Pot-pourri eBulletin 5 February 2021

President's Message

The Australian Government released the COVID-19 vaccine national roll-out strategy on 7 January 2021. The strategy outlines that frontline healthcare workers will receive the vaccine in Phase 1a, and other healthcare workers in Phase 1b. The strategy is likely to employ a range of vaccines, all of which will undergo a thorough review process by the Therapeutic Goods Administration (TGA) to ensure their efficacy and safety. Details of Australia’s vaccine agreements can be found on the Australian Government Department of Health website.

Children are included in the final phase of the Government’s strategy (phase 5), but the timing for that phase will be subject to the progress of clinical trials of the vaccines in children. The College will continue to monitor this situation.

The College has launched a webpage about COVID-19 vaccines, which will be updated regularly as more information is made available.

It is my great pleasure to flag the release of the College’s statement on Indigenous Child Health in Australia and Aotearoa New Zealand. A dedicated group of RACP members and staff have worked to bring this statement to fruition, taking care to consult thoroughly with stakeholder groups to ensure that the document provides a strong statement with key messages and a clear direction forward. We must seek opportunities to take action whenever possible. Learn the colonial history of your country. Recognise the strength and resilience of Aboriginal, Torres Strait Islander and Māori people and communities. Understand how privilege and institutional racism operates within healthcare systems and be open to naming it. To that end, may I encourage you to read and share this statement  – more information may be found on the RACP website. Thank you to Dr Danny De Lore and the working group for their efforts to produce a statement we can be proud of. 

Last month, the College was asked to provide feedback on the Commonwealth Department of Health’s draft National Medical Workforce Strategy 2021-2031. Workforce is an essential matter and a key priority of the College and PCHD. An area of key importance is adolescent and young adult medicine. As we know, the requirement for physicians to be able to work across both adolescents and young adulthood has been growing for many years, however it remains unrecognised. Other key areas in this space include digital health education, funding that allows more flexibility for trainees, and a deeper understanding of career choices. The Council will continue to discuss workforce matters and work with the College where appropriate. 

The Journal of Paediatrics and Child Health (JPCH) is now exclusively online, with no paper version, which is consistent with reducing paper and thus energy use. We will still publish monthly issues but online only. If you would like to receive regular email notifications of the JPCH electronic Table of Contents (eTOC), go to the Wiley website and click on ‘Get content alerts’. If you do not have a Wiley account, you can register for one on the website, it's free.

Lastly, I remind you to visit the RACP Congress 2021 website and register your attendance. There are a multitude of clinical updates, shared sessions and paediatric specific topics. You can attend your local state conference, or simply register for the virtual sessions. The PCHD Congress Leads, Associate Professor Daryl Efron and Professor Jim Buttery, have worked hard to bring together sessions of interest for paediatricians and I look forward to participating.

Clinical Professor Catherine Choong
PCHD President

Chapter of Community Child Health Committee (CCCHC): Chair’s update

A number of changes to CCCHC this year will offer exciting new opportunities to re-engage with our members and tackle our priorities as laid out in our 2021-2022 workplan.   

Chapter Satellite Day 2021: Last year’s Satellite Day was delivered completely online for the first time ever. Even though this was imposed upon us by the COVID-19 outbreak, it proved to be extremely popular with members who have been able to engage with the program in their own time, regardless of their geographic location. This positive outcome, as well as the ongoing pandemic situation, made it an easy decision to continue the online format for this year’s Chapter Satellite Webinar Series with presentation webinars to be rolled out from February. The webinars will be recorded and available on the website. A taste of the program follows:

  • FASD in Juvenile Justice (Dr Raewyn Mutch)
  • Ngā Tahi workforce development work in Hawke’s Bay (Professor Russell Wills)
  • Origins Project: a birth cohort study through the first five years of life (Professor Desiree D’Silva)

We’ll be promoting these presentations as the program rolls out, so keep checking this newsletter for more details.

