Royal College of Paediatrics and Child Health

Annual Report2005-2006

RCPCH Presidents

Royal College of Paediatrics and Child Health

Annual Report 2005-2006

Copyright © 2006 Royal College of Paediatrics and Child HealthFurther copies available on request – contact publications@rcpch.ac.uk

Professor Sir Roy Meadow 1996-1997

Professor David Baum 1997-1999

Professor Richard Cooke 1999-2000

Professor Sir David Hall 2000-2003

Professor Sir Alan Craft 2003-2006

Dr Patricia Hamilton President Elect

President’s Report 5

Registrar’s Report 8

Education 10

Continuing Professional Development 12

Health Services 14

Research 16

Training and Assessment 18

International Affairs 20

The Devolved Countries 22

Running the College 24

Fund-raising 26

Structure of the College 28

Treasurer’s Report 30

Accounts 32

Response Form 37

Contents

From the College’s Royal Charter

The objects of the College shall be:

(i) to advance the art and science of Paediatrics;

(ii) to raise the standard of medical care

provided to children;

(iii) to educate and examine those concerned

with the health of children;

(iv) to advance the education of the public

(and in particular medical practitioners) in

child health, which means the protection of

children, the prevention of illness and disease

in children and safeguarding their optimal

development.

4

There has been a clear

recognition that the

health of children is

intimately associated

with, and influenced

by, social and

educational factors.

In 2005 the Royal College of Surgeons of Edinburgh celebrated their 500thanniversary – the oldest of the medicalRoyal Colleges. The Physicians of Londonare not far behind. We ourselves are tenyears old and we are no longer theyoungest College since the formation ofthe College of Emergency Medicine in2005. A significant birthday is a time forreflection and for looking forward. TheBPA was founded in 1928 and along withthe Royal College of Physicians served theprofession well until the 1960’s when thefirst suggestions were made that weshould establish our own College. It tookanother 30 years to achieve this goal. Tenyears on we can reflect as to whether itwas worth the effort of our predecessors.George Frederic Still chaired the firstmeeting of the BPA in 1928, which wasattended by only six of the 24paediatricians invited. In his wildestdreams he could never have imagined a College for children with well over 8000members. The major reason to become a College was for paediatricians to be incharge of their own destiny and to have a real voice for children. Our break fromthe ancient Colleges of Physicians was not easy and for a while there were someremaining tensions. In the first annualreport of the College in 1997 the Presidentwrote, “Paediatricians now enjoy similarauthority and rights to those of othermajor medical disciplines. There is theopportunity for greater professionalrecognition of the importance of children,improved status of paediatrics and childhealth, and an enhanced role forpaediatricians as advocates for children.”Ten years on we work closely with allfour Royal Colleges of Physicians in theUK and Ireland. They recognise ourstrengths and we play a substantial role in the Academy of Medical Royal Colleges.We are now in charge of our own destiny.

Three years ago the Department ofHealth recognised the need to reformpostgraduate medical education andchallenged all Colleges to come up with plans to produce a workforceappropriately trained for 21st centurymedicine. We have taken up thatchallenge and redesigned our curriculumwith clear objectives as to what needs tobe achieved at all stages of training. Inthe past, time served in training postswas the major criterion for progression.The public now expects its doctors to be trained to an explicit standard andthis has meant a move to a competency-based curriculum with methods having tobe developed to test these competenciesas they are acquired. There is no doubtthat much of the work that we havebeen doing in this area has been at theforefront of educational thinking and ourwork has become a model aspired to byother Colleges.

We have also needed to modernise ourexam structures. Exams need to be fit forpurpose and to be as objective as oursubject allows. In the past the clinical partof the exam had been something of alottery. What we need to do is to ensurethat good candidates pass and others aregiven feedback as to how improve theirchances in future. Once again we are atthe forefront of development of medicalexams in the UK. Increasingly we arebeing asked to deliver examinationsoverseas. Whilst in many ways this is an attractive proposition we have to becareful not to overstretch ourselves.Clinical spaces in the UK are just about at capacity and we have occasionally hadto defer people to the next sitting. Itwould be attractive to hold more clinicalexams overseas but each sitting takes 10examiners and even if half are localexaminers, finding the other half in today’sstretched NHS will be difficult.

President’s Report

Professor Sir Alan Craft,

President

5

Indeed finding sufficient time from busy NHS or University consultants toundertake College work is increasinglydifficult. The new consultant contract withits very explicit work plan makes it hardto fit in outside activities. Most Trusts arevery generous with their consultants’ timeand we are grateful. However, we mustensure that the College has the staff andstructures to properly support thosepaediatricians who volunteer to help theCollege. Ten years ago we modelled ourstructure on the traditional College modeland philosophy. Most Colleges haverealised over the last few years that this isunsustainable. We are now a moderate-sized business and must act like such. Wehave an annual budget of almost £8m andnearly 100 employees. Len Tyler and hissenior staff, along with officers, have spentthe last year drawing up plans for a newstructure that fits the 21st century.

The NHS is a constantly changingorganisation and the College has to beflexible enough to “go with the flow”.Even such seemingly immoveable objectsas regional deanery boundaries havebeen constantly changed. The StrategicHealth Authorities invented a few yearsback are now being amalgamated intowhat look strangely like the old RegionalHealth Authorities. Primary Care Truststoo are getting together to look like theold District Health Authorities. However,there does seem to have been a consistentmove to decentralise the NHS and overthe next three years all Trusts willbecome Foundation Trusts with a hugeamount of autonomy. The College has to be nimble enough to react to theseconstant changes. There is little that wecan do to influence political dogma butwe can help paediatricians respond andadapt to the changes.

There has been a clear recognition that thehealth of children is intimately associatedwith, and influenced by, social andeducational factors. It seemed sensible,therefore, to bring health, social care andeducation together. At a central level theresponsibility for children’s health hasbeen split between DH and DfES and at alocal level it is anticipated that Children’sTrusts (an amalgam of all those with aninterest in children) will be the vehicle forthe commissioning and organisation ofservices. However, there is a real dangerof fragmentation of services as there is no mandatory model which has to befollowed. In the new NHS there are atleast six possible commissioners ofservices for children and no guarantee thatthey will cross geographical boundaries.What children need are networks of carewhich do not respect arbitrary boundaries.The College is pushing hard to achieve“network commissioning”.

The last ten years has also seen thedevolution of power to Scotland, Walesand to a lesser extent Northern Ireland.This has meant an increasing divergencein the way that the NHS is run in the four countries. The College has adaptedby setting up offices in Cardiff andEdinburgh and our strengthened Welshand Scottish committees are increasinglybeing called upon to give advice topoliticians and the executive.

We play a role in Europe by ourmembership of what is about to becomethe European Academy of Paediatrics, anamalgam of the CESP and the EuropeanBoard. The EU allows more or less freemovement of labour across its boundariesincluding the new accession states, some25 in all. Being trained and on thespecialist register in one country givesautomatic entry on to the register ofanother. Yet there has been nostandardisation of training or ofqualifications. Over the past few years wehave worked closely with our colleaguesin Europe to define curricula for all of themajor paediatric sub-specialties. Assessingprogress through training and itscompletion is more problematic. Very fewcountries have examinations and a greatreliance is placed on satisfactorycompletion of training posts, largely timeserved in a post. Visiting and accreditationof posts is being developed but there islittle enthusiasm for a Europeanexamination, especially from the trainees.But we have successfully run a pilot MCQbased on our own membership exam.Progress in Europe is slow but there willhave to be more integration, evaluationand accreditation of training. The UK is avery attractive place for professionals andwe are seeing increasing numbersapplying for posts here.

The President’s report last year majored onour child protection initiatives. We recentlylaunched the first module of a trainingpackage which has been developed inconjunction with the NSPCC and the AcuteLife Support Group. We envisage that thisone day programme of training will betaken by all trainees and will give them thefundamentals to make them basicallycompetent and confident to take the firststeps in recognising potential abuse andknowing how to take things forward.

6

President’s Report continued

The past year has also seen majordevelopments in the field of medicines for children. It remains a fact that 90% ofmedicines given to newborns and at least50% of those given to older children areuntested in children and, therefore,unlicensed. Recent European legislation will give incentives to the pharmaceuticalindustry to test new products on childrenalthough how to deal with those already onthe market is problematic. In 2004 theRCPCH produced a report, Better Medicinesfor Children, in which it made a number of important recommendations aroundincreasing capacity in paediatric clinicalpharmacology and clinical trials. The DHresponded with a £20m annual budget todevelop a clinical trials network for childrenin order to take advantage of theopportunities afforded by the newlegislation. The national co-ordinating centrehas now been established in Liverpool witha number of regional networks.

In the meantime we continue to need toprescribe medicines for children and 2005saw the production of the first edition ofthe British National Formulary for Childrenwhich is a natural successor to our formerMedicines for Children. The BNF-C isbeing sent free of charge to most doctorsin the UK and already considerableinterest is being shown from othercountries. This has been a majordevelopment over the last ten years and isa tribute to many people and in particularour collaboration with the Neonatal andPaediatric Pharmacists Group.

So my three years at the helm have endedand I pass over responsibility to PatHamilton at the Annual Meeting. My taskas President would not have been possiblewithout the support of the excellentCollege Officers and dedicated staff. I amalso grateful to all of our members andfellows who have supported the Collegeand the Officers in so many ways. I nowreturn to the backbenches and will lookon with interest and pride as we continueto build on the foundations established byStill, Spence, Paterson and their visionarycolleagues in 1928.

7

We are now looking

forward to seeing

much more

involvement for

young people in the

College’s activities.

