Pot-pourri eBulletin 7 February 2020

President's Message

In this, the first PCHD Pot-pourri for 2020, I’d like to open by expressing my sympathy for any members affected by the bushfires still burning through so much of Australia. A media release dated 11 January 2020 summarises the College’s concerns around the health impacts of climate change, and I would encourage all members to read this. It can be difficult to remain energised and positive in the face of such a natural disaster, so please remember that the College’s health and wellbeing resources are available to help you if needed.

Continuing the discussion of wellbeing, RACP Congress 2020 will feature an opening keynote by Professor Catherine Crock AM on ‘Balancing science with humanity: how kindness restores the whole in medicine’. Members are reminded that earlybird registrations are open for Congress, which will be held this year from Monday, 4 to Wednesday, 6 May at the Melbourne Convention and Exhibition Centre. The program is well underway and features a dedicated paediatrics and child health stream, as well as sessions for the Rue Wright Memorial Award, free paper presentations, and the PCHD Annual Members’ Meeting (AMM). At this year’s AMM, I’ll be handing over the tiller of the PCHD to the next President, Professor Catherine Choong – we hope you will be there to share the occasion with us.

Congratulations to two of our paediatric members who received Australia Day Honours: Professor Peter McIntyre who received an Officer (AO) in the General Division of the Order of Australia and Emeritus Professor Thomas John Boulton who received Member (AM) General Division of the Order of Australia.  This is a fantastic achievement and a full list of Fellows honoured can be viewed on the RACP website.

As you would be aware, nominations for Division, Faculty and Chapter elected positions closed yesterday. If a vote is required (eg. if more nominations are received than positions are available) this process will begin in March. In the meantime, nominations for appointed positions on PCHD committees will open on 18 February; members will receive an email inviting you to go to the website for information on available positions and details on how to apply. Joining a committee is an opportunity to create change and I encourage you take part in this opportunity.

The Paediatric Policy & Advocacy Committee will be opening EOIs for members to be involved in the revision of the Out-of-Home Care (OOHC) position statement. The original statement was produced prior to the 2011 Australian Government National Clinical Assessment Framework for children in OOHC, and the changes to child protection services in New Zealand. As such, the name will be changed to Health Care of Children in Care and Protection Services, and members will have the opportunity to use their expertise and shape the new policy. EOIs will be advertised shortly on the RACP expressions of interest webpage.

Lastly, many of our Basic Trainees will be sitting the written examination later this month. I wish them the very best, and ask our members to support them during this busy and demanding time.

Professor Paul Colditz
President, Paediatrics & Child Health Division

Important message for Australian members

The National Boards and the Australian Health Practitioner Regulation Agency (AHPRA) will be publishing an advance copy of the revised mandatory notification guidelines and supporting resources.

The Guidelines: Mandatory notifications about registered health practitioners and Guidelines: Mandatory notifications about registered students provide information about how to meet mandatory notification requirements. The guidelines aim to help practitioners, employers and education providers understand who must make a mandatory notification about a registered health practitioner or registered student and when.

Summary of changes

The guidelines were revised following amendments to the Health Practitioner Regulation National Law passed early in 2019 and expected to commence in early March 2020. 

The amendments changed the reporting obligations for treating practitioners by establishing a new, higher risk threshold for treating practitioners to report impairment, intoxication or practice that significantly departs from accepted standards. This further limits the circumstances for treating practitioners to make mandatory notifications. These changes aim to give practitioners confidence to seek help for health conditions if they need it, while continuing to prevent the risk of harm to the public. 

The requirement to make a mandatory notification about a practitioner is different for different notifier groups. For that reason, the guidelines about practitioners have been structured according to notifier type (that is treating practitioner, non-treating practitioner, employer) so that relevant information for that notifier group is easier to find.

As there are only limited circumstances when a mandatory notification can be made about a student, separate guidelines for notifications about students and practitioners have been developed.

You can find information and resources such as case studies and FAQs on the AHPRA website.

