Pot-pourri eBulletin 1 May 2020

President's Message

This is my last message as PCHD President, with my term coming to an end on Monday, 4 May and Professor Catherine Choong formally stepping into the role. I will also step down from the PCHD Council of which I have been a member since 2013. I have seen the Division move forward through some challenging times and I have witnessed some remarkable progress on important areas. I would like to thank all the members who have volunteered their time to support the work of the Division and to give voice to the wider membership and children across the two nations and abroad.

As I look back over the last two years, I am proud of what has been achieved. In 2018, we launched the Inequities in Child Health position statement, presented by the National Children’s Commissioner at Congress. We went on to hold a successful roundtable at Parliament House which resulted in the government announcing funding of $150,000 for the development of a National Action Plan for Children’s Health 2020-2030. To support further advocacy, we developed a toolkit to upskill members and communicate the importance of child health to all levels of government.

One of the most recent notable achievements has been the work of the Division and wider College on the first 1,000 days of life. In 2019, we launched the position paper on ‘Early childhood: the importance of the early years’ as part of our broader advocacy campaign on child health inequities. We followed this with another roundtable which was attended by Health Minster Greg Hunt, Shadow Health Minister Chris Bowen and numerous leading health experts, MPs, NGOs, psychologists and paediatricians. The roundtable was the first step in identifying the critical priority areas for the government to focus on for the next ten years. The recently held National Early Years Summit in March 2020 was attended by key Fellows in this space and saw progress towards a potential new blueprint to inform policy and advocacy on this issue.

In the international space, the PCHD has been instrumental in assisting our near neighbour colleagues with a number of activities. Following the signed Memorandum of Understanding with Fiji National University (FNU), Professor Richard Doherty led a review of the curriculum and delivered short practicums with post-graduate students when in-country. We had an overwhelming response from members registering interest in assisting FNU with academic teaching and review of examinations, and the College has supported FNU by sharing our online resources and webinar learning. There has been substantial work in the international space with significant input from paediatricians – it is pleasing to see the Division so heavily involved.

The Indigenous Child Health Position Statement is open for external consultation. Once this process is complete the statement will be launched. The statement includes two case studies of paediatricians working with local communities in Australia and Aotearoa New Zealand. The statement will be an important tool to assist paediatricians to address health inequities for Indigenous people in Australia and Aotearoa and I look forward to seeing the finished statement.

As we continue to work our way through COVID-19, it would be remiss to not highlight the considerable work already achieved by the Division and the College in advocating for our members and the community. The PCHD Policy and Advocacy Committee (PPAC) recently considered issues around the equity of access to telehealth consultations as we know many paediatric patients and their families do not have adequate access to the internet or devices needed for these consultations. The Federal Government has now removed the requirement for specialists and consultant physicians to bulk bill the new telehealth items, and we should be proud of our efforts in effecting this changed. We have also been discussing the importance of using language suitable for young people when communicating not only COVID-19, but health information in general. Young people are a unique group and it is important that our communication and approaches engage with them and reflect their needs.

As some of you may know, there is a PCHD Presidential Medallion which is handed to the new PCHD President every two years. The medallion depicts the Coat of Arms of the Australian College of Paediatrics which amalgamated with the RACP in 1999, becoming the Paediatrics & Child Health Division. In 1962 it was Dr Peter Jones who worked with the College of Heralds in England on designing the medal and its meaning. The motto 'Qualis Surculus Talis Arbor' was created for this coat of arms, with the original idea being 'as the twig is bent the tree will grow', suggesting genetics, nutrition, obstetric care, orthopaedics and so on. This was clumsy in direct Latin translation; after careful consideration it was suggested the motto should be officially translated as follows:

'As is the twig, so is the tree.'

To ensure this information is not lost, I have arranged for this to be shared with each new PCHD President and members can find further information in our College Library which holds a copy of  'A History of the Australian College of Paediatrics 1950-1980' by D G Hamilton. To read more about the medal and its history, see the PCHD webpage.