By the time you are reading this I willhave moved on to pastures new havingtaken up my new appointment asNational Clinical Director for Children in England at the end of 2005. I haveimmensely enjoyed my time as Registrarand it has been a privilege to workclosely with so many of you to takeforward the College’s important work. It has been another very busy year for all of us and this is reflected once againin the number of publications, guidancedocuments and responses we haveproduced and in the increasing number ofmeetings and College organised events.

Child protection continued to have majorprominence on the College’s agendaduring the year. The Child ProtectionCompanion is being published to assist all paediatricians and trainees in their day-to-day work in child protection. We appreciate the hard work that hasgone into producing this document fromcolleagues. Dr Jean Price chairs theCollege’s Child Protection Committee,which has had another very active yearaddressing a number of important issues.Among this work undertaken by theRCPCH was an initiative for judges inlocal areas to give advice to paediatricianson how to present evidence in Court. In the Mersey region, for example, jointtraining has been established with theFamily Law Bar Association to provideCPD, which is of mutual benefit fordoctors and lawyers. The College has also set up the Mini-pupillage scheme,which is a regional system to allowtrainees to accompany judges to court to learn about legal processes. Theimportance of cross-cutting childprotection work was recognised by theappointment of an additional member ofstaff to co-ordinate our child protectionactivities which includes increasing linkswith other colleges.

The 2006 Policy Conference is on thetopic of ‘Modelling Children’s Services for the Future’ to discuss the work theCollege is undertaking to update ourdocuments ‘The Next Ten Years’ and‘Strengthening the Care of Children in the Community’. This is a major Collegeproject to examine which service modelsare the most appropriate for delivering the best care to children in the light of therecent changes, which have taken place.In particular, addressing the impact of the Children’s NSFs on our planning andthinking. It is planned to publish thiswork in the summer.

An important issue that Council hasaddressed this year is how the Collegecan improve the service it provides toRegional Committees and thecommunication they provide to themembership. We have revised andupdated our guidance on RegionalCommittees and will circulate importantCouncil documents to regionalrepresentatives in plenty of time for these to be discussed by members locally and their views.

Communications with members will alsobe improved through further developmentof the website over the coming monthsincluding more links. We plan to includea section on Health Services issues andhave improved information for parentsand carers. In the longer term it is alsoplanned to introduce e-learning.

The College offices in Scotland and Walescontinue to expand to meet the demandsof the devolved governments there andadditional members of staff have beenappointed in Edinburgh and Cardiff.Activities in Ireland have also increasedsignificantly widening the College’s influenceboth north and south of the border.

Registrar’s Report

Dr Sheila Shribman,

Registrar

8

During the past twelve months I havebeen involved in the work to moderniseand restructure certain aspects of theCollege and its committees. Len Tylerdeals with progress in his report (seesection ‘Running the College’). The nextstage is to review the terms of referenceand work plans of all College committeesto ensure they are focussed on the workassigned to them by Council. In future,there will be a greater emphasis on settingup short life working parties rather thanestablishing more committees.

The Patient and Carers Advisory Groupcontinues to play an important role inproviding lay advice to CollegeCommittees. Mrs Carole Myer, who haschaired this Group since its inception in2000, has now stepped down. We willmiss her wisdom and enthusiasm and wethank her for an enormous contribution in this area of work.

The College published during the summer‘Coming Out of the Shadows: A Strategy to Promote Participation of Children andYoung People in RCPCH Activity’. Thiswas to take forward the policy agreed byCouncil to involve young people in thework of the College. The mainrecommendation of the report was torecruit a children’s participation managerand we have appointed Ms SophieAuckland to take this work forward. Weare now looking forward to seeing muchmore involvement for young people in the College’s activities.

Following publication of the KennedyReport last year, the College has beenrepresented on the committee consideringits implementation. In addition, Councilagreed to set up a Kennedy ImplementationGroup to address how the report shouldbe implemented and in particular, toproduce a detailed job description for theSUDI paediatrician. This report will bepublished in the Spring.

The publications approved by Counciland produced during the year includedthe Workforce Census 2003, a Frameworkof Competences for Core Higher SpecialistTraining in Paediatrics and a policyguidance document on Safe CoverArrangements for Paediatric DepartmentsOut of Hours.

We also produced a new short briefingpaper on revalidation on the website,with more guidance expected next year. It highlights the importance of CPD andthe need for regular appraisals. It isexpected that Colleges will be asked toplay an increasing role in setting thestandards for revalidation in the future.

In addition to the production of reportsand guidance the College responded to a wide range of consultation documents.These included:• The Ethics of prolonging life in

Fetuses and the Newborn (NuffieldCouncil on Bioethics)

• The GMC review on Good Medical Practice

• The Acutely or Critically Sick or Injured Child in the District GeneralHospital: A Team Response – TheTanner Report (Department of Health)

and a number of documents in relation toWorking Together to Safeguard Children(Department for Education and Skills).

I would like to thank the President,Officers, Members and College staff for all their hard work and the outstandingsupport provided to me during my periodof office as Registrar. I look forward tomaintaining close links with the College in my challenging, new role.

9

These projects are

varied but the

common thread is

that they aim to

develop knowledge

and expertise in

areas that are

important for all

paediatricians.

The Education Department has continuedwith its mission to provide stimulatingmeetings and courses and expand theeducational activities of the College. TheDepartment consists of just seven hardworking College staff members. They aregreatly supported by the members of theAcademic Board who ensure that theseactivities are of high quality and by themembers of the CPD Sub-committee, whowrestle with the increasingly complexareas of postgraduate medical educationand continuing professional development.

College meetings

The Spring Meeting must continue to be a showcase for scientific excellence andthe contribution of the specialty groups iscrucial for this. They decide which of thesubmitted abstracts are forwarded to theAcademic Board for consideration asplenary presentations. However themajority of papers are presented in thespecialty sessions and it is essential thatthese reflect the needs and interests of their members. The Meeting must beattractive to sub-specialists as well as those with a general paediatric interest.

Of course the College must speak for childhealth in general and therefore this aspectof the Meeting is most important. All sortsof educational activities take place and weare very grateful to those who provide thepersonal practice sessions, symposia andother sessions that make up this richmixture. In 2005 there were excellentsymposia on “Patient Safety: Children andYoung People in the NHS”, and “Autism”.

Because the Meeting is a complex mixtureof many simultaneous activities there arefew suitable venues. This complexity putsup the costs and we do not receive anydirect sponsorship, apart from the revenuefrom the trade exhibition, so the fees arehigher than we would like them to be.However the Spring Meeting makes littleprofit for the College and we keep thecosts and the venue under regular review.

For the third year we distributed a CD -“Highlights of the 8th Spring Meeting” to the 9,000 Fellows and Members of the College. The CD was prominentlydisplayed on the front of the Decembernewsletter. College members wereencouraged to comment on the CD and so far the feedback has been extremelypositive. We hope to produce a similar CD in 2006.

The introduction of electronic submissionof abstracts for the 2005 Meeting was verysuccessful and we have been able todevelop this system to facilitate adjudicationof the papers. The introduction of on-lineregistration in 2005 provided a streamlinedservice to those booking to attend themeeting and cost savings which weredirectly proportionate to its up-take.

Other meetings

The College organises joint meetings with the RSM twice a year. In October“Infectious Diseases: an Update forPaediatricians” was well attended. “Whatdo we Know about Chronic FatigueSyndrome/ME?” will take place at the RSM on 25 April 2006. There is an annualjoint meeting with the Royal College ofPhysicians of Edinburgh. This year the title is “The Art and Science of ChildProtection” and the meeting is scheduledin Edinburgh on 28 September 2006.

Education

Dr Chris Verity

Vice-president, Education

10

Dr Janet Anderson has played a mostimportant role in supporting College Tutorsby organising the planning of the yearlyAnnual Tutors Meeting and the first of aplanned series of meetings for the “Inductionof New Tutors”. The second of thesemeetings is being organised in June 2006.

We have been working with the CollegeStanding Committee on Child Protectionand the Child Protection Special InterestGroup to plan meetings about childprotection, including a meeting on “TheRole of Paediatric (NHS) Managers” whichtook place on 30 September 2005.

We were very pleased to work with Dr Peter Sullivan, the David Baum Fellow(Officer for International Affairs), to helpwith the organisation of a College coursefor Iraqi, Palestinian and Jordanianpaediatricians in Amman in December.This was the second such event, andcomprised two courses: “TeachingPaediatrics and Child Health” and“Paediatric Life Support”.

The development of courses

and teaching sessions

We ran the third Diploma Course onPaediatric Nutrition in May 2005 and thiswas attended by 13 participants/candidates,all of whom had previously completed theInterCollegiate Course on Human Nutrition.The next course will take place 15-19 May2006 in Southampton. The College and thesteering committee are taking forwardnegotiations for a formal partnership withthe University of Southampton that wouldlead to external accreditation for theDiploma. This provides a possible modelfor the development of other courses bythe College.

Other educational activities are wellunder way. The Child in Mind Project isdeveloping three teaching modules forpaediatric trainees, all aiming to enhancetheir appreciation of the complexemotional and behavioural issues thatconfront paediatricians in their practice.

A teaching package for junior traineesentitled “Safeguarding children –recognition and response in childprotection” has just been launched andwe are using a donation from theJohnson and Johnson Pediatric Institute to develop a more advanced childprotection course for senior trainees andcareer grade paediatricians. We are alsoplanning a series of linked days forpaediatricians who are interested inimproving their performance as teachersof the art of paediatrics.

These projects are varied but the commonthread is that they aim to developknowledge and expertise in areas that areimportant for all paediatricians. We hopeto expand such educational activities andwe are exploring the possibility ofproducing web-based learning packages to support these educational initiatives.

