RCPCH Newsletter 06 Spring

inside this issue

newsletterinside this issue

Spring 2006

Pages 2-3

EDITORIALS

Page 4-13

NEWS

Page 14

TRAINEES

Page 15

MEETINGS

Royal College of Paediatrics and Child Health50 Hallam Street London W1W 6DE

Telephone: 020 7307 5600 Website: http://www.rcpch.ac.uk

RCPCH

“Safeguarding Children - Recognitionand Response in Child Protection” waslaunched at the College on 10 January.Over 50 healthcare professionalsattended, along with governmentrepresentatives, health journalists andthe Minister for Children, Young Peopleand Families, Maria Eagle. The eventlaunched the first-ever nationwidecourse that will enable doctors to bebetter equipped to recognise and respondto possible cases of child abuse.

Together with the NSPCC and theAdvanced Life Support Group (ALSG),the College has developed the content ofthe training, which will commence inMarch. It will be rolled out to doctorstraining in paediatrics and consists of aday-long intensive course run byexperienced trainers, supported by aninteractive DVD and training pack. Thetraining pack uses interactive slides, casehistories and practical examples that will help doctors be more aware ofpossible cases of abuse when undertakingroutine examinations.

The DVD and training pack will alsobe available to doctors working in A & Edepartments and GP surgeries. Therollout of the course to both training andqualified paediatric specialists will helpensure that, for the first time, there is anationwide training standard for all

doctors and specialists who work closelywith children and young people.

Maria Eagle, Minister for Children,Young People and families stated that: “Thiswill make paediatricians more confident indealing with child protection issues.”

Dr Neela Shabde, the project leader said:“There has been overwhelming mediainterest in this. All of the project teamshare a great deal of pride and tremendoussatisfaction with the way the trainingpackage has come together. The DVD, in particular, is a fantastic resource.Although primarily designed for traineesin paediatrics, it will be of great benefit toall those who work in the field of childprotection including consultant paediatricians.I also hope that it will help paediatricianswith their duty and responsibility insafeguarding children naturally, andwithout too much anxiety".

continued on page 3

RCPCH launches biggestever child protectiontraining drive for doctors

Page 2 RCPCH

Well, my time as President is nearlyover. Three years have gone in

a flash and very soon Patricia Hamiltonwill have assumed the position of your leader.

Our main, statutory function as aCollege is to set and maintain standards ofcare for children and to be responsible fortraining doctors to deliver that care. Thepast few years have seen a huge change inthe work that we have to do. The advent ofthe Postgraduate Medical Education andTraining Board (PMETB) in September2005 has meant that there has been greater scrutiny of all College trainingprogrammes, examinations and othermethods of assessment. The Governmenthave committed themselves to a serviceprovided by trained doctors rather thanrelying on trainees for a great deal ofservice delivery. Modernising MedicalCareers (MMC) is the vehicle by whichtraining in all specialties is to berevolutionised. The RCPCH has been atthe forefront of developments and we arenow completing our new curricula not onlyfor basic training but also for all of oursubspecialties. From September 2007 wewill have a “run through” trainingprogramme whereby trainees will enterspecialist training after FoundationProgrammes and, if they negotiate theeducational barriers, will emerge in 5 to 8years on to the Specialist Register.Progression through the programme will bedetermined by achievement ofcompetencies not time served. This initself provides huge challenges forprogramme directors in managing posts.There have been concerns that theGovernment want to see a sub-consultantgrade. All Colleges are clear that our

PRESIDENT’S COLUMN

Editorials

training leads to the Specialist Register andnot some intermediate point, unless thelatter is a voluntary decision by trainees.Our training team of Patricia Hamilton,Mary McGraw and Claire Smith, aided byour College Education Adviser, KimBrown, are to be congratulated once moreon the exemplary work that they have donein this area.

In the last few weeks we havelaunched the first phase of our childprotection training programme whichhas been modelled on the APLS courseand indeed a great deal of support hascome from ALSG and the NSPCC. Webelieve that this short course, which willinitially be taken by all trainees, will give them the basic competence andconfidence to take the first steps inprotecting children who may have been abused. Neela Shabde is to becongratulated for leading this work.Much of our other work on childprotection is also coming to fruition.

The College has grown in stature andnow that we are in our tenth year we canreflect on the wisdom of becoming aseparate College. We now do have a realvoice for children in all four countries ofthe UK and are regularly consulted byministers and officials as well as otherbodies who are developing policiesrelevant to children. Our membershiphas grown to over 9000, annual incometo over £6m and staff to almost 100. TheDHs have funded the purchase of ourBNF-C for doctors throughout the UK.The annual meeting in York continues toattract excellent speakers and a steadyattendance of about 2000 people.

What do I perceive are the challengesfor the next few years? Along with allColleges, we must make sure that ourinfluence and role in setting standards isnot eroded by economic and politicalpressures. We need to deliver well-traineddoctors in about a third of the trainingtime that we have previously had available.Training needs to be protected and valuedin the NHS. Most big industries investheavily in training – up to 15% or more of

their budgets. Foundation Trusts and newmethods of payment for services are a realthreat but also an opportunity. We mustplay a real part in international affairs butensure that this does not overwhelm us.David Baum suggested a limit of 10% ofour effort in this area.

Over the last few weeks we have lostseveral giants of paediatrics in the UK.Eric Stroud, Tony Jackson, Sam Wellerand Michael Chan were real pioneerswithout whom our College would not bewhere it is today.

In signing off for the final time, can Ithank you all for the support that you havegiven me. It has been a truly wonderful 3years. Everyone asks me what I am going todo next and most cannot resist a smilewhen I reply that my unfulfilled ambitionis to become an Olympic athlete! The trueanswer is to return to looking after childrenin Newcastle - that is what I was trained todo and after 37 years still enjoy it.

I wish my successor Patricia Hamiltonand all of you well for the future and willwatch with pride as we continue to growthrough our adolescent years. Thank you forallowing me the pleasure of being President.

Alan [email protected]

Honorary editor: Mark Everard Editor: Joanne Ball

Email: [email protected] services: Chamberlain Dunn Associates

Advertisements: British Medical JournalPrinting: Rapid

Copy deadline for next issue: 1 May 2006

Published by the Royal College of Paediatrics and Child Health, 50 Hallam Street,

London W1W 6DE Tel: 020 7307 5600 Fax: 020 7307 5601

Website: www.rcpch.ac.uk Email: [email protected] College is a registered charity: no. 1057744

© 2006 Royal College of Paediatrics and Child HealthThe views expressed in this newsletter do not necessarily

reflect the official positions of the RCPCH.