It has been a pleasure to be the PCHD President and I have no doubt that the Division is in good hands with Professor Choong leading the way. I look forward to seeing many more achievements and advocacy wins for the PCHD and I wish you all the very best.

Professor Paul Colditz
President, Paediatrics & Child Health Division

From the incoming President

It is a privilege to step into the PCHD President role and I would like to thank Paul for his strong leadership over the past two years.

During my Presidency, I would like to see the Division begin to make a tangible difference in the achievement of the UN Sustainable Development Goals. Our College has an extremely important role in realising this ambition, especially as a regional leader in child health, and I believe that we must expand and raise the profile of our work in this area. It is of particular importance that we elevate action on global heating and its current and future impacts on human health higher on our agenda, along with other severe threats to child health and wellbeing such as family violence and pandemic infectious disease.

Our obligations to provide high-quality physician training and meet the educational and work-life needs of our trainee paediatricians are key concerns of the College in which I plan to engage more closely with during my presidency. Along with our advocacy for child health, the support we provide to our trainees and the quality of the training they receive will shape our future medical workforce and have major impacts on the health of generations of children and adolescents to come.

Catherine Choong

Professor Catherine Choong

Committee Spotlight: PCHD Policy & Advocacy Committee (PPAC)

The role of PPAC is both proactive and reactive. We aim to examine the current and future paediatric policy space to see where our members’ expertise and skills can provide benefit, but we also need to be nimble enough to react promptly and comprehensively to respond to immediate needs, such as the COVID-19 pandemic. PPAC is supported in this work by the College’s Policy and Advocacy unit as well as the PCHD Secretariat. These College resources allow the committee to develop, coordinate, implement and monitor policy and advocacy projects (approved by the PCHD Council). We are also often involved in consultations leading to the development of College position statements, submissions to government and media releases. PPAC acts as the authoritative source of direction and advice within the College regarding PCHD policy and advocacy matters.

The last 12 months have been very busy and productive for PPAC, with highlights as follows:

  • Finalised the Early Years position statement and launched it at Congress in Auckland 2019.
  • Led the College advice to the Federal Government on one of the most complex paediatric areas – gender dysphoria.
  • Developed and coordinated last year's child health roundtable.
  • Developed a new position statement on Indigenous child health to complete the set of Statements on Equity and Early Years, and updated a number of position statements on circumcision, breastfeeding, early intervention for children with disabilities and healthcare for children in care and protection services.
  • Reviewed and made decisions about the currency of a large number of current and expired position statements and policies, flagging some for revision, and a large number for archiving.
  • Ongoing involvement in a range of College consultations on paediatric issues.

Dr Pat Tuohy
Chair, PCHD Policy & Advocacy Committee

COVID-19 Kids Research Evidence weekly updates

The Melbourne Children’s campus has commenced a new weekly report entitled 'COVID-19 Kids Research Evidence'. This publication aims to collate COVID-19 child and adolescent health research literature, and seeks to answer the question 'What have the experts in child health been reading in the past week?' These weekly updates are available on the University of Melbourne website.

Associate Professor Margie Danchin and Dr Franz Babl
Paediatric Research Committee

Clarification on new Australian telehealth items

We have received the following clarification on the new telehealth items from the Department of Health:

  • Both recognised specialist and consultant physician practitioners practising in pain and palliative medicine, sexual health medicine and addiction medicine are able to bill consultant physician telehealth services (91824, 91825, 91826, 91834, 91835 and 91836).
  • Occupational and environmental health medicine physicians are eligible to bill specialist telehealth services (91822, 91823, 91832 and 91833).
  • Sexual health medicine, addiction medicine practitioners are able to bill telehealth services to prepare and review a management plan (92422, 92423, 92431 and 92432).
  • Public health physicians are able to bill telehealth services (92513-92516 and 92521-92524).

If there is uncertainty, Services Australia can advise practitioners of their eligibility to claim the new telehealth items and can be contacted on 1800 810 586.

College facilities remains closed for face-to-face meetings

The College continues to follow advice from the Australian and Aotearoa New Zealand Governments and recommendations for social distancing, hence all RACP offices remain closed for onsite meetings. Members will be advised when these circumstances change.

