Life in Lockdown Survey Results
As you will be very well aware, IBD services have been disrupted one way or another by the coronavirus pandemic and we know there has been an impact on you and on patient care. Our Life in Lockdown survey gave us an insight into how services have been impacted by the pandemic from the patient perspective – we received 7,666 responses from people with Crohn’s and Colitis. Look at our blog to find out more about the results and how you can use them.
Information and Resources for Patients
For regularly updated information about Covid-19, please continue to signpost patients to our website: https://crohnsandcolitis.org.uk/news/coronavirus-covid-19-advice
We have recently published a list of the ‘Top 8 things to do after a Crohn’s or Colitis diagnosis’, to help people who are new to the conditions navigate the wealth of information and support available to them. You can signpost patients to the new page using this link: www.crohnsandcolitis.org.uk/new-diagnosis
We have also added a new blog for patients ‘Top tips for getting the most out of your virtual appointment’. This blog answers questions or concerns for patients who have not had a telephone or video appointment before and gives clear tips for before, during and after the appointment.
While we cannot currently mail out patient packs, our online information is a great free resource that you can still signpost patients to.
We have called for everyone with Crohn’s or Colitis to have free access to the flu vaccine on the NHS this season, in a joint letter from our Chief Executive Sarah Sleet and the Presidents of the British Society of Gastroenterology and British Society of Paediatric Gastroenterology, Hepatology and Nutrition to the Joint Committee on Vaccination and Immunisation.
As you’ll know, the NHS guidelines on whether people with Crohn’s and Colitis are eligible to free vaccinations in England, Scotland, Wales and Northern Ireland are open to interpretation. Please encourage patients you consider eligible to get their flu vaccine as soon as possible. To help them with this, you can click here to download our open letter to vaccine providers explaining who with Crohn’s or Colitis is eligible for the free flu vaccine.
GINcast: Gastrointestinal Nursing Podcast
Episode 3 of GINcast explores how the Covid-19 pandemic has changed the way IBD nurses deliver care to patients with Crohn’s and Colitis. Listen to the podcast here.
Do get in touch with us at email@example.com if you have any queries.
This is a recording of the talks delivered by Dr Jeng Haw Cheng, paediatric gastroenterology grid ST8 at Alder Hey Children's Hospital, and Dr Hina Rizvi, paediatric gastroenterology SPIN ST7 at Birmingham Heartlands Hospital at the trainees' meeting on 19 August 2020. Video editing by Helen Vanker.
These videos will be open access until the end of October.
This page is restricted to BSPGHAN members.
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I hope that since my last bulletin, on 28th July, you have remained safe and well and have had time to rest.
Covid -19 has been the focus of bulletins this year, the pandemic having dominated all aspects of life – home, work, school, and healthcare.
We couldn’t foresee that in March, COVID would continue to be with us for so much longer than we thought.
Life has been busy with many challenges, but also with opportunities to reset the way we work.
I trust that you have all been getting to grips with restoring delivery of your services as best as your local resources will allow and that teams continue to be resilient in dealing with patients’ needs and concerns. I hope that trainees are supported to get back on track to achieve their ARCP targets.
One of the spin offs from the pandemic is the way we deliver education. The BSPGHAN Education series is live and also available on demand. The series of twice weekly live webinars offers CPD for trainees, associates and all members and usually a chance to join a friendly chat with colleagues.
Please do get in touch with myself or a council member if you need a discussion about your service or any items below-
1. ‘Shielding’ advice for children and young people
While up to up to 76 000 children were initially shielded at the start of the pandemic, the target was reduced to about 10 000. BSPGHAN this week will be contributing towards updating the national advice with the RCPCH and other key stakeholders. See information on which paediatric patient groups should be advised to ‘shield’ during the COVID-19 outbreak. We have an opportunity to discuss the definition of children who might be seen as clinically extremely vulnerable. As increasingly reassuring data becomes available, the definition includes far fewer children, but it would be good to have feedback from members, as to which children and young people in our speciality remain clinically extremely vulnerable. It seems likely to be restricted to those children and young people who are peri transplant or have specific immune deficiencies, but please do feedback.