RCPCH newsletter

Page 3RCPCH

REGISTRAR’S

COLUMN

Editorials

“Remember, Ginger Rogers did everything Fred

Astaire did, but backwards and in high heels.”

Faith Whittlesey

The news of my election as Registrar produced aninteresting array of reactions. My friends and familymuttered darkly that now I’d taken on yet another jobthey’d see even less of me than usual. Telling themthat this was ‘An Important Job for the College’ andtherefore ‘A Good Thing’ did little to dispel their gloom.My parents were puzzled, and unsure how to explainthis to elderly doting aunts. Despite the ‘Important Jobfor the College’ line, there was a niggling worry; surelyI’d already been a registrar 20 years ago? At thecurrent rate of regression they’d soon be putting methrough university again. Even some of my paediatriccolleagues looked vaguely mystified, before recallingseeing some papers about “that College Thing” in theautumn. The next question was absolutely universal:“But what does the Registrar actually do?” With just apound for every time I’ve heard it, I could make asizeable dent in the NHS overspend.

The answer isn’t straightforward! The Registrar isresponsible for working with the other senior officers,pulling together the strands of the College policy, andsupporting the President in ensuring that the large andcomplex work plan is coherent and on track. Otherresponsibilities include managing responses toconsultations, keeping a watchful eye on the AACprocess, and handling requests for external reviews.Most importantly, the Registrar needs to keep a listeningear open to the views and needs of the membership.

Pat told me that the frantic underwater paddling of theRegistrar keeps the swan (or College) moving alongapparently effortlessly. The invisibility of the role isclearly a testimony to the paddling skills of mypredecessors. The swan metaphor conjured up abizarre image in my mind of the senior officers in tutus,dancing a pastiche of Swan Lake. Where would Ifeature in that production? For a giddy moment I flirtedwith choreographer - but realised that the ‘principals’are already far too adept at choreographingthemselves. So I’ve settled for stage manager. Now Ijust have to ensure that the orchestra keeps playing,the spotlights stay on, and nothing causes an ungainlycollision on stage. Pat – ever fancied yourself as Odetteor Ginger?

Hilary CassRCPCH Registrar

National Neonatal Audit Programme

Following a great deal of groundwork, the College's ResearchDivision is pleased to report that ithas been successful in its bid todevelop and implement a NationalAudit Project in Neonatal Care.

This promises to be an excitingtwo-year project. The audit has beena clinician driven initiative and has been long awaited byneonatologists. There is wide spreadsupport for the College to lead thisinitiative which will involve thedevelopment of a web-based audittool for units who wish to collectdata separately from other systems,or will be linked into legacy systems.

In the first instance the nationalaudit will attempt to answer aseries of nine questions addressedby 22 data items that have beendecided after wide consultationboth within the profession andwith the baby related supportgroups such as BLISS. This dataset

is small and it has been agreed thatit will be included as a subset of theBAPM dataset. If a unit/ network isalready collecting the BAPMdataset, it is hoped to collect thiswider dataset.

When completed the system willprovide anonymised comparativereports to all those units whocontribute their data on a monthlyand yearly basis with an annualreport on neonatal care in Englandand Wales. It is expected that the majority of neonatal units will submit their data to the auditby 2008.

The system must ultimatelyinform good clinical practice suchthat national neonatal care will tocontinue to improve.

For further information contact:

Louise YouleProject Manager, [email protected]

continued from page 1RCPCH president-elect, Dr

Patricia Hamilton, added: “Doctorsare a crucial link in the childprotection chain and we want to doeverything possible to enable themto recognise and respond to possiblecases of abuse appropriately. Thetraining course is designed to be beneficial to trainees andexperienced doctors alike.”

The project was also madepossible due to grants from theDepartment of Health, the NSPCCand also the Johnson and JohnsonPaediatric Institute.

NSPCC director of training andconsultancy Enid Hendry said,“Our aim is to support Doctors.Deciding to report possible child

abuse can be a very difficultjudgement call but it could be thechild’s only chance of intervention.

“Paediatricians are often thebest placed professionals to noticesigns such as old fractures andunusual bruising.”

The inaugural child protectiontraining course, "Recognition andResponse in Child Protection", will beheld on 24 March 2006 in NorthernDeanery at Wansbeck GeneralHospital, Ashington, Northumberland.

For further information about thetraining and the pack, pleasecontact Dr Neela Shabde via email - [email protected], [email protected] BrunertHead of Media

RCPCH launches biggest ever childprotection training drive for doctors

RCPCHPage 4

News

I am extremely excited to have beenappointed to this prestigious post on a three-year secondment. I was appointed in opencompetition, following application anddiscussions with recruitment consultantsand an interview process, which wasdemanding and involved a focusedpresentation, with only five minutes and noaccoutrements, to put over complex points.I practised outside in the rain on the day inquestion, and wondered why at the age of 54with a great job in Northampton I wanted achange! Especially as it would involvecommuting to Whitehall. However, theopportunity to try to make a difference forchildren's health and healthcare in Englandwas too great to miss and the sober tones ofBig Ben, close by my office, remind me dailyof the need to get on with the tasks.

I plan to use over 20 years' experience asa consultant in the NHS as a paediatrician,working in areas of community child healthand establishing an integrated departmentin an acute trust, to good effect. I shall relyon my experience as a Medical Director forover 10 years and some taxing spells as aChief Executive too. However, theopportunities afforded me in my variouscollege roles over the years have beeninvaluable, and I will continue to look tocolleagues for wise advice and support ofcourse. I am only sorry that I was unable tocomplete my final few months as theRegistrar, a role I thoroughly enjoyed.

I asked for and have been given a goodinduction programme, includingreadingmaterial that is over 6 inches thick!Grasping the complexities of the internalorganisational arrangements is no mean feat,especially as I must understand the workingsof the Department for Education and Skillsas well as the Department of Health ofcourse. However, my new colleagues havebeen unfailingly courteous and helpful.

I started my new role in December.During the first week the departmentalbudget was frozen and there has been aninternal DH reorganisation, as many of youwill know, alongside the reconfigurationplans for SHAs and PCTs. However, there isstrong liaison work with SHA leads forchildren's services and PCT leads, whichwill be maintained this year. Even thoughthere is personal uncertainty for some I havebeen very impressed by their commitment

to take children's services forward in thefuture. Hopefully the reorganisation will notcut across areas where successful jointworking has been taking place and largerPCTs will offer an opportunity for improvedcommissioning of some services.

I am frequently asked about my priorities,and the commissioning of children's services,especially in the light of the new policydevelopments. Practice based commissioning,for example, needs more attention and so thatis one of the top ones.