1111

Continuing Professional Development(CPD) is a systematic process of lifelonglearning and professional development. Itsaim is to enable paediatricians to maintainand enhance their knowledge, skills andcompetence for effective clinical practiceto meet the needs of children.

The Directors of CPD Sub-Committee(DoCPD) of the Academy of MedicalRoyal Colleges ratified the 2005 updatingof the document “(Ten) Principles forCollege/Faculty CPD Schemes: AFramework for Continuing ProfessionalDevelopment”. The RCPCH schemealready conforms to these principles.

The CPD Sub-Committee of theAcademic Board have substantiallyedited the CPD guidelines for 2006 attheir meeting in September 2005,reducing reduplication and eliminatinginconsistencies and contradictions.

2005 was a progressive year for CPD withthe launch of the online website at the 9thAnnual Spring Meeting. The online systemenables participants to enter and monitortheir returns online, print out pointsummaries and maintain a detailed recordof activities diary. Use of the website isnot compulsory, however the response toits launch has been excellent. Within thefirst month of its launch 540 participantsregistered to use the website, and on the3rd January 2006 there were 1482participants registered to use the onlinesystem. Improvements are currently beingmade to make the website more userfriendly and a diverse range of facilitiesavailable. The New Year will see theaddition of the facility of being able toadd reflective notes online.

The launch of the online websiteuncovered a discrepancy between theapparent participation rate ofPaediatricians on the CPD scheme and the true participation rate. Statistics aregenerated for the RCPCH Council andRCPCH Executive Committee meetings.These show the number of doctorseligible to participate in CPD and thosethat are participating. All previous statisticshad been generated on the assumptionthat all doctors registered on the schemewere actually eligible. The new websitehighlighted that this was not the case.There were 1100 paediatriciansparticipating on the scheme who wereregistered but not eligible. Possiblereasons for these participation status are:retired from practice and not yet removedfrom the scheme, inappropriate grade,change of grade since registration orRCPCH membership lapsed. Since this has been discovered the data has beencleaned and procedures established toensure the standard of the data ismaintained. The current participation rate is 79.4%.

An annual audit of 5% of the RCPCH CPDparticipants is carried out. The results todate show a significant number of doctorswho have insufficient evidence to support25 points claimed for 2004 and no PersonalDevelopment Plan completed for 2004. The participants were asked to complete aquestionnaire regarding the possibility ofauditing internal CPD in the future and theevidence they could produce. The initialreplies show a trend of doctors concernedabout the increased workload relating tocollecting of internal evidence.

2005 was a

progressive

year for CPD.

Continuing ProfessionalDevelopment

Dr Alistair Thomson

Officer for CPD

12

13

It promises to be a

challenging year

but one in which

the RCPCH can

play an active role

both in influencing

the wider agenda

and supporting its

membership.

The prediction, made in last year's AnnualReport, that change in health serviceswould continue to accelerate, has provedto be correct. The introduction ofFoundation Hospitals, Independent SectorTreatment Centres, Payment by Results(PBR), the separation of commissioningand provision in a “Patient Led NHS”, theevolution of NPfIT to Connecting forHealth, and the expected White Paperfollowing the public consultation on “yourhealth, your say, your care” all signal morechange for 2006.

Recent ministerial speeches are setting a fairly clear future agenda. (see http://www.dh.gov.uk/NewsHome/Speeches/SpeechesList/fs/en). While there has beenunprecedented investment in healthservices over the last 10 years, andalthough many targets have beenachieved, overall this has not led to the degree of improvement expected.Consequently, there will be a focus on increasing choice, competition andcontestability, strengthening ofcommissioning, and increased regulation/inspection. Each of these elementsrequires better data capture, informationand knowledge, and much will depend on the success of the many Connecting for Health projects.

Given the enormity of the agenda, theHealth Services Committee (HSC) andPaediatricians in Medical ManagementGroup (PIMM) have spent some timerevising their remit and work plans, tocomplement one another, with HealthServices taking a more strategic view, andthe Medical Management group a moreoperational approach. The intention is todevelop a more proactive approach to thehealth policy agenda, with application inthe four nations, while simultaneouslyproviding more support to paediatriciansin leading roles and those involved inmedical management.

Given the importance of the informationagenda, the e-mail Informatics Forum hasbeen complemented with a College ChildHealth Informatics Working Group,consisting of members who represent the College on outside groups orcommittees. The external agenda thisyear has focused on the informationsharing, Choose and Book, and the workof the Care Records Development Board.In addition, the Department of Health isabout to have its first meeting toconsider the implementation of the NSFInformation Strategy.

Future workforce estimates continue to be a major preoccupation and mademore difficult by all the changes inpostgraduate medical education, thechanging workforce agenda and, inparticular, the potential for rolesubstitution between professions ascompetency-based approaches are rolled out through the health service.

During 2005 the College Workforce Teamreported on the 2003 census, highlightingproblems in the community and academicpaediatric workforce, and the growth ofnon-standard trust grade doctors. A furthercensus of career grade doctors and SHOsis now under way, alongside an SpRcareer intentions survey in order to informthe DH modelling process. The WorkforceTeam have supported both HSC and PIMMin undertaking surveys on the newconsultant contract, treatment centres anddesignated and named doctors for childprotection as well as contributing to theDH sponsored National Child HealthMapping Project.

Increasingly, services are being deliveredby teams working within wider networks,which will require even better workingrelationships between the variousprofessional groups involved, and this in turn needs to be supported by theorganisations representing those groupsthrough closer working relationships.

Health services

14

Dr Simon Lenton

Vice-President for Health Services

The Quality of Practice Committeecontinues to appraise and produce distillatesof the best evidence and the future focuswill be to find ways that this best evidencecan be put into practice at a local level.This fits well with the improvement agenda,and the potential future role of professionalbodies to support both individuals andsystems to deliver best possible care.

The major piece of work for 2006 isprovisionally entitled “Modelling theFuture”. The remit is to initially produce adocument that “proposes models of servicedelivery for children and families andexamines their applicability in a range ofsettings, covering small, medium and largepopulations; both in urban, rural andremote areas”. The medical workforceimplications of the various models,recognising the importance of teamworkand the competencies of other professionalgroups will then be examined.

It promises to be a challenging year butone in which the RCPCH can play anactive role both in influencing the wideragenda and supporting its membershipwith practical responses to the variouspolicy initiatives.

15

A number of

important research

activities have been

initiated and

completed this year.

This year has been both successful andeventful for the College’s Research Division!The year began with the launch of the firstRCPCH evidence-based guidelines: on themanagement of CFS/ME. This wasorganised by our collaborators, the patientsupport group AYME (Association ofYoung People with ME), at the Houses ofParliament. The guidelines have been wellreceived and we hope that they will makea contribution to improved standards ofcare for children with this puzzling yetdebilitating condition.

In May we re-located to new officesaround the corner from 50 Hallam Street.This move, which was in part due to thegeneral pressure on office accommodationin the headquarters building, also offeredan opportunity for the College todemonstrate its commitment to evidence-based paediatric practice by sublettingsome of the new space to the NICECollaborating Centre for Women’s andChildren’s Health. Co-locating the ResearchDivision with the NICE children’s team,led by Dr Monica Lakhanpaul, apaediatrician from Leicester, offers excitingpotential for closer collaboration betweenthe two units in the future.

In June 2005 the Research Divisionorganised one of the most colourful andenjoyable events I have attended at theCollege to mark the end of the 2-yearproject to develop a children’sparticipation strategy. This work involvedconsultations with over 70 children aswell as staff and members and the report“Coming out of the Shadows” maderecommendations for the RCPCH abouthow to encourage and support children’sparticipation. For the event, the Collegebuilding was festooned with balloons andboth children and adults were entertainedby clown doctors and an improvisationaltheatre group. Professor Al Aynsley-Greenattended as a guest speaker.

We believe we are the first medical Royal College to develop a participationstrategy targeted at children and youngpeople and I am pleased to report that at the time of writing the mainrecommendation of the report, theappointment of a Children’s ParticipationManager has already been delivered.

A number of important research activitieshave been initiated and completed thisyear. The team has been working on twonew RCPCH evidence-based guidelines.The first is to update the 1995 guidelinesfor the screening and treatment ofRetinopathy of Prematurity (jointly withthe Royal College of Ophthalmologists)and work has been continuing onreviewing the evidence for the physicalsigns of child sex abuse. The latter project,which is being undertaken with theAssociation of Forensic Practitioners andthe Royal College of Physicians (RCP) willresult in a clinical handbook to replace the RCP book last printed in 1997.

2005 has also seen some changes to theclinical effectiveness programme run bythe Research Division. At the beginning ofthe year we had three new staff and theautumn saw the departure of Dr HarryBaumer, who has chaired the Quality ofPractice committee (QPC), integral to thisprogramme, for the last 5 years. It waslargely due to Harry that the RCPCH’sguideline appraisal programme, which has now delivered over 25 appraisedguidelines, was initiated. We are extremelygrateful to him for his unfailingcommitment and hard work on behalf ofthe College to promote evidence-basedpractice. His role has been taken over byDr Edward Wozniak and we look forwardto an exciting new era of evidence-basedwork under his direction which is likely tosee gradual shift in focus from appraisingguidelines to providing implementationand audit tools to support members.

