Developing a community child health service for the 21st century

Section 10: Academic CCH

Professor Alan Edmond wrote a paper for BACCH about the future of academic community child health in 2005. He outlined the threats and opportunities. Citing imminent retirals of a tranche of academics across the UK and difficulties in finding suitable candidates for the replacement posts. The RCPCH census for 2009 noted a small increase (+13 WTE) overall in academic paediatricians across the UK. But there as no specific data about CCH academics.

The CCH21 Steering Group consulted Professor Anne O'Hare (University of Edinburgh) and Professor Charlotte Wright (University of Glasgow) ⁶¹ to garner opinion about the future of academic CCH. The following is a summary of their remarks:

"The academic standing of Community Child Health is reflected in the number of professors in CCH in Scotland. This academic leadership reflects the main areas of work in Community Child ie generic and important paediatric implications such as growth and failure to thrive; neurodisabiliy and child protection. These areas have a resonance for research and academic endeavour and postgraduate training across all the paediatric specialties but with Community Child Health giving leadership.

Community Child Health is particularly well placed for research and supporting of postgraduates because of its child health information systems, eg the Support Needs System and also the Community Child Health Child Protection Database held in Lothian which holds information on all children who come forward for an inter-referral discussion through the child protection referral pathways. The RCPCH Scottish Surveillance BPSU is presently gathering information on the child protection issue of straddle injuries.

The workforce can benefit from research for example by developing appropriate skills for selection of children using clear eligibility criteria to go into research programmes that might involve basic science such as the molecular genetics, translational research and randomised controlled trials.

There are very strong links between Community Child and AHPs, professionals in education and social work and in the voluntary sector which has led to a number of consultants have supervising MDs and PhDs, both with medical staff and also with allied professionals.

A number of consultants in Community Child Health are tutors with the neurodisability diploma in the University of Sheffield and a number of neurodisability trainees have completed this diploma. Postgraduate trainees have presented widely at a range of national and international meetings and Community Child Health regularly supports postgraduates and undergraduates in activities such as audit and special study modules.

Community Child Health has contributed to the evidence base across a range of areas including that of treatments for language impairment and has been able to build on the privileged position that it holds in working across with other professionals and agencies.

Community Child Health is also well placed to conduct research into conditions that have mental health implications and we collaborate with colleagues in child psychiatry and psychology, eg around developing an understanding of attachment disorder in the face of child emotional abuse and its differentiation from empathy disorders such as autism spectrum disorder.

Summary

Community Child Health is well poised to progress the academic agenda and training into the 21 ^st century and can build on the strengths of achievements to date, the scope from child health systems and the multiprofessional, multidisciplinary working that characterises the specialty of Community Child Health. Whilst a number of individuals work in collaboration with basic scientists, this specialty is also very well placed to develop the understanding of outcome tools.

Academic Community Child Health is a separate specialty and along with public health can work closely with the NHS, the Scottish Government and other bodies and play a useful dissemination role as well as undertaking research of direct clinical relevance and much postgraduate teaching and training.