ANNUAL REPORT 2010

Royal College of Paediatrics

and Child Health Annual Report 2010

Copyright © 2011 Royal College of

Paediatrics and Child Health

Further copies available on request –

contact publications@rcpch.ac.uk

FROM THE COLLEGE’S ROYAL CHARTER

The objectives of the College are:

(i) to advance the art and science of Paediatrics;

(ii) to raise the standard of medical care provided to children;

(iii) to educate and examine those concerned with the healthof children;

(iv) to advance the education of the public (and in particularmedical practitioners) in child health which means theprotection of children, the prevention of illness and diseasein children and safeguarding their optimal development.

FROM THE PRESIDENT/CEO 02

COMMUNICATIONS 04

RESEARCH AND POLICY 06

EDUCATION AND TRAINING 08

CORPORATE SERVICES 10

INTERNATIONAL WORK 12

DEVOLVED NATIONS 14

THE FUTURE 15

FORM OF CODICIL 16MAKING A BEQUEST ORDONATION TO THE COLLEGE 17

MISSION/VISION/VALUES 18

CONTENTS

FROM THE PRESIDENTAND THE CHIEF EXECUTIVE

Prof Terence Stephenson,President

Dr Chris Hanvey,Chief Executive

WE AIM TOSUPPORT

PAEDIATRICIANSNOT JUST AT

THE BEGINNINGOF THEIR

CAREERS BUTTHROUGHOUT.

Professor Terence Stephenson,President

This has been a year of enormous change for the Collegeand for child health. The new Coalition Governmentwasted no time in setting out its intentions. It publishedthe previously-commissioned Kennedy Report inSeptember 2010, followed by the White Paper ‘Equityand Excellence: Liberating the NHS’. Both will have hugeimpacts on the way in which children are cared for.The College responded to both, and has continued toengage with policy-makers in the four nations.

At the heart of our approach, as always, has beenensuring that children receive the best possible care.Our own Facing the Future report, published in theSpring 2011, argues for significant change in the waysin which the paediatric workforce is configured, andwe hope that members will engage fully in the vitalissues it raises.

Within the College, we have also undertaken majorchange. A full exercise to assess our staff structuretook place in the spring and summer of 2010, andimplementation has been undertaken since then.Although, sadly, several long-serving staff left during theprocess, we are confident that the new staff structure wehave as a result will be more robust, more accountable,and more able to deliver our strategic goals. As partof the restructuring, we have also introduced a newPeople Strategy, whose aim is to allow our staff manymore opportunities to develop and grow.

We also undertook an exercise to rebrand the College,which was completed on time (in November 2010)and 25% under its budget. The impetus for this was anearlier series of workshops with members and otherson the College’s Mission, Vision, and Values. We soughtto project an image suitable for a vibrant College whilenot losing sight of our heritage. The rebranding shouldalso be seen within the context of our other work to raisethe profile of the College and of child health. We haveinstituted a successful series of “policy breakfasts”which have been addressed by – amongst others –

Frank Field, Stephen Dorrell, and Sir Ian Kennedy.It has also been a year when we have sought to makethe College more fully a four-nation organisation.Major events have taken place in Scotland, NorthernIreland, and Wales, most recently a major St David’sDay conference on children’s rights, attended by allfour of the UK’s Children’s Commissioners.

The College’s exams continue to be one of ourflagship activities, and the expansion of the MRCPCHexam to India this year has been a major achievement.It represents a great opportunity for the College tohelp guarantee the standards of child health care inone of the most populous nations in the world. As thisis being written, however, the political turmoil in theMiddle East means that we have had to postpone somediets of exams held in that region. Our long-termcommitment to those countries, and more broadly toexpanding the reach of our exams, remains unchanged.

Over the coming year, the College’s major priorities are:

� The launch of a new College website to providemembers and others with more accessible andmore personalised information.

� The launch of a major fundraising campaign, tomark fifteen years since the Royal Charter.

� An expansion in our international activities.

� Increased levels of support and services to members.

� Embedding the staff restructuring described above.

� The establishment of a 2011-14 business plan toguide our future work.

It is our hope that members and other stakeholderswill see visible improvements in all areas of our workfrom the foundations we have built this year.

