Project background and what we did

Why Paediatrics 2040?

In 2018, the then Chief Medical Officer in England, Professor Dame Sally Davies, chose to focus her annual report on the health of the public in 2040. The report offered cause for optimism and concluded that it is realistic to aspire to better and more equitable health in the next 20 years. It also demonstrated how, in many cases, we already know what we must do to improve health in 2040 – including effective population prevention of ill health, investment in new technology to diagnose disease early and improve prognosis, and use of big data to make predictive analytics everyone’s business. By embedding and building upon these innovations and normalising their implementation, we can harness these opportunities for better health over the next two decades.

Paediatrics is no different. Economic, political, and social changes mean that the role of paediatricians, and the shape of paediatrics as a field today is very different to what it was two decades ago. It is likely that two decades from now, in 2040, paediatrics in the UK will look very different from how it looks at present.

Some of the likely challenges in the future are already known. Increasing pressures on paediatricians and on the health service are seen to be impacting negatively upon staff retention across the board. Shortfalls in the number of applicants for paediatric speciality training are a cause for concern and may have long-term impacts on the delivery of services.

We also know that more work needs to be done to improve health outcomes. The UK currently has worse child health outcomes in many fields compared to the EU15, including infant mortality (where the level in the UK is 30% higher than the EU15+ median) and medial (non-injury) mortality for preventable causes of death, including common infections and chronic respiratory conditions. Unless additional efforts are made, our child health outcomes will fall even further behind in the coming years.

In 2020, we saw unprecedented changes in paediatric services as a result of COVID-19. It transformed ways of working, to the extent that lots of the theoretical futures we were exploring in this project started to already be experienced. In June 2020, we published a snapshot report, “Reimagining the future of paediatric care post-COVID-19“, which shared the learning and changes from COVID-19 that the paediatric profession would like to keep and take forwards into the future.

Despite COVID-19, we recognised the importance of keeping our Paediatrics 2040 work going in ways that we could, moving the project online and speaking to members virtually wherever possible. After extensively consulting with doctors and children and young people, in this report we are setting out our vision for the future of paediatrics in the UK. This is an opportune moment to refocus our thinking about the future of paediatrics and how we want to shape it.

What we’ve done

For RCPCH to achieve its vision of ensuring a healthier future for children and young people, it is crucial that we have a vision of what the future is likely to look like, and of how we wish to shape it.

In Autumn 2018, we embarked on the journey of our Paediatrics 2040 project, established and led by Professor Russell Viner, RCPCH President from 2018-2021. We set out with a broad objective: “To better understand how paediatrics will function as a discipline in 2040, the role paediatricians will play in it, and how the College can continue to support our members into the 21^st century.”

We are of course the Royal College of Paediatrics and Child Health, and we strive to put children at the heart of everything we do – including through this project, where children and young people’s voice has influenced us throughout. However, we recognised that we needed to focus the scope of our work in order to deliver on our objective, and for that reason we largely limited our scope to paediatrics and paediatricians. However, we have, where possible, involved our broader child health colleagues in discussion and consultation, and we hope they will read this with interest.

Across a two year period, we have been busy collaborating with paediatricians, experts and young people across the UK to develop our credible vision for the future of paediatrics in the UK, concentrating on four areas – data and evidence, impact of innovation, models of care, and working lives.

We travelled across the four nations of the UK to speak to paediatricians and members of the wider paediatric community, including paramedics, nurses and medical students. We also ran online engagement, including a survey, allowing us to speak to hundreds more of our members in a more structured and quantifiable way. We’ve also had around 120 of our members – from medical students and foundation doctors through to retired consultants – working with us across our four workstreams. They have been steered throughout the process by members of our project board.

Around 900 children and young people have also been involved, sharing thousands of ideas, experiences and hopes for continuing the good care they receive into the future, and working collaboratively to find solutions where there are areas for development.

Who this work is for

In 2019, we saw the release of a Long Term Plan for the NHS in England, with a whole chapter dedicated to children and young people. Through our State of Child Health and Child Health in 2030 work, we supported the NHS England Children and Young people’s Team to develop that plan and continue to support them in executing it. Similar policy and public affairs influencing also takes place across the rest of the UK, and since the launch of our State of Child Health work in 2017, we have worked closely with the devolved governments to successfully put paediatrics and child health higher on the agenda. We hope that, by sharing the views of paediatricians and experts working across all four nations, this report is similarly helpful to policy makers across the UK, supporting them to look at the opportunities that need to be harnessed in order to achieve better heath for all children and young people in the UK in 2040.

This report is particularly for our members. The Paediatrics 2040 project would not have been possible without the UK members who have given their time to contribute. We hope to have reflected and represented as many of their ideas as possible in this report and throughout our supporting evidence. This is but a moment in time on the journey to 2040, but we hope this report leaves our members feeling inspired for a brighter future for paediatrics, and for the children and young people we care for.