2. Recovery and Restoration of PGHAN services
We saw widespread disruption to normal diagnostic activity with very low activity for almost 6 months – see some data https://www.rcpch.ac.uk/resources/covid-19-guidance-paediatric-services .
Changes in clinical practice emerged:- opportunities to redesign some outpatient services using remote consultations and clinical triage may already be altering endoscopy practice to lower volume- higher yield. While endoscopy was restored in children by July to 40% of pre Covid levels, there is a backlog of patients waiting, with concern about variation in activity and unintended harm due to long waits. Endoscopy activity in children is being highlighted to regional commissioning teams in order to support the reduction in the backlog of priority procedures.
3. RCPCH Conference 2020 online – FREE to register NOW. BSPGHAN speciality session is October 22nd 09.00-12.00
British Association for Paediatric Nephrology and British Society of Paediatric Gastroenterology, Hepatology and Nutrition is on https://www.rcpch.ac.uk/news-events/events/conference-webinar-british-association-paediatric-nephrology-british-society
4. BSPGHAN Annual meeting January 26-28th 2021
Please remember to book your study leave to join the virtual BSPGHAN Annual Meeting and AGM.
The meeting will provide a unique opportunity to show case the activity of BSPGHAN’s Working Groups, sessions for the Trainees, PEGHAN and Associate members and a virtual platform for posters.
The importance of the meeting in allowing colleagues to socialise and link up is important we hope that the sessions can be arranged to allow this aspect to continue.
We have delayed the BSPGHAN Annual Meeting in Birmingham to January 2022
5. RCPCH/BSPGHAN Clinical Standards Audit
The audit is up and running again. We have a registered PGHAN Audit lead in around 60% of potential Health Boards and Trusts and so please support the request to bring up the percentage up as high as we can before we start the data capture phase soon.
6. Recent Resource
A national consensus management pathway for paediatric inflammatory multisystem syndrome temporally associated with COVID-19 (PIMS-TS): results of a national Delphi process. https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(20)30304-7/fulltext
The current BSPGHAN advice on shielding will change on August 1st in line with Government advice.
From 1 August, the government will pause shielding unless the transmission of COVID-19 in the community starts to rise significantly.
See GOV.UK: guidance on shielding and protecting people who are clinically extremely vulnerable from coronavirus. **
This guidance will be updated on 1 August.
See specific advice for our patients’ families
**Clinically extremely vulnerable children and young people (0 to 18)
Specialists in paediatric medicine have reviewed the evidence on the level of risk posed to children and young people from COVID-19. The latest evidence indicates that the risk of serious illness for most children and young people is low.
All children and young people currently identified as Clinically Extremely Vulnerable, and advised to shield, should continue to do so until 31 July, when the government will pause shielding for everyone.
All decisions on whether children and young people should be removed from the shielded patient list (and therefore will not be advised to shield again in future if transmission starts to increase significantly) should be based on a consultation with a paediatric specialist or GP who will be best placed to determine the most appropriate care. Gov.uk advises that a paediatric specialist or GP will be in touch over the summer to have these discussions.
Returning to school
- children who are clinically extremely vulnerable can go back to school (when the rest of their class goes back)
See guidance on supporting children and young people’s mental health and wellbeing.
This advice is of a general nature and should be treated as a guide.
This does not replace any local public health measures put in place to protect the local population. If there is an outbreak of COVID-19 within your area, please follow any guidance set out locally or any specific law which applies to the area you live in .If local restrictions are in place in your area, please visit local lockdowns guidance
BSPGHAN President July 28th
BSPGHAN Educational events 2020 and Annual Meeting 2021
Please Save The Dates in your diary
- BSPGHAN Annual Meeting and AGM January 27, 2021- January 28, 2021
- BSPGHAN Masterclass “Intestinal Failure – Past, Present and Future”? August 12th, 2020 14.00 -15.00
- BSPGHAN Trainees meeting August 19th 2020 13.00-16.00
The pandemic has given us unique challenges in delivering and hosting educational events, especially our upcoming annual BSPGHAN meeting.
Our trainees have led the way and pulled together highly successful Zoom educational initiatives.
Following discussion at Council, Dr Ronald Bremner, my co-host, and I have agreed to arrange a virtual annual meeting and AGM in 2021, harnessing the recent success of weekly trainees’ online events.
