BRITISH SOCIETY OF
PAEDIATRIC GASTROENTEROLOGY AND NUTRITION
NEWSLETTER 2000
OCTOBER 2000
THE PRESIDENT ’ S REPORT
The new millennium began with a memorable meeting in Bristol. It had a certain style which we all recognised, and was particularly notable in that it inaugurated a new emphasis on our winter meetings. There were more scientific papers than previously, and the associate members attended in some numbers and established their committee. There was also time for a useful, and some might say a robust debate on training issues arising from the recognition of centres for tertiary training, on the specialty clinical services required in a district general hospital, and also on the report of the Endoscopy Steering Group. It was later agreed in York that the AGM should be moved to January to give us more time for discussion and debate. The meeting in York this year was notable for the guest lecture delivered by John Walker-Smith. This marked his retirement year and gave us all an opportunity to acknowledge the enormous contribution which he has made, we wish him well for the future.
There are three major areas in which we need to make progress. The first is to achieve equality of access to paediatric gastroenterology, hepatology and nutrition and services for children right across the UK. The Council has set up a working group to define the clinical specialist services needed in a district general hospital, and also the various professional and service links with the relevant regional centre which should be put in place. Links to this are the moves to redefine the organisation of specialty commissioning in the NHS. There are opportunities here but also threats bearing in mind the relative lack of emphasis on child health in the latest action plans for the NHS. The second area is the research and academic profile of the specialty. The structure of medical school academic departments is changing rapidly, it is certain that in the short term the funding available for clinically based research in our specialty will be limited. At the same time the clinical workload for individual consultants is increasing for the reasons that are evident to us all. There are several ways forward, these include nurturing trainees with research
interests, appointing many more consultant staff, and promoting collaborative projects. The Society is taking further action on this initially through the inflammatory bowel disease register and working group. The third area of concern must be to enable the three sub specialties within the society to further develop their identities and yet remain cohesive. There is a need to consolidate our postgraduate teaching as well as to establish identified departments within the NHS Trusts and medical schools. We have been fortunate in achieving the appointment of many talented individuals within the specialty over the last few years; it is crucial that the Society builds on their enthusiasm and skills as the next decade unfolds.
Martin Brueton
It has been a positive and successful year for the Society. The membership now stands at 239 (with 67 of these being Associate Members). The Associate Membership group is flourishing and we will continue to meet together at the Winter meeting. Our great thanks are due to Bhu Sandhu for organising a very successful Millennial meeting in January 2000, on both scientific and social fronts. At our meeting in York in April, the standard of papers presented was impressive, and the highlight of the meeting was Professor Walker-Smith’s guest lecture. Throughout the year, working groups have been convened (on IBD and endoscopy) and the CSAC continues to discuss the specifics of training, as well as the accreditation of training centres. There is a specific report on the work of the CSAC in this newsletter.
Please note our Winter meeting is now the major meeting of the year and John Puntis and colleagues are in the process of organising an excellent meeting in Leeds in January, which will follow the same format as Bristol, but with the AGM now at this meeting for the first time. Therefore, please make every effort to attend. A final, but very important, point to note is that we need to think about replacements for our Council Members coming to the end of their 3 year term of office in April 2001 Dr Martin Brueton (as President) and Drs Adrian Thomas and Mark Beattie. These are hard acts to follow but please give thought to their replacements, and send me nominations (having checked with the nominee first) by 1 March 2001.
Huw Jenkins
FOURTH JOINT MEETING OF THE BRITISH AND ITALIAN SOCIETIES OF PAEDIATRIC GASTROENTEROLOGY AND NUTRITION, OXFORD, 22-24 SEPTEMBER 1999
The somewhat chequered history of these meetings with our Italian counterparts (SIGEP) is well-known to BSPGHAN members and it was against this background that the Oxford team set about organising the Fourth Meeting with trepidation. In the event the months of planning and careful fiscal control paid off and the fears that no-one from Italy would turn up (very real fears as near as two weeks away from the meeting) proved groundless. There were 110 pre-registered delegates of which 27 (25%) where from SIGEP. A further 36 delegates registered on site. The meeting, preceded by an opening reception under the dinosaurs in the Oxford University Museum, was held over two days. The scientific format included two symposia (paediatric hepatology update and host-environment interactions) and 10 invited lectures; there were 22 free papers and 10 posters. Most delegates completed evaluation forms and analysis showed that the majority considered the scientific and educational content of the meeting to be high. The grand finale was the conference dinner in the mediaeval hall of Magdalen College where the highlight was undoubtedly Bob Bell’s masterful after dinner speech in Italian! The success of the meeting whilst being measured in terms of scientific content and conviviality must also be measured in terms of the final balance sheet. As far as this important aspect of the meeting is concerned, success was dependant upon considerable financial support from industry and the surplus generated has gone to bolster the resources of BSPGHN. Before the Fourth Meeting questions were being asked amongst Society members as to the viability of these joint meetings. After the meeting there seemed to be a general impression that they should continue and the next meeting should be in Italy. As to the next British host ?..well that’s somebody else’s problem.
