COVID 19 Grid Trainees – Update from CSAC 26th April 2020

I hope everyone is staying safe and keeping well during these unprecedented times when we are all having to think, work and function in very different ways – very stressful and very tiring, including the challenge of trying to practice Paediatric Gastroenterology with only limited access to endoscopy.

I wanted to update you with regard to training and our trainees many of whom have effectively had their training suspended partly because of the need to cross cover other areas but also as a consequence of the secondary impact of the endemic on our specialty.

I have been in touch with them regularly.

There are a number of issues which are general to all trainees and some specific to our specialty. These include uncertainty regarding training, progression, assessments and rotations.

David Evans has done a helpful update – see link  appended which is being regularly updated

There will be a modified ARCP process and we are awaiting the specifics and timeline and will facilitate CSAC progression forms once that is clear. The modified process will mean that the impact of COVID on training can be factored in.  The trainees will be concerned about clinical exposure, team meetings and endoscopy. There will be particular anxieties about exposure and training in endoscopy  with most services on hold at the moment, uncertainty about when they will resume and there being a likely need for significant catch up when that occurs.

We have had to cancel the face to face trainees meeting in May but have set up a virtual meeting and the potential for 1 to 1 discussions via Microsoft teams – I guess we are all getting used to this new way of working.

In the meantime – if possible – please continue to meet with your trainees regularly and facilitate training a much as possible so they we can offer them as much support as we can.  

All the best

Stay safe and keep well

https://www.rcpch.ac.uk/resources/covid-19-rcpch-trainee-progression-uk-through-2020#annual-review-of-competence-progression-arcp

Mark
Professor RM Beattie
Consultant Paediatric Gastroenterologist
Honorary Professor of Paediatric Gastroenterology and Nutrition
Chair of the Royal College of Paediatric and Child Health (RCPCH) College Specialty Advisory Committee (CSAC) for Paediatric Gastroenterology, Hepatology and Nutrition e- mail csac@bspghan.org.uk

President Update:  Sunday 19th April 2020   1. BSPGHAN IBD WG Position statement 2. BSG IBD Covid WG Guidance 3. RCPCH Guidance on shielding 4. Non Covid publication

President Update: Sunday 19th April 2020 1. BSPGHAN IBD WG Position statement 2. BSG IBD Covid WG Guidance 3. RCPCH Guidance on shielding 4. Non Covid publication

Dear Members

“For all those people who are finding it difficult at the moment: the sun will shine on you again and the clouds will go away.”

Captain Tom Moore has to date raised more than £25m for NHS Charities Together https://www.nhscharitiestogether.co.uk/ His words have embodied the outpouring of gratitude for Britain’s doctors, nurses and other healthcare workers on the front line.

Captain Tom got it right. He focused on the sacrifices made by health service workers and the efforts of everyone, who has been isolating since March 23. “You’ve all got to remember that we will get through it in the end, it will all be right, it might take time,” “At the end of the day we shall all be ok again.”​

We are humbled by his efforts and appreciation of the amazing work that frontline professionals are maintaining despite extraordinary pressures. The NHS has moved quickly and effectively to convert conference centres into Nightingale Hospitals. Professionals need the protection equipment to make them feel safe. Please make best use of supplies so that those working in high risk sectors are not short of adequate PPE and exposed to risk.

BSPGHAN has engaged with key organisations this week, NICE, RCPCH, BSG as well as our charitable partners. I will signpost you when the Covid-19 NICE Rapid guidance is published on Gastrointestinal and Liver conditions this week and guidance regarding Children who are immunosuppressed shortly after.

Please remind yourself below of the –

1.Bspghan IBD WG advice, and see new guidance that BSPGHAN has contributed towards from-

  1. The BSG,
  2. The RCPCH and
  3. A great non Covid article of importance to the well being of our patients

Also

  1. See considerations for use of PPE, and

Most excitingly,

  1. Trainees please note. Exciting plans to support national teaching by Zoom for BSPGHAN trainee members from trainers, starting off this week live from Birmingham. A national virtual meeting of interest to members may follow.
  1.  https://bspghan.org.uk/wp-content/uploads/2020/04/COVID_IBDWG_HCP.pdf

British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) Coronavirus (SARS-CoV-2) and COVID-19 in children with IBD

Position Statement: Management of PIBD during the SARS-CoV-2 pandemic​ IBD Working Group

  1. https://gut.bmj.com/content/early/2020/04/17/gutjnl-2020-321244

The British Society of Gastroenterology (BSG) COVID-19 IBD Working Group has published service provision, medical and surgical therapy, endoscopy, imaging and clinical trials.​​ The best available data and expert opinion has generated a risk grid for adults that groups patients into highest, moderate and lowest risk categories.

3. https://www.rcpch.ac.uk/resources/covid-19-guidance-paediatric-services

BSPGHAN has contributed towards the new RCPCH guidance.

It is also important to recognise that during this current pandemic, children who are unwell remain more likely to be unwell due to a non-COVID-19 condition than to COVID-19 itself; this includes those with the conditions described in this guidance. However, some children may remain more at risk of COVID-19 related disease, and these children should be protected as far as is possible from infection by ‘shielding’.

  1. https://adc.bmj.com/content/early/2020/04/16/archdischild-2019-318713

It is good to see an important publication from one of our trainee with the Oxford team entitled “hypoglycaemia: a hidden risk in paediatric colonoscopy,” and this sounds an important topic to audit when electives lists are back up and running.

  1. https://www.gov.uk/government/collections/coronavirus-covid-19-personal-protective-equipment-ppe

You will have seen in reports there is now a real concern at national level regarding the shortage of PPE gowns. Yesterday (Friday 17 April), Public Health England issued emergency advice on the use of gowns in clinical areas should shortages arise. It is important to emphasise that everyone should organise care to make best use of stock. The safety of teams is our priority and access to the appropriate PPE.

Stay safe, and if you have news from your region or updates or guidance to share, please get in touch.

Best wishes
Sue
BSPGHAN President April 18th 2020

CSAC Update

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:

CSAC QUESTIONS:

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

Rulla Al-Araji

CSAC Representative

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