Community child health - sub-specialty

Doctors specialising in community child health (CCH) work with vulnerable groups of children, including those with developmental disorders and disabilities, complex behavioural presentations, and at risk of abuse or are being abused. Access the current syllabus for training in this clinical area, including advice from the CCH College Specialty Advisory Committee. You can also now see the revised syllabus coming in August/September 2021.

What makes a community child health paediatrician?

A community child health paediatrician is a doctor who has expertise in working with vulnerable groups of children and their carers. They also have a particular role with children who are 'looked after or are in the process of being adopted.

They hold clinics in a variety of settings, including schools, with an emphasis on continuity of care, and have strong skills working with multiple agencies, particularly with education and social care.

Community paediatricians have a vital role in planning and implementing local strategies to improve the health of all children in their area, including safeguarding policies and overseeing universal and targeted lifestyle programmes.

RCPCH Progress curriculum and syllabi for level 3 training

Since August 2018, trainees in this sub-specialty use the RCPCH Progress level 3 generic syllabus alongside the RCPCH Progress community child health sub-specialty syllabus. Download both documents below

In addition to the generic learning outcomes for level 3, CCH trainees must fulfil the following sub-specialty learning outcomes:

  • Demonstrates proficiency in the paediatric assessment and management of vulnerable children, including those with developmental disorders and disabilities.
  • Adopts a leading role with children who are at risk of abuse or are being abused and for those who are 'looked after', and can contribute to the process of adoption.
  • Demonstrates strong skills in working with multiple agencies, particularly with education and social care.
  • Actively participates in planning and implementing local strategies to improve the health of all children in their area, including safeguarding policy and overseeing universal and targeted lifestyle programmes.
  • Contributes with other professionals to the management of children with life-limiting complex disability.

Revised syllabus coming in August/September 2021

We spoke with clinicians working in CCH, and agreed some minor enhancements to the sub-specialty syllabus. The revised version is approved by the General Medical Council (GMC) for use as of August/September 2021. Download the revised syllabus below

A summary of the changes:

  • The introductory statement has been amended; the word ‘lifestyle’ has been removed and replaced with ‘health promotion and protection’. 
  • Learning Outcome (LO) 1 has been amended with the following statements ‘physical and psychological’; ‘as well as counsellors, families and carers’ added. Key Capability (KC) has been amended: ‘and psychological’ added. 
  • LO2 has also been amended: ‘and neglect’ added. KC2 has now been amended where the term ‘physical and psychological’ have been added. 
  • KC3 the statement ‘both physical and psychological development’ has been added.
  • LO3 and KC1 have been amended by adding the term ‘primary care’. 
  • KC2 has been amended by adding ‘and psychological’. 
  • LO4 has been amended using the term ‘physical and mental health’ and replacing the word ‘lifestyle’ with ‘health promotion and protection' .
  • LO5 has been amended with the term ‘physical and mental health of’ now added. 
  • The Assessment Grid has been updated to reflect the changes to the KCs.

You can find out more about the updates to this and other sub-specialty syllabi. If you have any questions contact us on qualityandstandards@rcpch.ac.uk.

CCH CSAC advice

The CCH sub-specialty training programme is part of the RCPCH National Grid, or NTN Grid, as of September 2015.

Application process

  • NTN Grid recruitment for CCH follows the same timescale and process as all other RCPCH sub-specialties. 
  • Our sub-specialty training application guidance page provides the person specification, which has detailed information on the attributes and experience required for appointment, and the applicant guide, which describes the process of selection and appointment.
  • For grid appointments all Level 2 training requirements should be completed prior to Specialty Training 6 (ST6).
  • Trainees will usually apply for CCH Level 3 training while in ST5, to enter sub-specialty training in ST6. Those whose entry date is not September - for example, March starters - may be eligible for an extension of their CCT date by six months to accommodate sub-specialty training. 
  • Applications will be accepted to enter sub-specialty training in ST7 and ST8. However, to fulfil training requirements such applicants will have to show that their training in ST6 / 7 have been in level 3 CCH posts or in posts approved for Level 3 CCH training (see below).
  • Trainees can apply for grid training in up to three years. If unsuccessful after two attempts then they will need to have been deemed appointable at their second interview to be eligible to apply a third time.

Length of programme

  • The CCH training programme is designed as a three-year training programme.
  • Training is generally 36 months for specialty trainees, with a minimum requirement of 24 months CCH clinical training.
  • The remaining 12 months may be in a specialty relevant to CCH, a specific area of CCH (to develop a special interest) or approved research. The CSAC will be flexible about the nature of the ‘relevant specialty’ or research but it must help the trainee to enhance their competences in CCH (see ‘Relevant specialties’ section below).
  • With competency-based assessment, it is possible to complete training in less than 36 months but trainees will have to demonstrate that they meet the competencies of the curriculum to the depth and breadth required to practice independently as a community paediatric consultant in the UK. A minimum of 24 months spent in CCH is essential and non negotiable.
  • Level 2 training does not count towards Level 3 training. Therefore you cannot count your Level 2 (‘core’) CCH training towards Level 3

Relevant specialities

  • The CSAC is flexible about posts in other specialties which can be counted towards higher specialist training. RCPCH sub-specialty training posts that have been approved by the relevant RCPCH CSAC as below will automatically count for specialty training:
    • paediatric neurodisability
    • paediatric neurology
    • child mental health
    • paediatric palliative medicine
    • audiovestibular medicine
  • SPINs are available in all of the above areas.
  • These will automatically be approved for higher specialist training in CCH and will not require specific approval from the CSAC.
  • Posts outside this list of named RCPCH sub-specialties may still be approved but must be approved by the CSAC before a trainee takes up the post.  Retrospective recognition will not be given.
  • Other appropriate training could include general paediatrics, public health, audiovestibular medicine, CAMHS, clinical genetics, inherited metabolic disease, research and medical education. This list is not exhaustive. Posts in such specialties may not be approved if it is felt that the experience is more general and not particularly CCH orientated.
  • Please note that placements in specialties outside paediatrics, for example a full time placement in CAMHS cannot be recognised for training in paediatrics without prior approval and may need to be recognised as OOPT/E.

Research posts

  • Trainees counting one year of research towards Level 3 must do the other 24 months in CCH to complete training. Trainees must ensure competencies are kept up to date during research time. Research posts must be Deanery and GMC (General Medical Council) prospectively approved as OOPR (out of programme research). If wishing to count towards training, posts must approved by CSAC before starting to ensure they are relevant to CCH competencies.

Overseas posts

  • Approval must be sought prospectively for trainees wishing to count an overseas post towards training.