There has been some excellent work inprogress in relation to children's palliativecare, with a new commissioning guidepublished last December. Transitions, whichare particularly difficult for children with adisability, are another top priority. We arenot doing well in this area of children's careacross many diseases in helping young peoplethrough this difficult period into adult lifeand the care of other colleagues principallyphysicians. There will be a new publication,launched at a conference later in March, andthis area needs to be given higher priority inthe future by service providers. At present,young people are being let down by thesystem and professionals can help to put thisright. I believe as paediatricians, we havepaid too little interest to the needs ofadolescents in the past. But this is alsostarting to be rectified.

Health inequalities are a top priority forthe NHS this year, and there is much toconcern us in children's health and theirhealth services. I believe that there is anextremely unhealthy complacency about thisand we only need to look at our performancecompared to other countries in Europe, to seehow worrying our position is in the leaguetables considering the place where we shouldbe for many indicators. There is a need for amuch greater understanding of the causes oflow birthweight for example. Whilst we haveseen an encouraging fall in infant mortality, it is the gap between richest and poorest thatremains far too wide in this and many other areas.

Our performance as a country, inrelation to chronic disease in childhood isalso disappointing. I have been workingwith colleagues in the field of diabetes,where we are not doing well compared toothers in Europe and we need to askourselves difficult questions about our

approach to the disease, and the educationof children and young people and theirfamilies, not least because of the risingincidence and the 20 years loss of lifeexpectancy in those where control is poor.There should be a lead paediatrician inevery department by now. They should linkup with their colleagues in other districts.We should tackle more disorders ofchildhood on a local network basis. Sharingexperience with peers is invaluable. I hopeto see more networks established forchildren with other problems, for exampleepilepsy, in the future.

Much attention is being paid to theobesity epidemic, and rightly so.

Insufficient attention has been paid so farto the problems of alcohol and youngpeople, not to mention the potential forfoetal damage. Childhood accidents remaina key source of mortality and morbidity thisis also under addressed. We must work moreeffectively with our public health colleaguesin these areas in future whilst deliveringindividual care. I remain concerned aboutchildren's specialist services, and there mayneed to be more reconfiguration tostrengthen them in future.

At present, one of my key priorities isthe implementation of Standard Eight ofthe NSF looking at children withcomplex health needs and disabilities.Every Friday, when I undertake myclinical work, I am reminded of theproblems these children and families face,whether it is an absence of occupationaltherapy support for equipment, difficultieswith the transport arrangements forschool or the exhaustion from the lack ofshort breaks. I am a firm believer in theneed to expand children's communitynursing services, and I hope the newWhite Paper will promote opportunitiesto do this. I am also currently engaged inwork to take forward the palliative careagenda, which I'm sure the college willwish to support.

I have responsibilities for maternity care,as part of my brief. There are manifestocommitments, and priority targets in thisarea to achieve as well as teenagepregnancy and breast-feeding to worryabout. Child and adolescent mental healthservices have been expanding anddeveloping in recent times, but there is

New National Clinical Director for Children

Page 5RCPCH

News

Most of you by now will have heard ofModernising Medical Careers, which involvesa major reform of postgraduate medicaleducation. The first phase of MMC wasimplemented in August 2005 with doctors onqualifying from medical school entering a 2-year Foundation Programme that has specificaims and is performance assessed. Phase twoof MMC will be the introduction of specialtytraining programmes. Entry to these willbegin in August 2007.

The plan of our training programme isoutlined below. We have mapped it to theMMC framework that is currently on theirwebsite (mmc.nhs.uk)

This diagram cannot reflect themovement we anticipate as trainees enterprogrammes not only from Foundation butalso from abroad. Nor can it reflect themovement that we anticipate there will be astrainees, wishing to change specialty, applyto move between specialty programmes.However implicit in our philosophy is theintention that the system will be flexibleenough to facilitate these movements.continued on page 6

In a quest for information aboutimmunisation, many parents turn to theInternet. The quality of informationavailable varies from carefully considered,evidence-based material to highlypersonalised rants. It is often difficult forprofessionals, let alone parents, to assessthe validity of the information given.There are guides to help make thisjudgement, but it can still be a minefield.

Many parents turn to Great OrmondStreet Hospital for advice about theirchildren’s health. A year ago animmunisation website was set up, with thesupport of the RCPCH College StandingComittee on Immunisation and InfectiousDiseases, to extend this advisory role. Aswell as information about the routinechildhood vaccines, it seeks to address

some of the myths and misinformation thatabounds. It will also attempt to provide ananalysis of significant news stories andcurrent research. There is also a facility forparents to email questions. Whileindividual advice cannot be given, generalprinciples will be addressed.

The website was developed by DrDavid Elliman, Consultant inCommunity Child Health, Islington PCTand GOSH and Dr Helen Bedford, SeniorLecturer at the Institute of Child Health.Both are members of the CollegeStanding Committee on Immunisationand Infectious Disease.http://www.gosh.nhs.uk/immunisation/Helen BedfordCollege Standing Committee Immunisation and Infectious Disease

Immunisation Website-Great OrmondStreet Hospital/Institute of Child Health

much more to do. ComprehensiveCAMHS is due to be in place by the endof 2006. But further improvements will berequired in years to come.

I am already grateful to the collegefor its approach to collaborative workingwith the Department and I am sure thatthis will be fruitful in the months andyears to come.

I know there will be frustrations in my new role, and many of you will haveexpectations that may not be met.Nevertheless, I can assure you of mywholehearted commitment to take thingsforward as best I can and I look forward toworking with you all. I am optimistic aboutthe future of children's health and healthservices. We must find a way to use the newpolicy agenda to the benefit of mothers andbabies, children and young people.Sheila ShribmanNational Clinical Director for Children

The latest news on Modernising Medical Careersand training in paediatrics

News

RCPCHPage 6

The latest news on ModernisingMedical Careers and training in paediatricscontinued from page 5

How will trainees be selected?The eligibility criterion for selection will be evidence of achievement ofFoundation competences. The Conferenceof Postgraduate Medical Deans(CoPMeD) is responsible for appointmentto specialty programmes. There will be anational application form that will allowtrainees to select their preferred specialtyand their preferred geographical location.Selection will take place at a deanerylevel. The RCPCH is working closely withCoPMeD to develop specialty specificcriteria for recruitment into paediatrics.

We recognise that not only will thosetrainees completing Foundation becompeting to enter specialty training, butalso a variety of doctors with differentlevels of experience. MMC have indicatedthat there will be a transitional phase whenit will be necessary to ensure that traineeswho have already done some paediatrictraining are given the opportunities toenter specialty training at an appropriatelevel. Trainees who have already obtainedan NTN will be unaffected by thesechanges. Trainees who are eligible to applyto enter higher specialist training areadvised to apply now.

