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ObjectivesTo determine any change in referral patterns and outcomes in children (0–18) referred for child protection medical examination (CPME) during the COVID-19 pandemic compared with previous years.DesignRetrospective observational study, analysing routinely collected clinical data from CPME reports in a rapid response to the pandemic lockdown.SettingBirmingham Community Healthcare NHS Trust, which provides all routine CPME for Birmingham, England, population 1.1 million including 288 000 children.ParticipantsChildren aged under 18 years attending CPME during an 18-week period from late February to late June during the years 2018–2020.Main outcome measuresNumbers of referrals, source of disclosure and outcomes from CPME.ResultsThere were 78 CPME referrals in 2018, 75 in 2019 and 47 in 2020, this was a 39.7% (95% CI 12.4% to 59.0%) reduction in referrals from 2018 to 2020, and a 37.3% (95% CI 8.6% to 57.4%) reduction from 2019 to 2020. There were fewer CPME referrals initiated by school staff in 2020, 12 (26%) compared with 36 (47%) and 38 (52%) in 2018 and 2019, respectively. In all years 75.9% of children were known to social care prior to CPME, and 94% of CPME concluded that there were significant safeguarding concerns.ConclusionsSchool closure due to COVID-19 may have harmed children as child abuse has remained hidden. There needs to be either mandatory attendance at schools in future or viable alternatives found. There may be a significant increase in safeguarding referrals when schools fully reopen as children disclose the abuse they have experienced at home.

BackgroundAfter the onset of the COVID-19 pandemic, the government issued national lockdown restrictions. This was soon after the March 2020 changeover, meaning many paediatric trainees were working in new, unfamiliar hospitals with strict social distancing rules. This impaired the normal development of workplace relationships at a time where peer-support was pivotal.The risk of poor mental health and moral distress is well recognised in healthcare professionals. With isolation and restricted peer-support, this was likely to increase. The regional Trainee Support Network launched a series of pan-regional virtual Quiz Nights to combat this.ObjectivesTo organise virtual quiz nights that provide a safe environment for paediatric trainees, consultants and the wider deanery ‘paediatric family’ to see each other and have fun, in order to improve workplace relationships and boost staff morale.MethodsA 32-week project using plan-do-study-act (PDSA) cycles was completed (table 1). We evaluated interventions via mixed quantitative and qualitative questionnaires assessing whether people would attend again, would recommend the quiz to friends, and whether attendees reported improvement in workplace relationships and morale.A total of 6 virtual quiz nights were hosted across an 8-month period from May to December 2020.Abstract 1301 Table 1 PDSA Cycles 1 Launch of Quiz Night. Variety of questions, including region specific (‘Name the Hospital’ and ‘Guess the Consultant’ childhood photo rounds) and general rounds. 2 Further promotion, including a regional twitter hashtag. Addition of attendee requested rounds (continuing mixture of deanery specific and general rounds) 3 Head of School and TPDs invited to guest host rounds and addition of further innovative (COVID face mask) photo rounds 4 Quiz Night held in conjunction with regional PAFTAS award ceremony evening 5 Special edition quizzes (Back to School, Christmas Quiz) ResultsThe quiz was attended by a mixture of clinical, non-clinical, senior and junior paediatric staff and their families. Attendance ranged from 20–40 per quiz, peaking during lockdown. We received a total of 39 responses to our questionnaire.100% (n = 39) reported they would attend again and would recommend the quiz to a friend or colleague. 97% (n = 38) reported they agree or strongly agree that the quiz boosts staff morale. 92% (n = 36) reported it improved workplace relationships. When asked whether they preferred the quiz to be only trainee or consultant based, 100% (n = 39) reported they wanted it to be open to all.Attendees reported that it was a ‘great initiative’ that allowed people to ‘connect with colleagues’ at a time where this was ‘not possible in groups outside of work due to COVID.’ They ‘loved the banter’ and the ‘imaginative rounds.’ Thematic analysis demonstrated that what people valued most was the ‘chance to see friends’ from ‘around the region,’ ‘getting everyone together,’ and the ‘community feel’ created by these events through the ‘light-hearted entertainment.’ ConclusionsThrough innovative photo rounds, guest hosts, and friendly competition, the quiz was a ‘wonderful way to get trainees and consultants of the region together,’ improving staff morale and workplace relationships. Hopefully one day we can ‘do it in a pub.’

BackgroundStepping up to the role of Paediatric Registrar is a juncture that many trainees find daunting; adequate support is essential to ensure a smooth transition. Working effectively as a new Registrar requires a range of non-technical skills in addition to clinical knowledge and skills. Some of these important non-technical skills are not covered during regional or departmental teaching, nor routinely addressed during Supervised Learning Events or Supervisor meetings.ObjectivesKeen to improve the trainee experience of transition, and to level the playing field for trainees who do not have access to informal sources of information and support, we created the ‘LEAP into Leadership! ST3–4 Transition Day’, broadly covering Leadership skills, Educational tips, Acute assessment tips, and Personal/team wellbeing (LEAP).MethodsTrainees who were stepping up to work as Paediatric Registrars at any point over the following 12 months were invited; 23 trainees attended the day, which was delivered in August 2020 via Zoom. The impact of the Transition day was evaluated using pre- and post-course surveys.ResultsPre-course survey results indicated that 65% (n=15) of trainees thought Level 1 training had prepared them for the transition. However, 100% (n=23) of trainees reported feeling anxious, and 47% (n=11) did not feel confident about the transition. We enquired about previous teaching on pertinent topics; the percentage of trainees reporting that they had received teaching on each topic was as follows: effective handover: 53% (n=9 out of 17 responses), safety-netting: 24% (n=4), leading a busy out of hours shift: 12% (n=2), delegation: 6% (n=1), and complaints: 0% (n=0).Post-course survey results showed that 100% (n=23) of trainees felt they had a better understanding of what is expected of a new Registrar after attending the day. Trainees found it useful reflecting on the potential challenges of stepping up and having time to discuss these with more senior trainees (100%; n=23), and stated that they felt less anxious and more confident about stepping up after attending the day (96%; n=22). Comments included ‘reassuring to hear that a lot of the worries I have about stepping up are common’, ‘useful hearing personal accounts from current registrars, obstacles they faced and strategies to overcome them’, and ‘helped me plan how I am going to approach these situations with greater organisation, situational awareness and a more holistic approach - thank you!’.ConclusionsWe have developed a new, trainee-led day to support trainees in our region with the transition to working as a Paediatric Registrar. Feedback demonstrates that trainees found the day valuable, resulting in reduced anxiety and improved confidence about the transition. Trainees found the near-peer support aspect of the day especially useful, in addition to the practical tips relating to topics such as resuscitation, leading busy shifts, safety-netting, delegation, complaints, and wellbeing. The Transition day will be embedded within our regional teaching programme; additional work to further boost peri-transition support is in progress.