Research

Professor Neil McIntosh

Vice President, Science and Research

16

Supporting doctors in child protectioncontinues to be high priority on theCollege agenda and the Research Divisionis helping to deliver this. In 2005 the 2004survey of members about complaints inchild protection was followed by aqualitative interview study by Dr JackieTurton to identify why paediatricians arevulnerable to complaints in childprotection. Over 70 paediatricians wereinterviewed and preliminary findingsindicated how stressful the experience had been for many. Factors that appearedto trigger a complaint included diagnosticuncertainty, the way in which the possiblediagnosis was communicated to families,failures in multi-disciplinary working, lackof expertise or failure to follow goodpractice and a lack of resources such asspace, time and skilled staff, especially out of hours. A full report of the researchfindings will be available in early 2006.

Obesity has been another College priorityand RD work in this area includesfacilitating the development of an obesityresearch initiative. A multi-disciplinarygroup of experts has developed a researchproposal to evaluate interventions toinfluence early nutrition, dietary, physicalactivity patterns in infancy based on healthvisitor education. In 2005 the RD alsocompleted 13 months surveillance on non-type 1 diabetes through the BPSU partlyfunded by Diabetes UK. Preliminaryfindings suggest an incidence of non-type1 diabetes in under 17’s of 1.16/100,000and 0.43/100,000 for type 2 diabetes withover 87 cases of obesity-related type 2diabetes notified over the period. Asecond BPSU study by research staff, on early-onset eating disorders, incollaboration with the Royal College ofPsychiatrists, began in May 2005 and inthe same year funding was received fromthe Department of Health for a pilot studyin collaboration with the Scottish Neonataland Paediatric Pharmacy Group to test thefeasibility of national surveillance ofadverse drug reactions (ADRs) in childrenwhich will begin in 2006.

The workforce team, under the directionof the Officer for Workforce Planning, Dr Sue Hobbins, published the results ofthe 2003 census early in 2005. Althoughnumbers of paediatric consultants continueto rise, the census revealed concernsabout the numbers of community andacademic staff, as well as significantgrowth in non-standard Trust grade doctorposts. The 2005 census is now under wayand results are expected during 2006. A report on the career intentions of finalyear SpRs also showed that more than40% of trainees aspire to work part-timeon becoming consultants. The imminentintroduction of MMC and the run-throughgrade has meant the workforce team hasworked closely with colleagues in Trainingand the NHS Workforce Review Team toplan the numbers of trainees needed tosupport future needs.

The forthcoming year is a particularlyexciting one for the BPSU and marks our20th year of surveillance. Over this periodthe unit has facilitated surveillance of over 60 conditions, identifying more than20,000 cases, data from which has leantitself to over 300 publications andpresentations. To recognise thisachievement the Unit will be holding asymposium at the ICH London in May2006. We are also launching a new BPSUwebsite and would urge you to visit thesite and also ask your Trust webmasters toadd a link to it at http://bpsu.inopsu.com.

The past year has seen the BPSUExecutive consider seven preliminary andthree full applications for new studies,with three studies, MRSA, scleroderma andearly onset eating disorders commencingin 2005. The Sir Peter Tizard bursary for2005 was awarded to Dr Shamez Ladhaniand his study on Malaria commenced inJanuary 2006. With five studies ending in2005 we have spaces available on theorange card, so may I take thisopportunity to encourage those with ideasfor a surveillance project to contact theBPSU. The return rate for the orange card

remains over 90% though this is downnearly 2% on 2004 so we do urge all who receive cards to return them. On theinternational front the BPSU continues toserve as the link between the InternationalUnits and will be hosting the fourthINoPSU conference in London in 2006.

Finally there have been several changeson the Executive. Professor Mike Preece is stepping down as chair after nearly fiveyears, Mike Richardson and Bill McGuireafter five years also stepped down fromthe committee, we thank them all for theirinvaluable contribution. As always thesuccess of the BPSU is wholly dependenton the contribution of the paediatriccommunity, and on behalf of ourinvestigators we thank you.

Finally, it is very exciting to report that in November the RD secured the awardof a 2-year contract from the HealthcareCommission to develop and implement anational programme of audit of neonatalintensive care. The project will start inJanuary 2006 and involves a web-basedcollection of a minimum audit dataset,already developed with substantialclinical and parental input. It is hopedthat this audit will encourage neonatalunits to participate in a qualityimprovement programme.

17

We have come up

with a programme

that will enable the

trainees of the future

to acquire all the

competences they

need in the breadth

and depth that is

suitable to their

chosen career.

It has been another extremely busy yearfor the Training and Exams Departments.We have been trying to keep up with all the challenges posed to us by thePostgraduate Medical Education andTraining Board (PMETB) and ModernisingMedical Careers (MMC). We have furtherdeveloped the curriculum and have now,we hope, finalised our trainingprogramme, ensuring that we are happywith the quality and suitability of thecontent, whilst also conforming to thepressures placed on us by MMC. We feelthat we have come up with a programmethat will enable the trainees of the futureto acquire all the competences they needin the breadth and depth that is suitable to their chosen career. We feel that theprogramme is truly competence-based andhas built into it sufficient flexibility toallow trainees to progress through itaccording to their competence, theirconfidence, and the context in which theyare training towards their chosen eventualspecialisation, whether this be in generalpaediatrics or in one of our subspecialties.We have worked hard to accommodatethe needs of academic trainees and havehad discussions with our Academic Panelon how best to incorporate their needs.

We have done a lot of thinking abouthow we will select trainees fromFoundation years into a run-throughgrade for our specialty. We talked withthe GPs and other Colleges about havinga common first year with them but havecome to the conclusion that we wouldlike to select into the first year those whoare really enthusiastic about paediatrics.We must of course cater for those whoare undecided or change their minds andso are working on mapping our commoncompetences with those of, for example,the GPs. We will need careful workforceplanning to accommodate trainees intothe new grades.

With considerable hard work from ourEducation Adviser, Kim Brown, we havefinalised the next stage of our competence

framework, and published thecompetences for core higher specialisttraining. We have also made considerableprogress on the post-core trainingcurriculum. Clearly there need to be 14 ofthese to incorporate all our subspecialties,including the new subspecialties ofPaediatric Neurodisability and PaediatricAccident & Emergency Medicine. Each of them will have a common, genericcurriculum, suitable for all who willbecome paediatric consultants, as well as detailing the depth of the subspecialtyexperience in training that they will need.

We had another successful year of runningthe NTN Grid. This is an immenselycomplex process, whereby we ensure that trainees are appropriately placed inaccredited programmes for subspecialtytraining. This inevitably involves some ofthem moving regions in order to get theexperience they need, and the Deans havebeen extremely accommodating inallowing us to do this and in helping tofacilitate the process. We hope that mosttrainees will get their first choice ofsubspecialty and geography, and we doour best to ensure that this happens.

Competence-based training means that weneed to have robust assessment processes.Our first assessment is, of course, ourexamination, of which we are extremelyproud. The Examinations Department, ledby Graeme Muir, and our ExaminationsOfficer, Tom Lissauer, have continued todo a superb job in delivering, around theUK, an exam which is mapped to ourcompetence framework, and which hasbeen rigorously evaluated. The new multi-station clinical examination has been asuccess and we are very pleased with it.Sadly, one of our evaluation processes hasidentified instances of cheating in thewritten papers. We were extremelydisappointed to find this and have had todevelop a policy to deal with this and anypotential future offenders. We have madeprogress on updating the DCH clinicalexam and have established an exams

Training and Assessment

Dr Patricia Hamilton

Vice President, Training and Assessment

18

office in Scotland as well as continuing to deliver the examination abroad.

Workplace-based assessment has occupiedus greatly this year. Mary McGraw, ourOfficer for Higher Specialist Training, andClaire Smith, our Donald Court Fellow,have both done a huge amount of workto facilitate hard-pressed paediatricians indelivering workplace-based assessment.Helena Davies and her team at Sheffieldhave been of immense help to us withrolling out and evaluating the multi-sourcefeedback (SPRAT) to core and post-coreSpRs. Rachel Howells has helped us todevelop a video assessment tool for clinicconsultations, which can be adapted foruse with individuals, particularly thosewho need further help in such situations.We will continue to look at otherassessment tools and map these to ourcompetence framework next year.

Claire Smith and Mary McGraw have hadto cope with the changes that PMETB isproposing on the visiting process andhave led the responses to the manyquestions that PMETB has proposed. Thechairs of the College Speciality AdvisoryGroups have continued to do invaluablework with the specialist visits and theNational Grid process.

Alix Clark and her team at the Collegehave put an enormous amount of workinto developing our response to Article 14, together with Wilson Bolsoverand Penny Dison. The processes ofapplication for admission to the SpecialistRegister via Article 14 are immenselycomplicated, and we have had to takepart in numerous consultations anddevise College-specific criteria for thosewho wish to apply via this route. We are doing our best to help Staff andAssociate Specialist Grade doctors whoare eligible to get through the process.Fran Ackland has been instrumental inhelping us to produce a careersbrochure, which should be availablesoon for use at careers fairs, and toencourage those currently in medicalschool or foundation training to choosepaediatrics as a career. We have beendelighted to see the SafeguardingChildren basic training programme cometo fruition and Neela Shabde, who hasled on this in conjunction with theNSPCC and the ALSG, has done anenormous amount of work.

Similarly Avril Washington and her teamhave worked hard on the Child In Mindproject, the first phase of which is nowcomplete and the second has been

successfully piloted. The mini-pupillagescheme, which aims to deliver sometraining and experience in family justicecourts, was developed further and wehope to roll this out next year.

Janet Anderson has put in a lot of workinto supporting tutors and has runsuccessful training days for them. We hope to expand this into a course for“educating the educators” in future.

Barbara Golden has run the internationaltraining scheme which continues to attractapplicants from abroad who then taketheir expertise back to their home country.

