I do hope that this message finds you and your families and friends in continuing good health. It is an unsettling update today on the situation as it unfolds, as it is anticipated that there will be a rapid climb of Covid-19 to hit our hospitals and community services this week and next.
The focus has to be on pulling together as an NHS team to incident manage life threatening situations. When we emerge from this, there will be an important recovery phase to plan for.
Today, BSPGHAN has helped to kick start the process and contributed towards a Gap Analysis to feed back via the RCPCH to NHS E. This will help planners understand the need for time dependent diagnostic procedures and appointments for patients who are referred with commonest or high risk PGHAN conditions.
I am indebted to the BSPGHAN IBD Working Group and the Birmingham Children’s Hospital Nutrition nurses who have prepared the following guidance for members and the two items that you can use for information for parents/carers (attached):
1.BSPGHAN IBD Working Group statement for Health Care Professionals COVID_IBDWG_HCP
Coronavirus (SARS-CoV-2) and COVID-19 in children with IBD.
2.BSPGHAN IBD Working Group
PARENT/CARER INFORMATION LEAFLET COVID_IBDWG_Parents_Carers
Coronavirus (SARS-CoV-2) and COVID-19 in children with IBD.
3. Parent/ Carer Information Letter for families of children on home parenteral nutrition (authored by Birmingham Women’s and Children’s Hospital Nutritional Care Team nurses) Birmingham Letter for HPN patients
I would like to draw your attention to advice on practice and service provision for patients with IBD. Please mitigate risks of infection to theatre teams and preserve the PPE supply by limiting all but non emergency endoscopy for now.
Importantly, the parent carer guidance, 2. and 3. provides; –
a] paediatric-specific advice on shielding, helping professionals and families interpret what ” shielding” looks like for ‘At Risk’ children with IBD who are on immunosuppression and for those on Home PN, and
b] advice to avoid “late presentation” of febrile episodes in patients with IBD and on home PN.
I am mindful that I would not ordinarily send out a letter intended for families unless it had been ratified by Council, but in these exceptional circumstances, there is a need for rapid guidance, especially if there is confusion on ‘shielding’ advice. Please can I ask members to check the home PN letter and amend the content as you see fit for local use before you share it with your families.
The next few weeks may be tough for our teams. Please look after each other and make sure that you stay protected and remain safe.
Thank you to Jochen and the IBD working Group and a personal thanks to Elaine, Louise and Gemma and all our amazing IBD, Gastroenterology and Nutrition nurses who are working tirelessly to keep our families well informed, safe and well.
Sue, President of BSPGHAN
April 7th 2020.
Following the last CSAC meeting held via teleconference on 31/3/20, I just wanted to update you all with some answers from Dr Beatie and the CSAC team to your questions so far as below:
1) How are we doing CSAC progression form and meeting this year? Should we be looking at booking study leave half day for example to give allocated time for teleconference at home where wifi more reliable than hospital or will it be a call?
CSAC will do whatever is needed to sort once the process and timeline (which I suspect will be revised) is sorted.In view of the Coronavirus Epidemic there are considerable (ongoing) uncertainties for trainees about their training and career progression. Many have been re-allocated to other areas and training opportunities such as ward rounds, clinics and endoscopy are significantly reduced.
Update from RCPCH from David Evans highlighted – (which will be updated with new information) regularly.
COVID-19 – RCPCH trainee progression in the UK through 2020
2) PGHAN training has ground to a halt – no elective endoscopy, no Reg clinics and consultants doing telephone clinics. Apart from ward experience what else should we be doing? Is there any suggestions to minimise impact of covid to training? What will happen with training length if this pause continues for example 6months?
I think this is unanswered at the moment but I agree training is effectively on pause.
Trainees should still (where possible and practical) avail themselves of learning opportunities and update/reflect in their portfolio – CBD’s may or may not be possible but can be done if there is time/supervision to complete.
I agree endoscopy training is on hold.
We will wrestle with all these issues and help with once the process and timeline is clearer.
3) May be not CSAC specific but signposting to online learning materials would be much appreciated
It seems most journals are promoting free content and different societies are promoting guidance relating to COVID and I presume/hope some guidance is being given for trainees who are moved out of their usual/familiar clinical area
4) Maybe a zoom conference with all trainees and CSAC might be quite nice. At other hospitals, they are going to emergency covid rota and hospital team have been hosting zoom conference with 30+ participants logging in from home – very informative/useful discussions and helpful when 20-30% of workforce self isolating.
CSAC can be part of this if we can facilitate it and you help with getting the technology right
Please see the following updates
- Guidance for health professionals with IBD or liver disease
- Cvid19 UK IBD registry tool for adult patients
The tool aims to help identify and reach moderate and high-risk IBD patients.
The IBD registry tool is currently restricted to those are are aged 18 years or older but they are working on extending its use to under 18s
- COVID-19 – RCPCH trainee progression in the UK through 2020
- EMA press releases related to COVID-19:
Please check EMA’s dedicated webpage on COVID-19 for the latest updates.
Thank you all again for your continued collaborative effort to support professionals and patients.