Training principle of the month 4: Patients and families are heard

This month, Dr Lia Davies has worked with the College's Children and Young People's Engagement team, or RCPCH &Us, to consider how to effectively listen to patients and their families, and how you can facilitate the right conversations. Dr Kiran Rahim also shares a case study on how we can support breastfeeding.
RCPCH Progress+ Training principle of the month
Last modified
9 February 2022

From children and young people

The following two videos, created by our Children and Young People Carer representatives, offer fantastic advice on how you can ensure that patients and families are heard.

Could you incorporate more of the advice on engagement from children and young people into your practice? 

We want to ensure that our forgotten voices become involved


Several young people, a parent and our Assistant Registrar share why engagement matters. One young person reminds us to be bold, proactive and compassionate, and another details her three-point plan for checking accessibility. Plus specific ideas on checking for safeguarding issues, signposting to resources and looking at different ways to connect to primary care.

The next video gives some tips - from making sure patients have all the information in a format that works for them to working with schools and hospital youth forums.

Breastfeeding support - case study

Training level: All levels

Setting: NICU

What prompted the change? Having a child on NICU can be a stressful and overwhelming experience for most parents. One of the things parents can choose to do to support the health of their baby is breastfeed. Breastfeeding is a personal choice and its important that as healthcare professionals we support parents in their feeding choice.  However, the UK has one of the lowest breastfeeding rates in Europe for many reasons. Parents have identified a lack of support as one of them and financial cuts means a lot of NICU parents have lost access to breastfeeding support services over the years. Many parents on the NICU identified that they needed support with breastfeeding. 

What happened? A trainee designed a quality improvement project to provide evidence based information on breastfeeding and its benefits. All parents were provided with an information sheet on the benefits of breastfeeding and how to seek help. One of the change ideas was to invite the breastfeeding midwife to a parent coffee morning run weekly on the NICU. This allowed parents to learn about breastfeeding, how to breastfeed effectively, troubleshoot any problems and share their experiences with one another.

This led to increased confidence of mothers in relation to breastfeeding meaning they were more likely to persevere.

How did this support training and trainees? Breastfeeding is not part of the trainee curriculum but plays an important role in child development. This project allowed for trainees to learn about breastfeeding and implement a support session that is evidence based and allows for parents to share their concerns.

Listening to problems with breastfeeding on NICU enriched trainee knowledge on common problems with breastfeeding and how to support breastfeeding parents.  

Any practical tips? All child health professionals should be trained to deliver simple breastfeeding advice. The College has a wealth of information on breastfeeding and a position statement, and all doctors should read this article from Paediatric FOAMed.

Understanding how asthma affects a child's life - case study

Training level: All levels

Setting: Outpatients

What prompted the change? On the daily ward round, after seeing a number of children with exacerbation of asthma, trainees felt they wanted to understand more about how asthma impacts a child’s life. 

What happened? Trainees organised time with the children’s asthma nurse. This included a teaching session and attending asthma clinics. During these multidisciplinary clinics, discussions were had focusing on the child’s and the families’ questions, such as answering questions about the condition and discussing the impact it has on their life. 

How did this support training and trainees? These experiences gave trainees the opportunity to see how conditions affect children and their families and what about their conditions concerns them. They were also able to explore how they can help with the burden which certain conditions can put on children. Trainees could think about the questions to ask young people about the effects of a child’s illness and bring them to the centre.

Any practical tips? The College produced an example health diary that can be given to young people before their appointment, prompting them to think about what they want from clinicians.

Asking a child about their preferences when admitted to hospital - case study

Children and young people appreciate it when doctors and healthcare practitioners take a real interest in them as people first and foremost

Anne - RCPCH&Us Parent Carer  

Training level:  All levels

Setting: Inpatient paediatric ward

What prompted the change? Being admitted to hospital can be a stressful and upsetting time for any young person. As clinicians we need to think about how we can make this experience easier for the child by working with them and their parents.

What happened? Trainees looked at the admission paperwork for inpatients with other members of the team, including nurses. Questions were incorporated to include a section on the child’s preferences, for example, what makes them happy or sad, what helps them feel comfortable? These were then used when admitting children to gain additional information to be kept in their notes.

How did this support training and trainees? This allowed trainees to help let children and their families take the lead and inform health care professionals as to how to we can improve children’s experiences. It allowed trainees to explore and learn more about the impact of an inpatient admission on children and young people.

Any practical tips? Think about different ways children can express how they feel. The use of images to allow children to express themselves in a different way is particularly important if they cannot always find the appropriate words. See the College's popular emoji cards and resources produced by care-experienced children and young people such as games to share how they're feeling.

Dr Lia Davies is an ST2 trainee and is the KSS regional representative on the RCPCH Trainee Network and Dr Kiran Rahim is an ST5 in London NCEL and is also the QI representative on the RCPCH Trainee Network.

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