Children who are CEV & vaccination advice

by BSPGHAN | Jan 20, 2021 | News

Dear members

Children who are CEV & vaccination advice

Following our involvement in the development of the College’s advice on children and young people who are clinically extremely vulnerable, I would like to highlight the College’s recent statement on the COVID-19 vaccination programme.

As you will be aware, the Joint Committee on Vaccination and Immunisation (JCVI) has advised that those who are clinically extremely vulnerable (CEV) and aged 16+ should be vaccinated as part of priority group 4, alongside those aged 70-74. JCVI’s advice is available here. The College supports JCVI’s approach on vaccine prioritisation, and we’d encourage you to follow that. It is essential that the programme is guided by evidence and we expect to see more safety and efficacy data gathered in the next few months that will inform vaccination strategies for groups not covered by this first phase (such as children and young people under 16 who are CEV).

The RCPCH also wanted to flag with you that it has recently come to our attention that, following the introduction of lockdown in England on 4 Jan, all those who are CEV and on the NHS Digital shielded patient list in England (adults, children and young people) have been sent a letter from the DHSC advising them to shield. This letter also refers to the vaccination programme but does not make it clear that those aged under 16 are not in the priority groups in the first phase. Contrary to what is said in the letter, it is not expected that children and young people under 16 who are CEV will be invited for vaccination by mid-February 2021. The RCPCH have raised this unfortunate miscommunication issue with DHSC and NHS England and asked them to look into it.

Sue
BSPGHAN President

Frontline Gastroenterology- Online Access Now Available for BSPGHAN Members

by BSPGHAN | Jan 18, 2021 | News

BSPGHAN Council are delighted to announce that we have consolidated an affiliation with Frontline Gastroenterology. FG is an official publication of the British Society of Gastroenterology  and is a companion journal to Gut and BMJ Open Gastroenterology. Frontline Gastroenterology publishes articles that accelerate adoption of innovative and best practice in the fields of gastroenterology, hepatology and clinical nutrition. Frontline Gastroenterology is especially interested in articles on multidisciplinary research and care, focusing on both retrospective assessments of novel models of care as well as putative future directions of best practice. The journal also publishes articles in the domains of clinical quality, patient experience, service provision and medical education.

This arrangement offers an exciting opportunity for BSPGHAN members to receive Free access to the online publication as a benefit of membership.

Access is via the secure member area on the BSPGHAN website- after logging in, click on the Frontline Gastroenterology link to access the journal. If you have any problems accessing this, please email us at webmaster@bspghan.org.uk.

Shielding Advice 5th January 2021

by BSPGHAN | Jan 5, 2021 | News

Dear members,

Please accept our very best wishes for 2021 to you all from all on BSPGHAN council.

As we enter the third national lockdown, with surges of cases of the new variant of Covid19 and rates of transmission high nationally, government has issued guidance on shielding for adults. https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19

Importantly, since the first wave, our knowledge of COVID-19 has grown. We now know that very few children and young people are at highest risk of severe illness due to the virus. This means that the National Guidance for children and young people issued December 21 is current at the time of writing and I hope that it is useful for you to review it here- https://www.rcpch.ac.uk/resources/covid-19-guidance-clinically-extremely-vulnerable-children-young-people

The RCPCH guidance sets out that the evidence gathered since the start of the pandemic indicates that the risk of severe disease caused by SARS-CoV-2 or Covid19 infection in children is extremely low and although no one group of conditions has been identified as being at particular risk, specialists have identified those conditions which may make the child or young person CEV as set out in group A list (see the list on the link). 

Group A
These children are usually CEV under normal (non-pandemic) circumstances, and at risk of severe disease due to a variety of infections which would result in mild disease in the majority of the population. 

Group B
Lists conditions that require discussion between the clinician and the child and their family/carer to establish whether they are clinically extremely vulnerable (CEV) on a case by case basis. This decision will depend on the severity of the condition and knowledge that the secondary and tertiary care clinical teams have of the particular circumstances of the child. Of note, the majority of children with conditions listed in Group B will not be CEV.

Group B Paediatric gastroenterology, hepatology and nutrition

Paediatric inflammatory bowel disease (IBD) patients who meet one or more of the following criteria:

• Commencement of biologic therapy plus immunomodulatory or systemic steroids within previous six weeks
• Moderate to severely active disease not controlled by moderate risk treatments who may require an increase in treatment

Intestinal failure patients requiring Home Parenteral Nutrition (HPN) who meet one or more of the following criteria:

• Primary immunodeficiency or immunodeficiency induced by drugs as part of their therapy.
• Other significant conditions or other organ involvement (renal, haematology, cardiac, GI, respiratory, diabetes mellitus)

Liver disease who meet one of more of the following criteria:

• Decompensated liver disease

Receiving post-transplant immunosuppression or on Liver/small bowel/multivisceral transplant waiting list

• Liver disease and other significant conditions or other organ involvement (renal, haematology, cardiac, GI, respiratory, diabetes mellitus)
• Active or frequently relapsing autoimmune liver disease where they are likely to need increase in treatment.

As far as I am aware, the guidance shared here for children has not been updated but of course it may be updated at any time. We understand that when a considerable proportion of the most vulnerable groups have been vaccinated, there is the prospect of relaxing some of the lockdown measures, but the vaccine time table according to Prof Chris Whitty reamins “realistic but not easy”.

Please get in touch if you hear further updates and we can share with members.

Sue Protheroe

President BSPGHAN 5th January 2021

End of Year Message from BSPGHAN President

by BSPGHAN | Dec 23, 2020 | News

Dear members

Wishing you all good health and companionship in the festive season.

2020 has been especially difficult for so many families, organisations and our social and healthcare. The year has however been notable for positivity –  the many acts of kindness shown by supporting each other and for people coming together with shared learning experiences.

Covid 19 continues to create so many challenges for us. I would like to give a personal thanks to BSPGHAN Council and Working Groups and our charitable partners for the rapid advice produced for our families. Thank you to Executive Lucy and Mansoor, and to Carla for all your support this year.

The pandemic has amplified difficulties faced by those with vulnerabilities and those who are most at risk from anxiety, homelessness or loss of work. There is  much to do in 2021 to tackle disadvantage and support the mental well-being of our communities.

We all look forward to what 2021 will bring- collectively moving to a time where everyone can feel that their ethnic, cultural and spiritual beliefs are understood and acts of kindness are commonplace.

Please take the chance to relax and unwind with your loved ones.

Thank you to each centre for completing the BSPGHAN Quality Standards Audit if you can by the end of the year.  It’s timely to map our services now as the NHS move towards  developing Operational Delivery  Networks in 2021/2. BSPGHAN is ahead of the game in taking stock which will enable support for our networks in the UK to develop best and equitable delivery of care.

Also don’t forget to book your place for the BSPGHAN annual meeting.Our working group chairs and abstract submitters won’t disappoint,  with such a stimulating and innovative programme on offer.

All the best for the season and good health to you all.

Sue Protheroe
President

Dr Sue Protheroe,
Consultant Paediatric Gastroenterologist,
Birmingham Women’s and Children’s Hospital.
Birmingham. B4 6NH.
President of British Society of Paediatric Gastroenterology, Hepatology and Nutrition.