December 2002
PRESIDENT’ REPORT
The Society has had a good year over the last 12 months. The establishment of Working Groups has been extremely successful and members of each group have taken their work seriously. It has enabled the Council to be certain that decisions that it takes in relation to our speciality have been considered by the appropriate groups of people.
A particular highlight of the year is the growing strength of the trainees group. This holds regular meetings and has representatives on CSAC and on Council. The mechanism by which the Council member is elected has now been formulated. The trainees group elect a Chairman and the presence of that Chairman on Council is submitted for ratification at the annual general meeting. This year is also seeing the development of a forum for paediatricians with an interest in gastroenterology. It is hoped that this will allow the Society to encompass both the highly specialised member and the more general member. It is possible that the forum will propose a council member in future developments in council. In this way, the Society can be certain that its aims are supported by a wide body of paediatric opinion. During the course of the year there have been successful scientific meetings both in London (the Winter Meeting) and in York together with the RCPCH. The associate group has more than fulfilled the expectations I outlined in last year’s letter, and their activities have included a successful meeting in Cardiff, in addition to significant contributions to the other two meetings.
Finally, I would like to thank every member for their hard work over the course of the last year. My discussions with paediatric gastroenterologists around the country encourage me to think that the Society is developing into a large harmonious group that see the aim of establishing excellence in paediatric gastroenterology in the British Isles as the determining factor in decision making.
Ian R. Sanderson
President
i.r.sanderson@mds.qmw.ac.uk
SECRETARY’S REPORT
This has been a good year for the society starting with the highly successful winter meeting in London. Huw Jenkins handed over to me shortly after that. I hope to continue his commitment and enthusiasm and the society is indebted to him for his hard work over the previous 3 years.
We now have 199 full members and an active associate members subgroup which will report separately in this newsletter. I need all members to keep me up to date with their contact details in particular their E Mails addresses. The various subgroups are active and pushing forward the speciality and will report on progress via this newsletter, the AGM and most importantly the web. The DGH services sub group final report is now on the website and will hopefully be ratified at the AGM. I am indebted to the group members and the wider membership for their input into this hopefully helpful document.
The key challenge in the next 2-3 years will be to respond to the National Services Framework and its impact on the speciality. A sub group has been set up to revise the guidelines for purchasers produced in 1996 which will hopefully have a draft on the web for consultation soon. It will probably also be necessary for there to be a workforce survey as well to update our data on who does what where which will help us make the case for targeting service expansion. A key part of the national services framework is likely to be the establishment of clinical networks which need people in post and with the time to devote to this. Adequate training is going to be essential and the establishment of the national grid is a welcome step in the right direction. The next priority will be to address the training needs of the DGH paediatrician with a special interest.
I hope as many people as possible will join us in Dublin. Please let me know if there are any particular issues which you feel should be raised at the AGM. Can I give advance warning of the York Meeting and the joint Italian meeting in Lucca next year. Further details are on the website.
Mark Beattie
REPORT FROM THE COLLEGE SPECIALIST ADVISORY COMMITTEE ON PAEDIATRIC GASTOENTEROLOGY HEPATOLOGY AND NUTRITION
In last year’s report, I mentioned that there were two objectives for this coming year. One was to develop a modular training programme in gastroenterology, hepatology and nutrition; and the other was to develop the National Grid for gastroenterology. In addition, the regional training advisors (Dr Anil Dhawan and Professor Peter Milla) have been active, visiting five centres in the last year.
The modular form of training will enable the Royal Colleges to present trained members with a CCST in gastroenterology, hepatology and nutrition with a suffix of one of these three areas. The training programme is designed so that in years 3, 4 and 5 those undertaking the gastroenterology module will do 2½ years of gastroenterology, six months of hepatology and within the three years they undertake six months of nutrition spread throughout those two areas. The hepatology module will be 2½ years hepatology and six months gastroenterology with six months nutrition spread throughout those three years. The syllabuses for both theses modules are now in place and the log book will soon be ready. The training for the nutrition module is still under development. CSAC is concentrating its efforts on the nutritional aspect of the gastroenterology and hepatology training before fully developing the syllabus in nutrition.