In addition to the Satellite Day program, the CCCHC has committed to giving input to the CCH Advanced Training Committee lecture series wherever possible. We’ll also be working to highlight the impact on children of substance abuse in parents and working with the policy team to ensure that this is included where possible in position statements.

In May this year I will step down as Chair of the Chapter, and I am very pleased to introduce the new Chair to you – Dr Paul Hotton. Dr Hotton is a Sydney-based Fellow of the College (PCHD and CCCH), currently working in CCH across the Sydney Children’s Hospital Network in the areas of child protection, developmental and behaviour paediatrics and priority population health. Dr Hotton has been a member of the CCCHC since May 2020 and is also involved in the Chapter’s education committees. While it is with some sadness I step down from the Chair’s role after many years, I feel confident that the future of the CCCHC and the Chapter overall is in very good hands.

Dr Chris Pearson
Chair of Chapter of Community Child Health

Online course: Working with Adolescents and Young Adults

We are very pleased to announce that the previously named Working With Young People (WWYP) online course has been reviewed, revised, and relaunched by a working group of the Adolescent & Young Adult Medicine Committee, and is now called Working with Adolescents and Young Adults (WWAYA). This online course has been designed to help trainees develop the knowledge, skills and attitudes required to deliver effective health care to young people.

Topics covered in the course are:        

  • adolescent development
  • ethical and legal issues
  • therapeutic engagement
  • psycho-social assessment
  • promoting self-management
  • transition to adult care.

Although the course is designed to be undertaken by trainees, we encourage participation by any College member who has an interest in working with adolescents and young adults. Just go to the Online Learning Resources page of the RACP website to self-enrol using your College log-in details.

Dr Simon Denny and Dr Bridget Farrant
Adolescent & Young Adult Medicine Committee

PREDICT Australian and New Zealand Guideline for mild to moderate head injuries in children

Children frequently present with head injuries to acute care settings. The majority (98 per cent) are mild to moderate in severity with a Glasgow Coma Scale score of 14 or 15.  Although international paediatric clinical practice guidelines for head injuries exist, they do not address all considerations related to triage, imaging, observation versus admission, transfer, discharge and follow-up of mild to moderate head injuries relevant to the Australian and New Zealand context.

Led by Paediatric Research in Emergency Departments International Collaborative (PREDICT) and funded by grants from the National Health and Medical Research Council (NHMRC), a multidisciplinary guideline working group (GWG) including emergency physicians, paediatricians, neurologists, neurosurgeons, radiologists, sports medicine doctors, neuropsychologists, general practitioners, rural clinicians, ambulance staff, retrieval clinicians, nurse/nurse practitioners and consumers developed a bi-national guideline for mild to moderate head injuries in children.

The goals of the Guideline are to:

  • improve outcomes for children who present with mild to moderate head injury
  • identify all paediatric patients who have a clinically important intracranial injury in need of intervention
  • promote consistency of management and in doing so reduce unnecessary interventions, including use of head CT scans in children at very low risk of intracranial injury, and
  • improve guidance for discharge and follow-up.

The GWG searched for and assessed existing international guidelines. Four high-quality guidelines were identified, and recommendations were mapped to 33 clinical questions. Following an updated literature search, recommendations were adopted, adapted or newly developed based on the supporting evidence-base and its transferability to the local setting. Following public consultation, 71 recommendations relevant to the Australian and New Zealand setting were developed (evidence-informed=35, consensus-based=17, practice points=19). In addition to triage related recommendations, the Guideline provides guidance for imaging and observation after head injuries including in children with underlying ventricular shunts, bleeding disorders, neurodevelopmental disorders, associated intoxication, or concerns such as abusive head trauma. It also includes discharge-related recommendations. The guideline is presented as three documents:

  1. a detailed full Guideline summarising the evidence underlying each recommendation
  2. a Guideline Summary, and
  3. a clinical algorithm on imaging and observation decision-making for children with head injuries.

The Guideline provides evidence-based, locally applicable, practical clinical guidance for the care of children with mild to moderate head injuries presenting to acute care settings. The Guideline recommendations, algorithm and the methodology behind their development will be published in Emergency Medicine Australasia and is available on the PREDICT website.

