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British Society of Paediatric Gastroenterology, Hepatology and Nutrition

Dear BSPGHAN members 

I trust that this message finds you and your families well. 

I will try to provide updates if I receive advice which will help members plan services and support challenges due to workforce shortages. 

Speciality specific advice

Please see COVID-19: BSG and BASL advice for healthcare professionals in Gastroenterology and Hepatology  for speciality advice on Covid 19 for healthcare professionals in Gastroenterology and Hepatology. 

General advice

There is likely to be several changes in the guidance over this week and follow the most up to date guidance from  https://www.england.nhs.uk/coronavirus/  and specifically for your area, see the following links  Public Health EnglandHealth Protection ScotlandPublic Health Wales and Public Health Agency Northern Ireland.

Paediatric advice

The RCPCH are monitoring the evolving public health challenge of COVID-19 – and the risks and impacts on members and the wider child health workforce, and on children and young people. They  have produced guidance for paediatric services and links to information from statutory bodies in all UK nation.

What we know so far

We know that children of all ages in China were susceptible to COVID-19. Clinical manifestations of pediatric patients were generally less severe than those of adults’ patients. We do not know which groups are at more at risk than others , but young children, particularly infants, underlying pulmonary pathology, and immunocompromising conditions have been associated with more severe outcomes with non- COVID-19 coronavirus infections in children. Paediatrics. 2020; doi: 10.1542/peds.2020-0834 

Advice for families  

Patients should continue following regional safety netting advice if parents are worried that their child is unwell. 

Currently, national advice should be followed regarding attendance at school, need for testing or attendance at hospital for assessment 

People  should now avoid non-essential contact and to stop all unnecessary travel. 

Local and regional paediatric services are putting in place detailed plans to treat and support all children who have severe COVID-19 infection. There is a national plan in place for the management of children requiring intensive care management (PICU). NHS Trusts are working in conjunction with the Regional and National NHS Command Structure, to agree what support to the wider NHS will look like and to free up capacity for care,  including intensive care beds. 

What BSPGHAN is doing

BSPGHAN is linking with key stakeholders rapidly to protect patients  who we suspect may be more vulnerable to the knock on effects of the pandemic on healthcare resources.

The risk may increase over the coming days and disruption to routine delivery of care  will affect all patients .

  1. Home parenteral nutrition patients

The HPN National Framework in England is coordinating an action plan for hospital teams and home care providers and is preparing a statement for professionals and patients, to include children. It is envisaged that there will be a coordinated plan for potential disruption to home and hospital PN compounding, deliveries and supply and home care services. Home PN teams are already in touch with patients advising that there will be notified about changes in the way services are delivered. 

  • Liver and intestinal Transplant patients –  Please look at advice  British Transplantation Society
  • IBD patients We have linked in with the BSG and we are exploring if a national coordinated response can be given from NHS E to secure access for children on biological therapy, and their routine blood monitoring. I will keep you updated when more advice becomes available. See the BSG COVID-19 Guidance and Advice Knowledge Hub and BSG and BASL COVID-19 Advice for Healthcare Professionals in Gastroenterology and Hepatology.
  • Endoscopy teams are advised to follow national guidance for reducing transmission of infection with COVID19 but also agree their local protocols and policies in collaboration with management, Infectious disease or Infection Control teams (see BSG link  for their advice on cancellation of endoscopy https://www.bsg.org.uk/covid-19-advice/). 

Research

Please see linked here a statement about the impact of COVID-19 on research funded or supported by NIHR.

The priority is the safety of our patients and health professionals and families. BSPGHAN has cancelled the annual trainees and associates’ meeting in May. We are all now working in different ways,  running virtual clinics, prioritising essential versus non-essential contacts,  cancelling elective theatre lists and redeploying staff. 

As advised, individual treatment plans will need to be made between the patient, family and physician. 

Sue Protheroe

President 17 March 2020

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