Committee Spotlight: Paediatric Research Committee

September 2019 saw Professor Harriet Hiscock step down from the Paediatric Research Committee (PRC) having served as Chair since May 2017. I would ask all PCHD members to join the PRC in thanking Harriet for her valuable leadership during this time. Under Harriet’s excellent leadership, the PRC’s key achievements included the May 2019 launch of the Paediatric Academic Pathways guide and the accompanying video guide. The PRC looks forward to continuing this same enthusiastic promotion of and advocacy for paediatric research into the future. Specifically, we will be looking at ways that funding opportunities may be improved for all Fellows interested in participating in or conducting research, not just those on post-graduate research career tracks. The PRC is looking towards fostering the many paths that Fellows can take as clinician researchers, and as such I encourage you to look at the video that will hopefully provide useful information for Fellows, particularly women considering clinical research, who may be juggling part-time clinical, research and family commitments. I am currently serving as Interim Chair, however nominations for this position will be open shortly for all members to apply through the College election process.

With RACP Congress 2020 in Melbourne this year from 4 to 6 May, I am looking forward to hearing from the keynote speaker, Professor Catherine Crock AM, on 'Balancing science with humanity: how kindness restores the whole in medicine'. I have no doubt this will be a highlight. I am especially delighted to see that Harriet will be a speaker for the Chapter Satellite Day on the topic of 'Inequalities in mental health for children and adolescents'. Chapter members can register for this event via the Ancillary Events Congress webpage.

I would urge all PCHD members interested in research to attend the Research and Innovation Showcase sessions which extend across the Monday and Tuesday of Congress. I am also pleased to note that members of the PRC are currently involved in assessing abstract submissions received for the Best Poster Prize in Paediatrics & Child Health – make sure you check out the successful posters and please support the trainees who are presenting at Congress.

The PRC will next meet on Wednesday, 1 April 2020, its last meeting with the current committee composition. I would like to thank all PRC members, especially those stepping down in May, for their enthusiastic and considerate contributions. I encourage all PCHD members interested in research and related advocacy to make an application to join the PRC when nominations open on Tuesday, 18 February.

For more information about the PRC, visit the College website.

Associate Professor Margie Danchin
Interim Chair, Paediatric Research Committee

Chapter Satellite Day 2020

The Chapter of Community Child Health will hold their Annual Chapter Satellite Day on Sunday, 3 May 2020 at the Melbourne Convention and Exhibition Centre, the day before commencement of the RACP Congress. All Chapter members are encouraged to attend this event which will include the Chapter’s Annual Members Meeting; it will also be a valuable opportunity to hear presentations from a range of prestigious community child health experts.

The program continues to be developed; presentations confirmed so far include:

  • Professor Harriet Hiscock, 'Inequalities in mental health for children and adolescents'
  • Associate Professor Emma Sciberras, 'Child Development and Behaviour: Sleep'
  • Dr Anne Smith, 'Fabricated Illness'.

Chapter members are invited to attend a joint dinner with the Chapter and the Neurodevelopmental and Behavioural Paediatric Society of Australasia (NBPSA) on Saturday, 2 May 2020, at The General Assembly at South Wharf.  

Visit the RACP Congress website to register for the Satellite Day 2020 and the CCCH/NBPSA Dinner.

Congress 2020 banner

'Complexity in clinical practice' at RACP Congress 2020

You’re invited to one of the premier annual events on the RACP calendar, Congress 2020: Balancing medical science with humanity. Held on Monday, 4 to Wednesday, 6 May in Melbourne, we’ve developed an immense program filled with a diverse range of local and international speakers.

We are pleased to confirm Dr Michael McDowell as a speaker for our dedicated Paediatrics & Child Health stream. A paediatrician specialising in child development and behavioural disorders, Dr McDowell has shared this preface with us:

James (not his real name) has chronic recurrent encopresis. He has learning disability and ADHD. At school he is socially immature and intermittently angry, both a recipient and perpetrator of bullying. The school’s goodwill is fading as James’ learning and behaviour problems persist. He is in foster care following early childhood neglect. His behaviour at home threatens his placement.