He Tangata, He Tangata, He Tangata: Centre equity and Te Tiriti o Waitangi in all COVID-19 pandemic planning, strategy and responses

Aotearoa New Zealand’s COVID-19 pandemic response must centre equity for Māori and must honour the principles of Te Tiriti o Waitangi. Without an equity-centred pandemic response, Māori will experience multiple negative outcomes from this event. This is not acceptable.

“We are still operating under the fallacy that one size fits all. A national programme, while necessary, will lead to exacerbate health inequities. While things are being done for the general population, they don't have an equity lens, which is essential from the beginning.” 
- Professor Papaarangi Reid

Read and share the RACP Statement and look further to the Urutā statement for research and evidence from Te Rōpū Whakakaupapapa Urutā (National Māori Pandemic Group). Please share these as widely as you can, let's steer a new path.

New Pomegranate podcast: Ep57: The art of telehealth 

COVID-19 has left few people around the world unaffected, and health practitioners are among those at the top of the list. Their daily and intimate service to the public inevitably puts them at risk of catching the virus, while social distancing precautions can compromise the work that they do. Dreadful as the viral disease is, the bigger consequences of the pandemic may be on the disruption to routine healthcare.

Consulting patients by video or phone can be a way to keep healthcare ticking over, but many doctors are nervous as they adopt it for the first time. In this podcast we go over some of the bureaucratic and tech support questions that clinicians have been asking during the current crisis. We also discuss the art of building trust with new patients and conducting a physical examination through telehealth.

The guest speakers are oncologist Professor Sabe Sabesan and paediatrician Dr Michael Williams, who have been pioneering telehealth outreach to rural and remote Queensland for more than a decade.

Guests

  • Professor Sabe Sabesan FRACP (Director, Townsville Cancer Centre; James Cook University)
  • Dr Michael Williams FRACP (Director, Queensland Paediatric Telehealth Service)

Fellows of the RACP can claim CPD credits via MyCPD for listening to this episode and reading the resources.

Subscribe to Pomegranate Health in Apple iTunesSpotify or any Android podcasting app.

Listen to podcast

Request for input from members: College submission to the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability

Disability and the NDIS has been a key ongoing policy priority for the College and the broader health sector. The Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability (the DRC) was established in April 2019 in response to community concern about widespread reports of violence against, and the neglect, abuse and exploitation of, people with disability.

The DRC’s terms of reference cover what should be done in all settings such as the home, schools, out-of-home care, the justice system, as well as in the disability support system to:

  • prevent, and better protect, people with disability from experiencing violence, abuse, neglect and exploitation
  • achieve best-practice in reporting and investigating of, and responding to violence, abuse, neglect and exploitation
  • promote a more inclusive society that supports the independence of people with disability and their right to live free from violence, abuse, neglect and exploitation.

The DRC has released four issues papers to date: education and learninggroup homescriminal justice system and health care for people with cognitive disability.

The RACP’s Policy and Advocacy team have developed a draft submission which covers a range of areas that the DRC is interested in and that the College has a position on.

Members are encouraged to provide feedback, with particular regard to the sections where it is noted that there are no College positions yet. Please provide feedback to Rebecca Randall, Senior Policy and Advocacy Officer, via RACPConsult@racp.edu.au by close of business Friday, 8 May 2020. We look forward to receiving your valuable feedback.

Quality and safety resources for members

Quality and safety are central to the delivery of healthcare in Australia and Aotearoa New Zealand. We offer a number of resources to help you create a culture of quality and safety in your healthcare setting. 

Register for the quality and safety online course to learn about developing a preventative mindset and identifying and remediating situations where the quality and safety of patient care may be compromised. 

Refer to the Quality and Safety Curated Collection for a peer-reviewed list of high quality resources on the topic. Or to learn about strategies for communicating effectively with patients about the risks and benefits of treatment options, enrol in the communicating risks and benefits online course.

RACP Online Learning resources are free for members and count towards Continuing Professional Development requirements.