Trainees entering specialty training in paediatrics will follow the newcompetency based curriculum andprogression through training will dependon trainees achieving the necessarycompetences. We are currently developingour assessment strategy, which will includethe current MRCPCH examination and a range of workplace performanceassessments. We will update you on thedetails in a future newsletter.

Setting up training programmesWe know there are more SHO posts thanare required to fill the current number ofSpR posts and therefore not all SHO posts in paediatrics will be incorporated intopaediatric specialty programmes. We alsoknow that General Practice have a need formany more paediatric training posts than arecurrently available in recognised GPtraining schemes. The RCPCH wishes tosupport future GPs to train in paediatrics as

we recognise that 25% of GP consultationsrelate to children. We therefore encouragespecialty leads in paediatrics and generalpractice at a deanery level to work togetherclosely to facilitate paediatric SHO postsbeing incorporated into general practiceprogrammes. We have also had requests fromthe Faculty of Accident and EmergencyMedicine and from the Royal College ofAnaesthetists to be able to incorporatepaediatric posts into their programmes andthere may be others. We are continuing tonegotiate for more NTNs, and thus moreSpRs posts, which in turn will require moreearly training posts to feed into them. Wetherefore hope that all current paediatrictraining posts will be incorporated intospecialty training programmes.

What are time limited trainingposts and career posts?The MMC team are concerned that thereis a skills gap between Foundation andCareer posts. Therefore those individualswho do not wish to enter the specialtytraining route cannot enter career postsimmediately. They can apply for timelimited training posts instead as a means ofbridging the skills gap. It is suggested thatthe contracts for these posts will be for amaximum of 2 years.

Time limited training posts are also an option for trainees who fail to get into specialty training from Foundation.Trainees will be able to re-apply to enterspecialty training the following year.There will be no competitive advantage tothose taking this route and so it is not onewe would encourage.

We recommend that as many SHOlevel posts as possible are incorporatedinto specialty training programmes andthat the number of time limited trainingposts is kept small.

Staff grade posts and associate specialistposts would be examples of career posts.Doctors in these service posts will be able todevelop competences through continuingprofessional development. In theory if theycould gain all the necessary competencesand provide evidence for this, they wouldbe eligible to enter the specialist register viaarticle 14. However this should not be seenas an easy option. It will be much morechallenging to cover the curriculum in asystematic, supervised and assessed manneroutside specialty training programmes.

How to keep abreast of the changes.This is a time of great change. We knowthat for trainees in particular theuncertainty of the processes that will beinvolved is also a cause of anxiety. Wesuggest you visit the MMC websiteregularly. We will be updating RegionalAdvisors, Programme Directors and Tutorson a regular basis and they will becascading that information to theircolleagues and trainees locally. We willalso be publishing further updates in thenewsletter and on our website.

Mary McGraw Claire SmithVice president Donald Court Training and Assessment Fellow

FOR THE ATTENTIONOF ALL STAFF ANDASSOCIATE GRADE(SASG) DOCTORSIn order to represent SASG interestsin RCPCH Regional Committeesand to give advice to SASG doctorson career and training issues, theRCPCH has appointed by electionSASG Regional Representatives.

To do their work properly, however,these Regional Representatives needlists of the SASG doctors in theirareas, so that they can inform them ofrelevant developments and keep intouch with them.

In this context, it would beenormously helpful if SASG doctorscould e-mail the SASG RegionalRepresentative in their area and givethem their contact details, keepingthese up to date. The e-mail addressesof the SASG Regional Representativescan be found on the SASG section of the RCPCH website (go to“COMMITTEES” and scroll across.)

It would also be very helpful ifclinical directors and other paediatriciansdrew the attention of any SASG doctorsthey knew to this leaflet.

With thanks for your attention.Natalie Lyth

Chair, RCPCH SASG Committee

There is a SASG update on theRCPCH SASG webpage.

RCPCH Page 7

Advocacy is a challenge. Within theRCPCH ‘s statement regarding “Duties of aPaediatrician” we are reminded that weshould serve as advocates for the healthneeds of children both nationally andinternationally. However, it is difficultenough to conquer the word’s fluctuatingphonetics let alone apply such a powerfulconcept to daily work if there is uncertaintyin our own advocating abilities.

Advocacy has protean definitions suchas “ speaking out in a cause”, “promotingthe rights of oneself or others” or “givingpower to the powerless”. Since itsfoundation, the college has sought to speakout on behalf of children in this countryand abroad, and has made it a duty forpaediatricians everywhere to do the same.The standing committee for Advocacy wasset up with this in mind and to ensure thatthe college held true to this principle.

Are paediatricians succeeding asadvocates? Are we happy in this role and howcould we be more effective? As the Collegereaches the grand age of 10 years and reviewsa decade’s work it is equally as important tolook forward and plan for the future.

As today’s trainees begin to swell theranks of modern day NHS paediatricdepartments will they be able to continuethe excellent advocacy work that has gone

before? A recent survey of 47 paediatricspecialist registrar trainees in the Easternregion is a cause for concern.

Approximately, 50% of all the traineesdeclared they had either a poor or nounderstanding of advocacy and 66% saidthey were unaware of the handbook“Advocating for Children” produced by theCollege (but available only on the website).

However, when provided with adefinition and examples of advocacy, 96%of trainees stated they were applying theprinciple of advocacy on a regular oroccasional basis. Disturbingly this suggeststhere are a significant number of traineeswho in the course of their daily work arespeaking out on behalf of children but areunsure of their methods.

The role of mentoring consultantwould appear to be an ideal position torectify the apparent deficit in knowledgeand confidence but the questionnairesuggests that senior paediatricians have asimilar lack of awareness or concern.Although 33% of trainees had receivedsome formal encouragement or training todevelop an advocating role only 13% oftrainees had ever been assessed on theirability and effectiveness.

The questionnaire empowered traineeswith 90% recognising that despite their

relatively junior positions with effectiveadvocacy they could significantly improvethe lives of children they cared for at workas well as the lives of children in society as a whole. It is unsurprising that 83% of the group wanted to increase therole of advocacy in paediatric training(currently available only as part of Master’s programmes).

The college guide “ Advocating forChildren” has recently been updated and isan excellent resource for all paediatricianswho need to review their working andteaching practice in light of the abovefindings. Copies will be circulated to allmembers later this year.