James’ problems are not easily separable into discrete components for individual consideration and management. Each component interacts with the other components. The boundaries of health, education, family and other services are not distinct.

As James’ paediatrician, how do you approach this level of clinical complexity?

The evidence base that guides medical practice is built on research that, by definition, answers problems that are answerable. Challenges that arise in clinical practice, by contrast, may involve complexity where the recursive interactivity of contributing components prevents quantitative evaluation. Complexity arises inherent to the situation. It is not due to clinical inadequacy. It will not be resolved with additional assessment.

This talk introduces complexity as a necessary consideration in clinical practice, and offers approaches guided by how other systems (e.g. business administration) address this challenge.

Dr Michael McDowell will present on 'Complexity in clinical practice' at 4.25pm on Tuesday, 5 May 2020 as part of RACP Congress 2020.

RACP Congress is a unique networking opportunity for you to meet members of the Division, as well as members from the broader College, while learning about a diverse range of clinical and other health topics. For more information and to register, visit the Congress website. Hurry, early-bird rates available until 3 March 2020.

Register now

The Australian bushfires

As the bushfires and hot weather continue, our thoughts are with those who have been affected by this unprecedented disaster. Your College released a media statement on the bushfires on 11 January 2020 and we recognise that the full extent of the health impacts are not yet known.

We’ve had many members contacting us to ask how they can help. We encourage members who can assist to contact the relevant rural doctors’ organisation coordinating your state’s health workforce response.

For more information, please visit these websites: 

Trainee re-registrations due

A reminder that registrations for Basic and Advanced Trainees for the Australian 2020 clinical year are now open:

Please note the deadline for Advanced Training applications has been extended to Sunday, 1 March 2020 due to unexpected delays in processing 2019 Supervisor’s Reports and 2020 applications.

As a trainee, you must re-register your training annually.

New Zealand registrations have now closed.

For more information check your relevant handbook or contact us.

What’s happening in the new Basic Training programs

Early adopters

We’re excited to announce the training settings that will be the second group to adopt the new Basic Training program.

Early adopters are training settings who are working with the RACP to lead the rollout of the new Basic Training programs. The purpose of early adopter implementation is to:

  • test the new training program
  • test supporting materials and activities 
  • develop a network of change champions.

We will be working with the following settings:

2020
Lead Setting(s) Affiliated training settings Phase(s) of training
Gold Coast University Hospital
(Adult Medicine)
Robina Hospital
Innisfail Hospital
Foundation (BPT1)
The Townsville Hospital
(Adult Medicine)
N/A Foundation (BPT1)
Starship Children’s Hospital
(Paediatrics & Child Health)
Kidz First Children’s Hospital, Middlemore
Waitakere Hospital
Whangarei Hospital
Foundation (BPT1)
Women’s and Children’s Hospital, Adelaide
(Paediatrics & Child Health)
Flinders Medical Centre Foundation (BPT1)
2021
Lead Setting(s) Affiliated training settings Phase(s) of training
Box Hill Hospital
(Adult Medicine)
Angliss Hospital
Epworth Eastern Private Hospital
Latrobe Regional Health
Maroondah Hospital
Peter James Centre
Wantirna Health
Foundation (BPT1)
Consolidation (BPT2)
Dunedin Hospital
(Paediatrics & Child Health)
N/A Foundation (BPT1)
Consolidation (BPT2)
Queensland Paediatric Training Network
(Paediatrics & Child Health)
Queensland Children's Hospital
Gold Coast University Hospital
The Townsville Hospital
Bundaberg Hospital
Caboolture Hospital
Cairns Hospital
Hervey Bay Hospital
Ipswich Hospital
Logan Hospital
Mackay Base Hospital
Redcliffe Hospital
Redland Hospital
Rockhampton Hospital
Sunshine Coast University Hospital
The Prince Charles Hospital
The Royal Darwin Hospital
Toowoomba Hospital
Foundation (BPT1)
Royal Hobart Hospital
(Paediatrics & Child Health)
Launceston General Hospital
North West Regional Hospital
Foundation (BPT1)
Taranaki Base Hospital
(Paediatrics & Child Health)
N/A Foundation (BPT1)
Waikato Hospital
(Adult Medicine)
N/A Foundation (BPT1)
Consolidation (BPT2)
Sunshine and Footscray Hospitals
(Adult Medicine)
Albury Wodonga Health
Ballarat Hospital
Williamstown Hospital
Foundation (BPT1)
Consolidation (BPT2)

