Advancing Children's Care at RCPI Faculty of Paediatrics Autumn Conference
Perspectives in paediatric oncology and palliative medicine, and updates on the new children’s hospital, were heard at the Autumn Conference held by RCPI Faculty of Paediatrics.
The important college meeting took place at No 6 Kildare Street on 3 October - the product of several months’ planning by the faculty’s dean Dr Judith Meehan.
The conference saw the launch of a new Infant and Children’s Health Research Charter, developed by the faculty’s research committee in consultation with young people. The charter is designed to help children, families and caregivers, and health professionals to have informed conversations about child health research.
The first panel session began with updates on national clinical programmes, by clinical leads Dr Hilary Stokes and Prof Colin Hawkes (National Clinical Programme for Paediatrics) and Prof John Murphy (National Clinical Programme for Neonatology).
During a session dedicated to Clinical Pearls, the conference heard about contemporary challenges facing paediatricians. Dr Kathleen Gorman (paediatric neurologist, Children’s Health Ireland at Temple Street) gave an update on what paediatricians need to know about tics. A presentation on Status Complexicus was delivered by Dr Louise Baker (neurodisability subspecialist, Children’s Health Ireland at Temple Street). Dr Irwin Gill (acute rehabilitation service, Children’s Health Ireland at Temple Street) reported on the ascendant rise in brain injuries related to E-scooter use.
Paediatric oncology and palliative medicine were the focus of a session featuring speakers from further afield. Prof Bee Wee (palliative medicine consultant, Oxford University Hospitals), who trained in Dublin during the 1980s as Ireland’s first Senior House Officer in palliative medicine, gave an update on the state of palliative care for children in Ireland. “Giving children with life-limiting conditions the best quality of life, and adults a path through bereavement, is crucial,” she said.
Prof Wee said the introduction of the National Model of Care Services in Ireland allows treatment of children with life-limiting conditions to take place closer to home, by paediatricians supported by tertiary clinics. In child palliative care, child and family are considered a decision-making unit, who trigger a response from a multi-disciplinary team when needed.
Following a scoping review that found palliative medicine consultants have low exposure to child patients, recommendations have been made to the Higher Specialist Training in Palliative Medicine programme that all trainees have 12 months’ exposure, caring for at least two children and/or adolescent young adults. Prof Wee encouraged that the upcoming national review of paediatrics training be viewed through a palliative medicine lens. “You are good at collaborative approaches in paediatrics but be sure to include palliative care as well,” said Prof Wee.
The current state of childhood cancer diagnoses was the focus of a presentation by Prof David Walker (paediatric oncologist, founder of the University of Nottingham’s Children’s Brain Tumour Research Centre). Prof Walker said a network of child cancer services in Ireland and the UK - the Children and Young People’s Cancer Association – is working to reduce delayed diagnosis.
Prof Walker warned of the adverse outcomes after delayed diagnosis of brain tumours, including persistent hydrocephalus and cognitive damage, blindness, and temporal lobe damage. He also spoke of the new awareness of neuroendocrine disability (“We’re becoming increasingly aware of the consequences for survivors”).
However, Prof Walker also said that deepened familiarity with symptoms is leading to accelerated diagnoses, with certain tumour types able to be identified for increased awareness, and to help close the gap.
The promising impact of screening and genetics testing concluded the session, with a presentation by Dr Noelle Cullinan (paediatric oncologist, Children’s Health Ireland at Crumlin). “Ten percent of children with cancer have a pathological variant,” she said.
“Every single patient we meet asks us: why?” said Dr Cullinan. “It’s important to determine if it’s inheritable or not. Other siblings might be at risk. We can give families proper advice.”
Identification of a predisposing variant might change the diagnosis and treatment slightly, with up to 50% of paediatric cancers having a druggable target, according to Dr Cullinan.
Dr Cullinan mentioned that some larger institutions are now offering genomic testing for all children. In Ireland, a multidisciplinary team set up as part of the Paediatric Cancer Genetics Programme has tested 110 patients over nearly three years, and found 45% of them had a cancer predisposing variant. The cohort has included children and parents with benign tumours who were subsequently sent for treatment. A children’s genomic testing programme is currently in piloting stage. “We all need to upskill in genetics,” said Dr Cullinan.
The annual Ralph Counahan Memorial Lecture, delivered in honour of the pathfinding Irish paediatrician, was given by Prof Anthony Costello, a British paediatrician renowned for his work as former director of maternal, child and adolescent Health at the World Health Organisation. Prof Costello’s lecture encouraged optimism for the future, sharing his experience as paediatrician involved in community engagement projects in South Asia during the 1990s.