The National Grid is currently being developed and should be ready for September 1 st 2003 with interviews in the previous March (2003). Training centres have been grouped into regions in which trainees will spend three years. Attention has been paid to providing gastroenterology together with hepatology centres and hepatology to gastroenterology centres. We have asked for each region to have a region lead to help co-ordinate the rotations in their area.
Finally, the question of how a research year would be incorporated into the three year training programme has been discussed. It was felt that trainees wishing to undertake a year’s research in lieu of clinical training should apply to the Chairman of CSAC for a CSAC prospective approval. The reason for individualising this request is because of the nature of some research projects is far more clinical than others.
Our objectives for the coming year are to see that National Grid securely in place and to see our first trainees being presented with the modular form of CCST.
Ian Sanderson
i.r.sanderson@mds.qmw.ac.uk
ASSOCIATE MEMBERS’ REPORT
It is now three years since the associate members group was founded and the association appears to be growing from strength to strength. There are now over 90 members, 45 nurses, 32 dieitians and others including speech and language therapists, clinical psychologists and pharmacists. This year, the associate members had a successful meeting at the Winter meeting of BSPGHAN in London and were fortunate to have Gill Brooks, Clinical Nurse Specialist from the Liver Unit at Birmingham Children’s Hospital as a guest speaker talking on her MSc subject, ’Children’s Rights’.
A highlight of this year has been the involvement of some of the associate members in the organisation of the first ever post-graduate course for nurses and dietitians at the meeting of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) in Sicily in June. This proved a very successful course and scientific meeting and a wonderful opportunity to meet and network with colleagues from across Europe. The town of Taormina in Sicily was a very beautiful venue for this meeting and in between the hard work, we enjoyed welcome drinks at the famous San Domenico Hotel and a trip to the Greek amphitheatre. There is now a formal organising committee composed of nurses and dieticians from many countries in Europe and we are already involved in developing the next post- graduate course and free paper session for nurses and dietitians in Prague 2003. For further information on attending or presenting at this meeting, please contact me.
- covering the expenses of the tri-yearly committee meetings
- to be the prime sponsor for the annual educational meetings
- to provide an annual travel award of £750 to an associate member
- some sponsorship to help associate members attend the winter meeting of BSPGHAN
- Some sponsorship to help associate members attend ESPGHAN
Until January then! All Best wishes,
Clare Burnett, Clinical Nurse Specialist,
Chair Associate Members BSPGHAN
BSPGHAN FINANCE
Balance in the region of: £30,000. Details at AGM in Dublin.
Grants for overseas trainee presentations may be made available in 2003.
Dr Stephen Hodges. (Tel: 0191 2820324)
ENDOSCOPY STEERING GROUP
Having produced, after a lengthy but necessary consulatation process within out membership, a general agreement on the training requirements for paediatric endoscopy skill acquisition (which can be viewed on the website of the Joint Advisory Group on Endoscopy Training, JAG, which is to be found at www.thejag.org.uk ). Log books are now available from CSAC for documenting an endoscopy training record. The major issue which has received attention is the debate between deep sedation v general anaesthesia for endoscopy /colonoscopy. This is coming into sharper relief since the publication in 2002 of an evidence-based report from an intercollegiate group in Scotland brought together to try to make some conclusions from available reliable evidence w.r.t. sedation and GA for all paediatric procedures. Recommendations, which are likely to be taken up by the RCPCH in due course as their official position, come down heavily on the side of GA for procedures such as endoscopy and are based mainly on safety data. This will obviously have implications for our practice in paediatric gastroenterology, and it is clear that our membership will have to agree on some kind of guidelines in the light of this development.
Hence the Steering Group will meet in the near future in order to begin the process of producing guidelines for best practice with regard to sedation and anaesthetic practice in paediatric endoscopy and will again involve canvassing the membership for opinions and current practice.
Any interim comments would, as before, be warmly welcomed.
Dr Mike Thomson
NATIONAL REGISTER OF PAEDIATRIC INFLAMMATORY BOWEL DISEASE
Since obtaining generous funding for the next three years from the Crohn’s and Colitis in Childhood Research Association (CICRA), the Paediatric Register of Inflammatory Bowel Disease (PRIBD) is going from strength to strength. It is undergoing a radical reorganisation, with a remodelled database to allow for more complex data analysis and addition. An epidemiologist, Mary Jane Platt, with considerable experience in register operation, has been appointed to the committee.