It may well be that individually weare looking after the interests of childrenvery effectively but as recent studieshave shown, large numbers ofpaediatricians, junior and senior, aremoving away from the more overt areasof advocating, and in particular thedifficult challenges of child protectionwork. This is just one of many reasonsthat those doctors, who are comfortablewith and embrace the role of advocate,need to disseminate their expertise andenthusiasm, widely and vociferously,throughout the profession.

The recent questionnaire hasdemonstrated a keenness within thetrainees of the Eastern region to be moreactive in effectively “promoting the rightsof oneself or others”. Such a positiveresponse would appear to have benefits forboth children and the College.

The publication of the updated collegeguide on advocacy is an excellentopportunity for all members of the collegeto address or revisit their own personalpractice. The Advocacy committeewould be delighted to receive feedbackregarding the guide and to hear aboutspecific examples of advocacy work andtraining that members are currentlyundertaking. There would seem to be astrong case for improving the training inadvocacy for all paediatricians.

Dr Nik JohnsonTrainee Representative, Standing Committee on [email protected]

Advocacy – a powerful voice for the future?

News

Dr Nik Johnson

RCPCH Newsletter Spring 06 Page 8 is left intentionally blank

RCPCH Newsletter Spring 06 Page 9 is left intentionally blank

News

RCPCHPage 10

In 2000 a survey1 of parents attendingpaediatric outpatient clinics in the Bath areashowed that 32% of parents attending had usedthe Internet to seek medical information.Today the figure is likely to be much higher.Parents can easily surf the Internet andoverload themselves with information that is sometimes inaccurate or out of dateinformation. Help lines from certain nationalcondition groups have expressed their concernsabout this. The Rett Syndrome AssociationUK report that they quite frequently receivecalls from families who incorrectly believe theirchild is terminally ill as a result of seeing thecondition described as a progressive degenerativecondition on the Internet. The TuberousSclerosis Association told us of parents whoread about all the complications that couldoccur with that condition and then assumedthey will all happen to their child, causingthemselves unnecessary worry.

There is of course a wealth of goodinformation to be found on the Internet andparents can find this detailed informationreassuring as well as helpful.

“We were reassured about his condition”Parent

“It gave us fuller information so we felt in abetter position to ask more questions”Parent

Parents cannot be prevented fromsearching the Internet and Platt2 suggests adoctor’s way of working needs to evolve tomeet this challenge. To help Contact a Familyhave produced a leaflet for health professionalsto give to parents as part of the Parents andPaediatricians together project. The advice onthis leaflet is based on more detailed guidelinesproduced by Contact a Family and theInformation Management Research Institute(IMRI), School of Informatics, NorthumbriaUniversity, Newcastle upon Tyne.3

The leaflet also includes a list of a fewreliable websites for parents to surf. The newInternet leaflet can be downloaded fromwww.cafamily.org.uk/papt.html.

Paediatric health settings can order printedcopies of the leaflet free of charge to hand out tofamilies by telephoning Contact a Family on0808 808 3555 or emailing [email protected]

Sheila DaviesContact a Family

1 Tuffrey C & Finlay F, Use of the internet by parents of paediatric outpatients, 2002 Archives of Disease in Childhood, 87:534-536

2 Platt M mad Platt A, Conflicts of Care, 2005 Archive of Disease in Childhood 2005; 90:331

3 Judge: Websites for Health www.judgehealth.org.uk

Start Up of Child Health Teaching in West Bank

Three days before the momentous election in Palestine on 25thJanuary there was another historic first in Ramallah when theRCPCH teaching programme was launched. Conceived by DavidBaum in 1998 as a bridge of peace in the Middle East, the programmehas had to overcome innumerable hurdles to get off the ground, inparticular the conflict and consequent difficulties with access. Thanksto the generosity of the David Baum International Foundation, theteaching has now started as a three-month pilot for 10 candidates.These comprise 8 doctors from primary care clinics in three sectors(Ministry of Health, UNRWA and an NGO Medical Relief) and twoMOH nurses who are all prepared to be guinea pigs in the trial of theweb-based teaching which will cover acute conditions, chronic illness

and emotional and behavioural health. The inclusion of nurses hasnot been universally applauded but is felt to be essential in view of theneed for better teamwork at primary care level, and the potentiallyvery significant contribution of nurses to child health care.

We are assisted by four excellent paediatricians from local hospitalsand the medical school who will act as tutors and also evaluate thepilot: Drs Tareq Hindi, Samia Hillaleh, Nizar Maraqa and KhaledElian. The candidates enjoyed the first session which included a trialof some self-directed learning techniques, and have also accessed thespecial RCPCH website developed for this teaching. The ten willmeet weekly with their tutor and during each week have a series oftasks to carry out in their clinics, which they will present at the tutorialsession. The nurses seem to be tough enough to compete with thedoctors and perhaps to take the DCH exam at the end of the fullcourse – if the RCPCH regulations can be amended to allow this.

Following full evaluation we hope to welcome these candidates andmany more onto a year’s course of teaching leading up to a DCH examset in the country.

I am very grateful for the contributions of Jean Bowyer and MaryRudolf in joining visits to the West Bank over recent months, andto Rosalind Topping in ensuring the steady flow of information andresources to the West Bank. A fuller report will appear at the end ofthe pilot. Tony Waterston

British Society for theHistory of Paediatrics andChild HealthAutumn Meeting: Birmingham University 15 -16th September 2006

Our Society is interested in anyaspect of the history of paediatricsand child health anywhere in theworld and at any time.

Speakers will have to presentor read a paper for 20 minutes andthen take questions for 10minutes. Abstracts of up to 250words are accepted.

Enquiries regarding thisconference can be obtained fromits Secretary Mr Bob Arnottemail [email protected]

Any enquiries or just a discussionabout possible presentations can be directed to the PresidentBSHCHP Andrew Williams [email protected]

BSHPCHGuiding Parents Who Seek Medical Information On The Internet

News

RCPCH Page 11

A Passage to India

Although we run our exams primarily fortrainees in the UK, the number taking theMRCPCH and DCH overseas has beengrowing steadily for some time, withcentres in the Middle East and Far East.With so many Indian doctors coming tothe UK to work and to take our exam, wehave from time to time considered whetherwe should offer the exam in India too.Viewed professionally we hoped that theCollege exam might be welcomed as a“gold standard”. Viewed from ourinternational office we hoped that it mightstrengthen ties with Indian colleagues.Indian trainees would save on travel to theUK, and the College Treasurer wouldhopefully not be too unhappy withadditional exam fees. So we would, as theysay, be in a win-win situation.