Many other people have contributed tothe hard work and success of the Trainingand Assessment department, and as this is my last report as Vice-President, I’d liketo record my thanks to all of thosementioned above and also to all of thoseit has not been possible to nameindividually, which especially includes all the Tutors, Regional Advisers, andExaminers, who have served the Collegeso well over the last year.

19

The College is

committed to try

to influence

governments to move

child health higher

on their agenda.

Why must the Royal College of Paediatricand Child Health maintain an internationaldimension? Because, as paediatricians, wewant to help create conditions that willimprove the lives of children. Because werecognise that it is in those areas of ourworld with least resources that children’shealth is most severely under threat. Becausewe recognise that as a Royal College…aCollege of Paediatricians…we are rich inresources. We have “know how” that, whenput together with a relatively small amountof money, can accomplish a great deal. Andfinally, because British paediatrics isregarded (especially in Commonwealthcountries) as a benchmark for excellence.

The College is amongst organizations thatare calling for the next decade (the

countdown to 2015: the deadline for theMillennium Development goals to beachieved) to be “the Decade of the Child”.The College is committed to try to influencegovernments to move child health higher ontheir agenda over this period.

Over the last six years we have developedan international strategy underpinned by adesignated budget for international affairsand an excellent administrative infrastructure.The focus of our strategy is the educationand training of paediatricians in order toimprove child health. The David BaumInternational Foundation (DBIF), guided byan energetic Trustees Advisory Group, hasgone from strength to strength and hasfunded numerous educational projectsaround the world.

International Affairs

Dr Peter Sullivan

David Baum Fellow (International Affairs)

20

Figure 1. East African delegates from the “Best

Evidence” course funded by DBIF and run by

Dr Mike English (top right) in June 2005 in

Nairobi, Kenya

Figure 2. Delegates on the College’s Training-

the-Trainers course exploring small group

teaching in Dar es Salaam, Tanzania

(October 2005)

The College’s programme of internationalwork spans many countries in 4 continents:In the Balkans we have helped promotethe formation of the Kosovan PaediatricAssociation. The College has signedMemoranda of Understanding with theUniversity of West Indies, the West AfricanCollege of Physicians, the Indian Academyof Pediatrics and the Pakistan PediatricAssociation to promote mutual benefit and ongoing collaboration with paediatricinstitutions abroad. In South Africa wehave helped set up a review of nursingprovision at the Red Cross Hospital inCape Town. We have run evidence-based training courses in India, Braziland Kenya. In Tanzania we have directlysupported post-graduate paediatriceducation at the Universities of Tumainiand Muhimbili. Also in Tanzania we areassisting the World Health Organizationto set up training courses forpaediatricians from throughout EastAfrica to improve case management of children with severe malnutrition.

One of our most important areas of workhas been in the Middle East. Dr TonyWaterston and his team have patientlypersevered through many difficulties todeliver an excellent training programmefor Palestinian paediatricians. In a jointventure with the Jordanian PaediatricSociety, we have provided training coursesfor paediatricians from all the majorpaediatric centres in Iraq.

Many other College activities and groupshave an international dimension such asthe International Child Health Group, theInternational Paediatric Training Scheme,the VSO programme, the InternationalScholarship schemes, the MembershipPanel and, in particular, the work of theExams Department which oversees therunning of examinations in 17 countriesaround the world.

This is my final report as the first DavidBaum Fellow. I now hand over the reinsto Dr Stephen Greene, who will beassisted by Miss Shanaz Islam in theInternational Office and by three newAssociate International Directors withspecial responsibility for South Asia, Africaand the Middle East. I wish them everysuccess in their efforts to maintain theCollege’s international dimension.

21

Figure 3. Professor Luay Al-Nouri from Iraq receiving a copy of James Spence’s “The Purpose and

Practice of Medicine” from the David Baum Fellow at the closing ceremony of the course in

December 2005 in Amman, Jordan.

Wales

We have seen some changes in the RCPCHWelsh Committee this year. I have taken overfrom Jo Sibert as Officer for Wales and MichaelMaguire has replaced David Tuthill as theCommittee Secretary. John Barton has alsofinished his term as Regional Advisor and beenreplaced by Robert Evans. They are a hard actfor us to follow and I know we would all liketo thank them for their hard work on behalf ofthe College over the last few years.

We have also settled into the (now not so)new Office in Cardiff Bay, where ouradministrator Siobhan Conway deals with

the running of the College affairs in Walesassisted by Elen Evans. Although not aWelsh speaker myself, I am pleased wehave someone in the Office who can speakthe language.

The Welsh Assembly Government hasproduced a document called Designed forLife, to help achieve the ambition of “world-class healthcare and social services in ahealthy, dynamic country by 2015”. This islikely to see changes in the way the NHSworks in Wales and therefore changes inPaediatrics and will probably provide quitea challenge for us. We are seeking theviews of members to ensure that children’sneeds are considered by those responsible

for suggesting changes. To that end I havealso met with some of the Assemblymembers during the year, including theHealth Minister and the Minister forChildren. The National Service Frameworkwas formally launched by the First Ministerin September, with the support of all theparties and although there is no allocatedfunding for it, we hope it will help improvethe health (and other) services that childrenin Wales receive.

The first stage of the Children’s Hospital forWales was opened on St David’s Day thisyear. It includes medical wards and anoncology ward and out-patients area.Fundraising is continuing for the second

Scotland

I have enjoyed my first nine months asScottish Officer and I am starting to get myfeet under the table. I am pleased to reportsome of the highlights of 2005.

Office ExpansionIn May 2005 the office expansion meant amove from the first floor of the RCPE tothe Second Floor where we now have twomeeting rooms and two offices with asmall kitchen and toilet facility.

New StaffClaire Burnett joined us in June 2005 as afull time Administrative Assistant. Clairesupports the Scottish Officer and the OfficeManager. Daniel Crane joined us from theLondon Office in October as the full timeExaminations Coordinator for Scotland.

Scottish CommitteeIn line with the Executive Committee of RCPCH the Scottish Committee isseeking to streamline in 2006. This effortwill save both professional time andexpense and will allow us to hold ourcommittee meetings in our new officesat 12 Queen Street, Edinburgh. There isalso great enthusiasm for video-conferencing facilities to be installed inthe new office and are seen as anessential component for efficientprofessional interfacing.

We welcomed Dr Peter Fowlie as our newHonorary Secretary in April 2005.

Regional Representatives/Regional AdvisersSince 2004 there have been more RegionalRepresentatives in Scotland and theScottish Committee is looking at active andconstructive ways of using this group of

individuals. This may mean that they willattend regional meetings as opposed tothe Scottish Committee in future.

Regional Advisers continue to meetregularly and are involved along with theScottish Officer in National Planning andNTN Grid Meetings.

Development of Examinations in ScotlandAs part of the ongoing process of taking over the running of the MRCPCH in ScotlandDaniel Crane was appointed as ExaminationsCo-ordinator in Scotland in August 2005. Asof January 2006 RCPCH in Scotland will beentirely responsible for the running of bothclinical and written examinations.

Dr Alan Houston remains the PrincipalRegional Examiner for the West ofScotland and we have appointed a new

Ireland

The Ireland Committee meets in Belfastin January, in York at the Spring AGMmeeting and in Dublin prior to theFaculty of Paediatrics RCPI AGM. DrAlun Elias-Jones represented the RCPCHat all meetings.

2005 was a relatively quiet year for theCommittee. We met in January with the

Commissioner for Children in NorthernIreland, Mr Nigel Williams and with MsEmily Logan, Ombudsman for Childrenin the Republic. Both people havestatutory and reactive responsibilitiesconcerning children. Both peopleemphasised their advocacy roles.Paediatricians in both jurisdictionscomplained about gaps in services,inadequate consultation with governmentand failure to prioritise children’s needsin health budgets.

The BNF for Children has beendistributed to paediatric units inNorthern Ireland (NI). A reply isawaited from the Health ServicesExecutive in the Republic (ROI). Therehas been no change in the MRCPCHexamination situation. There has beenrelatively little cross border movementdue to a frustrating combination offactors. SpRs in paediatrics are able to avail of training days in the ROI and NI.

The Devolved Countries

22

phase which will include surgical beds and theatres.

On the academic front in Wales, SaileshKotecha has taken up the post ofProfessor of Child Health and JohnGregory has been deservedly awarded apersonal Chair. A few years ago Waleshad one Professor in Paediatrics, now wecan boast four. The All Wales Child HealthNetwork (LINK) goes from strength tostrength, having recently appointed a parttime administrator and been successful ina joint application (with Children in Walesand the Paediatric Palliative CareNetwork) to obtain funding to set up aChild Health Research Network. We are

also a pilot site for the CEMACHchildhood death survey, reporting ofwhich has been added to the WelshPaediatric Surveillance Unit green card.

On a more social front the St David’s DayLecture this year was held in Cardiff witha wonderful talk from, the then Presidentof the Royal College of Psychiatrists, MikeShooter. We have also had our usual twomeetings of the Welsh Paediatric Society;the first hosted by paediatricians inWrexham and held jointly with ourcolleagues from Ireland; the second inMerthyr Tydfil, the first time to myknowledge that the meeting has beenheld in a football club.

Finally, for anyone who wishes to contacttheir regional representative on the Welshcommittee, they are Brendan Harringtonand Val Klimach (North Wales), TomWilliams and Alison Kemp (South & EastWales) and Gareth Morgan and DewiEvans (Mid and West Wales).

PRE for the South East – Dr ChristopherSteer (Kirkcaldy) and a new PRE for theNorth, North East & East – Dr SteveTurner (Aberdeen).