Professor Terence Stephenson, PresidentDr Chris Hanvey, Chief Executive

03

COMMUNICATIONS

BY COMMUNICATING EFFECTIVELYABOUT THE COLLEGE'S GOALS ANDPRIORITIES, WE CAN RAISE THE PROFILEOF CHILDREN'S AND YOUNG PEOPLE'SHEALTH NEEDS.

04

Media

During the last twelve months, our media work hasfocused on the major policy statements that havebeen developed (see overleaf). The College has alsogained high prominence for its responses to externalpolicy documents, such as the Kennedy Report onChild care and the Government’s proposed NHS healthreforms in the Health and Social Care Bill.

Rebranding

This year, we’ve been developing a new CollegeMission, Vision & Values statement, followingconsultations with members throughout the UK.The Council agreed to a rebranding project.This was delivered in November 2010, 25% underbudget, and can now be seen on our publications,website and buildings.

Membership

Importantly, we needed to develop the level of servicewe provide to our members (without increasing fees).Membership numbers have continued to grow overthe last few years, with new services such as the onlineASSET and E-Portfolio being provided to trainees.Total College membership now exceeds 12,000.A new category of Student Membership allows medicalstudents who’ve not yet embarked on paediatrictraining to become affiliated to the College. Nearly400 students have taken this up so far.

Events

The College’s flagship event is its Annual Conference,which in 2010 was held at the University of Warwickafter many years in York. Despite taking place duringthe Icelandic volcano eruption that grounded UKair flights, attendance was up on the previous year,as were delegates’ responses in their feedbackquestionnaires. Other courses this year included theCourt Skills in Child Protection, which gives theopportunity for paediatricians to work with lawyers tounderstand the particular stresses of giving evidencein child protection cases.

Publications

Our flagship journal ‘Archives of Disease in Childhood’(co-owned with the BMJ) continues to flourish underthe editorship of Professor Howard Bauchner. It hasexpanded its reach to countries such as Brazil andextended its web presence. The British NationalFormulary for Children, published with the BMJ andthe Royal Pharmaceutical Society, celebrated its5th anniversary with a reception at the Houses ofParliament. Other new publications included a jointventure with the European Academy of Paediatrics toproduce a new edition of the popular “Mastercourse”.Dovetailing paediatric curricula across Europe, thebook was edited by Malcolm Levene and AlfredoTenore, and published by Elsevier in October 2010.

OUR GOALS:

TO RECRUIT 255 NEW FELLOWSBY 31 AUGUST, 2011

TO GO LIVE WITH OUR NEWWEBSITE,ON A NEW PLATFORM, BY AUGUST 2011

TO ACHIEVE A 10% INCREASE (ON 2009/10)IN POSITIVE MEDIA COVERAGE AND

PRESENCE IN A WIDER RANGEOF MEDIA OUTLETS.

05

RESEARCH AND POLICY

THE COLLEGE DEVELOPSHIGH QUALITY PIECES OFRESEARCH TO DRIVE POLICYFORMATION. IN TURN, WE USEOUR POLICIES TO LOBBY FORHIGHER QUALITY TREATMENTOF CHILDREN AND YOUNGPEOPLE – BOTH IN THE UKAND ABROAD.

06

CENTRAL TO OUR RESEARCH PROFILE IS ARIGOROUS, EVIDENCE-BASED APPROACH TOHEALTH CARE. AS AN EXAMPLE OF THIS, OUR

CLINICAL STANDARDS UNITWORKS TOEVALUATE GUIDELINES PRODUCED BY OTHER

BODIES (THESE ARE PUBLISHED ONLINEATWWW.RCPCH.AC.UK/RESEARCH/CE

WEALSO HOST THE BRITISH PAEDIATRICSURVEILLANCE UNIT (BPSU) – A JOINT

VENTUREWITH THE HEALTH PROTECTIONAGENCY AND THE INSTITUTE OF CHILD

HEALTH –WHICH FACILITATES RESEARCHINTO RARE CHILDHOOD CONDITIONS.

WE TAKE ON AWIDE RANGE OF RESEARCHPROJECTS ON SPECIFIC ISSUES, OFTEN ATTHE REQUEST OF GOVERNMENTAL BODIES.

