The role of a Royal College and a Learned Society in the 21st century

Terence Stephenson

The Future?

• ‘X rays will prove to be a hoax’ Lord Kelvin, president of the Royal Society, 1899

• ‘There is not the slightest indication that nuclear energy will ever be obtainable’ Albert Einstein, 1932

• ‘I think there is a world market for maybe five computers’ Thomas Watson, Chairman of IBM, 1943

• ‘640K ought to be enough for anybody’ Bill Gates 1981

The Past

•Royal College of Physicians

•Barber Surgeons•Apothecaries

The Worshipful Society of Apothecaries of London - historic livery company granting licenses to practise medicine throughout England and Wales since 1815

“The aims of the Association are to promote excellence in research relevant to child health and to support the

teaching of paediatrics”

‘A crowded landscape’

• GMC• BMA• RCPCH• AoMRC• APA (GB & Ireland)• PRS & Specialty Societies• Acad Med Sci• RSM

Role of the RCPCH

• Revalidate - CME• Examine MRCPCH• Training – CSAC’s• Inspiration and careers advice• Set standards• Publish guidance• Leadership and Lobbying• Reconfiguration• Research and academic paediatrics• Journal• Annual Meeting• International & fundraising

Royal Colleges andRecertification

• Revalidation = relicensing +/- recertification

• Although the recertification will be awarded by the General Medical Council, it will be assessed on the evidence submitted to the RCPCH against standards set by the RCPCH.

What tools could be used for recertification?

• Theoretical examination• Multisource feedback• Internal peer review audit of 50 cases• Departmental error/audit meetings• CPD attendance records• CPD points earned through assessment related to educational

events/material• Analysis of complaints/untoward incidents/complications• External peer review of whole department• Logbook of cases• Audit against published data• Performance in on-line assessments of skills/clinical

judgement• Observation of practice

Recruitment

(and retention)

Final Year SpR Career Intentions

by type of post

RCPCH October 2004

• Neonatal intensive care: 90% survival

• Sudden infant death syndrome: deaths halved

• Haemophilus meningitis: deaths abolished

• Acute Leukaemia: 70% survival

Setting standards and implementing them

Reconfiguration

• Currently there are 30,000 consultants, 10% working in paediatrics

• EWTD: maximum will be reduced to 48 hrs

• There are currently 266 acute rotas (general and neonatal, excluding specialist rotas) that have a "middle grade" component

• A 10 person middle grade rota

Reconfiguration ?

• reducing need/demand• providing the same care with different

people (skill-mix)• delivering front-line care with consultants• the reconfiguration of services, with the

closure of inpatient beds, to reduce the requirement for on-call rotas

• International Medical Graduates (IMGs)

Advocacy1928 - 1998 - 2008

Budget: 2004

- £100m increase in NHS R&D funding by 2008- bring combined budget for medical research to £1.2bn- purpose will be to achieve effective and efficient translation of scientific advances into patient care

‘Best Research for Best Health’ 2006:• NIHR £992m in 2010/11• MRC £600m• AMRC £1bn in 2011• Pharma £3.5bn p.a. on R&D

in the UK

Comprehensive Clinical Research Network (CCRN)

From molecules to populations:Translational respiratory research £5.7m

• Departments of Child Health

• Multidisciplinary Research Institutes

• £28m across 4 bids of which 3 involve child health

The future of academic medicine - APA

• Teaching, researching and providing service will continue to be important but expecting individuals to be competent in them all will be increasingly impractical

• Teamwork will become more important

• Competition among academic institutions is likely to increase and the competition will increasingly be international

• Teaching and learning will be increasingly important—not least because dissatisfied students may go elsewhere

• It will be increasingly important to combine research, both basic and applied, with implementation and improvement

Role of the RCPCH

• Revalidate - CME• Examine MRCPCH• Training – CSAC’s• Inspiration and careers advice• Set standards• Publish guidance• Leadership and Lobbying• Reconfiguration• Research and academic paediatrics• Journal• Annual Meeting• International & fundraising