British Paediatric Neurology Association
Minutes of the Annual General Meeting
Held at the Crowne Plaza Hotel, Liverpool
on Sunday 12 January 2003

1. Dr Sheila Wallace and Dr Margaret Borzyskowski
   The President opened the AGM with a one minute silence in memory of Dr Sheila Wallace and of Dr Margaret Borzyskowski. He expressed our feelings of a great loss and the deep regrets of all members of the BPNA.

2. Apologies
   None were received.

3. Previous minutes
   The previous minutes were accepted as correct.

4. President's Report
   New President
   The President congratulated Dr Kennedy on becoming President Elect of the BPNA. Dr Kennedy will be taking over as CSAC Visit Co-ordinator from Dr Green, with a handover in the next few months. The President also congratulated Dr Verity on his election to Chair of the Academic Board of the RCPCH and Professor David Hall on his Knighthood.

   Election of Officers
   An election was held for the post of Chair of the National Training Committee, to replace Dr Kennedy. Dr Forsyth was elected (22 votes; Dr Rittey 18; Dr Cross 16).

   Leicester
   The President thanked everyone for their involvement and reported that the review has now been completed and has hopefully achieved its purpose, despite some criticisms of how it was carried out. It is hoped that Dr Holton will return to work in medicine, although details are still not clear. Dr Stephenson asked about the legal liability of those taking part and was reassured that the University Hospitals of Leicester NHS Trust has provided full indemnity.

   Clinical Networks
   Following the Leicester Review and the National Sentinel Clinical Audit of Epilepsy-Related Death, the President met with the Clinical Medical Officer, Professor Donaldson, to discuss the management of childhood epilepsy. He described the Clinical Network Document and the involvement of the Deanery Advisors and epilepsy interest groups. The aim of networks is to avoid professional isolation and support Paediatricians with a specific responsibility for epilepsy. The Clinical Network Document is intended to be a living document, leading to audit and focussed research, and therefore will have governance issues. In future it is hoped to apply the same principles to developing networks and guidelines for other conditions.

   Organisation of Council
   The President suggested that as the Training Committee has a very similar agenda to Council itself, it seems appropriate to join the two together. He proposed that the full Council could consist of elected Officers, Co-opted Members and Deanery Advisors. In addition he asked whether Officers should be elected at the AGM, as at present, or by postal vote. These proposals will be put forward in the Spring Newsletter for further debate.

   Role of Deanery Advisors / Service planning: new posts
   The role of Deanery advisers is increasing. Service expansion is a particular issue: it is important that every centre has a business plan for an extra Consultant post prepared and available, since this can take six to ten years to achieve. The President will circulate guidance notes on how to do this, including how to identify short falls in current services and resources, so that data can be provided to local Specialist Health Authorities and Specialist Commissioning Services.

   Secretariat
   The appointment of Mrs Philippa Rodie has been a major success. She has provided a very efficient service and has centralised a number of functions. Her role will increase with the development of clinical networks and the maintenance of a database on CSAC Visits. It is proposed that she shall set up transferable systems.

   Distance Learning Course
   The launch has been delayed. The first residential conference will be before the Sheffield Meeting in January 2004. There will be a training meeting for mentors in the autumn. The material provided by the authors of each unit looks both exciting and interesting.

   Dr Rosenbloom asked about the co-ordination of regional trainers activities with those of other paediatric specialities. Dr Newton explained that we currently attend the Paediatric Speciality Board to allow a combined approach. Dr Rosenbloom asked how a Deanery should pay for multiple visits by different speciality teams, each inspecting training provision in their own field. Dr Newton explained that, according to a Departmental circular, Trusts are expected to meet the expenses.

5. Constitution
   Amendments to the Constitution proposed in the last Newsletter (abolition of the conference fee for members aged over 80 and changes to the electoral process to Council) were approved unanimously.