On behalf of the Guideline Working Group:
Professor Franz Babl, University of Melbourne and Murdoch Children’s Research Institute, Melbourne, Australia
Professor Stuart Dalziel, Starship Children’s Hospital, Auckland, New Zealand.
Dr Emma Tavender, Murdoch Children’s Research Institute, Melbourne, Australia

Update on Computer-Based Testing

After a rigorous tender process, we have selected Elumina eLearning to provide computer-based testing (CBT) for the upcoming May 2021 Australasian Faculty of Rehabilitation Medicine (AFRM) Module 1 examination and the limited rollout of the Divisional Written Examination (DWE) in October 2021.

The Elumina platform is modern, easy to use and provides several benefits to candidates. They also have excellent back up processes and contingency plans to minimise any disruptions.

More information about Elumina and the benefits they provide are on our website.

The CBT project is on track and preparations are going well.

We have set January to March 2021 for rigorous testing. This includes User Acceptance Testing, and we will also run an end-to-end mock exam in live test centres.

COVID-safe measures and contingency plans will be in place in case the pandemic impacts exam day.

2021 DWE

The CBT DWE will be held on Tuesday, 26 October 2021. This exam will be limited to 250 Adult Medicine and 80 Paediatrics & Child Health places.

The College Education committee has agreed that the October CBT exam will not count as an official attempt.

Registrations will open after the February DWE results have been released. If we receive more registrations than places, we will run a ballot to allocate positions. This will be overseen by independent adjudicators to make sure it is fair for everyone who has applied.

The exam will be run in most Australian capital cities as well as Christchurch and Auckland in Aotearoa New Zealand.

We will continue to keep you updated on preparations for the CBT exam. More information is also available on our website.

RACP Congress 2021 Six Cities

RACP Congress 2021

The start of 2021 has brought with it a flurry of activity for RACP Congress 2021 as sessions continue to be finalised, the list of speakers grows, and each city is working hard to ensure the face-to-face events are as engaging and enjoyable as they have ever been.

The Division and Faculty program has been announced

Featuring a combination of live webinars, and on demand events, the Division and Faculty streams will no doubt be a highlight of Congress. The program will present a range of both paediatric and child health specific and more general topics. Sessions include:

  • Providing optimal care for trans children and young people in Australasia: An update on clinical care and research, and the role of advocacy
  • Indirect effects of COVID-19 on child health
  • Sustainable health: is it truly sustainable?
  • Achieving equity: Charting a practical course.

To find out more about the program dates and time, as well as speaker bios, College events and the face-to-face events in your local city, visit the RACP Congress 2021 website.

Don’t miss out on your CPD credits

Whether you attend in-person or virtually, attendance at RACP Congress Series 2021 can be claimed as CPD credits. The RACP provides the MyCPD program as an online service to Fellows to assist in meeting mandated continuing professional development (CPD) requirements.

IMiA21

IMiA21 – Meet your panels

With less than one month to go, the IMiA21 conference continues to bring together expert voices for a range of panel discussions. Augmenting the strong selection of keynote speakers, the panel discussions promise to be no less engaging as the list of speakers is finalised. With a three-day program packed with content, the breakout sessions are another great reason to attend this virtual event.

Read more about the panels speakers and register at the IMiA21 website.  

Australia’s doctors to examine addiction in wake of COVID-19 pandemic at IMiA21 conference

The Royal Australian College of General Practitioners released a media statement on 3 February 2021 about the IMiA21 conference being held from Friday, 26 February to Sunday, 28 February 2021. Professor Nick Lintzeris, President of the RACP's Australasian Chapter of Addiction Medicine is quoted.

RACP Statement on Indigenous child health in Australia and Aotearoa New Zealand

We have released a landmark statement on Indigenous child health in Australia and Aotearoa New Zealand, providing concrete steps that paediatricians, health professionals and the healthcare system can take to improve the health of Indigenous children in Australia and Aotearoa New Zealand.