Peter B Sullivan
COLLEGE SPECIALIST ADVISORY COMMITTEE REPORT
It is intended that the visits to centres wishing to provide training for tertiary trainees will be completed by the end of March 2001. Peter Milla has taken over from John Walker-Smith as a training adviser, Deidre Kelly will be able to continue until this phase of the CSAC activities has been completed. A register of all the tertiary trainees is being drawn up, and it is intended that there should be a meeting for the trainees specifically at Leeds in January. There are moves to establish a national system for the appointment of trainees in the various sub specialties. This means that we will need to provide very clear information to the Postgraduate Deaneries concerning the training programmes available, and the number of trainees required in relation to the consultant posts to be appointed. It is probable that the training programmes will need to involve consortia of centres, and thus there will be years during which an individual centre may not have a tertiary trainee in post. The implications of this will need to be discussed within the Society. The administration of this approach is being described as a ’national grid’, it is likely that gastroenterology/hepatology and nutrition will not be involved until the appointment round for SpR’s starting in September 2002.
The committee is now moving on to consider the training components of the SpR posts which are undertaken by registrars who will be appointed to district general hospitals. Proposals will be based on the conclusions of the Council’s working group on clinical service needs in the District General Hospitals Issues relating to appraisal and assessment are being highlighted in the discussions relating to investigative procedures. The deliberations of the endoscopy working group in relation to competency assessment are awaited with interest
Martin Brueton
THE NATIONAL REGISTER OF PAEDIATRIC INFLAMMATORY BOWEL DISEASE
The National Register of Paediatric Inflammatory Bowel Disease has now been running for three years. It has collected basic data on over a thousand children at time of diagnosis with IBD from 53 hospitals across the UK. A review of the cases collected so far is awaiting publication. The future development of the Register must demonstrate its worth as a research tool which can contribute to appropriate diagnostic and management strategies as well as providing insights into aetiology and natural history. Thus many new and ambitious developments are envisaged and the roots of these developments are being established. The Register will be sited at The University of Liverpool Institute of Child Health based at Alder Hey Children’s Hospital. A new Research Assistant is being appointed and should take up the post in November 2000. Plans are being drawn up to create one or several cohorts of patients registered to address key issues in a continuing, longitudinal fashion.
Following the conclusion of the Glaxo grant which enabled the Register to be established, the longer term security of the Register has now been guaranteed through a substantial grant from Crohn’s in Childhood Research Association (CICRA). This will cover in full the operating costs of the Register, including the salary of the new Research Assistant. A generous donation has also been kindly provided by Nestle UK Ltd which will allow the cover purchase of computer software and certain overheads. With the continued impressive support of the Register within the paediatric community I envisage that over time a unique and valuable structure will be established which will impact significantly on improved care for children with Inflammatory Bowel Disease.
David Casson
IBD WORKING GROUP
A working group on IBD has been established by the BSPGHAN. The group includes the existing members of the IBD register committee plus Peter Milla, Ian Sanderson and Adrian Thomas (chair). The principal aim of the group will be to develop evidence based guidelines for the investigation and management of IBD in children. The first phase is to identify and critically appraise existing guidelines. If you are aware of any such evidence based guidelines for adult or paediatric IBD please send details to Adrian Thomas as soon as possible agthomas@manu.demon.co.uk .
A secondary aim of the group will be to facilitate multicentre collaborative research and audit. The first such study will be an audit of the UK experience of infliximab in children. If you have any such experience please also contact Adrian Thomas.
Adrian Thomas
BRITISH SOCIETY OF PAEDIATRIC GASTROENTEROLOGY AND NUTRITION WINTER MEETING 21ST AND 22ND JANUARY SWALLOW ROYAL HOTEL BRISTOL
The millennium meeting of the British Society of Paediatric Gastroenterology and Nutrition was held in Bristol at the Swallow Royal Hotel on the 21st and 22nd January. It was the largest society meeting to date. 72 society members and 34 non-member doctors, paediatric surgeons, visiting paediatric gastroenterologists and paediatric gastroenterologists in training attended . For the first time there was a separate section at the meeting for associate members. These included GI nurses and paediatric dieticians involved with gastroenterological and nutritional patients. In addition 45 associate members attended and the meeting was successful and enjoyable.