Prof Costello quoted German-American philosopher Hannah Arendt: “Power is never the property of an individual; it belongs to a group.” He shared evidence from a community engagement trail in Nepal wherein nine women groups were established to identify problems in maternal health and plan new strategies, and to liaise with maternity wards. Peer group evidence saw a 30% reduction in neonatal fatality.
A presentation on workplace equality, diversity and inclusion was given by High Court judge Ms Justice Marguerite Bolger, who, prior to serving as a judge, was a barrister working in the area of employment law and equality, acting for physicians and hospitals.
Ms Justice Bolger referenced an Irish Medical Organisation study finding that 27% of incidents of inappropriate behaviour experienced by healthcare workers was directed at them by patients. “It’s tricky” she said. “They themselves are in a desperate situation.”
63% of reported bullying experienced by healthcare workers was directed at them by colleagues.
“Equality leads to better health outcomes,” said Ms Justice Bolger. To resolve bullying on an organisational level, she suggested diversity should be everywhere, that panels sound be audited for representation, and that training should be delivered on unconscious bias.
The conference’s final panel was dedicated to the new children’s hospital. Ms Lucy Nugent (Chief Executive, Children’s Health Ireland) said the hospital will open sometime in 2026.
Clinicians on the panel discussed the culture-change for the paediatric community brought on by the new children’s hospital. “It’s the biggest change project for paediatrics in Ireland,” said Prof David Coughlan, a paediatrician tasked with overseeing the clinical commissioning and transformation of specialties for the opening of the hospital. “It’s not just a building. It’s an ecosystem.”
“It’s not about the building. It’s about us,” said Prof Susa Bensler, head of paediatric academic affairs at Children’s Health Ireland. “It’s about all of you, and I need your help.” Dr Ciara Martin, the National Clinical Advisor and Group Lead for Children and Young people, shared a similar sentiment: “It’s about the community uniting.”
The conference concluded with the annual faculty awards ceremony.
KATHLEEN LYNN MEDAL
The highest award in Ireland to recognise paediatricians that have been outstanding in their careers and in their contribution to paediatrics, named after the pathfinding founder of St Ultan’s Children’s Hospital.
Recipient: Dr Kevin Connolly
SIR HENRY MARSH MEDAL
Named after one of the founders of the first hospital for sick children in Dublin in 1822, the Sir Henry Marsh Medal is awarded to the lead author of the best paper by a Paediatrics trainee on the topic of child health or the delivery of child healthcare in Ireland published in the preceding year.
Recipient: Dr Shauna Quinn
VICTORIA COFFEY AWARD
The Victoria Coffey Award, named after the outstanding expert in the field of congenital abnormalities and metabolic disorders, is awarded to the lead author of the best paper by a Paediatrics trainee arising from work produced as part of a higher degree, published in the preceding year.
Recipient: Dr Lucy Geraghty
CONOR WARD ESSAY COMPETITION
Named after Prof Owen Conor Ward, founding dean of RCPI Faculty of Paediatrics and a pioneer in the development of paediatric cardiac services in Ireland, this prize recognises the best original and thought-provoking paediatric narrative/essay.
Dr Danielle Clifford
“Managing Complexity in Paediatrics: A Trainee’s Perspective on Chronic Illness in Childhood.”
NATIONAL TEACHING AWARDS
Voted for by RCPI trainees in paediatrics.
NATIONAL EXCELLENCE IN TEACHING (SUBSPECIALTY PAEDIATRICIAN):
Dr Cilian O Maoldomhnaigh
NATIONAL EXCELLENCE IN TEACHING (NEONATOLOGY):
David Corcoran
NATIONAL EXCELLENCE IN TEACHING (GENERAL PAEDIATRICS in a REGIONAL HOSPITAL):
Dr Orla Flanagan
NATIONAL EXCELLENCE IN TEACHING (GENERAL & COMMUNITY PAEDIATRICS in GENERAL HOSPITALS):
Dr Paul Gallagher
DEAN’s AWARD FOR WELLBEING
Inaugural award recognising an initiative which improves and promotes trainee health and wellbeing.
Recipient: Dr Dubhfeasa Slattery, Children’s Health Ireland Professionalism Peer Support Programme
Special Recognition: Dr Ngozi Oketah and Dr Una Murtagh, Gentle Landing project for international trainees