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.

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

Trainees in this sub-specialty use the level 3 generic syllabus and the child mental health sub-specialty syllabus (version 2, updated as of August 2021). You can download both documents below.

Training in this sub-specialty

Paediatricians in the UK start their training in general paediatrics. Some then choose to train in a paediatric sub-specialty, such as community child health.

The RCPCH Progress curriculum provides a framework for paediatric training, and outlines the Learning Outcomes and Key Capabilities required at each stage before attaining the Certificate of Completion of Training (CCT).

The syllabi support the curriculum with further guidance on how the Learning Outcomes can be achieved and demonstrated. Those in sub-specialty training use two syllabi, which are part of the RCPCH Progress curriculum, and you can download both below.

Level 3 generic syllabus (for all level 3 trainees)
Sub-specialty syllabus.

About updates to the paediatric nephrology syllabus in 2021

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

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.

Advice from the Community Child Health CSAC

The CSAC is the College Specialty Advisory Committee, and superpervises the development and delivery of sub-specialty training.

Application process

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 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 sub-specialty 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.