Please contact us if you would like more information.

Million Minds – an MRFF initiative to improve mental health care

One in seven Australian children aged four to 17 years old will experience a mental health disorder in any given year. Over the last seven years, more and more children and young people are presenting to Australian emergency departments (EDs) with serious mental health and behavioural problems. Some of these problems could be better managed before coming to the ED – potentially preventing ED presentations – whilst others could be better managed in the ED. 

The Medical Research Futures Fund (MRFF), the new research funding initiative by the federal government, provides support for clinician researchers across a wide range of projects. MRFF funding calls are often targeted towards specific conditions or problems. One such MRFF opportunity was the MRFF Million Minds call for mental health projects.

A team of researchers – paediatricians, emergency physicians, psychiatrists, psychologists and research experts – from Monash University, Murdoch Children’s Research Institute, University of Western Australia, University of Melbourne, Deakin University and the Paediatric Research in Emergency Departments International Collaborative (PREDICT) network received $5 million in funding for a five-year grant entitled: The Kids are Not Okay: Emergency Department management of acute mental health crises in children and young people.

This funding provides an opportunity to work out who is coming to the ED with mental health and behavioural problems, why, and how we can improve the care for children, adolescents, and their families. 

The research, to be conducted across multiple hospitals across the PREDICT network will explore factors which influence how staff care for these patients, and will develop – in partnership with patients, families and clinicians – priorities for research in this area through a Delphi process. The research team will also examine current practice and clinical outcomes for these patients across multiple hospitals, both tertiary children’s hospitals and suburban, regional and rural emergency departments. The team will also conduct a trial on an enhanced safety planning intervention to help patients with suicidal thoughts. Multicentre randomised medication trials for oral and intramuscular sedative agents will help determine the optimal drugs for acute severe behavioural disturbance.

Professor Harriet Hiscock FRACP Murdoch Children's Research Institute
Professor Simon Craig FACEM, Monash University, PREDICT
Professor Franz Babl FRACP University of Melbourne, PREDICT

Educational Development (Study) Grants

Applications are opening soon for the 2020 Eric Burnard Fellowship worth up to $10,000. This grant can go towards gaining new technical expertise, training at an institution, or participating and presenting a paper at a conference or scientific meeting in the field of neonatology.

Associate Professor Louise Conwell was awarded the Eric Burnard Fellowship in 2019 for her observership on neonatal hypoglycaemia and congenital hyperinsulinism at the University College London Institute of Child Health, Great Ormond Street Hospital for Children.

Other Educational Development Grants available in the 2020 round include the:

  • Richard Kemp Memorial Fellowship
  • Aotearoa New Zealand Educational Development Grant
  • Queensland Regional Committee Educational Development Grant.

Submit your applications online from Friday, 21 February to Monday, 23 March 2020. Information about this award including eligibility criteria and the link to the online application form is available on the RACP Foundation webpage.

Quality and safety resources for members

Quality and safety is central to the delivery of healthcare in Australia and 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.

IMS banner

The Tri-Nation Alliance International Medical Symposium

Register for the Tri-Nation Alliance International Medical Symposium (IMS), on 'Providing care to underserved populations'. The symposium will be held on Friday, 20 March 2020 at the Amora Hotel in Sydney.

