Good Quality Training in Community Child Health

Dr Charlotte McAuley, CSAC Trainee Representative

Dr Cliona Ni Bhrolchain, CSAC Chair

BACCH Meeting October 2012

Content

• What should training consist of?• Support• Assessment• Quality• www.communitychildhealth.org.uk• Question/Answer session

Training in CCH: basics

• Three year programme• Structure– 2 years in CCH– 1 year more flexible

• Curriculum• Competency-based – (except old-style SpR)

Allied subspecialties

• Paediatric neurodisability

• Child mental health

• Audiovestibular Medicine

CCH curriculum (specific areas)

• Child public health• Behavioural paediatrics• Safeguarding• Neurodisability

http://www.rcpch.ac.uk/training-examinations-professional-development/quality-training/curriculum/curriculum

What is a relevant specialty?

– Paediatric neurology– Paediatric audiology– Palliative care– DGH neuro/epilepsy (perhaps 3/12)– Enteral/parenteral feeding (perhaps 3/12)– Long term ventilation (perhaps 3/12)– General paediatrics?? (depends on content)

Remember

• CCT in Paediatrics (CCH)

• MUST be competent in– General paediatrics– Neonatal paediatrics– Community Child Health

• Not just CCH

But…

• Feedback from trainees:– general/neonatal service commitments interfering

with CCH training

• General/neonatal should be – no more than 1/3 of 48 hours– try to preserve daytime clinical commitments

Supporting training

• Curriculum and assessment guidance

• Resource pack of ideas www.communitychildhealth.co.uk

• Guidance on preparing CV

• Guidance on CESR requirements

• Deanery leads for CCH (all deaneries)

• Specialty Training Advisor (STA) for individual advice on

CCT/CESRhttp://www.bacch.org.uk/training/trainees.php

Assessment

• WPBA

• Annual ARCP including trainer’s report

• START

• CCT application (assessed by STA)

http://www.rcpch.ac.uk/training-examinations-professional-development/quality-training/quality-training

Ensuring quality

• Deanery questionnaire (should differentiate CCH)

• GMC questionnaire (should differentiate CCH)

• New consultant questionnaire

• BACCH AGM trainees meeting

• Trainee rep on CSAC

Issues with quality assurance

• No grid– Unable to identify trainees– Unable to monitor trainees

• The solution– Work with Heads of School– Deanery leads for CCH– RCPCH database of all CCH trainees

How many trainees are there?e-portfolio figs; excl SpRs;

London Deanery

West Midlands Deanery

Scotland (all deaneries)

Wales Deanery

Northern Deanery

Severn Deanery

Northern Ireland

East Midlands Deanery (North)

Kent, Surrey and Sussex Deanery (KSS)

0 5 10 15 20 25

Pop 0-15 (100,000s) Number of trainees

Currently in London figs

RCPCH Education & Training Support Workforce Dept

Who encourages CCH trainees?

Oxford Deanery

Mersey Deanery

East Midlands Deanery (North)

East Midlands Deanery (South)

Wales Deanery

West Midlands Deanery

East of England Deanery

Yorkshire and Humber Deanery

Wessex Deanery

0.00 1.00 2.00 3.00 4.00 5.00 6.00 7.00

Percentage of total trainees training in CCH

RCPCH Education & Training Support

Should we have a Grid?

Positive• National profile• Like everyone else• Competition• National standard for

recruitment• More control of

appointment and numbers• Even out numbers

Risks• Lack of mobility might put

off trainees with family commitments

• A lot of time and effort for same result (past experience!)

Remember

• Still subspecialty trainees – not GRID

• Expect 32/48 hours in the subspecialty

• Training needs should be met

• Quality of training should be paramount

• College (CSAC) role is to ensure quality

Suggestions for HoS

• Establish expected workforce needs (next 5 years)

• Re-evaluate CCH training programme– Demand for places– Quality checklist– Trainee feedback– Review of fitness for purpose

Do we need CCH replacements?

RCPCH census 2009

Quality of training

General paediatrics

Community Child Health

Neonates In a DGH In a Specialist Hospital

0

2

4

6

8

10

12

14

16

18

20

How well have the following elements of your train-ing prepared you for your current post?

Very well

Well

Satisfactorily

Poorly

Very poorly

BACCH survey 2012 H Brewer & T Woodbridge

What effect has rotating through posts in dif-ferent hospitals/locations had on your training?

Very positive

Positive

Neutral

Negative

Very negative

What effect has rotating through posts in different hospitals/locations had on your personal life?

Very positive

Positive

Neutral

Negative

Very negative

Certificate of Eligibility for the Specialist Register

• CESR (Combined programme)

• CESR in CCT specialty: Paediatrics (CCH)– Training/qualifications/experience equivalent to CCT

• CESR in non-CCT specialty (CCH)

• http://www.rcpch.ac.uk/training-examinations-professional-development/certification/certificate-eligibility-specialist-register

Website Demonstration

Summary

• Content• Support• Assessments• CCT/CESR• Quality