by BSPGHAN | May 3, 2020 | News
I hope this email finds you in continuing good health.
We are taking stock while coming through a “peak ” of hospitalisations and set to enter the second phase in the NHS’s response to Covid-19.
On April 29th we heard from the NHS CE and CEO about:-
- Increased Covid-19 testing capacity – a pilot followed by roll out of regular testing to asymptomatic staff, guided by PHE and clinical advice.
- NHS to step up non-Covid19 urgent services as soon as possible with attention to infection prevention and control and start of some routine non-urgent elective care.
- Provisional plans to factor-in the availability of associated medicines, PPE, blood, consumables, equipment and other needed supplies.
- Expanded winter flu vaccination campaign alongside a school immunisation ‘catch up programme’.
Now more than ever a safety and learning culture is vital. BSPGHAN has been working with the RCPCH, PHE and NHS E this week to:-
1. identify which patients should be recommended to still “shield” (or stay at home with stringent social distancing) once lockdown restrictions are lifted and
2. understand more about the impact of delayed presentations to healthcare or delayed delivery of care within our speciality
3. consider recovery and restoration plans of our routine activity for children and young people.
I would like to hear from members about these issues and what your current concerns are. I will email out a survey monkey very soon. It should only take a few minutes to complete and I would be very grateful if you would return it straight away if possible and by Tuesday May 6th at the latest please. Thank you.
NICE Covid-19 rapid guideline: children and young people who are immunocompromised- published May 1st 2020 NICE guideline [NG174] https://www.nice.org.uk/guidance/NG174
This guideline is designed to be used alongside our professional guidance. It aims to maximise the safety of children, protect staff from infection and enable services to make best use of resources during the pandemic. It can be updated as necessary.
Children with a systemic inflammatory response – be aware and notify https://www.rcpch.ac.uk/sites/default/files/2020-05/COVID-19-Paediatric-multisystem-%20inflammatory%20syndrome-20200501.pdf
Most children are asymptomatic or exhibit mild symptoms from COVID-19 infection. However in the last two months a small number of children have been identified who develop a significant systemic inflammatory response which may be associated with COVID-19.
COVID-19 and the gastrointestinal tract: emerging clinical data https://fg.bmj.com/content/early/2020/04/27/flgastro-2020-101507
– prevalence of virus in the stool is important, impacting on endoscopy provision.
- clinical importance of continued presence of RNA in the stool is uncertain.
– the likelihood of faeco-oral transmission is low.
– data on outcomes of adult patients undergoing surgeries during the incubation period of COVID-19 infection – should testing prior to surgery become routine?
Outcomes of COVID-19 in 79 patients with IBD in Italy: an IG-IBD study. https://gut.bmj.com/content/early/2020/04/30/gutjnl-2020-321411
– Active IBD, old age and comorbidities were associated with a negative COVID-19 outcome, whereas IBD treatments were not.
– Preventing acute IBD flares in patients with IBD is important.
BSG Guiding principles on restoration of endoscopy services. https://mailchi.mp/fb3ebe293ed0/welcome-to-the-august-edition-of-the-bsg-e-newsletter-12317385?e=12419cdbd5
– Consensus opinion and review of the available evidence.
– Some data is not yet available; some data is inconclusive: in this guidance, therefore, the safety and wellbeing of patients and staff is taken as paramount.
The pressure will remain in these uncertain times. Look after each other and be aware that enhanced and active support from your NHS employer is there to ensure your wellbeing and safety.
Please take a few minutes to report back in the anonymised survey. It asks about your concerns about your personal wellbeing and that of your patients as well as your answers to the questions above (1). THANK YOU.
Best wishes
Sue
BSPGHAN President May 3rd 2020 e-mail President@bspghan.org.uk
by BSPGHAN | Apr 29, 2020 | Education, News
Recent journal publication: COVID-19 and the GI tract: emerging clinical data. Authors: Professor Mark Beattie, Dr James Ashton and Dr Ian Penman. Full article is free to download https://fg.bmj.com/content/early/2020/04/27/flgastro-2020-101507
by BSPGHAN | Apr 26, 2020 | News
Dear members,
I hope this message finds you well. BSPGHAN has been working with key stakeholders on rapid guidance. Please have a look at the following links-
1. COVID-19 rapid guideline on gastrointestinal and liver conditions https://www.nice.org.uk/covid-19
2. CCUK decision tree for children- isolation/ social distancing and shieldingApplicability of “shielding” is complex for children as the evidence for risk of serious illness / mortality from Covid-19 amongst children who are immune suppressed is very limited. This decision tree for families is welcome.
crohnsandcolitis.org.uk/news/advice-for-people-with-crohns-and-colitis-self-isolation-social-distancing#child-risk
If you’d like to share via social media there is also a short link crohnsandcolitis.org.uk/decision-tree-children
See also RCPCH Shielding list .