PROJECTS IN 2009-10 HAVE INCLUDED:

� The creation of National Care Pathways forchildhood allergies

� A major piece of work on understanding parents’information needs and experiences whenprofessional concerns of non-accidental injurywere not substantiated

� A national survey to ascertain the number ofchildren with diabetes

� Care bundles aimed at providing safer practicein neonatal care

� The creation of a series of ‘Medicines for Children’leaflets providing clear and accessible informationon commonly prescribed drugs for both parentsand children

� The continued roll-out of the College’s new growthcharts for children aged 0-18, with accompanyingeducational material

In our recent work, we have been encouraging moreand more children and young people to discuss theirexperiences of the health system. Examples will beshowcased at a major conference that we’re runningin Cardiff in March 2011.

A new series of policy breakfasts was initiated in 2010(and will continue on into 2011), at which policymakersmeet to discuss topical issues in an informal setting.

The results of the biennial RCPCH Workforce Census,last undertaken in 2009, were published in 2010.The Census provides a detailed breakdown of thepaediatric workforce across the UK, analysed by area,specialty and job type. Over many years, it has becomeestablished as a central planning tool in its field. Thenext one will be carried out in the summer of 2011.

2010 also saw a number of major changes in the fieldof UK child health. The new, government-issuedKennedy Report on child health was followed by aWhite Paper proposing a radical reorganisation ofthe NHS commissioning structure. We published a

response to both of these, as well as to more than50 consultations on other issues from governmentaland other bodies.

Our major policy work of the year was the creationof ‘Facing the Future’. This report, which is to belaunched in the spring of 2011, recommends a radicalreconfiguration of paediatric services and theworkforce to address the changing conditions inthe NHS. A ‘Facing the Future’ follow-up, also to bepublished in 2011, will address the separate issuesraised in our Community Child Health work.

Finally, the College has developed a number of majoreducation packages to support the goals set outby our research and policy. These are increasinglybeing delivered via eLearning, which is both morecost-effective and more flexible than traditional routes,as it allows learners to work at their own pace. Ourcurrent elearning projects include:

� The Healthy Child Programme: an elearningresource in support of the Department of Health’s‘Healthy Child Programme’

� Safeguarding Children and Young People: a suiteof programmes for doctors at various stages oftraining in paediatrics, providing the essentialcompetences required in child protection practice

� Maintaining and Updating Competences in ChildProtection: a detailed training in child protectioncompetences for consultants and career-gradedoctors, delivered via eLearning for Healthcare

� The Adolescent Health Project: a Departmentof Health-sponsored programme supporting thedelivery of quality care to young people (aged11-19), delivered via eLearning for Healthcare

OUR GOALS: TO DEVELOP ‘POLICY BRIEFINGS’ON A MINIMUM OF FIVE KEY ISSUES OVERA 12-MONTH PERIOD

07

EDUCATION AND TRAINING

THE COLLEGE HAS ASTATUTORY RESPONSIBILITYFOR THE OVERSIGHT OFPAEDIATRICS TRAININGIN THE UK.

08

OUR GOALS:

TO ACHIEVE A 5% INCREASE IN NET INCOMEACROSS ALL EDUCATION, TRAINING ANDASSESSMENT AND RESEARCH ACTIVITIES

TO SET AND MONITOR THE STANDARDSAND TRAINING FOR CLINICAL PRACTICE

OF THE PAEDIATRIC WORKFORCE

Training

In the last year, we launched a major new initiative toencourage more doctors to choose paediatrics as acareer. This embraced a ‘Careers Fair’, which was heldat the College, a new section on our website givinginformation about the specialty, and a range of leafletsand other publications.

Those who enter paediatric training have their progressmonitored through ePortfolio, the College’s onlinelearning tool. This enables trainees to track theirprogress by monitoring the skills and knowledge theygain. Supervisors can use ePortfolio to measure theprogress of their trainees, as well as record meetingsand complete assessments.

The trainees’ progress is measured against the College’scurriculum, in which the competences are mapped tothe skills tested in the various levels of our exams.