Invitation to contribute in a personal capacity – Children’s Digital Health Collaborative Clinical Information Requirements for 5 to 14 year old children

The National Children’s Digital Health Collaborative is seeking the views of consumers and health professionals to identify key clinical information deemed valuable in managing the healthcare of children aged 5 to 14 years old. The Collaborative is undertaking this work to understand the potential value of including such information in a longitudinal health record such as the child’s My Health Record.

The Collaborative is seeking views from individual clinicians about the items which should be included.

Please note that the College will not be making a submission, and we request that clinicians complete the response survey in an individual capacity.

Find out more and complete the survey

The Kids' Cancer Project Research Establishment Fellowship

Apply now for The Kids' Cancer Project Research Establishment Fellowship worth up to $180,000 ($90,000 per annum for two years), offered by The Kids' Cancer Project through the RACP Foundation. This grant supports physician-scientists specialising in paediatric oncology and encourages research to increase capacity for bench-to-bedside medicine, minimise harmful impacts of treatment, improve quality of life and function post-treatment, or improve survival and ultimately find cures for childhood cancer.

These and up to 50 other awards and grants with a total value of $2.5 million are offered by the RACP Foundation and are available to Paediatric Fellows and trainees across the different categories:  Career Development Fellowships, Research Establishment Fellowships, Research Entry Scholarships, Research Development Scholarships, and Travel Grants.

The Paediatrics International Grant – Asia Pacific Region worth up to $10,000 is also available to medical graduates or specialists from outside Australia or Aotearoa New Zealand who intend to further their knowledge in the fields of medical education and research. The application must be sponsored by a Fellow of the RACP and submitted before 31 July 2020.

Full details for these opportunities are available on the RACP Foundation webpage.

Howard Williams Medal

Congratulations to Professor Louise Alison Baur who has been awarded the Howard Williams Medal to acknowledge her outstanding contribution to improving the health of children and young people.

Professor Baur is the Professor and Head of Child & Adolescent Health at the University of Sydney as well as Head of Children’s Hospital Westmead Clinical School. She is a senior consultant paediatrician at the Sydney Children’s Hospitals Network where she is an active member, and former Head of Weight Management Services.

Professor Baur has worked in many clinical, public health and policy aspects of paediatric obesity and nutrition. She has made extensive research contributions to the prevention of obesity, especially in early childhood, the impact of food marketing to children, the antecedents of obesity and the metabolic syndrome in young people, the complications of obesity, the management of obesity and related disorders in a variety of clinical settings and the measurement of body composition, dietary intake and physical activity in young people. She is currently the Director of the NHMRC Centre of Research Excellence in the Early Prevention of Obesity in Childhood.

Professor Baur is a Founding Fellow and Member of Council of the Australian Academy of Health & Medical Science. In 2010 Louise was made a Member of the Order of Australia (AM) for service to medicine and to the community.

Louise Baur

Examination Medal in Paediatrics & Child Health

Congratulations to Dr Alison Boast who has achieved the best performance in the RACP Written and Clinical Examinations in Paediatrics & Child Health.

Dr Boast is a paediatric trainee with an interest in infectious diseases and clinical pharmacology. She completed an undergraduate degree in Biomedical Science at Monash University before the Doctor of Medicine at The University of Melbourne, where she graduated dux of her year. Dr Boast is keen to combine clinical medicine with research and has recently commenced a PhD in the use of pharmacometrics to develop novel treatment strategies for invasive infections.

Alison Boast

COVID-19 update from the Medical Board of Australia

See the latest newsletter from the Medical Board of Australia covering the COVID-19 pandemic.

Monash University-led COVID-19 Work and Health Study

Monash University’s Insurance and Health Group is leading a study that seeks to understand the impact of COVID-19 on the work and health of Australians who have become unemployed or lost work during the pandemic. This study aims to provide unique and important data that can be used to inform decision making by workers, their employers and government as the pandemic unfolds.

