Between 2015 and 2018, recruitment to Specialist Trainee 1 in paediatrics fell from 97.5% to close to 80%, with this once-popular specialty having the lowest competition ratio of all the medical specialties.

Recruitment shortfalls are one manifestation of broader problems in the specialty, with paediatricians now representing around 5% of referrals to the NHS Practitioner Health Programme (PHP), a confidential mental health and addiction service for doctors. This is an over-representation compared with other specialties. In addition, the service sees a higher percentage of trainees (70% compared with an average of 54% across all specialties). Neonatologists and intensive care specialists form a significant subset of the paediatric group. Almost all paediatricians presenting to PHP have mental illness as opposed to addiction problems, with the vast majority displaying anxiety, depression and symptoms of burn-out. Most tragically, a small number have committed suicide.

In 2018 two meetings (‘Spotlight on Paediatrics’) were convened to discuss the issues which may have contributed to this worrying trend, and to try and find solutions. This paper describes the format and outputs of the two meetings and provides key insights into how recent changes in the paediatric environment have produced adverse conditions for clinical staff. Drawing on this information, the authors make recommendations for how individuals and organisations can come together to improve the situation, not just for paediatricians but for the whole multidisciplinary team, and the patients and families they serve.

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