We are very grateful to Drs Tom Turnerand Tom Marshall for their hard work inexams in Scotland in the past and for TomMarshall for his continuing contribution.

Thanks also to Graeme Muir, Head ofExaminations in London, for his lecture atthe Policy Conference in October and hishelp and support in this period of changein Scotland.

RCPCH Scottish Policy ConferenceThe Policy Conference was held on 28October 2005 in the Stirling ManagementCentre and looked at Improving ChildHealth and the Way Forward inImplementation of the National

Framework. In the afternoon Neil Gibsonled the debate on Postgraduate Trainingfor Paediatricians in Scotland, andGraeme Muir addressed the audience onExaminations in Scotland and How to bean Examiner.

St Andrew’s Day SymposiumThis joint event with our College, SPS,RCPSG and RCPE was a very successfulday, with 178 attendees, held in the RoyalCollege of Physicians, Edinburgh on 23rdNovember 2005. There were high qualitypresentations. Professor Neil McIntosh,Vice President of Science and Research ofRCPCH, gave the RCPCH address “WhatHave the Romans Ever Done for Us? YourCollege Research Division” and presentedthe prizes, and Dr Robert Tasker ofAddenbrookes Hospital, University ofCambridge gave the Charles McNeilLecture entitled ‘Sea-horse, Egyptian God,

Spaceman in a Rocket and the Decadesof the Brain’. Next year SACCH willbecome a co-sponsor of this event, thus integrating almost all Scotland’spaediatricians at this meeting.

ConsultationsWe have this year assisted with 10consultations from the Scottish Executive.This is an important part of our remit andthe Scottish Executive is now takingadvantage of the Scottish Office of RCPCH.

The ROI now ranks seventeenth in BPSUmonthly returns and NI third. The IPSUcard for 2006 will include 3 cross borderstudies on childhood stroke, peanutallergy and on non-CF bronchiectasis.The number of paediatricians in ROI and NI has expanded and it is hopedthat all new appointees will becomemembers of RCPCH. Paediatricians in the ROI have benefitted greatly, andwill continue to do so, from RCPCHactivities and publications such as the

Kennedy Report, the Child ProtectionCompanion and the BNF for Children.

Plans are in preparation for a newchildren’s hospital in Belfast. It is hopedthat the Northern Ireland Assembly willrecommence in 2006. A review ofpaediatric hospital services, particularly for Dublin tertiary specialties, is beingconducted in January 2006. JoeMcMenamin is the current Dean ofPaediatrics RCPI. The Ireland

Committee owes a great thanks to MoiraStewart who will step down as Secretarythis year.

Dr Gwyneth Owen

Officer for Wales

Dr Adrian Margerison

Officer for Scotland

Professor Denis Gill

Officer for Ireland

23

The College belongs to

its members and is

ultimately answerable

to them for all that

it does.

The College continues to grow rapidly, forwhich (on the whole) we should begrateful. More people wish to be members,which gives us more resources - people andcash - which allows us to do more work onbehalf of children and on behalf of theprofession. This work is illustrated in thepreceding chapters of this Annual Report.How we organise ourselves to do that workhas been a continuing preoccupation for usduring the year. One self-evident truth isthat it is becoming more and more difficultto persuade employers to releasepaediatricians to carry out essential work forthe College, acting as officers, regionaladvisers, Councillors, examiners, tutors andcommittee members. As the time of ourmembers becomes a more and morevaluable commodity we must use it moreand more efficiently. In part this meansstreamlining our processes, and in part itmeans the delegation of tasks not requiringclinical expertise to paid managers andadministrators. We have looked at bothissues during the year. We have slimmeddown Executive Committee and we havetried to make Council meetings morefocussed, so that Councillors canconcentrate on issues of strategy andgovernance and more easily hold theexecutive to account over its achievementsagainst agreed targets. The process ofdelegation will be gradual, and we mustensure that we are careful which functionsare delegated and that we do not lose sightof the fact that the College belongs to itsmembers and is ultimately answerable tothem for all that it does.

One group of members to whom wecontinue to be very grateful is the PressPanel, to whom we again referred manymedia queries during the year. We had anumber of difficult high profile cases, wherepaediatricians were appearing before theGMC. There is always a difficult call to bemade in these cases. Should we, in ourpress releases, reflect the concern (andsometimes anger) of our members at theoutcome of certain hearings and thus riskappearing to be primarily concerned with

the welfare of doctors rather than children?Or should we try to avoid commenting onindividual cases, thus missing the chance to speak out for both the profession andchildren? We intend, in 2006, to be moreproactive in our work with the media –both in commenting on “bad news” andpromoting good news.

Growth in our activities meant that we hadto take on additional office space duringthe year, and Research Division moved toGreat Portland Street, where it is co-locatedwith the National Collaborating Centre.Other promising options for expansionhaving fallen through, we have spent sometime looking for sites where we couldbring the College together again in a singlebuilding somewhere in central London. We are not the only medical Royal Collegetrying to do this at present and, as otherColleges have found, suitable buildings arevery few and far between. We hope that,whatever solution we come up with, theCollege will be more accessible tomembers than it has been in the past. Wedo not plan to turn the College into a clubwith leather armchairs, but a room wheremembers can come and read the journalsover a cup of coffee when they are inLondon would be nice, and we hope toprovide facilities at least at this level. Weplan to consult members over what elsethey would like to see in a new building.

Finally, though we look towards the future,we are conscious and proud of our past.Bernard Valman and Susan Scott continue to ensure that the College’s history isdocumented and in particular that we haverecords of the achievements of our membersin the form of a CV kept on file here at theCollege. You will all be invited to submitone in due course. Could I appeal to all ofyou who have already been asked to do soto let Susan have a CV as soon as you can?

My thanks as ever to all of the Collegeofficers, staff and committee members fortheir help over the past year.

Running the College

Mr Len Tyler

College Secretary

24

10,000

9,000

8,000

7,000

6,000

5,000

4,000

3,000

2,000

1,000

02002-3 2003-4 2004-5 2005-6 2006-7

Target Actual

Membership Numbers

£7.0m

£6.5m

£6.0m

£5.5m

£5.0m

£4.5m

£4.0m

£3.5m

£3.0m

£2.5m

£2.0m

£1.5m

£1.0m

£0.5m

02002-3 2003-4 2004-5 2005-6 2006-7

Target Actual

Financial Reserves

12,000

11,000

10,000

9,000

8,000

7,000

6,000

5,000

4,000

3,000

2,000

1,000

02002-3 2003-4 2004-5 2005-6 2006-7

Target Actual

No. of doctors sitting College examination

50%

45%

40%

35%

30%

25%

20%

15%

10%

5%

02002-3 2003-4 2004-5 2005-6 2006-7

Target Actual

Percentage of members who are fellows

25%

20%

15%

10%

5%

02002-3 2003-4 2004-5 2005-6 2006-7

Target Actual

Proportion of ethnic minority members on College committees

20%

18%

16%

14%

12%

10%

8%

6%

4%

2%

02002-3 2003-4 2004-5 2005-6 2006-7

Target Actual

Staff Turnover

25

excluding retirements at or after the normal age and the completion of short-term contracts

We are very grateful

to all those who have

made donations to

the College to help us

achieve our aims.

The last 12 months has been a busy timefor the Fund-raising Section in the College.

After much planning and consultation,the brochure Striving for a HealthierFuture for Children was published anddistributed to our members in late 2005,highlighting the importance of donationsto the College to allow us to fulfill ourambitions in improving the health ofchildren in the UK and beyond.

As a result, we received over £6,500 in one-off donations within a few weeks, and a lotof interest has been shown from membersin exploring additional ways of supportingthe College financially, including makinglegacies in favour of the College.

We are very grateful to all those who havemade donations to the College to help usachieve our aims. This will help us to investmore in research, education and training.

Once again, I would like to thank MikePoole and the staff of the Finance andMembership Department, especially ElaineJohnston, for their invaluable support andadvice in raising funds for the College.

David Baum International

Foundation

Active fund-raising for the Foundationcontinued over the last 12 months. Themost notable event was the “Palace toPalace” walk, which took place in Scotland.

David Gerrard who organized the walksaid “I organized a ‘Palace to Palace’walk to mirror that fateful ‘Palace toPalace’ cycle ride in memory of DavidBaum on which he tragically died inSeptember 1999 and to assist in raisingfunds for the DBIF.”

His efforts have been rewarded by warmsupport and participation from friends,family and colleagues of the College,

including members of the Baum family.An excess over direct costs of £27,000was raised. This represents a generousaddition to a healthy Foundation, whichis now funding a growing number ofeducational projects in developingcountries in Africa and Asia as well as in Gaza and the West bank.

A gift in your Will

The College is a charity and a gift inyour Will can help reduce yourinheritance tax burden. We have astandard codicil form (an appendix toyour Will) that we can send you to sendto your professional adviser. And if youhave not yet written a Will and need asolicitor we can help with that too.Please fill out the response form on page37 accordingly if you would appreciatesuch assistance.

Alternatively, guidance on making a legacyin favour of the College is given on theCollege website, which along with all theinformation on fund-raising, appearswithin the “Membership” menu option.

Other ways of making a donation include:• Regular donations by direct debit• Single donations by cheque or

credit card• Gifts of shares• Gifts of dividend income• Support by payroll giving through

your workplace• Taking part in a sponsored event

If you would like to help us by makingone-off donations then please use theresponse form on page 37 as it includes agift aid declaration which can increase thevalue of your donation by over 28%. Theresponse form can also be used to help usto provide you with further information onhow to further support the College.