The study is seeking participants who have lost work or become unemployed during the COVID-19 pandemic. It involves completing an online survey that takes about 15 minutes, on four separate occasions over a six-month period.

Further information about the study including how to enrol is available on the Monash University COVID-19 Work and Health Study website.

Ventilator Training Alliance App

As hospitals are procuring additional ventilators from wherever there may be supply, healthcare practitioners are having to operate a wide range of ventilator models and make, regardless of the ones that they have had prior training on. To serve this gap in ventilator training, the Ventilator Training Alliance formed by the participating ventilator manufacturers has launched the Ventilator Training Alliance App to provide healthcare practitioners easy access to training materials in a timely and convenient manner. The free app, powered by Allego, contains training videos and manuals for all ventilator types by all major ventilator manufacturers including Medtronic.

Together with Medtronic, the app to-date has training materials for ventilators from Dräger, GE Healthcare, Getinge, Hamilton Medical, Nihon Kohden and Philips.

Available offline and online, this app is ready for download worldwide in the Apple App Store and Google Play Store.

Evolve case studies

To support the implementation of Evolve and Choosing Wisely recommendations in clinical practice, we have launched two case studies depicting clinical scenarios in which recommendations on reducing low-value care apply. These case studies explore a clinical scenario based on one of the Evolve recommendations on low-value care.

Evolve is seeking enthusiastic Fellows and trainees to partner with us in developing case studies for more specialties. The aim of the case studies is to support Fellows and trainees to build an understanding of low-value care within their specialty and act as a tool for clinical educators and supervisors. Email evolve@racp.edu.au to get involved.

Aotearoa New Zealand Medicines Adverse Reactions Committee – Vacancies for members and Chair

Applications are currently being sought for two positions on the Aotearoa New Zealand Medicines Adverse Reactions Committee (MARC). This is an opportunity for Aotearoa New Zealand based members to join the MARC and improve the health of New Zealanders, contributing to:

  • improving medicines safety
  • pharmacovigilance
  • the regulation of medicines, and
  • balancing the benefits and risks of harm of medicines.

The MARC is an independent expert advisory committee to the Minister of Health. The MARC provides advice on potential adverse reactions to medicines. This is an important part of the regulatory framework for safeguarding public health in New Zealand. Applications are being sought from New Zealand specialist clinicians in fields such as paediatrics or psychiatry.

Successful applicants will be:

  • working in clinical practice and have at least five years of clinical experience
  • using their superior critical appraisal skills in their practice, and
  • knowledgeable in medicines use.

Applications are also being sought for the position of Chair of this Committee. In addition to extensive clinical experience at a specialist level, applicants for this position should preferably have previous experience in chairing committees of healthcare professionals. Applicants may be current members of the Committee or be seeking to join the Committee.

Appointments to the Committee are made by the Minister of Health for a term of three years. This term is renewable once for a further three years.

See the MARC Committees page for more information, including the Terms of Reference and the Committee process.

If you would like to obtain further information or clarification, please contact Medsafe on (04) 819 6800 and ask to speak to the MARC Secretary or email MedsafeADRquery@health.govt.nz.

Please complete the application form provided below and email this together with your current curriculum vitae by Friday, 5 June 2020 to MedsafeADRquery@health.govt.nz.

Application form

Medicare genomic testing by paediatricians

A Medicare funding model is anticipated in 2020 to allow genomic (exome) testing of children with a moderate to severe intellectual disability through their primary paediatrician.

The NSW research and implementation team working on this project have designed a short survey to understand what support NSW paediatricians need in order to carry out whole exome testing. The results of the survey will be directly used to inform the support and resources we implement in NSW.

Please take 10 minutes to complete the survey.

If you would like to be interviewed to provide further insight please email the Implementation Scientist working with the team on this project – Hossai Gul (hossai.gul@mq.edu.au).

What are the benefits of whole exome sequencing (WES) for children with moderate to severe intellectual disability?

WES results in a molecular diagnosis for approximately 40 per cent of children with a moderate/severe intellectual disability1,2,3. The data generated from this testing can also be re-analysed in future, as our understanding of genetics improves.