Currently we have 1410 patients registered, with Crohn’s disease (CD) accounting for 841 of these registrations, ulcerative colitis for 381 and indeterminate colitis for 159. The remaining cases are registered as orofacial granulomatosis (OFG) or CD and OFG. It is with your continued commitment to the register that we have successfully started to obtain consent from new patients and those already listed. Any centres that require advice or assistance in establishing a system for the consent process can contact Lucy Taylor on 0151 228 4811 x3566 or e-mail lbtaylor@liv.ac.uk . Our thanks go to all those who continue to commit time and effort in order to improve the PRIBD in respect to both content and data protection.
A programme of research and data analysis is now under way, with two papers in the pipeline. The first paper is a review of the data collected between May 1997 to June 2000. General characteristics such as age, sex and centre type have been identified and analysis details the characteristics of each disease group. The second paper analyses data collected between June 1998-June 1999 and compares the PRIBD data collected during this period with the incidence data generated by the British Paediatric Surveillance Unit inflammatory bowel disease survey. It is anticipated that the first register based research project will commence before the end of the year, investigating the epidemiology and aetiology of indeterminate colitis. A newsletter has been circulated to all participating centres in November.
IBD WORKING GROUP
Report to be received in Dublin at the Winter AGM.
Best wishes,
Dr Adrian Thomas,
agthomas@manu.demon.co.uk
BRITISH ASSOCIATION OF PAEDIATRIC SURGEONS
Main overlapping interest is in the British Intestinal Failure Survey with which BAPS are mostly in agreement. No other major points of information at present re BSPGHAN.
Mr Mervyn Griffiths
Mervyn.Griffiths@suht.swest.nhs.uk
CONSTIPATION MANAGEMENT WORKING GROUP
The working party for the management of children with constipation consists of;
Graham Clayden, Reader in Paediatrics, London
Charlie Charlton, Consultant Paediatric Gastroenterologist, Nottingham
John Tripp, Consultant Paediatrician, Devon and Exeter
Clare Burnett, Nurse Specialist, Oxford Radcliffe Hospitals
Sue Young, Surgical Nurse Specialist, Southampton
Jenny Gordon, Complementary Nurse Specialist, PhD student, Edinburgh
Lyn Stirling, Senior Dietitian, Oxford
Kate Blakeley, Clinical Psychologist, London
We have had two meetings and discussed at length the priorities for the working party and the society. At our second meeting in September 2002, the decision was made NOT to attempt to write evidence-based management guidelines for the management of children with constipation at the moment. Conducting literature searches and grading papers is very time consuming for the working party and a suggestion was made to search for funding for a research fellow and possible a nurse/assistant to undertake this work and link with the working party. Good evidence available for managing children with constipation is poor and well organised, multi-centre and controlled studies are required before such guidelines are written.
Therefore, the working party has decided to focus on developing an education package for health care professionals rather than writing guidelines. This may be a modular course and, hopefully accredited for doctors, dietitians and other disciplines. We have arranged an initial educational course to be held in Nottingham next year and this will be facilitated by the working party with workshops and scenarios in addition to some didactic lecturing. This meeting will be advertised on the web and with flyers to trainees, associate and full members and health care professionals working in the community.
The working party is meeting again early in the New Year and we are happy to receive any feedback and comments about the proposals made so far.
DGH SUBGROUP OF THE BSPGHAN
At the last two council meeting we have discussed whether there should be a formal DGH sub group of the BSPGHAN with representation on council which in some respects would be a natural follow on from the DGH services document sub group. The remit would be to represent the paediatrician with a special interest in Gastroenterology, Hepatology and Nutrition. The initial feedback following my message cascaded via the website has been very positive. I am keen this is pushed forward. It will be discussed at the AGM to ensure there is a clear mandate. I am keen to have 2-3 nominations of interested persons with a lead who would be interested in setting the group up. Once the group is established the constitution will need to be amended so that the chair of it can sit on council.
Mark Beattie
SERVICE PROVISION GROUP
Mark Beattie
Rob Heuschkel
Ian Sanderson
Mike Thomson
The group has revised and extended the document that set out details of services as provided to purchasers in 1996. The amended document has been available for review and comments on the web site since November 2002.
