Dear Paediatric Trainees
I am writing to you at the start of some very interesting and different times for the NHS, the country and the world as a whole. I’ve certainly never seen anything like it in my lifetime, and I suspect the nearest you get to a rapid global refocussing like this is before a war. In these times, much changes, but its also important to stay rational, stay focussed on what we are trying to achieve, and to work together. There has been a lot of information coming out, some rapidly updated, with guidance and directives coming thick and fast. I wanted to lay out what the School of Paediatrics, on behalf of all trainees in London and all involved with the development of paediatrics, is recommending at these times.
1 The scale of what is going on
It seems clear that this pandemic will not be causing bulk paediatric problems. Our departments will be affected because our staff will be sick and not able to care for the children who have the normal things that fill our wards up.
The adult side is very different and the DoH is planning for really big numbers of admissions requiring respiratory support. Their staffing will be as big a problem as ours.
At this time, numerous things are being cancelled in the NHS, mostly to flatten out the rise in cases, so not everyone is sick at the same time and we have enough staff to manage.
Its important that we follow guidance carefully and live with it as it changes. there is lots of national and local guidance coming out. please follow it. If you want to track the epidemic, this is useful: https://www.arcgis.com/apps/opsdashboard/index.html#/f94c3c90da5b4e9f9a0b19484dd4bb14
2 Changes to School activities
Sadly, but not at all unexpectedly the School conference on the 24th march has been cancelled. I’d like to thank Andy, Harsita and Susie especially for putting together what i reckon was the best ever conference and it must be a blow to them to see the huge amount of work apparently annulled.
Its a fast moving situation, and we are looking to replace the conference with an abbreviated and streamed event. We may instead move the conference to the autumn. More information in the next couple of days.
Other school events, such as training days and STCs are also not happening. Many we will move to Skype or other types of meeting. Again watch this space.
3 Changes to training and clinical activities
Things may change depending on how bad staffing and patient need becomes. As a marker of intent, the GMC has provided advice essentially allowing medics to work out of their trained areas for patient need. I for instance may well end up looking after adult ICU patients. Again, we are being well led by the DoH, so follow national and local guidance.
Training wise, its business as usual until it can’t be. Local teaching can continue, as local supervision and training. There may be a time where this is not tenable, but it will be more clear as time passes.
As for study leave, it’s a little up in the air. There is no point taking study leave for a course that is cancelled, and as we don’t know how the staffing will pan out, it would be reasonable for trusts to cancel any that you have taken. On the other hand, at the moment, this is not the case. What is therefore suggested is that study leave that has been already granted will not be cancelled now, but expect this may change. Study leave requests for the next 3 months will not be granted, until the shape of the pandemic is clearer.
4 What about….
There are a lot of these, and at this stage there really aren’t answers. A few questions have been arising – for
instance, this diet of START will be cancelled. Where does this place trainees approaching ARCP at the end of training? What about ARCPs – will they continue, and will the criteria be the same for this year?
I really don’t know at this stage, but we will try to do something that is in the best interests of our patients and our trainees.
There will also be issues with money spent on courses that have been cancelled. If it has been approved by HEE, then I am told you will be able to get this reimbursed. If not and you have already paid, claim this back directly from the course organisers.
I will put this letter on the LSP website, and new information will be added as FAQs there for reference.
I hope this has provided some information, and if not answers, at least demonstrates that HEE is watching the situation very closely, and trying to come up with sensible and proportionate responses.
Reader in Clinical Education
Consultant Paediatric Intensivist
Paediatrics, Head of School
St George’s Hospitals NHS Foundation Trust
St George’s University of London
Health Education England