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is the result of a three year project which set out, in the words of RCPCH President, Professor Russell Viner, “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 21st century.”

The report is the result of discussions with paediatricians, other health colleagues and nearly 900 children and young people, across all four nations. Around 120 College members – from medical students and foundation doctors through to retired consultants – worked with the report’s authors across four key areas of focus:

• Data and evidence;
• Workforce demand and how paediatricians’ working lives may change;
• Impact of innovation;
• Changing models of care.

The report uses data from the Global Burden of Disease study (a tool which quantifies poorer health from hundreds of diseases, injuries, and risk factors) in order to identify the likely trend in burden of disease from various causes among children and young people across the UK. This data was then used to forecast change in all-cause disability-adjusted life years (DALYS) to 2040.

One prediction is of continued reductions in deaths, illness and disability resulting from most major causes of disease, but a simultaneous rise in health problems affecting young people in childhood and later life as a consequence of surviving neonatal disorders.

Worryingly, the report predicts increases in mental health disorders and substance misuse for adolescents and young adults.

Any forecast increase in DALYS from a particular cause is likely to indicate a need for additional workforce or a change in training focus.  The report predicts a need for broader training to include increased numbers of paediatricians with skills in dealing with mental health problems and broader adolescent health issues.

“Only by actively planning for the future can we hope to have some control over it,” says Professor Viner. “Paediatrics 2040 is a project which of course began way before the emergence of COVID-19. If nothing else, the pandemic has taught us that the future is partly unpredictable but partly something for which we can, and must be, better prepared.

At the beginning of last year, we asked members what they thought would be the biggest health issue affecting children and young people in 2040. Almost 44% of responses predicted that mental health would be the most important issue. How much more concerned are we about young people’s mental health now, after a year of lockdowns and missed school?

This report is about looking at where we are right now in order to be prepared for what is to come. We owe it to children and we owe it to paediatricians to be properly-equipped and properly-resourced to meet these changing needs.

A key part of the report is a set of aims we wish to see implemented across innovation, models of care and working lives. These include:

• Paediatric models of care that are truly child centred, rather than built to suit existing systems, with communication and adaptation as the key ingredients in any system
• An improved landscape for innovation, with increased capacity for research that is specific to innovation and technology in paediatrics
• Widespread implementation of appropriate guidelines and frameworks that are specific to paediatric care to make technology safe and accessible for all
• More children and families empowered to know when to seek care, with reduced pressure on emergency department attendances
• Flexible and progressive rotas which allow doctors to deliver high quality patient care, not impeded by excessive workload, allowing for both continuity of care and attention to sleep, as appropriate
• Staff wellbeing being at the forefront of institutions