Although not changed in its overall format, the document highlights the need to move toward a ’hub and spoke’ model of service provision. The services that should be available at a ’hub’ unit are outlined without giving specific detail on the numbers of patients / investigations that should be performed annually.
The document gives broad guidance on referral criteria to ’hub’ centres and tries to better define the relationship between referring ’spoke’ centres and their ’hub’.
Once reviewed by the membership and ratified by the society, this document would then provide a useful tool in the allocation of resources in the forthcoming national service framework for paediatrics.
Crucial to the provision of our services on a national level is the knowledge of what services are being provided at present. We will seek to reassess this from all members attending the annual meeting. We would ask all members to complete a short form on where they practice and how much of their time is spent seeing paediatric gastroenterology patients.
All comments are appreciated and can be directed by e-mail to either Rob Heuschkel or Mark Beattie.
BSPGHAN WEBSITE REPORT http://bspghan.org.uk
The website has grown over the last year. The list of meetings is now more comprehensive and a job vacancy section has also been introduced. All official BSPGHAN documents are available on the website and hopefully in time this will lead to a great reduction in the number of papercopies that has to be sent around to members. There has also been an increasing use of email to make members aware of changes to the website and inform them of important announcements. This service which is potentially the most useful service that can be provided by the website is unfortunately compromised by the fact that our present list of members emails is incomplete and even among those emails that we have there are at least twenty which are now incorrect. As a consequence probably half the membership do not receive these announcements and I am sure it should be an aim for us to get as complete as possible list of email addresses over the coming year.
It is hoped that it will be possible in the next year to further update the website and improve its look and feel. Although from a functional point of view it works reasonable well, it still has a rather "amateurish" look to it. While there is ample web space and potential to greatly increase the functionality of the site, my time is unfortunately limited and if members feel there is a need for a greater range of services on the site this probably will require investment in appropriate professional help.
Suggestions and help from members will be gratefully received and I would be very happy to speak to anyone about the site at our annual meeting in Dublin in January.
Dr MIKE BISSET ( webmaster@bspghan.org.uk )
TRAINEES IN PAEDIATRIC GASTROENTEROLOGY HEPATOLOGY & NUTRITION (TiPGHAN)
The trainees group met prior to the Winter Meeting in London 2001 and invited speakers included Prof Ian Sanderson who spoke about conducting research and Dr Mike Thomson who gave us some tips on working abroad. Both were informative and entertaining and evoked much discussion amongst trainees.
The rest of the meeting was taken up with electing a committee to represent trainees’ needs and hence TiPGHAN was established, with Nikhil Thapar as President, Helen Evans as Secretary and Richard Russell as CSAC Representative. Diana Flynn and Naeem Ayub were elected as committee members without portfolio. The trainees also agreed a Constitution for the committee.
The formation of TiPGHAN is obviously an exciting development for trainees, especially in the current climate of establishing a national training scheme for SpRs in our speciality and creating dedicated log books for training. We have already met as a committee to discuss these and other issues, such as national BSPGHAN training days and forming a link with the Trainees’ section of the British Society of Gastroenterology (TIG).
It is clear that in order to disseminate information among trainess, we need to establish a register of all trainees committed to training in our speciality. Therefore, I would ask all trainees to E-mail me with your current contact details (address below). Finally, we wish to continue the tradition of holding a trainees meeting prior to the Winter Meeting and any ideas for topics you wish to cover or speakers will be welcomed.
We look forward to meeting you all in Dublin in January!
Helen Evans - Secretary TiPGHAN
FORTHCOMING MEETINGS AND DEADLINES:
PLEASE SEE http://bspghan.org.uk/meetings.htm FOR FURTHER INFORMATION.
One meeting we have been asked to post here as well as on the website is: The Second International Congress on Schwachman Diamond Syndrome in June 2003. Details can be obtained on the Society website.
IMPORTANT NOTE
Would all members please be kind enough to e-mail or send their up to date contact details, most importantly e-mail addresses to Mark Beattie at secretary@bspghan.org.uk , so that future communication and newsletters may occur by this route. Thanks and best wishes for a successful and happy 2003.
Newsletter produced by Dr Mike Thomson - apologies for any errors or omissions.
Copyright © 2006 British Society of Paediatric Gastroenterology Hepatology and Nutrition