6. Immediate Past Presidents Report: Visits
   Dr Green reported that all Visits have now been completed and that all but two reports have been sent to the RCPCH. After review, RCPCH makes recommendations for the training programmes. Apart from two Centres that are considered too small, all have been approved for training. It has been suggested the two without approval could link to neighbouring centres. The RCPCH will be writing to Centres to check implementation of their recommendations. There will be a London-wide review of training, particularly as any increase in Consultant numbers in London will require a co-ordinated approach. There is also a proposal to visit Dublin.

   Dr Green highlighted both good practice points and difficulties found during the Visits. Similar difficulties, especially in IT, secretarial support, child psychiatry training and structured teaching, recurred in several centres. He raised the possibility of SpRs spending time in other centres for more specialised experience, for example in neonatal neurology.

   Dr Sharples asked about the inspection of both service and training. Dr Green explained that in large organisations such as neonatal group each aspect could be assessed separately but the BPNA Visits tried to combine inspection of both. The meeting thanked Dr Green for his work in setting up and carrying out this work.

7. Assistant Secretary's Report: Manpower figures and Workforce
   Dr Ferrie presented the names of colleagues proposed for membership, who were all elected. He reported that there are now 290 members, which is a steady rise over time. There are 13 academic and 50 whole time and 5 part time consultants in paediatric neurology in the UK. As of September 2002, there were 5 unfilled posts. Over the next few years there will be approximately 2 retirements annually and therefore newly created posts will form the bulk of expected vacancies. 9-10 trainees will be completing their CCST annually over the same period, although this may be an overestimate. Due to other factors such as part time working, manpower and training requirements are in balance this year. It is still the aim of the BPNA to achieve 120 Consultant Paediatric Neurologists in post by the year 2010 but this will need more new posts in 2005 and 2006.

   He also reviewed outreach services: a true outreach clinic is defined as a combined clinic with a local Consultant Paediatrician and a visiting Consultant Paediatric Neurologist both present. There is a marked shortfall in such clinics.

   He discussed amendments to the rules governing election to membership of the Association and the maintenance of the membership list by the Secretariat. He suggested everyone should have a unique membership number and that members names should be listed on the Website, without contact details. If a member changes address they could inform the Secretariat electronically instead of using the current time consuming process. He also proposed that applicants already in recognised training posts would not have to provide a CV. He will detail these proposals in the Newsletter. Dr Jardine asked about losses of trainees in paediatric neurology. The data is not available, although it was agreed it would be useful, especially with the National Grid Professor Neville pointed out that an academic appointment is sometimes considered an official form of "wastage" which can distort trainee numbers. Dr Ferrie said that he had tried to allow for this but it does need more accurate quantification.

8. Treasurer's Report
   The accounts show an increase in secretarial expenses, partly due to the cost of organising the conference. Dr Cross described the difficulties in setting up a credit card payment system for the conference. Due to our current positive balance, there will be no rise in membership subscriptions this year. Professor Neville asked if the rising cost of the Conference could be halted since a high fee was difficult for Centres who had to pay for several research fellows to attend. Professor Besag suggested subsidised support for younger fellows. Professor Stephenson asked about reduced fees for senior members under the age of 80. He said that two senior members have not been able to attend this year because of the cost. It was suggested that cheaper hotels could be made available for those who wish.

9. Training / Europe
   National Grid
   Dr Kennedy described the teething difficulties with the National Grid last year and how these have been remedied, particularly in terms of the advertisement. There were some problems over contacts between trainees and training centres. Most trainees last year obtained their first or second choice post. The interview was extremely important, as ranking was based on the interview and CV.

   Trainee registration is now complete. 23 trainees are exempt but 9 are not, who are all in National Grid posts. There will be 7 posts this year. He requested that all training centres should provide information about themselves and their training programme on a single side of A4.