Virtual annual meeting and AGM January 2021
We plan to offer interactive “live” panel discussions and debates to continue our professional and friendly interactions on January 28th, 2021.
For abstract submission and management, we will use the online system that worked well last year and offer poster submission with poster walks using uploaded video presentations alongside.
Following demand, we plan to offer to stream parallel sessions for the Associates, Trainees and PeGHAN colleagues on the first day January 27th 2021. We are willing to secure a venue to host a small face-to-face meeting alongside the online annual meeting nearer the time if this is in demand. We hope that this hybrid meeting will offer the best of both worlds. It may become the template for meetings in future, hopefully with a large proportion of the meeting being face-to-face in future. Council have agreed that we run a meeting in Birmingham in 2021.
Please book your study leave now.
Twitter – The trainees, led by Joe Chan and supported by Mark Beattie plan to use our BSPGHAN Twitter account take on a larger role for the virtual meeting.
Uses will include publicising upcoming talks, facilitating online discussions and post-talk questions for the speakers.
The first BSPGHAN Masterclass on 12th August 2020 https://BSPGHAN.org.uk/events
You are invited to join the first BSPGHAN Masterclass on August 12th, 2020 14.00-15.00. Dr Sue Protheroe will deliver a talk on ‘Intestinal Failure; Past Present and Future’. Time and registration details will be circulated shortly “BSPGHAN Masterclasses” will invite a wider audience (to include international trainees, non-GI health professionals, non-BSPGHAN members) with the intention of sharing GI learning to a wider audience, and extending the society’s reach and influence.
BSPGHAN Trainee’s meeting on 19 August 2020 ; https://BSPGHAN.org.uk/events
A trainee members’ meeting has been organised by Dr Neil McConnell, chair of the Trainee Group. The programme is being finalised and will be uploaded shortly. Talks will cover why to train in gastroenterology and hepatology; insight into the START Exams and Consultant Interview Tips. This meeting is open to Trainees and those who may be interested in a career in Gastroenterology and Hepatology.
Returning to Hospital Schools
The Department for Education has published a suite of guidance relating to school opening in September. It is the intention of the department that all pupils, in all year groups, will return to school full-time from the beginning of the autumn term. From 1 June, DfE asked schools to begin welcoming back more pupils in specific year groups. Hospital schools on hospital sites were asked to work towards a phased return of more children and young people without a focus on specific year groups and informed by risk assessments. Since then, the prevalence of coronavirus (COVID-19) has decreased, the NHS Test and Trace system is up and running, and there are clear measures that need to be in place to create safer environments within schools.
Returning to school is vital for children’s education and for their wellbeing, and we therefore need to ensure all pupils can return to school sooner rather than later. This includes pupils receiving hospital education on hospital sites.As you will see from the guidance (https://www.gov.uk/government/publications/guidance-for-full-opening-special-schools-and-other-specialist-settings/guidance-for-full-opening-special-schools-and-other-specialist-settings), we are asking hospitals to work with the relevant Infection Prevention and Control team and NHS Trust to ensure that all pupils educated on hospital sites are able to return to education in September where it is safe and feasible to do so and in line with hospital IPC measures. We expect headteachers and NHS trusts to work together over the summer holidays and beyond, to enable the return of all pupils at the start of the autumn term. We would be very grateful if you could share the guidance with the relevant members of your staff teams to ensure key messages are widely distributed and to enable planning for September to commence
- Pause of the National Audit of Quality Standards for Paediatric Gastroenterology, Hepatology and Nutrition (‘the PGHAN Audit’).
The RCPCH/BSPGHAN PGHAN Audit Project Team have put the audit on hold during the COVID-19 pandemic and will reinvigorate the audit in August. The pause has given us an opportunity to discuss consider potential changes to the dataset that might be required due to the effects of COVID-19 on the healthcare system and PGHAN services in particular.
I am grateful for all of your input and support with the PGHAN Audit to date. The dataset had been agreed and built into a data platform which was ready to pilot in May/June. The PGHAN Audit clinical lead had registered in around 45% of Health Boards and Trusts across the UK by the end of April.
Please can I ask you to contact your Medical Director if you haven’t recruited a PGHAN Audit clinical lead.