Projects of this size are not however tobe undertaken lightly. Would the examreally be welcome in India? Once we hadstarted, could we meet the likely demand,or would our Examinations Departmentin London simply be overwhelmed?Whatever we did clearly must notjeopardise the development of the examin the UK to the standards that PMETBand others are demanding of us.

Just as we were preparing to dip our toeinto the water, the first part of the answercame to us. The British Council in Indiahad conducted some market researchsuggesting considerable unmet demand forforeign (preferably British) medicalqualifications. After some promising initialdiscussions in London, a small Collegeteam was put together consisting of DrRamesh Mehta (Vice Chair, MRCPCHPart 2 Board and Chair of BritishAssociation of Physicians of Indian Origin),

Mr Graeme Muir (Head of Exams) andmyself to visit India and reach somedefinite conclusions.

Three days of intensive meetings andhospital visits were the compromisebetween the weeks that it would take to dojustice to the size and complexity of India(on the one hand) and the time each of uscould spare from the day job (on theother). So, no leisurely pink gins on theveranda of some colonial hotel, then.

The British Council in Delhi andChennai arranged an excellent programmefor us. We had valuable discussions with theCouncil staff over the administrativearrangements for the exam, with the BritishHigh Commission over political issues andwith the Indian Academy of Pediatrics overprofessional collaboration. Dr Nitin Shah(current President of the IAP) and ProfHarshi Sachdev (past President) were bothimmensely helpful and it is clear thatrunning our exams would enhance theincreasingly important programme ofactivity that we already have in India.

We followed these meetings up withvisits to hospitals in Delhi - the MaulanaAzad Medical College (MAMC) and theAll-India Institute of Medical Sciences -

two of the premier government medicalinstitutions in India. After an evening flight toChennai, we then had a packed day ofmeetings with British Council staff there andvisits to Sri Ramachandra Medical College,Kanchi Kamakoti Child Trust Hospital and theChennai Apollo Hospital. We were delightedat the very positive reception that we receivedeverywhere and the immediate understandingof the nature of our exams and the facilities thatwould be needed to run them. It would be nounderstatement to say that we were treatedroyally – as the photographs show! – anindication of the keenness of our Indiancolleagues to work with us.

So what did we learn? We are certainthat the exam would be welcomed by amajority of colleagues in India and (inprinciple, we hope) by the IndianGovernment. India over-produces doctorsand giving clinicians internationallyrecognised qualifications was seen as abonus, not a threat. Doctors frequentlywork for a while outside India and thenreturn bringing new skills and experience.Facilities are excellent and there should beno shortage of willing and knowledgeablelocal examiners. Most important perhaps,we have made many valuable professionalcontacts. Any move to take exams to Indiawould however have to be seen in thecontext of our work in India generally, andwe would need to include training forthose taking the exam and for examiners.We would also need to proceed step bystep, ensuring always that we were notplacing too much of a burden on analready overstretched UK operation.There are still many issues of detail toresolve, but we can now confidently takethe project to the next stage of detailedcostings and Council approval.

Three days hopefully well-spent therefore.And now, at last, for that pink gin ….Len TylerCollege Secretary

News

Page 12RCPCH

The RCPCH is once again invitingapplications for the Sir Peter TizardResearch Bursary from paediatricians to undertake a study through the British Paediatric Surveillance Unit.The successful applicant will receiveupto £15,000 towards costs.

The purpose of the bursary:- • To encourage paediatricians who

are not research active to undertake astudy of a rare disease or conditionwhich affects children and which is ofscientific or public health importance.

• To enable paediatricians to furtherdevelop their research knowledge and skills.

• To add to the body of knowledge ofrare childhood diseases and conditions.

• To promote the role of the BPSU inthe surveillance of rare diseasesaffecting children.

• To support the Royal College ofPaediatrics and Child Health’sobjective of building and strengtheningresearch in paediatrics.

Applicants must:• Be members of the RCPCH• Have not previously undertaken a

BPSU study • Be paediatricians with NHS contracts

(PT or FT) who are: a) Specialist Registrar/staff /AssociateSpecialist grade or b) Consultant grade (less than fiveyears in post)

N.B. Priority will be given toencouraging young clinicians in training.

What are the selection criteria?The purpose of the bursary award is toencourage paediatricians to developskills and experience in epidemiologicalresearch. Applications will be judged on:the scientific quality of the application,the justification for the study beingcarried out through BPSU and the likelybenefits to the candidate in terms ofdeveloping their research knowledge andskills. The scientific and public healthimportance of the condition proposedwill be taken into account but will not bea sole criterion. Closing date for initial application isThursday 15 June 2006.Further information is available on the BPSU website at: http://bpsu.inopsu.com/methodol.htm#bursary or from RichardLynn, Scientific Coordinator, Tel: 0207323 7911 or E-mail: [email protected] LynnBPSU Scientific Coordinator

BPSU Bursary Applications Open

We are pleased to announce severalchanges at Archives of Disease inChildhood – all to enhance the visibilityand reputation of the Journal:• On Line First debuted this year –

original articles that are accepted forpublication are posted within 2 weeksof acceptance on ADC online. Theywill then appear in the print edition afew months later. This means that wehave virtually eliminated any timebetween acceptance and “publication.”

• The time from acceptance topublication in the print edition is nowunder six months for both ADC andFetal and Neonatal.

• In January, 2006 the layout of the tableof contents changed. We have revertedto a more traditional presentation –editorials and perspectives, followed byoriginal research, and then reviews.We continue to encourage qualitativeand health services research.

• Both the College and BMJ Publishinghave supported a substantial changein the editorial board. Attempting toreflect the world we live in, the Boardwas reconstituted from January 2006. Members are from the UK,Europe, Africa, Middle East, NorthAmerican, Asia, and Australia. Wehad a meeting in London inDecember of the new board –enhancing the reputation of ADCaround the world, and ensuring morecontent that reflects global healthinitiatives were discussed.

• In the next few months we will besurveying our readers. If you are askedto complete a short on-line survey wewould appreciate your cooperation.Information from our readers iscritical to our success.

Howard BauchnerEditor, [email protected]

Changesat ADC

News

RCPCH Page 13

The Children’s Food Bill (CFB) aims toimprove children’s health now and in thefuture by improving their diet in a varietyof ways. It is intended to improve thequality of children’s food and protectchildren from commercial activities thatpromote less healthy food and drink. Thecampaign for this bill is coordinated bySustain: the alliance for better food andfarming. Already at least 276 MPs, over150 organisations and thousands ofindividuals are supporting the campaign,This article describes what the CFB aimsto do and why a Bill is needed.