A Sub-Committee of Associate Members is being set up and it is planned to have another Associate Members meeting at the next winter meeting of the society.
The academic sessions were chaired by Professor Ian Booth, Professor Peter Milla, Dr Deirdre Kelly, Professor John Walker-Smith and Dr Martin Brueton and Dr Christine Spray. There were talks on ’Bacteria in IBD’ by Dr Christopher Probert, Adult Gastroenterologist in Bristol, ’Mucus in IBD’ by Dr Anthony Corfield and ’Colonic Mucins in Normal Children and in Hirschsprung’s Disease’ by Paediatric Surgeon, Mr Adil Aslam. Dr Andrew Sawczenko presented the preliminary data on the National IBD Surveillance study. There were 19 free papers on a range of subjects ranging from ’An evaluation of the Micronutrient Status of Children Receiving Enteral Feeding’ to ’A Novel Approach to Management of Severe Lower Gastrointestinal Bleeder’.
On Saturday morning Dr David Challacombe, who has recently retired, gave a talk on the work he had been involved with on Intestinal Organ Culture - Sowing, Reaping and Gleaning. There was a lecture on Gastro-Oesophageal Reflux in Children in India by guest speaker Dr Santosh Mittal from New Delhi, India and a talk on Barrett’s Oesophagus from Mr Richard Spicer’s team by Mr Suren Arul.
The Swallow Hotel provided a very pleasant setting for the meeting with some of the delegates getting a swim in before the Saturday morning session. It was good to see a number of delegates with their families including young children. The reception and dinner was in the Kings Suite at the Swallow Hotel and entertainment was provided by rap artists Dr Huw Jenkins and Dr Mike Cosgrove.
In summary the meeting provided a good mixture of a varied academic programme and some enjoyable socialising.
Bhu Sandhu
NEWS FORM THE TRAINEES FORUM
There is to be new and potentially exciting developments for trainees for the next year. There will be an inaugural trainees morning on Thursday 18 th January in Leeds before the start of the annual BSPGHN meeting. This is specifically to look at training issues with guest speakers, but will also be a forum for trainees to bring issues of concern for discussion. The full programme is currently being drawn up and I would ask that you email me with your thoughts or to obtain the finalized programme. I think that it is vital that all trainees attend this meeting to make it a success!
Secondly, there is going to be set up multi-regional Calman training days in gastroenterology and hepatology for those training either to be tertiary specialists or with an interest. These will be consultant led and will happen probably three times a year. The educational content will be high and I am sure will be supported by the postgraduate dean in each region. The pilot scheme will be in the southwest but it is envisaged that the second "multi-region" will be the North of England (and perhaps Scotland). More information will be available in Leeds or contact me P.J.McGrogan@ncl.ac.uk
Paraic McGrogan.
NEWS FROM THE ASSOCIATE MEMBERS GROUP-BSPGHAN
Following the very successful inaugural meeting of the associate members at the Winter meeting of the BSPGHAN in Bristol, January 2000, I am taking this opportunity to update everyone on it’s progress. I am hoping that the associate members have a regular slot in the BSPGHAN newsletter and I am very honoured to be composing the first of many contributions to follow!
Shortly after the Bristol meeting and carried along on the wave of dynamism and enthusiasm from all that attended, a committee was created. The committee members and areas of responsibility are as follows: Clare Burnett-chairperson, Jackie Falconer and Sian Thomas-deputy chair(s), Sarah Irwin-secretary, Jane Clayton-marketing and PR, Pamela Rogers-IT, Sian Thomas and Jacqui Lowdon-education/organisation of educational study day/scientific programme.
By the time this newsletter is printed, we will have already had two committee meetings. A decision has been made to have two meetings per year of the associate members group, one alongside the winter meeting of the BSPGHAN and the other as an independent day to meet our own educational needs. Consequently, we shall meet in Leeds in January 2001 and again in Cardiff in June 2001 when we are planning our first Associate Members educational/scientific meeting.
This has been, and will continue to be a very exciting venture and one that has received much support from the council of the BSPGHAN. We are advertising ourselves via this newsletter, the web site and a flyer. Please contact anyone that you think may be interested in becoming an associate member that is, ’a health care professional working within Paediatric Gastroenterology, Hepatology or Nutrition who is registered and currently working in clinical practice or research. ’ For information contact Clare Burnett at the address below and for an application form, contact Dr. Huw Jenkins at the University Hospital of Wales, Cardiff. Application forms need to be accompanied by a CV and the fee for membership will be £10.00 per annum. Associate members currently include nurses, dieticians, pharmacists and some doctors. Those previous members from industry will no longer be included, unless they fulfil the above criteria.