This annual event provides a great opportunity to share the latest insights in higher medical education. The program will explore how best to train, prepare and retain medical specialists to care for underserved populations in Australia, New Zealand and Canada due to isolation, geographical location or many other social determinants and how innovative technologies can enhance their access to healthcare.

Keynote speakers include Professor Roger Strasser, formerly Dean of the Northern Ontario School, of Medicine, an expert renowned for promoting the importance of socially accountable medical education to serve communities and Dr Lisa Richardson, Faculty of Medicine Strategic Advisor, Indigenous Health at the University of Toronto, an expert in urban underserved populations in Canada. Professor Diane Sarfati, a public health physician and cancer epidemiologist from the University of Otago with expertise in the area of ethnic disparities in disease outcomes and Dr Belinda O’Sullivan, a researcher leading international scale studies on rural health systems, from the University of Queensland Rural Clinical School will provide the other keynote presentations.

Other sessions will provide interesting insights into education and training to support access to care from Associate Professor Elana Curtis, a Public Health Physician from the University of Auckland. The Chair of the Royal Australasian College of Surgeons Rural Surgery Section Committee, Dr Bridget Clancy, an ENT surgeon based in rural Victoria, will also provide interesting perspectives on meeting the challenges of practice for rural and underserved populations.  

More information is available on the IMS website.

The member colleges of the Tri-Nation Alliance are the Royal College of Physicians and Surgeons of Canada, The Royal Australasian College of Physicians, The Royal Australasian College of Surgeons, The Australian and New Zealand College of Anaesthetists and the Royal Australian and New Zealand College of Psychiatrists.

New Pomegranate podcast: Ep55: Starting out in practice

This podcast is about one of many pathways in medicine; private practice. It’s a pathway that presents many opportunities, but also personal and financial challenges. When doctors are starting out in private practice, they typically do so within the safety net of an established practice, and perhaps only for part of the working week. In a simple model, they would be renting a room in exchange for an agreed portion of the consultation fees to cover administration costs.

The next level of complexity is setting up shop for one's self, and this requires registering a company in order to employ other staff. Finally, one can partner in a group practice, which may bring efficiencies of scale, but potentially also personality clashes with other shareholders.

And behind all of this, there is the need to build awareness and trust among the patient community. In this podcast we hear the experiences of a private rheumatologist practising for 25 years, as well as learning about accounting and financial planning. 

Guests

  • Dr Louis McGuigan FRACP, Consultant Rheumatologist, Miranda
  • Paul Copeland, Director, William Buck Chartered Accountants
  • Scott Montefiore, Managing Director Hillross Montefiore and Co.

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

Evolve case studies

Internal Medicine Society of Australia and New Zealand case study

Hugh is a 48 year old male plumber, ex-smoker with mild chronic obstructive pulmonary disease. He takes Spiriva inhaler regularly and a Venotilin inhaler as required. For 10 days he has had a bad head cold with runny nose and sore throat, followed by a hacking cough and shortness of breath on exertion. Does Hugh have a viral/cough-induced costochronditis or does he have acute pulmonary thromboembolism (PTE) with clots passing to his lungs? Download the RACP Evolve | Choosing Wisely Australia | Internal Medicine Society of Australia & New Zealand case study to learn what investigations can be used for PTE.

Australasian Society for Infectious Diseases case study

Rosie is two and a half years old, born at term, immunised with no regular medications, and has started day-care recently. For 24 hours she has had a runny nose, a cough, is miserable and has no appetite. Rosie’s parents want her to take something to make her better soon. Download the RACP Evolve | Choosing Wisely Australia | Australasian Society for Infectious Diseases case study to find out the appropriate and inappropriate management options.

Improving clinical case management, infection prevention and control of clostridioides difficile infection

The Australian Commission on Safety and Quality in Health Care supports health service organisations in implementing effective infection prevention and control strategies to reduce the risk of patients acquiring preventable healthcare-associated infections. In 2016, the Commission established a Community of Practice to investigate what future measures would support maintaining low rates of clostridioides difficile infection (CDI) in Australia. The Commission continues to monitor the prevalence of CDI in Australian public hospitals annually and has recently published the Clostridium difficile 2017 Data Snapshot Report along with an associated infographic. The Community of Practice also made several recommendations relating to the surveillance and management of CDI in Australia which can be found in the 2018 Technical Report: A Model to Improve Prevention  and Control of  Clostridium Difficile Infection in Australia.