The CFB will:• Protect children from the marketing of

unhealthy food and drink products• Introduce mandatory nutrient and

quality standards for all school meals• Prohibit the sale of unhealthy food

and drink products from schoolvending machines

• Ensure compulsory food education and related practical skills in thenational curriculum

• Place a duty on Government topromote healthy foods to children,such as fruit and vegetables

The CFB will be debated again in theHouse of Commons on 16/6/2006. Ifpassed and enacted it will have asignificant effect on the diet of ourchildren, particularly the most needy.

The National Diet and Nutrition Survey1

(NDND) has shown that children aged 4-18 in England are eating:• Over twice the saturated fat recommended• Over twice the salt recommended• Over twice the refined sugars/

carbohydrates recommended• Only a quarter of recommended fruit

and vegetables

This poor diet is thought to becontributing to the epidemic of obesity aswell as being a major influence on adult(ill-) health. NDNS also indicatesprocessed foods contribute to these

problems, and that it is difficult to achieverecommended intakes/consumption profilesfrom processed foods alone.

The quality of food in schools is beingtackled by the government to a limitedextent, following Jamie Oliver’s highprofile condemnation of current schoolmeals (perhaps the culmination of yearsof efforts by professionals). DfESproposals for school food-based standardsare to be implemented in September2006, but will need to be accompanied bysignificantly increased spending on thefood as well as training and support ofkitchen staff.

Improvements are needed in thequality of foods/drinks in school vendingmachines as well as the marketing offood and drinks to children. Ofcom has recommended the restriction of food advertisements to children.2 Thegovernment has chosen to encouragevoluntary controls in the first instance, despite previous experiencewith smoking, alcohol, breast milksubstitutes etc, where voluntary controlsfailed to work. Voluntary controls offood marketing are very unlikely to be effective because failure to comply will give parts of the foodindustry a competitive advantage.Legislation would at least create a “level playing field”.

Meanwhile the food industry isdiversifying their methods of promotingfood and drink, e.g. using the internet.Banning TV adverts alone is unlikely to have a measurable effect. It needs to be done as part of a wider programme to influence what childreneat and drink.

Children need to learn about growing,preparing, and cooking food, as well asnutrition, as a core part of their education,particularly if this is not provided withinthe home.

Promoting healthy food is a tall order!It has been estimated that for every £500spent marketing “junk” food, only £1 isspent promoting healthy eating. A reportcommissioned by the FSA3 concluded

that TV advertising of food to childrendoes have an unwanted effect onchildren’s eating habits. So maybe thebalance should be improved, to reducethis adverse influence.

These actions alone may have littlemeasurable effect, but together theywill start a move towards a moreappropriate environment for ourchildren to grow up in. The RCP/RCPCH/FPH report “Storing upProblems”4 emphasised the need forintervention at all levels if we are tostop the rapid increase in obesity. Thesame message is clear in the House ofCommons Health Committee report ofits inquiry into obesity5 and theDepartment of Health’s white paper“Choosing Health”. Public support forintervention has been growing steadilyover the last few years.

We should accept the challenge to takemore responsibility for protecting ourchildren from unwanted and unhealthyinfluences and to create a betterenvironment for all.

For more information go to:

www.childrensfoodbill.org.ukOr contact me at:

[email protected]

Penny GibsonRCPCH advisor on Childhood ObesityConsultant Community Paediatrician

1 Food Standards Agency, (2000), National Diet and Nutrition Survey of Young People 4-18 years, TSO, London.

2 Office of Communications, (2004), Childhood Obesity – Food Advertising in Context, Ofcom, London.

3 Food Standards Agency, (2003), Review of research on the effects of food promotion to children, FSA, London.

4 Royal College of Physicians, Royal College of Paediatrics and Child Health, Faculty of Public Health, (2004), Storing up problems. The medical case for a slimmer nation. Report of a working party 2004. Royal College of Physicians, London.

5 House of Commons Health Committee, (2004), Obesity - Third Report of Session 2003-04, TSO, London

Children’s Food Bill

Trainees

Page 14RCPCH

Trainees' Committee Chairs' Column for RCPCH Newsletter March 2006Members are asked to cut out or copy and display these pages for all their trainees to see, particularly those who are not members of the College.

Struggling to keep my eyes open andmaintain a pleasant frame of mind, Ihurried along the corridor at 0300.January 2006 and A&E had just calledwith the escalation plan in place, the waittime had increased to 90 minutes and thewaiting room was full of children. Iwondered where they had all come fromas I used a few well-worn phrases and sentmost of them home again. I resisted theurge to rant about changing times as Itried to turn the experience into atraining opportunity for the SHO andinvited her to make me a cup of tea so wecould discuss bronchiolitis. I was thwartedby the announcement of a crash sectionfor 31week twins – my tea would be atleast two hours in coming.

So what? I know that I am not the onlybusy one and that up and down thecountry ‘the busy season’ hits paediatrics.We all are coping with the stresses ofshifts and A&E waiting times and keepingabreast of current training issues becomesa low priority. To help the busy and tiredtrainee, we have summarised some of thesalient points.1. ShiftsMost paediatric trainees are working fullshifts now. It is clear that in order toprovide the best quality of life andflexibility for leave, a minimum of 8people to a rota is required; trusts shouldcontinue to strive to create these rotas.

We were involved in the writing ofWorking the night shift: preparationsurvival and recovery. This is a reallyuseful booklet giving evidence-basedadvice for night shifts. It is beingpublished in February and will be sentto all NHS trusts for distribution tojunior doctors. It will also be availableon our website.2. TrainingThe creation of individual learningaccounts for trainees is in process and isbeing rolled out across all deaneries. Eachtrainee will keep their study leave budgetwith them and can use the money whenthey need it.

There is a general move towardscreating training opportunities within

the clinical work place as well as formalstudy leave. You may choose to use yourstudy leave to sit in a specialist clinic,for example, rather than attend atraining course.

Two child protection courses are beingdeveloped by the College aimed both atSHO level (being piloted) and at moresenior level (still in progress). The juniorcourse is being run through the ALSG. (www.ALSG.org.uk) These shouldprovide both standardised and highquality training in this important field.