   Replying to a question from Dr Lin, Dr Kennedy said there had been 12 applicants for the 8 posts, with 1 already in post and 1 with an academic link. Dr Lin also asked if candidates could be ranked as being unsuitable. Although theoretically possible, this did not happen. Dr Cavanagh asked about an unfilled trainee post. It was suggested that he and colleagues in a similar position should contact the National Training Adviser rather than their lead Deanery. Dr Sharples raised the issue of academic trainees, who have difficulties since it is not possible to accept a post and then to take time for research before starting the post. At present, if such a post is accepted, this would require local negotiations with the paediatric Regional Adviser and the Deanery Adviser in paediatric neurology. It was agreed that these are important issues, some of which are unresolved. Dr Newton asked about counselling for candidates who were not appointed. Last year the Chairman contacted the unsuccessful candidates.

   Assessment of trainees / RITA
   Dr Kennedy described the Deanery Adviser pack that he has circulated, based on the RCPCH model.

   In the penultimate year assessment it has proved impossible to have a representative from outside the Deanery as planned, so it has been agreed to centralise the assessment, as nephrology and oncology have done. The trainees' portfolio and the report from their educational supervisor will be important in this assessment.

   CCST Developments in Europe
   Dr Kennedy reported that there will be a cycle of six instructional courses, lasting two days, with an assessment at the end, starting at the meeting in Sicily in October 2003. He also reported that the proposed paediatric neurology syllabus has been accepted and that paediatric neurology is now an official sub-speciality of paediatrics in Europe.

10. Disability
    Training
    Dr Whiting described the competency based training pack, which has now been condensed to fifty pages. She also described the case of need for sub-speciality status for disability, which will in turn lead to a separate training CSAC, visits to approved training centres etc. At present the symbiosis between the BPNA and neurodisability has been very fruitful and it is hoped it will continue.

    Standing Committee on Disability / BACCH liaison
    Dr Smythe reviewed the current membership of the Standing Committee on Disability at the College and its areas of work (education and training, rehabilitation and mental health needs of adolescents). The CDDG, which is part of BACCH, is a member of the Neurodisability group. There is also close liaison with the working party on the management of autism for the national service framework, and with the national service framework on disability.

11. Audit
    Dr Whitehouse drew attention to his last Newsletter item and the audit meeting held the previous day. New audits include the role of Steroids in Epilepsy (Dr White and others); Guillain Barre Syndrome (Dr Pike), and the development of a clinical care pathway for this (Dr Appleton). He also described the BPNA Surveillance Unit set up by Dr Peake with an initial study on Transverse Myelitis. The study on Dancing Eye Syndrome has proved complex to set up because of the requirement for local research ethic committees approval. The aim is to achieve four studies per year.

12. Governance
    The current Committee consists of Dr Kirkham, Dr De Souza, Dr Kirkpatrick and Dr Whitehouse. Dr Kirkham reminded members of the questionnaire that has been circulated and encouraged everyone to return it.

13. Website
    Dr Jardine was thanked for setting up and maintaining our original site. The Secretariat is setting up a new website, www.bpna.org.uk.

14. MacKeith Press
    Dr Bax drew attention to the report that has been tabled. He highlighted three specific issues. There is difficulty with referees not returning items speedily. There is a need for more referees: he would be grateful for volunteers to contact him directly. Direct electronic access, which will be free to all members, is also being arranged: it is planned to use a password identical to the BPNA membership number. Finally, he mentioned the Editorial succession. The Search Committee is chaired by Richard Robinson. Please could anyone interested in the post contact Professor Robinson or Dr Rosenbloom.

15. Meetings
    RCPCH 9 April 2003
    Dr Rittey described the timetable of the neurology session at the York meeting. There will be two presentations on childhood encephalopathy. No papers have been accepted for the plenary session.

    BPNA 21-23 January 2004 Sheffield [dates later changed to 23-35 January 2004
    BPNA 2005 GOSH, London

16. Any Other Business
    
    None.

17. Next meeting
    Next Meeting: 8.30am Sunday 25 January 2004, Hallam University, Sheffield
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