This Millennium year has been a great start to the development of the associate members group and I look forward to seeing you all at the next Winter meeting in Leeds. This shall be a good opportunity to discuss the forthcoming scientific programme in June, a day that aims to meet the educational needs of professionals caring for children with gastrointestinal, hepatic or nutritional health care concerns.
Clare Burnett
BSPGHAN WINTER MEETING
18/19 th JANUARY 2001
The BSPGHN meeting will be held in Leeds on January 18/19th 2001, at the Crowne Plaza Hotel, Wellington Street (about 1 mile from the railway station). Please note that this is a Thursday/Friday meeting, with Thursday morning allocated to the Associate Members Group, and also for a trainees meeting. The conference dinner will be on the Thursday evening and the meeting will conclude at lunch time on Friday.
Registration forms will be sent out to BSPGHAN members towards the end of October and can be also be obtained from: Mrs Mavis Price, Postgraduate Centre Manager, The General Infirmary at Leeds, Great George Street, Leeds.
The deadline for abstracts will be the end of November.
John Puntis
MOVING ON : PARENTERAL NUTRITION TO SMALL BOWEL TRANSPLANT-A REALISTIC OPTION FOR CHILDREN
Date: Tuesday 14th November 2000
Time: 9.30-3.45pm
Venue: The Birmingham Children’s Hospital
Cost: £40 (including lunch) (cheap rate for students £25)
Accreditation 4 Dietetic Diploma Hours, Approval for 7 CDP points (RCPCH)
A multidisciplinary study day providing an opportunity to increase knowledge and understanding on the indications, management and success of small bowel transplantation in children in the UK.
Further details can be obtained from Anne Daly at The Birmingham Children’s Hospital Tel 0121-333-8029
11TH ANNUAL COURSE IN PAEDIATRIC GASTROENTEROLOGY, ROYAL FREE HOSPITAL.
4TH-6TH DECEMBER 2000.
COURSE ORGANISER SIMON MURCH.
This intensive three day post graduate course in Paediatric Gastroenterology is open to SpR’s, consultants and other interested professionals, approved for CME 6 credits per day. Keynote Lecture: The developing field of glycobiology. Dr Hudson Freeze, La Jolla, USA. Invited speakers include: Victor Fox, USA, William Treem, USA, Ricardo Troncone, Italy, Jan Taminiau, Netherlands.
Course Dinner at the Royal College of Surgeons.
For Information and registration forms please contact
Dr S Murch
The Royal Free Hospital
Tel No 44 207 830 2779
Fax No 44 207 830 21476
3RD MASTERCLASS IN MODERN PAEDIATRIC ENDOSCOPY,
6-8 DECEMBER 2000
COURSE ORGANISER MIKE THOMSON.
2 day course covering all aspects of diagnostic and therapeutic paediatric endoscopy, colonoscopy, ERCP and enteroscopy with live illustrative cases. Open to registrars and consultants. Approved for 6 CME credits per day
For Information and registration forms please contact
Dr M Thomson
The Royal Free Hospital
Tel No 44 207 830 2779
Fax No 44 207 830 21476
Paediatric Gastroenterology Course Fee £275 .
Endoscopy Masterclass Course Fee £200.
Fee for both courses £400.
BSPGN WEBSITE
Available on the website Draft proposals for training in Paediatrics with an Interest in Paediatric Gastroenterology, Endoscopy training document, Updated CSAC documents for training in Paediatric Gastroenterology, Hepatology and Nutrition.
Newsletter produced by Dr RM Beattie - apologies for any errors or omissions
GASTROHEP.COM
GastroHep.com is now on line at http://www.GastroHep.com . GastroHep.com is the global on-line resource for all aspects of Gastroenterology, Hepatology and Endoscopy
I would like to draw your attention to a new Gastro/Hepatology communication which is on line. I have been asked to pioneer the paediatric interest and would like to hear from any of you who are interested in being involved. The editors are looking for speakers and topics for the soap box, for interesting articles and ideas on research. I have suggested that we have a paediatric section perhaps quarterly or more frequently if people feel enthusiastic. Perhaps you could let me know directly or Roy Pounder who is the main editor. It is easy to access and perhaps you could look at the page first and let me know what you think
Deirdre Kelly Deirdre.Kelly@bhamchildrens.wmids.nhs.uk
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