Paediatric Guidance Checklist for Grid Training Centres
These standards were derived to assist in the assessment of the paediatric training standards in your
deanery
Speciality:
Paediatric Rheumatology
The Programme (which may consist of several posts) should provide:
1. Supervision
1.1 An educational supervisor who is a Consultant with special responsibility for
Paediatric Rheumatology working predominantly in paediatric and or adolescent
rheumatology and trained in work based assessment and appraisal.
1.2 An educational supervisor who provides regular educational supervision (an average
of 1 PA per 4 trainees per week)
1.3 Evidence that the assessment strategy is being delivered
1.4 Trainers receive appropriate training on the delivery of the assessment strategy
1.5 Clinical supervision ensures Patient Safety
Yes / No
2. Other Personnel
2.1 A minimum of 2 full time equivalent consultants in Paediatric Rheumatology to
support and supervise
2.2 More than one ST4 -8 in the department
2.3 MDT consisting of as a minimum, specialist paediatric clinical nurse(s),
physiotherapist(s), and occupational therapist(s).
3. Service requirements and facilities
3.1 Specialty specific requirements of subspecialty department:
Regular access to supervised clinics to include new and review patients.
Regular access to combined clinics with appropriate sub-specialties (see 3.2)
3.2 Specialty specific requirements of related clinical departments that are
involved in delivery of the curriculum:
Primary care, Community paediatrics, PICU and spectrum of sub-specialities including
nephrology, neurology, dermatology, ophthalmology, immunology and infectious
diseases, cardiology, gastroenterology, endocrinology and respiratory, adult
rheumatology
3.3 Specialty specific requirements of service departments relevant to delivery of
curriculum (e.g. investigation departments, PAMs departments, surgery or anaesthesia):
Day case facilities for joint injections (under general anaesthetic and Entonox) and drug
administration (e.g cytotoxics, biologic agents), imaging (radiology including MRI,
ultrasound), physical therapy and eye screening.
3.4 Specialty specific requirements of clinical networks:
Opportunity to work within shared care networks in primary and secondary care. To
include drug monitoring (immunosuppressive agents) and shared care clinical
guidelines and protocols.
4. Educational activities and training
4.1 Specialty specific clinical exposure required to provide sufficient learning
opportunities (NB if giving workload data ensure it is explicit whether this is number per annum or number trainee
would be expected to be exposed to over entire programme):
Joint injection lists with experience of general anaesthetic and Entonox, and a variety of
small and large joints and use of imaging.
Counselling of patients and carers about the use of biologic and cytotoxic therapies.
Experience of transitional care and adolescent services to adult rheumatology clinics.
Experience of continuity of care for patients with chronic rheumatic disease.
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Experience of clinical research (such as Registries) and clinical trials processes to
include consent, data collection.
Experience of application for biologics.
4.2 Specialty specific requirements for structured training opportunities to
include courses:
Study leave to allow attendance at the annual trainees meeting (2 days) and BSPAR
(British Society for Paediatric and Adolescent Rheumatology) meetings wherever
possible.
GCP training (which can be online).
Training in Teaching and learning.
5. Working patterns
5.1 Safe cover arrangements for paediatric department out of hours in line with RCPCH
guidance
5.2 Evidence of compliance with existing employment rules to working time
5.3 Working intensity and pattern that is appropriate for learning
5.4 It is unlikely that sufficient access to sub-specialty will be given if more than 1/3 of
hours is outside the specialty
5.5 This post forms part of a complete paediatric training programme which provides a
minimum of 5 years of acute clinical experience, including out of hours duties
6. Specific Post requirements
6.1 Recommendation to work in at least one other paediatric rheumatology centre over
the course of grid training to gain experience of different models of working, shared care
and breadth of case mix. The two training centres should complement each other in
training opportunities, taking into consideration other factors aside from geography /
convenience.
7. Enabled to learn new skills, necessary skills and curriculum coverage (specialty
specific)
This section can be used to highlight marker conditions to which trainee should be
exposed or the numbers of cases/procedures that trainee will be expected to see/do.
Ensure that it is clear whether any numbers are for whole training programme or per
annum.
7.1 Specialty specific marker conditions trainee should be exposed to:
The breadth of specific conditions is outlined in the curriculum
http://www.rcpch.ac.uk/system/files/protected/page/2010%20Paediatric%20Rheuma
tology%20curriculum%20document_0_0.pdf
7.2 Specialty specific skills/procedures trainee needs to complete:
Paediatric rheumatology does not stipulate numbers of cases to be seen within
diagnostic categories, but emphasises the importance of breadth of case mix exposure
and experience of diagnosis and management of such cases. Specific skills and
procedures are outlined in the curriculum
http://www.rcpch.ac.uk/system/files/protected/page/2010%20Paediatric%20Rheuma
tology%20curriculum%20document_0_0.pdf
8. Access to clinics and ward rounds and long term care of patients
8.1 Specialty specific numbers and types of clinics expected to attend (including
outreach clinics):
2 consultant supervised clinics per week to include new and review patients and to
experience breadth of case mix as outlined in the competency framework for Level 3
training in paediatric rheumatology (numbers are not the issue but evidence of breadth
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of case mix experience).
1 joint injection list per month minimum and experience of joint injections under
entonox sedation.
Attend outreach clinics.
Experience of adults with paediatric onset rheumatic disease and / or adolescent care
and transition.
8.2 Specialty specific combined clinics expected to attend:
Regular access to joint clinics with appropriate sub-specialities (such as nephrology,
neurology and ophthalmology)
8.3 Specialty specific ward rounds consultant led and independent per week:
Consultant led review of day-case patients and in-patients should occur weekly as a
minimum.
8.4 Specialty specific involvement in transitional care:
Provision to facilitate transfer to adult rheumatology
8.5 Specialty specific care over time:
Assess and manage children of all ages with rheumatic disease from referral onwards
over a period of time providing a long term perspective
9. Meetings
9.1 Specialty specific number and types of MDT meetings expected to be exposed
to:
Attend and participate in multi-disciplinary team meetings
9.2 Specialty specific multi-professional meetings expected to be exposed to:
Experience of transitional care MDT meetings and transfer of care documentation
9.3 Speciality specific other meetings:
Drugs and therapeutics committee (such as application for approval for “off licence” use
of medication).
Evidence of collaborative working with peers in other paediatric rheumatology centres.
10. Clinical audit
10.1 Evidence of trainees participation in clinical governance (at least 1 full audit/year
and attendance at critical incident meetings)
10.2 Evidence of trainees participation in clinical guideline development
10.3 Participation in national audit programmes of NICE guidance.
11. Teaching appraising and assessing
11.1 Opportunities for formal and informal teaching including delivery of paediatric
rheumatology topics to general audiences (e.g. medical students and paediatric trainees).
11.2 For senior trainees: opportunities for involvement of assessment of others.
11.3 For senior trainees: opportunity to be involved in the appraisal of others.
12. Research
12.1 Provide formal teaching on research ethics and research methodology and research
governance. Trainees to have GCP training and experience clinical research and clinical
trials processes.
Trainees to have opportunity to be involved in the Paediatric Rheumatology Clinical
Studies Group.
12.2 Provide opportunities to be involved in clinical research.
12.3 Opportunity to participate in multi-centre collaborative research.
13. Management
13.1 Opportunities to be involved in management e.g. participation in management
meetings and projects such as clinical governance and business case for service
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development.
X-ref
Comments
The competency framework for paediatric rheumatology does not stipulate numbers of
cases to be seen within diagnostic categories, but emphasises the importance of breadth of
case mix exposure and experience of diagnosis and management of such cases.
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