Our attempts at negotiating a traineediscount for the RCPCH Spring Meetinghave so far been unsuccessful. Eachtrainee should try to go at least once intheir training period as it is a fantasticexperience even though it is expensive.We will be holding a trainees’ forum onthe Wednesday lunchtime this year andencourage you all to come. 3. Modernising Medical Careers (MMC)The training pathway diagram fromMMC changed in November. Thepaediatric diagram has been changedaccordingly and in its last draft was in its10th version. There is still much that is tobe decided before the new run- throughgrade is established in August 2007 andthere are many issues regarding transitionfrom the old system to the new. The waysand means of selection and assessmentbefore and during the training arecurrently being devised. The main advicethat can be given to the anxiousundergraduates and SHOs out there is tokeep checking the MMC website forinformation on the developments.(www.MMC.nhs.uk)4. Post Graduate Medical Education andTraining Board (PMETB)This has been up and running now sinceSeptember and has taken over the qualityassurance for our training. As such it isnow responsible for ratifying the trainingaccreditation of posts and the visitsprocess. The latter has been a particularsubject of contention but the fewtransitional visits that have taken placehave been successful.

There has also been much publicity

about the rise in fees for CCT and forarticle 14 applications. These fees seemlikely to stay so be prepared to have to pay£750 when you apply for CCT. You alsoneed to make sure that you have all ofyour RITA documentation for the entiretraining period if your application forCCT is to be successful.5. Academic issuesClinical academia is undergoing markedchanges in structure to fall in line withMMC, following the Walport reportoutlining the issues preventing traineesfrom entering into academic training.In the next few years, a run throughgrade will be established allowingfoundation trainees to compete forentry into academic training. Successfulcandidates will enter a clinicalfellowship to obtain an MD or MPhD,and progress to a clinical lectureship.The aim following CCT is to apply forestablished senior lectureships.6. Committee newsWe are looking for a number of newmembers for the committee and self-nomination forms for these posts areincluded in this mailing. Please considerjoining us.

Work on our website is ongoing and wehope that you will see a new improvedlook before too long. Don’t forget that ifyou have any concerns or queries you canalways contact your regional representative(details on the website) or one of us. Welook forward to seeing you in York.

Martha Wyles and Paul DimitriChair and [email protected]@hotmail.com

RCPCH Meetings

UK

� 6 – 7 April 2006Child Protection Training for Senior CliniciansVenue: Postgraduate CentreCity Hospital, BirminghamContact: Diane Reay, Course Organiser,Institute of Child Health, WhittalStreet, BirminghamTel: 121 333 8710E-mail: [email protected]

� 12 – 13 April 2006 Child Protection Training for Senior CliniciansVenue: Birmingham Medical Institute,Highfield Road, Edgbaston, BirminghamContact: Diane Reay, Course Organiser,Institute of Child Health, WhittalStreet, BirminghamTel: 121 333 8710E-mail: [email protected]

� 19 - 21 April 2006Cardiology in the Young ConferenceVenue: Institute of Child Health &Great Ormond Street Hospital, LondonTel: 0207 829 8692 Email: [email protected]: http://www.ich.ucl.ac.uk/ich/html/education/cpdp/apr06/city.html

� 25 April 2006What do we know about ChronicFatigue Syndrome/ME?Venue: The Royal Society of Medicine, LondonContact: Sarah NettleshipTel: 020 7290 3934Email: [email protected]: www.rsm.ac.uk/paediatrics

� 15-19 May Diploma in paediatric Nutrition 2006-02-10 Location: Chilworth Manor, SouthamptonTel: 0207 307 5630Email: [email protected]

� 18 – 19 May 200610th International Paediatric Haematologyand Oncology Update MeetingVenue: Royal College of Physicians of Edinburgh, UKWeb: www.iphoum.com

� 1 June 2006St Mary's NHS Trust Paediatric TeamAnnual Paediatric Allergy Study DayVenue: Royal College of Physicians,Regent's Park, LondonTel: 01234 710930

� 6-8 June 2006 5th Annual Course Dematology for PaediatriciansContact: Megan Wood, Heartlands Education Centre, Birmingham Heartlands Hospital Birmingham B9 5SSTel: 0121 424 3939Email: [email protected]: www.qualityvenues.co.uk

� 12-16 June 2006Management of adolescents withDiabetes – Postgraduate ModuleContact: warwick Diabetes care,University of Warwick, Coventry CV4 7ALTel: 024 7657 2958Web: http://www2.warwick.ac.uk/fac/med/healthcom/diabetes

� 29 June 2006ADHD – Facts not Fiction! Enough’s Enough!Venue: Suffolk ConstabularyHeadquarters Martlesham, SuffolkTel: 0870 881 0464E-mail: [email protected]: www.adhdinsuffolk.org

� 7-8 July 2006Cambridge Summer Paediatric MeetingVenue: King’s College, CambridgeContact: Paediatric Secretariat,Cambridge conferencesThe Lawn, 33 Church Street, Grt Shelford, Cambridge CB2 5ELTel: 01223 847464Email: [email protected]

� 14 – 15 September 2006Paediatric Cardiology for PaediatriciansContact: Dr David Mabin, Royal & Devon Exeter Hospital,Gladstone Road, Exeter, EX4 5EPTel: 01392 406807Fax: 01392 406706E-mail: [email protected]

� 20-21 September 2006British Association for Community Child HealthAnnual Scientific MeetingVenue: ReadingContact: BACCH administrator on Tel: 0207 307 5625 or E-mail: [email protected]

RCPCH Meetings

Abroad

� 6 – 7 June 20062nd Annual Obesity EuropeConferenceVenue: Le Chatelain All Suite Hotel, BrusselsTel: 02920 642 701E-mail: [email protected]: http://www.epsilonevents.com

� 8 – 10 June 9th International Workshop, CatheterInterventions in Congenital andStructured Heart DiseaseVenue: Congress Centre, Frankfurt,GermanyContact: Horst SievertTel: +49 69 46031 344E-mail: [email protected]: www.chd-workshop.org

� 14 – 17 June 2006Drugs & Children, 10th BiannualESDP CongressVenue: StockholmWeb: www.esdpstockholm.org

� 14 – 18 September 2006AMEE 2006 (an internationalassociation for medical education)Venue: Genoa, ItalyTel: 01382 631953 Fax: 01382 631987Email: [email protected]: //www.ame.org

� 9 – 12 September 2007The International Paediatric SurgeryWeek in Buenos AiresVenue: Hotel Hilton, Buenos Aires, ArgentinaE-mail: [email protected]: www.pedsurg2007.org.ar

� 4 – 5 October 2006International Congress, Incentives and Events MarketplaceVenue: MilanContact: Angela BatesE-mail: [email protected]

� 7 – 10 October 2006 The Europaediatrics 2006,C.E.S.P./European Academy ofPaediatrics - EAP meeting Venue: Barcelona, SpainWeb: www.kenes.com/europaediatrics

� 11 – 14 January 2007Pedicon 2007Venue: Renaissance Mumbai Hotel & Convention Centre, IndiaWeb: http://iapindia.org/pedicon07

RCPCH

Meetings

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