Our Trainees’ Committee, currently chaired byDr Damian Roland, represents the interests of traineesat all levels in the decision-making process, includingrepresentation on Council, the College’s governing body.

Examinations

The College runs two examinations: the MRCPCH(the membership exam), and the DCH (the Diploma inChild Health, intended for those who don’t work solelyin paediatrics but who make it a significant part oftheir practice).

The MRCPCH consists of a written exam, Part 1(comprising two papers, 1a and 1b); a written Part 2,and a final clinical examination. Each of these parts

must be completed for the candidate to proceed tothe next. On completion of all three, the candidateis admitted to membership of the College. The DCHconsists of an initial written paper (shared withMRCPCH Part 1a) and a clinical exam.

The MRCPCH is internationally recognised as a rigorousqualification in paediatrics. Accordingly, the examshave been held in a range of countries outside theUK (including India, where a major initiative recentlypaved the way for the launch of Part 1 of MRCPCH).

Continuing Professional Development

Continuing Professional Development has long been anintegral part of the College’s approach to the educationof doctors. Participants in the CPD scheme are expectedto perform 50 hours’ worth of educational/developmentactivity each year. They can record these credits onlinevia a web interface, and so are able to keep a continuallyupdated record of their CPD.

The major development in the future of CPD is theintroduction of Revalidation, the process by whichdoctors will be formally assessed on their competenceto practice every five years. This process wasrecommended by Dame Janet Smith’s inquiry intoHarold Shipman’s practice, and its development hasinvolved extensive cooperation between the MedicalRoyal Colleges and the General Medical Council. It ishoped that College members will be provided with anonline Revalidation tool that builds on the ones thatcurrently exist for CPD online.

09

CORPORATE SERVICES

THE COLLEGE'S CORPORATE SERVICESPROVIDE THE INFRASTRUCTURETHAT ALLOWS OUR OTHER WORKTO BE CARRIED OUT EFFICIENTLYAND EFFECTIVELY.

10

OUR GOALS:

TO EVALUATE THE CURRENT STAFFINGSTRUCTURE AND MAKE ANY

NECESSARY CHANGES IN 2010/11

TO ACHIEVE 100% RETURN ON APPRAISALS,MID + END OF PROBATION REVIEWS

OF NEW STAFF

TO EVALUATE ALL EXISTING CONTRACTSHELD BY THE COLLEGE AND ESTABLISHA ROBUST AND CONSISTENT PROCESSTO DEAL WITH FUTURE CONTRACTS,

BY DECEMBER 2010

Dr Sue Hobbins stands downas the College’s Hon Treasurer

in April 2011; she will be succeededby Dr David Vickers.

Education 8%

Training 7%

Other 6%

Assessment 28%

Research 7%

Annual Meeting 3%Publications 9%

MemberSubscriptions 32%

Annual Meeting

Research

Education

Training

Assessment

Member Services

0 500 1000 1500 2000 2500 3000 3500 4000

Our overall financial position remains solid, despitethe difficult circumstances in the global economy.The College’s income in 2009-10 was £10.20m againstexpenditure of £10.33m, resulting in a small deficitof £0.13m

Income 2009-10Total = £10.2m

Expenditure 2009-10Total = £10.3m

Overall, this has been another year of growth for theCollege. We remain financially sound with substantialassets, and have a strong cash-flow to fund operationsfor the foreseeable future. Our overall reserves positionremains good, and membership growth has stayedstrong. Given the predicted decline in research andeducation grants over the next few years, the challengewill be to create and sustain new sources of income.

Our financial plans for the future include a targetedbudget surplus of £0.5m in 2010-11. This is based onthe assumption that membership, together withincome from assessments, will continue to grow.This figure also envisages development of commercialincome, consistent results from publications, andexpenditure held close to 2010 levels. Moreover, ourplans assume that government grants will declineover the coming years, but that those alreadycommitted will be honoured.

A major reorganisation of College staff has taken placeover 2010-11. The aims of this are to provide a staffstructure that is better suited to the tasks at hand,and to remove unnecessary layers of management.Although the process has carried one-off costs, thetypes of new posts it has opened up (for instance, inFundraising, Public Affairs and IT) should enable usto operate more efficiently.