Taking further action on outdoor alcohol advertising

Alcohol is one of the most harmful yet most heavily promoted products in the world. Evidence clearly shows that young peoples' exposure to alcohol marketing increases their alcohol consumption, as well as the risk of starting drinking at a younger age. The World Health Organization recommends bans or comprehensive restrictions on alcohol advertising, sponsorship and promotion to reduce alcohol use and harm.

Market research indicates that 92.6 per cent of consumers are exposed to outdoor advertising at least once per day, and that three out of five shoppers are influenced by outdoor marketing immediately prior to shopping. This form of marketing is extremely influential and therefore acutely harmful, especially for young people. 

As highlighted in the Foundation for Alcohol Research & Education’s (FARE) Snapshot of the current state of play, most Australian jurisdictions have introduced some controls on outdoor alcohol advertising. While these restrictions work to limit exposure, they are not comprehensive enough to prevent children and young people from viewing all outdoor alcohol advertising.

Current restrictions need to be strengthened by legislating bans or more comprehensive restrictions and introducing sanctions and monitoring and enforcement mechanisms. The RACP’s Alcohol Policy supports the three options proposed by FARE to remedy this policy shortcoming:

  • Ban on all outdoor alcohol advertising and sponsorship across the jurisdiction
  • Ban on all outdoor alcohol advertising and ban on sponsorship at all family-friendly events
  • Ban on outdoor alcohol advertising on government-owned assets and public transport infrastructure. 

Read more

National lung cancer screening program

Cancer Australia is investigating the feasibility for a national lung cancer screening program for people at high risk of lung cancer. The consultation is being hosted on the Department of Health’s Consultation Hub until Monday, 17 February 2020.

You are invited to provide your input into the Consultation Hub. The survey takes around 10 minutes to complete and submissions can also be attached.

For more information about the Lung Cancer Screening enquiry, please visit the Cancer Australia website.

Webinar: Registering and uploading records to My Health Record

My Health Record is a secure online summary of an individual's health information available to all Australians. Healthcare providers authorised by their organisation can access My Health Record to view and add to their patients' health information. Understanding how to register and upload to My Health Record can be challenging. Join Professor Steven Boyages as he interviews Carey Doolan from the Australian Digital Health Agency who will provide practical advice to help you register and upload to My Health Record.

Upon registration, you will receive a confirmation email  about how to join the webinar.

Register now

Medical Board of Australia Newsletter January 2020

Read the latest news from the Medical Board of Australia.

Journal of Paediatrics and Child Health

The Journal of Paediatrics and Child Heath January 2020 edition is out now. It features an interesting article questioning if Australia should tax sugar-sweetened beverages.

Other topics this month include:

  • Futility in adolescent anorexia nervosa and the question of withdrawal of care
  • Flushing of peripheral intravenous catheters: A pilot, factorial, randomised controlled trial of high versus low frequency and volume in paediatrics
  • Adherence to surgical antibiotic prophylaxis guidelines in children: A cohort study
  • Diagnostic value of serum cytokeratin‐18 in children with chronic liver disease

Read now

The early view of the next issue of the Journal of Paediatrics and Child Health is now available on the JPC Wiley page.

2019 Novel Coronavirus: A Physician's Guide from the American College of Physicians

The American College of Physicians (ACP) has developed educational resources that are freely available to the healthcare community as a public service in response to the coronavirus outbreak, including:

  • Novel Coronavirus: A Physician's Guide – an online learning activity providing a clinical overview of infection control and patient care guidance
  • Coronavirus: What the clinician needs to know podcast.
Access resources

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'.

Member Advantage deals

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