Dr Danny de Lore, Māori paediatrician, led the RACP working group that worked closely with Aboriginal, Torres Strait Islander and Māori people to develop a statement that provides tools and actions for health professionals to ensure more equitable health outcomes for Indigenous children in Australia and Aotearoa New Zealand.

The statement calls on physicians to:

  • recognise the strength and resilience of Aboriginal, Torres Strait Islander people and Māori communities.
  • understand how privilege and institutional racism operates within healthcare systems and be open to naming it.

All RACP members are encouraged to read the statement and implement the key messages in their practice and workplace.

Learn more

Improving your experience with the RACP website

We are undertaking an extensive project to help you find the information you need on the RACP website. The project is being delivered in two stages and will enhance and improve your experience in navigating our online services.

To help us improve the navigation on the RACP website, you’re invited to participate in this short online RACP Member Card Sort activity. Card sorting is a method that designers use to understand how people group information. The activity will take around 10 minutes.

  • Your responses will be kept confidential.
  • This activity is for RACP members only. Please don’t share the activity link with non RACP members.

Your time is appreciated and will go a long way to help us develop a website that meets your needs.  

If you have questions about the project or need assistance with the activity, please email Member Services.

Digital health

A series of digital health webinars has been developed to help you better understand digital health initiatives. The webinars cover My Health Record, available systems and compliance requirements. To find out more and to register visit this RACP webpage.

The webinars have been developed by the Australian Digital Health Agency, who are responsible for the delivery of Australia's National Digital Health Strategy. The Strategy's key pillars include driving innovation, education and workforce development, enhanced models of care, interoperability and data quality, medicines safety, My Health Record and secure messaging.

Find out more

More evidence for minimum unit pricing of alcohol – join our campaign for a minimum price in Western Australia

The Northern Territory has the highest rates of alcohol-related harm in the country. In recognition of this grim statistic, the NT Government became the first and, so far, the only jurisdiction in Australia to introduce a minimum unit price (MUP) for each standard drink of alcohol.  

A new study by Wright et al. on alcohol-related intensive care unit admissions to Alice Springs Hospital adds to the growing pool of evidence for the effectiveness of price-related interventions in minimising harms of alcohol. The study shows a nearly 40 per cent reduction in harmful alcohol use after alcohol reforms, including MUP, were introduced in 2018.

Both modelling and recent empirical research from Scotland shows that the heaviest drinkers and those with the lowest incomes are the biggest beneficiaries of the health gains attributable to MUP – heavy drinkers prefer the cheapest beverages and since they drink more alcohol, they also respond to price changes. A January 2021 study shows that the introduction of MUP in Scotland and Wales shifted purchases from higher to lower strength products – the alcohol by volume of beer dropped by 2 per cent and of cider by 7 per cent.  

Australian governments know that policies aimed at reducing alcohol’s availability via increasing pricing and reducing access save lives and dollars. The introduction of MUP and associated reforms in the NT indicated that the Government recognised the high price paid by its citizens and its budgets for alcohol-related harm. However, the NT Government’s recent bypassing of the usual liquor licensing process in favour of Endeavour Drinks Group’s push to open a ‘big-box’ Dan Murphy’s store within walking distance of three ‘dry’ Aboriginal communities shows that commercial pressures are already undermining progress.  

The RACP actively advocates for MUP and other evidence-based alcohol harm reduction policies. In 2021, we will be asking for member support as we push for MUP in Western Australia as part of our pre-election campaign. Learn more about the RACP campaign for MUP in our information sheet on the intervention.   

Low-value care during the COVID-19 pandemic

During COVID-19 it is more important than ever to reduce practices that may cause unnecessary harm or pose unnecessary risk of transmission. Evolve has shared recommendations and resources that are particularly relevant to physicians during this pandemic. View relevant recommendations on TwitterFacebook and LinkedIn or search for #RACPEvolve.