Other one-off projects should bring long-term benefits.Aside from the rebranding project (see p6-7), the mostimportant of these has been to develop a new Collegewebsite. The current site is too difficult to navigate, anddoesn’t provide the degree of personalisation thatmembers require. The development process for the newsite began in 2010, and it will launch in the spring of 2011.

In addition, we are looking to adopt a more commercialapproach to the use of our facilities. As part of the staffreview, several facilities functions were outsourced.As a next step, we are looking to hire out our meetingrooms to outside organisations and so generate anew income stream. Details of this new venture willsoon be available on our website.

20102009

11

INTERNATIONAL WORK

THE FINANCIAL CONTRIBUTION EACHMEMBER MAKES DEMONSTRATESOUR TOTAL COMMITMENT TOINTERNATIONAL WORK.

12

There have been a number of internationalachievements over the last year:

� The ETAT-Plus course, a partnership project whichprovides training in Emergency Triage Assessmentand Treatment. Following a successful roll-out inEast Africa, the College is actively seeking otherareas where it can be used.

� The Diploma in Palestinian Child Health (DPCH)where UK paediatricians could share theirknowledge and skills with Palestinian colleagues.The clinical leaders of this course are Dr TonyWaterston, Dr Jean Bowyer and Prof. Mary Rudolf.

� A training course for Iraqi paediatricians held inIrbil, with tutors including the College’s VicePresident for Education, Alistair Thomson.

� The continuing VSO scheme to allowpaediatricians from the UK to do placementsin the developing world.

� The continuing International Paediatric TrainingScheme (IPTS), which helps to bring paediatriciansfrom outside the EU to complete part of theirtraining in the UK. Sadly, owing to governmentfunding cuts, the College was forced to suspendthis scheme in early 2011.

THIS YEAR, DR STEPHEN GREENWAS SUCCEEDED AS THE DAVIDBAUM FELLOW BY PROFESSOR

STEVE ALLEN. WE’VE ALSOCREATED A NEW ‘HEAD OF

INTERNATIONAL OPERATIONS’ROLE, TO WHICH DR JUSTIN

THACKER HAS BEEN APPOINTED.

13

DEVOLVED NATIONS

Wales

In Wales, the RCPCH is represented by the WalesExecutive Committee and the Wales AdministrativeOffice in Cardiff Bay. The Officer for Wales isDr Iolo Doull.

RCPCH Wales supports the organisation of thebi-annual Welsh Paediatric Society’s Spring andAutumn meetings (in association with the College),and the St David’s Day Lecture and Study Afternoon.RCPCH Wales is also hosting ‘My Right to a BetterHealth’, a major conference on children’s rights, inSpring 2011.

Representatives of RCPCH Wales have met withMinisters and Officials of the Welsh Government onvarious occasions this year. Issues of particularconcern have included workforce numbers and howwe can provide specialist services.

Ireland

Historically, we’ve appointed an officer withresponsibility for both Northern Ireland and theRepublic of Ireland, given the close cross-borderlinks between the two health services. The currentincumbent is Dr Moira Stewart.

Issues dealt with this year include the continuing impactof the European Working-time Directive and, therefore,the difficulties in filling rotas across Northern Ireland. Inaddition, the reduction of in-patient beds in Belfast, hascreated serious knock-on effects for paediatric services.

In the Republic of Ireland, negotiations continue aroundplans for a new dedicated paediatric hospital in Dublin,scheduled to open in 2016. What’s more, our plans tohave office support in Ireland will hopefully be movedforward in the coming year.

Scotland

Our Officer for Scotland is Dr Jim Beattie, who leadsour Scottish Committee with the support of ourEdinburgh Office team. In the last year, meetings havebeen held with Dr Harry Burns (Scottish CMO) andMs Shona Robson, the Scottish Government Ministerwith responsibility for Child Health. Issues raised inthe meetings have included the continuing pressureon medical workforce and the College’s Equity andExcellence Outcomes Framework.

The Scottish Office has been involved in organising anumber of conferences this year, including their AnnualConference, a new Paediatric Lecture Series, and theregular St Andrew’s day Symposium. Dr Peter Fowliewill take over as the Officer for Scotland in 2011.