A genetic diagnosis can also:

  • provide closure and alleviate parental guilt.
  • prevent further unnecessary investigations.
  • assist with access to support groups and services.
  • provide information for families for future family planning.
Genomic

  1. Hamdan et al. PLOS Genetics. 2018 Oct, 10 (10) De Novo Mutations in Moderate or Severe Intellectual Disability
  2. Clarke et al. NPJ Genom Med. 2018; 3: 16. Meta-analysis of the diagnostic and clinical utility of genome and exome sequencing and chromosomal microarray in children with suspected genetic diseases
  3. Amor DJ. J Paediatr Child Health. 2018 Oct;54(10):1154-1158. Investigating the child with intellectual disability

An update from the Obesity Collective 

When our partners, the Obesity Collective (OC), celebrated the first World Obesity Day in early March 2020, the impact of COVID-19 was just beginning to be felt across Australia’s health system, economy and society. Since then, frontline healthcare and community workers, including many members of the OC, have risen to the challenge of dealing with a major national public health emergency.

Across the wider community, COVID-19 related self-isolation and social restrictions pose challenges for healthy eating and activity goals and may affect access to usual care. On a systemic level, there is also hope that the current crisis will lead to a greater recognition of the value of the healthcare system, preventative health, and to appropriate strategic and financial responses to other public health challenges.

There has been emerging evidence (reference 1reference 2) of a link between obesity, chronic diseases and worse health outcomes from COVID-19. The OC believes it is important to be aware of and communicate these observations clearly – it also notes it is critical to do so in a careful and balanced way that minimises risk of stigma, shame, and anxiety. This simple one-pager from Obesity Canada is a good example of clear non-stigmatising communications about COVID-19 and obesity.

We would also like to remind members that the OC Evidence Hub is growing, with the addition of a new chapter on the health benefits of weight loss by Dr Priya Sumithran, FRACP PhD, and updated sections on proposed improvements to Health Star Ratingimpact of food marketing on children, new approaches to restricting price promotions and the case for a tax on sugary drinks. The OC will soon launch a brochure offering patient-friendly, fat bias-free information about obesity, its causes, attendant health challenges and whether and/or how to consider weight loss.

Obesity Collective

OC Emerging Leaders

A group of OC members and volunteers are creating an Emerging Leaders group for younger professionals who are keen to influence the areas of prevention, treatment and communication about obesity and living with obesity. The group aims to raise awareness of stigma, build up the existing network and enhance ways of talking about and dealing with obesity. The OC is hoping to attract more young leaders in health professions as well as other young people who are interested in the challenge of obesity more broadly. To find out more or express your interest, please email the-collective.info@sydney.edu.au or dorota.sacha-krol@racp.edu.au.

Discounted shopping with your benefits

Australian families are doing it tough with the recent COVID-19 situation and your benefits program can help you and your family save on household essentials and online shopping.

You can save five per cent ordering your WISH e-gift card online through your benefits website, giving you the full buying power of the e-gift card without paying full price. For example, if you order a $300 Woolworths e-gift card with a five per cent discount for $285, you can then use your e-gift card to purchase your entire weekly fuel and groceries up to the value of $300.

Easily available online, you can quickly save hundreds on weekly groceries, fuel and stores accepting WISH e-gift cards. You can even purchase them for your family and friends to use.

Purchase your e-gift cards online and browse the range of other retailers available. Visit your RACP Member Advantage benefits website.

*Terms and Conditions apply; credit card surcharges do not apply to WISH e-gift cards. WISH e-gift cards are typically delivered within 12 hours of purchase.

Pot-pourri submissions welcome

To submit an article for publishing in Pot-pourri, please email paed@racp.edu.au. The article should be no more than 350 words. If you would like to submit an image with your article, it would be assumed that you have received appropriate permission to use the photo and it needs to be of high resolution, above 300 dpi. Please note that articles may need to be edited by the RACP Communications Team.

Update your details with the College

Did you know that you can now update your address details online? Simply Login to MyRACP and go to 'Edit my details'.
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