COVID-19 has encouraged us to stop and reflect on what tests, procedures and practices are essential, and when it might be in the patients’ best interest to watch and wait. Do you think COVID-19 will change how we deliver medicine in the future? Read more in the latest edition of RACP Quarterly on pages 6 to 8.

If you are interested in shaping Evolve and being a leader in reducing low-value care email evolve@racp.edu.au to join the Evolve Policy Reference Group.

New Telehealth online course

Access all of the information and tools you need to prepare for and conduct culturally competent and patient-centred telehealth consultations in this new Telehealth online course. We understand you’re busy, so we’ve made sure RACP Online Learning Resources are accessible anywhere and optimised for mobile on-the-go learning. Our courses are designed to enable you to dip in and out, or just do the parts that are relevant to you.

Evolve Webinar Series 2021

This year, Evolve will host a series of webinars that will explore interesting topics relevant to low-value practice.

The inaugural webinar will feature Professor Ian Scott who will be presenting on ‘Cognitive biases in clinical decision making’. The webinar will be held on Tuesday, 16 February 2021, 6pm to 7pm (AEDT) / 8pm to 9pm (NZDT).

Behavioural science tells us that our decision making is influenced by biases, and physicians are not immune to this. Join Professor Scott in a discussion about the cognitive biases that physicians experience in their clinical decision making and how this can play a role in the continued delivery of low-value care.  

Register for Evolve webinar

Journal of Paediatrics and Child Health January 2021 is available online

The Journal of Paediatrics and Child Health, Volume 57, Issue 1, January 2021 is now available on the JPC Wiley page.

An early view is also available of future articles.

Pomegranate Podcast – Boosting public health in the Indo-Pacific

Ep67: Boosting Public Health in the Indo-Pacific

This is the fourth and final part in our series on Global Health Security. Australia’s Indo-Pacific Centre for Health Security was launched in 2017 to provide development assistance to health services as far-flung as Fiji, Cambodia and Timor L’este. Its mission is always tailored to the needs of the partner government. In Indonesia it has provided training to the veterinary sector to foster antimicrobial stewardship. The 2020 COVID-19 pandemic was a sudden shock to the development agenda and has forced a rapid redeployment of resources. Since recording this interview there has been an additional $500 million dollar commitment to fund doses of COVID-19 vaccine and technical assistance to the Pacific and Southeast Asia.

Listen now

RACP Fellows can claim CPD credits through MyCPD for listening to this episode and reading the resources at the website. To be the first to hear about the latest episodes of Pomegranate Health, subscribe in Apple PodcastsSpotify, any Android podcasting app or join our email alerts list.

New resource to help clinicians implement best-practice guideline for the assessment and diagnosis of autism

Autism CRC has launched a National Guideline Implementation Toolkit to help clinicians to upskill and deliver the recommendations of the recently published National Guideline for the Assessment and Diagnosis of Autism.

The Toolkit makes an important contribution to nation-wide implementation of the Guideline. It aims to improve clinician knowledge of best-practice assessment and diagnosis procedures and provide them with practical tools for use in clinical practice.

Professor Andrew Whitehouse, Autism CRC Research Strategy Director and Chair of the National Guideline Research Executive Committee, said the Toolkit is a valuable resource for clinicians who want to learn more about the Guideline, or to check their practice aligns with the latest scientific evidence.

“The Toolkit provides a succinct overview of the Guideline recommendations, with a clear step-by-step process for assessment, covering which professionals should be involved at each stage, assessment settings, information to collect, and how to approach informed decision-making.

“The Guideline aims to improve assessment practice and consistency across Australia, and to give clinicians greater clarity and confidence in the accuracy and reliability of diagnostic decisions.”

The National Guideline Implementation Toolkit includes videos, fact sheets, a clinical practice audit tool, template forms and training information. Individuals undergoing an assessment, parents and caregivers can also access resources to learn more about the Guideline and what to expect from the assessment process.

“Ultimately, we want to give clinicians the knowledge and tools to ensure that individuals and families across Australia receive the best possible care,” Professor Whitehouse said.