14

International

The College already has ambitious overseasprogrammes in Africa, Asia, and the PalestinianTerritories, and has plans to do much more.

Education and Courses

The College has developed ground-breakinge-learning programmes, often made freelyavailable within the UK.

Developing College Buildings

We have plans to turn the public space ofthe College headquarters into an innovativenew education centre.

Prizes and Fellowships

Your support can enable paediatricians from thedeveloping world to attend College events andconferences. With increased finances we can reachout to more children and young people, not only inthe UK but in other areas of the world.

THE FUTURE

15

FORM OF CODICIL (Please complete this form, detach and send to you solicitor.)

I(name in block capitals)

Declare this to be a Codicil which I make this

day of 20

To my Will which bears the date

day of 20

of

(address)

(1) I bequeath to the ROYAL COLLEGE OF PAEDIATRICS AND CHILD HEALTH(‘The College’) or to any successor body carrying out the same or similar charitablework the sum of

£ amount in words

free of all taxes whether payable in the United Kingdom or in countries overseas forthe general purposes of the College and I declare that the receipt of the – HonoraryTreasurer for the time being of the College shall be sufficient discharge for the same.

(2) In all other respects I confirm my said Will. In witness thereof I have here unto set myhand the day and year first above written.

Signed by the said Testor/rix

(Signature)

as a Codicil to his/her last Will in our joint presence and by us in his/hers.

Witness 1(name in block capitals)

(Signature)

of(address)

Witness 2(name in block capitals)

(Signature)

of(address)

The Royal College of Paediatrics and Child Health (RCPCH)is a registered charity in England and Wales (1057744) and in Scotland (SC038299).

16

MAKING A BEQUEST OR DONATION

The enormous advances made by the medical professionhave cut a swathe through previously fatal diseases, andbetter nutrition and living conditions have produceda healthier child population. However, other dangers,social and medical, continue to threaten, and in today’smarket-oriented climate, money is always needed toenable us to fight for children’s welfare, to fund researchand to provide better education for paediatricians inwhose hands lies the health of the nation’s children.

A bequest to the RCPCH in your Will would helpthe College to continue its important work. On theopposite page you will find a printed form which,duly signed and witnessed, would become a codicil toyour exiting Will. It can be simply filled in, detachedand sent to your solicitor.

If you intend to do this, will you please note thefollowing points:

1. Please read the document to ensure that it accordswith your wishes. Any alterations must be madebefore you sign.

2. Then date the document where indicated.

3. Then in the presence of two witnesses sign yourname at the end of the document where indicated.

4. The witnesses must sign their names and write theiraddresses where indicated. The witnesses areneeded in England, Wales and Northern Ireland; onewitness in Scotland.

5. You and the witnesses must all be present togetherwhen you sign, and the witnesses must see you sign.

6. No person taking benefit under the document orthe husband or wife of any such person should bea witness, otherwise such person will not be able totake any benefit under the document.

7. All alterations should be initialed by you and thewitnesses in the margin opposite the alteration.

8. On no account should anything be pinned, stapled,paper-clipped or fastened in anyway whatsoever tothe document.

Members wishing to contribute in this way are askedto contact the fund-raising section of the College(e-mail fundraising@rcpch.ac.uk), especially if theywish any bequest to be used for a specific purpose.

THE HEALTH ANDWELL BEING OFCHILDREN HASALWAYS BEENTHE CONCERN OFPAEDIATRICIANS.

MISSION:To transform child health through knowledge, innovation and expertise.

VISION:A healthier future for children and young people across the world.

VALUES:• AUTHORITATIVE Recognised and respected as the authority on child health.• MODERN Committed to leading the way in paediatric research and training.• INFLUENTIAL Champions of the best health outcomes for children and young people.• PROFESSIONAL The standard bearer of child health within the medical profession.

Royal College of Paediatrics and Child Health

5-11 Theobalds Road, London WC1X 8SH, Tel: 020 7092 6000 Fax: 020 7092 6001, email: enquiries@rcpch.ac.uk

www.rcpch.ac.ukThe Royal College of Paediatrics and Child Health (RCPCH) is a registered charity in England and Wales (1057744) and in Scotland (SCO38299)