The pause in the audit has offered us chance to reflect on its purpose in the context of BSPGHAN’s strategic intentions-
- To continue to examine PGHAN professional networks and see how BSPGHAN can support research, education and training,
- To allow us to consider the impact and value on PGHAN health care provision that the BSPGHAN Clinical Standards provide,
- To reflect critically on BSPGHAN’s function, to promote national best practice and outcomes of our patients especially moving forward from paused activity,
- To harness opportunities to support service resetting and recovery post COVID-19, and how this may be done at a national level,
- To harness opportunities to sustain any positive changes in the way we work, capturing innovations that have been rapidly developed during the pandemic (Please still feedback to me on innovations. See below **).
Additionally, it is timely to reflect on further intentions-
- To accelerate BSPGHAN’s national education strategy to develop virtual learning opportunities for trainees and members,
- To use our new website to share education / clinical updates; to measure the impact of the content of our new site;
- To build on the closer links that have arisen during the pandemic when writing joint rapid updates for example; for BSPGHAN to work more closely with key stakeholders such as the BSG, Royal College and charitable partners
- To support the productivity of BSPGHAN “task and finish” projects– using virtual get togethers. I hope that remote meetings will encourage participation from more members from devolved nations and foster rapid outputs from council and working groups.
2. Shielding Update
I know most will have seen the latest shielding letter from the Chief Medical Officer & NHS Medical Director AVAILABLE HERE which provides New clinical evidence on children
Recent experience and knowledge of the impact COVID-19 infection has on children and young people with comorbidities suggests not all those on the Shielded Patient List need to be shielding. RCPCH recently published updated guidance which paediatric patient groups they think should be advised to shield. They have identified three groups:
- children and young people who are cared for just in primary care are very unlikely to need to continue to shield;
- a small group of children who are clinically extremely vulnerable due to their pre-existing condition will need to continue to shield; and
- a further larger group of children exists who due to their underlying condition may need to shield and the decision to continue to shield would normally result from a discussion between the clinician, the child and their family.
RCPCH expect that all patients who need to continue to shield will be seen in a specialist centre before September 2020 (but not all those with specialist appointments will need to shield). Decisions on shielding will generally be led by a specialist, balancing the clinical and social impact of shielding. Patients should only be removed from the Shielded Patient List by their GP or specialist following consultation with the child and their family, and other clinicians where appropriate.
Further guidance on having conversations with children and families can be found on the RCPCH website The Government works closely with the RCPCH and welcomes their valuable scientific input. We recommend that clinicians follow up with children (and their parents) on the Shielded Patient List to discuss what RCPCH guidance means for them.
Risk stratification (adults) A team academics have been working with clinicians to develop a predictive risk model that reflects a wider range of factors such as demographics alongside long-term health conditions, to better understand cumulative risk of serious illness for individuals if they catch COVID-19. The COVID19 risk stratification model will be set out in the BMJ soon . It will only be for people aged 18 years as fortunately there’s a paucity of data for modelling in children and young people — see the publication of the research protocol
3. Feedback from members on Service Innovations **
I mentioned a few weeks back, I am keen to capture service changes relevant to our patients.
This is a polite nudge to ask those of you who haven’t got back to me, for your thoughts, so that I can make sure they’re captured.
See survey via this link or see the questions below
The survey asks the following four questions:
- What beneficial innovations/changes have occurred in your specialty and within patient pathways?
- Please describe the impact of these innovations/ changes (e.g. population health outcome, patient outcome, safety, wider system, efficiency, productivity). How did you measure the benefit?
- What is needed to sustain the change?
- What, if anything, hasn’t worked so well.
Thank you for getting back to me by 4pm on 30th June. If you can’t make this deadline, please still feedback as your input will be useful to harness and share improvements in patient pathways.
4. ACCEA secretariat update
Ministers agreed the suspension of the 2020 national Clinical Excellence Awards round https://www.gov.uk/government/news/extension-to-clinical-excellence-awards-due-to-expire-in-april-2021
Subject to Ministerial agreement, there will be an extended National awards 2021 competition, with a lengthened timetable from November 2020 until the end of January 2021.
Please stay well and as always, I welcome your involvement and your feedback.
28th June 2020