3. Vulnerable children guidance
There are unintended consequence of lockdown on some vulnerable families (i.e. those known to CAMHS, social services and those with education, health and care plans.) see PHE Vulnerable children guidance. Bspghan is linking up with the Rcpch and the children’s team at NHS England to consider which groups should continue shielding once the lockdown restrictions are lifted.
4. Zoom teaching for Bspghan member trainees
I am grateful to our webmaster who has arranged weekly national teaching. The session yesterday was a success with 40 participants. There is uncertainty over training opportunities, progression, rotations, CCT and access to training. PGHAN Csac is actively linking up and supporting trainees.
5. Strategy
BSPGHAN has set out a new strategic focus while some initiatives are paused. We continue to contribute to national guidance to keep our patients and colleagues well and as safe as possible. Thinking ahead, we are tackling how best we will support recovery of services, training needs and ensure that children’s best interests are considered when lockdown restrictions start to ease.
If you wish to highlight issues or signpost to resources, please do get in touch. Please have a look at the website, which is currently being reorganised so that you can find information more easily. Personal thanks to Carla and Kwang Yang Lee our administrator and webmaster for their expertise and to Council for coming together today for an extraordinary meeting.
With very best wishes
Sue
BSPGHAN President
23 April 2020
by BSPGHAN | Apr 13, 2020 | News
Dear all
I hope this finds you all well and spending time to rest and restore your batteries over the long weekend.
The anticipation of working in different ways and the pressure of making new judgements for patient care has been stressful.
The calmness of the NHS and other frontline carers and their leaders has been remarkable in the face of constant change and education. Their anxiety about risks, protecting themselves and their loved ones at home is real. We hope that increasing knowledge of the virus, on keeping a safe distance and being as well protected as possible, gives them some of the peace of mind that they need.
It is truly touching to see the tributes for key workers and the acknowledgement of the vital roles that all workers play.
Keep cascading the message to parents that we are open for “business as usual” as per the RCPCH recent campaign (see link) and keep good records of those who need to be seen later on.
https://issuu.com/joballrcpch/docs/covid19_advice_for_parents_when_child_unwell_or_in
I am personally grateful to all the Bspghan members who have been so supportive and working hard to contribute to national initiatives and to make new guidance rapidly. A few examples are –
- Messages we sent to NHS leaders and RCPCH that we are worried about routine areas of care for children have been heard and received by government.
- We have helped the NHS identify and reach out to our most vulnerable patients.
- We have written tailored guidance for families and and IBD registry
- We have contributed towards rapid NICE guidance.
- We have suggested key conditions and timelines for recovery plans when routine services start opening.
- We have collaborated with stakeholders and charitable partners such as the BSG, BASL, CICRA,CCUK and CLDF who have have been supportive at achieving a common goal to advise, support and protect our families and staff.
The qualities that health professionals signed up to – sacrifice, patience, and tolerance have always been present but are clear in the acts of kindness and putting others first. Please give a particular thought to all ward based staff this weekend who are now “masked up” all day. My masked working this weekend has been in short bursts and uncomfortably hot. The ward nurses no doubt feel the same all day, but without complaint and they deserve a huge thanks.
This crisis has shown us that we can collaborate rapidly and work together, adapt, and break out of the silos that have existed in the NHS. Please also say a thanks to the IT crowds who have worked hard to bring in remote working and conferencing overnight.
Our thoughts go out to new staff as young medics have been hastily graduated and the retired staff who have returned. Our prayers are with them to stay strong and safe as their offers to support the NHS are not just token efforts.
We don’t know when this will be over. We hope that Covid testing and a vaccine will bring about change. The knocks and impact on sections of society will be enormous. Keep the connections and interactions going. Resolutions to be mindful of the legacies are not self righteous (in my mind); if we can maintain the current emphasis on social and cultural values, and the ability to learn and respond to change when the pressures is on us, things will be different and a bit better.
Reach out to those in your networks and beyond who may be in smaller teams. Again, a personal thanks to the friends who have helped me each in keeping you informed and connected. They are all leaders and I am enormously grateful.
Do get in touch if you have ideas, suggestions to share with others, or if you just need a chat.
Best wishes
Sue
BSPGHAN President April 12th 2020