Fund-raising

Dr Ben Ko

Assistant to the Honorary Treasurer

26

Further information

Please visit our website at www.rcpch.ac.uk(on the website the fund-raising sectioncan be found under the “membership”button). Alternatively please contact Elaine Johnston at: The Royal College of Paediatrics and Child Health, 50 Hallam Street, London, W1W 6DE. Email: elaine.johnston@rcpch.ac.ukTelephone: 020 7307 5622.

Major Donations, Grants

and Gifts

We would especially like to thank thefollowing who have supported ouractivities in 2005 through majordonations, grants, gifts and gifts inkind (including consultancy servicesand advice):

Children’s Research Fund

Charles Crowther (David BaumInternational Foundation)

Department of Health

G M Morrison Charitable Trust

GlaxoSmithKline PLC

Health Protection Agency

Institute of Child Health

Johnson & Johnson Pediatric Institute

Medical Aid for Palestinians (MAP) (David Baum International Foundation)

Medical Protection Society

NSPCC

Wales Office of Research andDevelopment for Health and Social Care(WORD)

Well Child

West Midlands Specialised Services Agency

Plus a big thank-you to our members whokindly donated to the College in responseto our fund-raising brochure, ‘Striving for a healthier future for children’. Your kinddonation will help us expand our work forthe benefit of children everywhere.

27

To quote from the brochure Striving for a Healthier Future for Children:

“A great many lives are saved

each year by the work of

paediatricians. Many more lives

are extended, and much pain is

alleviated, resulting in a dramatic

improvement in the quality of

childrens’ lives. The College is

determined to increase its resources

so that future generations of

children, throughout the world,

and their parents and the public,

can be provided with the best

information, the best education

and the best preventions and

treatments.”

2004/2005 College Boards andCommitteesThe governing body of the College is itsCouncil, which consists of the Trustees of the College. Trustees are elected by members and fellows of the College andcomprise honorary officers, representativesfrom each of the College regions in theUK and the Republic of Ireland, paediatricians in the training grades, associate specialists, honorary and seniorfellows and specialty paediatrics.

The College’s primary functions are co-ordinated by a number of boards andcommittees, which are in turn supportedby sub-committees and working parties,which report their activities to Council.

The officers of the College meet formallyand informally with representatives fromother Royal Colleges, and with governmentand external organisations allied to childhealth. The College also participates fully in consultation exercises and wider discussions on paediatric health care issuesat national level.

Regional representatives, regional advisers,paediatric tutors and specialty adviserswork on behalf of the membership acrossthe UK and Republic of Ireland. Regionalcommittees have been established toimprove communication at all levels.

The College’s national network is managedthrough its Scottish, Welsh and Irish committees. These provide a powerfulvoice for fellows and members, and alsoensure effective communication with thefour UK Departments of Health.

The College is in regular touch with itsmembers through the monthly publicationof its scientific, peer-reviewed journal,Archives of Disease in Childhood, andquarterly newsletter which contains generalnews and information.

Executive CommitteeReviewing College activities, offeringstrategic direction to College activities and advice to Council Chair: President, Professor Sir Alan Craft

Finance CommitteeResponsible for ensuring the propermanagement of the finances of the CollegeChair: Honorary Treasurer, Dr Alun Elias-Jones

Specialty BoardCoordinating the work of College specialtiesChair: Vice President, Dr Patricia Hamilton

Training BoardSetting, delivery and maintaining the standards of paediatric training and examinations throughout the UK andRepublic of IrelandChair: Vice President, Dr Patricia Hamilton

Research Division ExecutiveCommitteeReviewing research activity and offeringstrategic direction in the areas of research,surveillance and data collectionChair: Vice President, Professor NeilMcIntosh

Health Services CommitteeProvision of child health services and service configurationChair: Vice President, Dr Simon Lenton

International BoardCoordinating the international activities ofthe CollegeChair: David Baum Fellow, Dr Peter Sullivan

Academic BoardManaging conferences, scientific meetingsand CPDChair: Vice President, Dr Chris VeritySecretary: Dr Alistair Thomson

Examinations CommitteeSetting and conducting the MRCPCH and DCH examinationsChair: Officer for Examinations, Dr Tom Lissauer

Publications BoardStrategic management of College publicationsChair: Honorary Editor, Dr Mark Everard

Structure of the College

Heads of Department

College Secretary: Len Tyler

Committees: David Ennis

Education: Rosalind Topping

Education Adviser: Kim Brown

Examinations: Graeme Muir

Finance and Membership: Mike Poole

HR Laura Vincent

IT and Information: Mary Butler

Research: Linda Haines

Training: Alix Clark

28

Officers of the College

PresidentProfessor Sir Alan Craft

Vice PresidentsDr Simon Lenton (Health Services)Dr Patricia Hamilton (Training &Assessment)Professor Neil McIntosh (Science & Research)Dr Chris Verity (Education)

Honorary TreasurerDr Alun Elias-Jones

RegistrarDr Sheila Shribman

ScotlandDr Adrian Margerison

WalesDr Gwyneth Owen

IrelandProfessor Denis Gill

ExaminationsDr Tom Lissauer

David Baum Fellow (International Affairs)Dr Peter B Sullivan

Donald Court Fellow Dr Claire Smith

Higher Specialist TrainingDr Mary McGraw

Continuing Professional DevelopmentDr Alistair Thomson

Workforce PlanningDr Sue Hobbins

Honorary EditorDr Mark Everard

Dr Ramesh Mehta East Anglia

Dr Sian Snelling Mersey

Dr Geoffrey Lawson Northern

Dr Ben Ko North East Thames

Dr Ruby Schwartz North West Thames

Dr Ian Swann Oxford

Dr Andrew Evans South East Thames

Dr Ruth Charlton South West Thames

Dr Jane Tizard South Western

Dr Peter Macfarlane Trent

Dr Edward Wozniak Wessex

Dr Steve Bennett Britton West Midlands

Dr David Beverley Yorkshire

Dr Iolo Doull Wales

Dr Stephen Greene N, NE, E Scotland

Dr Sepideh Taheri South Eastern Scotland

Dr Jack Beattie Western Scotland

Dr Moira Stewart Northern Ireland

Dr John Cosgrove Republic of Ireland

Dr Martha Wyles and Paul Dimitri Trainees

Dr Greg Dilliway and Natalie Lyth Associate Members

Prof. Richard Olver Association of Clinical

Professors of Paediatrics

Dr Margaret Mearns Senior Members

Dr Richard Newton and Dr Helen Venning Paediatric Specialities

Details correct as of 31 August 2005.

Patron: Her Royal Highness The Princess RoyalTrustees 2004-2005: The Officers of the College and members of Council are as follows:

29

The College has

invested heavily in

developments

in Training and

Education, competency

assessment, and the

Child in Mind project.

This financial period (2004-2005) hasyielded a further substantial surplus for theCollege of £1,634,553 (split £1,402k/£232kbetween unrestricted and restricted funds).

This surplus has been generated by a13.7% rise in incoming resources to£7,834,470 plus a substantial gain oninvestments of £592,468. This has beenoffset by a 16.1% increase in expenditureto £6,694,336 and a turn around in theCollege’s share of the RCPCH Publicationsresult from a £14,716 surplus to a £98,049deficit as a result of developing the BritishNational Formulary for Children (BNFC).

Income from exams rose by 10.1% to£2,512,767 (2004- £2,283,183) reflecting the increased number of candidates in the UK and overseas. However, the totalexpenditure on education, training andexams has also risen from £2,680,103 in2004 to £3,093,759 in 2005, with theintroduction of the new modularexamination system and first diet of thenew format clinical exam in October 2004.

Membership income rose mainly as aresult of a significant increase in totalCollege membership from 7,968 to 8,479(and 8,688 by end December 2005).

Within “Other income”, income frominformation and publications totals£293,009, a fall from 2004 (£347,021) andis mainly generated by income fromArchives of Disease in Childhood. Thisincome stream is under threat fromdevelopments in electronic publishing. We are working closely with our partner,BMJ Publishing, to minimise this threatand having launched the additionalEducation and Practice Journal in June2004 together with Archives to aid CPDand maintain our competitiveness; the year ending December 2005 has seen an increase in the net profit to a forecast£498,859 shared between RCPCH and BMJ Publishing with a further budgetedrise in net profit to £556,000 for 2006

In September 2003, the second editions of Medicines for Children and PocketMedicines for Children were published,and both books sold well and generatinggood sales shared with our partners, theNeonatal and Paediatric PharmacistsGroup. This surplus was largely used tofinance our share of the developmentcosts of the BNFC, published in September2005 delivered free to all doctors andpharmacists in England through aDepartment of Health contract, and withsubstantial orders for doctors and otherprescribers in Wales,Scotland and NorthernIreland. A freely available website has alsobeen developed along with a CD rom. A palm top version is planned with thesecond edition to be published in July2006.There has been considerable interestin the BNFC in Europe and elsewherewith the possibility of translation oradoption of the book in several countries.

Despite continuing uncertainties over the impact of the Postgraduate MedicalEducation Training Board, the College has invested heavily in developments in Training and Education, competencyassessment, and the Child in Mind project,including a number of new key posts.

Treasurer’s Report

Dr Alun Elias-Jones

Honorary Treasurer

30

The College continues to consider itsaccommodation needs with a rise inCollege staff from 24 FTE in 1997 to 75FTE as recorded in the accounts for theyear ended 31 August 2005 and over 100people on the payroll as we entered 2006.With this in mind we have continued tofollow a prudent approach to theinvestment of the retained surplus, withmuch of it likely to be required for a newbuilding to house our evolving Collegewhich is currently split between 3 sites in London with additional offices in Cardiff and Edinburgh.

