by email on president@rcpch.ac.uk or on Twitter @RCPCHPresident

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