About the National Guideline

Launched in October 2018, the National Guideline for the Assessment and Diagnosis of Autism is the first unified approach to the assessment and diagnosis of autism in Australia. It aims to provide greater equity in access to an assessment, transparency and confidence in the decision-making process, and a clearly defined pathway to meet support needs.

The Guideline recommendations have been approved by the National Health and Medical Research Council as representing best practice health care in Australia, and are already being implemented by major diagnostic service providers around the country.

The National Guideline Implementation Toolkit was developed and published by Autism CRC with the financial support of the Australian Government's Department of Social Services.

To access the National Guideline Implementation Toolkit, or to download the Guideline, go to autismcrc.com.au/national-guideline.

Contact information

Cally Jackson, Marketing and Communication Manager, Autism CRC
Phone: 0428 390 705
Email: media@autismcrc.com.au

COVID-19 Vaccine solidarity campaign – Social media toolkit

As the COVID-19 vaccine is being rolled out all over the world, to counter misinformation, the International Pediatric Association (IPA) leaders from 164 member societies in 149 countries unite to support the COVID-19 vaccine. Please share the IPA social media toolkit widely in your network.

Invitation to participate in Aotearoa New Zealand End of Life Choice Act Workforce Survey

The End of Life Choice Act 2019 (the Act) comes into force on 7 November 2021 in Aotearoa New Zealand. 

The Act gives people who experience unbearable suffering from a terminal illness, and who meet all the criteria for assisted dying set out in the Act, the option of legally asking for medical assistance to end their lives. The Act includes safeguards to ensure anyone seeking this assistance is making an informed decision of their own accord. 

The Aotearoa New Zealand Ministry of Health has established a new team to manage the implementation and oversight of the Act and is developing a work programme to manage all aspects of implementation.

Further information on the Act can be found on the Aotearoa New Zealand Ministry of Health's website

Implementation of the assisted dying service – workforce survey

One of the first priorities for the Ministry of Health's The End of Life Choice Act team is to better understand the views of Aotearoa New Zealand health practitioners with a specified role under the Act, in relation to assisted dying. A short survey for Aotearoa New Zealand health practitioners has been designed to give them an early indication of workforce knowledge, understanding and attitudes towards the Act.   

Learning about the number of health practitioners who may choose to have a role in the assisted dying service, the settings they currently work in and any specific concerns they may have in relation to the Act will help inform the design, planning and implementation of the system.  

Health practitioners have a right to conscientiously object to providing assisted dying services. It’s important to note that any response to this survey is not a confirmation of a choice to either participate in, or opt out of, the service. The results will help inform their approach to workforce development for an assisted dying service. Responses will not be individually identified by the Ministry.  

The survey for Aotearoa New Zealand health practitioners can be accessed online. The survey is optional and closes on Sunday, 28 February 2021.

More information about the implementation of the Act will be shared over the coming weeks. In the meantime, any questions regarding the survey or the implementation of the Act can be directed to eolc@health.govt.nz

Are you ready for active ingredient prescribing from 1 February 2021? 

Regulatory changes came into effect on 1 February 2021 bringing mandatory active ingredient listings on medicines, with some exceptions. The NPS MedicineWise active ingredient prescribing information hub contains a number of resources and useful links, including a fact sheet for prescribers outlining what you need to know and do to be ready for these changes, including ensuring your prescribing software is up-to-date. 

Conferences and events

The Royal Australasian College of Physicians publishes notices of events and courses as a service to members. Such publication does not constitute endorsement or mandating of any such events or courses. 

ONE-Sim (Obstetrics and Neonatal Emergency Simulation) workshop
Wednesday, 3 March 2021, 1pm to 4pm, attend at Monash Children's Hospital Simulation Centre, Clayton, Victoria or online

Puawaitahi, Starship Hospital and MEDSAC Paediatric Training Course on the Medical Assessment of Sexually Abused Children and Adolescents
Thursday, 18 March 2021 to Friday, 19 March 2021, 8am to 5pm, online
See Expression of Interest form.

Go to the events list at any time to see what events are coming up.

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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