The College has continued with the sameinvestment manager Lazard AssetManagement appointed in October 2001.Funds administered by Lazard achieved areturn including gains of 19.5% (20045.3%) for the year. Meanwhile cash fundsinvested as deposits with the College’sbankers have yielded 4.6% (2004 3.9%).The corresponding Bank of England baserate averaged 4.7% (2004 4.0%).

Accompanying Statement by theCouncil of the Royal College ofPaediatric and Child Health

These summarised financial statements on pages 32 to 35 have been derived from the full statutory Council report andfinancial statements for the year ended 31August 2005 which have been audited bySargent & Co who gave an unqualifiedaudit opinion on 22 February 2006. Theauditors have confirmed to Council thatthe summarised financial statements areconsistent with the full financial statementsfor the year ended 31 August 2005.

The full statutory Council report andfinancial statements were approved byCouncil on 22 February 2006 and signedon their behalf by Professor Sir Alan Craftand Dr Alun Elias-Jones. They will besubmitted to the Charity Commission by30 June 2006.

These summarised financial statementsmay not contain sufficient information to allow for a full understanding of thefinancial affairs of the College. The fullstatutory Council report and financialstatements can be obtained from:

The Secretary, Royal College of Paediatricsand Child Health, 50 Hallam Street,London, W1W 6DE

On behalf of Council, 22 February 2006Dr Alun Elias-Jones

31

Consolidated Statement of Financial Activities for the Year Ended 31 August 2005

Unrestricted Restricted Endowment 2005 2004Funds Funds Funds Total Total

£ £ £ £ £

Incoming ResourcesIncoming Resources from Generated Funds

Voluntary income 7,067 187,455 - 194,522 101,649Activities for generating funds 166,511 - - 166,511 138,508Investment income 353,716 24,693 - 378,409 264,036

Incoming Resources from Charitable ActivitiesExaminations 2,512,767 - - 2,512,767 2,283,183Spring Meeting 507,446 16,495 - 523,941 474,403Education 90,266 283,351 - 373,617 322,165Training 64,139 360,503 - 424,642 437,523Research - 494,867 - 494,867 215,818Members subscriptions 2,183,063 - - 2,183,063 2,073,908Other income 582,131 - - 582,131 576,461

TOTAL INCOMING RESOURCES (see note 3) 6,467,106 1,367,364 - 7,834,470 6,887,654

Resources ExpendedCost of Generating Funds

Costs of generating voluntary income 38,982 - - 38,982 30,623Fundraising Trading: Cost of goods sold and other costs 27,807 - - 27,807 29,201

Charitable activities

Examinations 1,705,443 - - 1,705,443 1,442,302

Spring Meeting 519,548 17,625 - 537,173 509,984

Education 239,778 393,634 - 633,412 660,376

Training 89,298 665,606 - 754,904 577,425

Research 443,332 412,108 - 855,440 726,511

Other professional activities & standards 2,026,269 71,049 - 2,097,318 1,749,796

Governance costs 43,857 - - 43,857 41,449

TOTAL RESOURCES EXPENDED (see note 1) 5,134,314 1,560,022 - 6,694,336 5,767,667

Net Incoming / (Outgoing) Resources

Before Interest in Associate and Transfers 1,332,792 (192,658) - 1,140,134 1,119,987

Interest in result of Associated Undertaking (98,049) - - (98,049) 14,716

Transfer between Funds (424,873) 424,873 - - -

Net Incoming Resources BeforeOther Recognised Gains and Losses 809,870 232,215 - 1,042,085 1,134,703

Gains and losses on investment assets 592,468 - - 592,468 57,224

Net Movement in Funds 1,402,338 232,215 - 1,634,553 1,191,927

Fund balances brought forward 8,133,554 1,154,213 14,855 9,302,622 8,110,695

TOTAL FUNDS CARRIED FORWARD £9,535,892 £1,386,428 £14,855 £10,937,175 £9,302,622

There were no recognised gains and losses for the period other than those included in the Statement of Financial Activities.

AccountsSummarised Financial Statements

32

Consolidated Balance Sheet as at 31 August 2005

Group Group2005 2004

£ £

Fixed AssetsTangible Assets 2,361,645 2,342,526

Investments 4,732,580 3,703,470

7,094,225 6,045,996

Current AssetsStock of Publications and Merchandise 1,147 1,665Debtors 734,303 493,457Investments - 4,000,000Cash at bank and in hand 5,256,766 243,707

5,992,216 4,738,829Creditors: Amounts Falling Due Within One Year (2,148,266) (1,481,203)

NET CURRENT ASSETS 3,843,950 3,257,626

Total Assets Less Current Liabilities 10,938,175 9,303,622

Creditors: Amounts Falling Due After More Than One Year (1,000) (1,000)

NET ASSETS £10,937,175 £9,302,622

Represented by:Unrestricted Funds:

Designated Funds 3,833,441 3,921,675Charitable Trading Subsidiary Fund 4 4Charitable Trading Associate Fund (98,049) -General Funds 5,800,496 4,211,875

Total Unrestricted Funds 9,535,892 8,133,554

Restricted Funds 1,386,428 1,154,213Permanent Endowments 14,855 14,855

TOTAL FUNDS OF THE COLLEGE (see note 2) £10,937,175 £9,302,622

33

Other Allocated Costs in 2005 can be further analysed by activity as follows:

Costs of generating voluntary income are those incurred in seeking voluntary contributions and do not include the costs of disseminatinginformation in support of the charitable activities.

Governance costs include the costs associated with the meetings of the Council, Executive Committee and Finance Committee and those incurred in connection with the statutory external audit.

All costs have been allocated on the basis of the headcount except: £58,893 of the Information Technology cost which has been directly attributedand £30,684 of the Finance cost which has been allocated on the basis of number of transactions.

AccountsNotes to the Summarised Financial Statements for the Year Ended 31 August 2005

1. TOTAL RESOURCES EXPENDEDOther Other

Staff Direct Allocated 2005 2004Costs Costs Costs Total Total

£ £ £ £ £

Costs of generating voluntary income 12,208 18,838 7,936 38,982 30,623

Fundraising trading: cost of goods sold and other costs - 27,807 - 27,807 29,201

Examinations 567,100 853,138 285,205 1,705,443 1,442,302

Spring Meeting 73,208 437,341 26,624 537,173 509,984

Education 127,637 456,344 49,431 633,412 660,376

Training 369,452 237,173 148,279 754,904 577,425

Research 484,810 192,333 178,297 855,440 726,511

Other professional activities and standards 772,594 1,013,200 311,524 2,097,318 1,749,796

Governance costs - 43,857 - 43,857 41,449

TOTAL RESOURCES EXPENDED 2,407,009 3,280,031 1,007,296 6,694,336 5,767,667

Total Other Premises & Human Information Allocated

Facilities Resources Technology Finance Costs£ £ £ £ £

Costs of generating voluntary income 3,873 842 2,146 1,075 7,936

Fundraising trading: cost of goods sold and other costs - - - - -

Examinations 120,718 26,254 106,324 31,909 285,205

Spring Meeting 12,937 2,813 7,166 3,708 26,624

Education 23,059 5,015 12,773 8,584 49,431

Training 74,239 16,145 41,123 16,772 148,279

Research 89,603 19,487 49,633 19,574 178,297

Other professional activities and standards 148,762 32,352 94,109 36,301 311,524

Governance costs - - - - - - -

TOTAL OTHER ALLOCATED COSTS 473,191 102,908 313,274 117,923 1,007,296

34

2. FUNDSUnrestricted FundsThe General Funds of £5,800,496 (2004 -£4,211,875) represent the “free” funds of the College which are not designated forparticular purposes or restricted in any way;they are essentially the College’s reserves.Such funds need to be held as reserves topermit a responsible reaction to uncertainties.During the year the College reviewed thelevel of reserves it requires and set therequirement at one year’s expenditure, which is currently in excess of £7million. In addition, it is estimated that a further£3million will be necessary to enable theCollege to acquire the type of premises it hasidentified as being required in the long-term.

Designated funds comprise unrestrictedfunds that have been set aside by thetrustees for particular purposes. They includethe Fixed Assets Fund £2,293,790 (2004 -£2,267,645) and the balance of the EverleyJones Bequest £1,038,353 (2004 - £1,196,829).

Restricted FundsRestricted funds are funds which are to beused in accordance with specific restrictionsimposed by donors or which have beenraised by the College for particular purposesand comprise funds for the WellChildFellowships, David Baum InternationalFoundation, Education & Training, Research,Overseas Levy and Awards & Prizes.

Permanent EndowmentsPermanent Endowments are monies whichhave been given to the College in trust withthe restriction that they are held as capitalwith the income generated from them to be used for specific awards.

3. INCOME FROM COMMERCIALCOMPANIESA list of commercial companies who pay fora presence at the Spring Meeting and similarevents organised by the College is availableon request from the Head of Finance &Membership at the College. Any commercialcompanies who have made significantfinancial contributions to the College in thecalendar year 2005 are included in the Fund-raising report within this Annual Report.

36

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Compiled and edited by RCPCH IT & Publications Department

Typeset and designed by Chamberlain Dunn Associates Ltd, Richmond

Back Cover: RCPCH 5 St Andrews PlaceLondon NW1 (1985 -1997)

Front cover: RCPCH 50 Hallam StreetLondon W1W (1997-present)

39

Royal College of Paediatrics and Child Health

50 Hallam Street, London W1W 6DE

Tel: 020 7307 5600, Fax: 020 7307 5601

e-mail: enquiries@rcpch.ac.uk

Website: http//www.rcpch.ac.uk

Registered Charity 1057744

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