Dear members Please share this updated letter C0106 HPN COVID patient information_UPDATED_27 March  with families of children on home parenteral nutrition. It outlines plans that home care providers are putting in place and changes that families may expect.  Please be aware of the latest advice.   "Keeping yourself safe" "The government is regularly updating its guidance on at-risk groups. In light of the  latest information your hospital teams now consider that patients on HPN are a high risk group, as you/your child have significant organ impairment (GI) and a central venous access device in place. This advice is endorsed by the British Society of Gastroenterology. It advises you to follow the guidance on ‘shielding’ stringently, as outlined by the government, and you are strongly advised to stay at home and avoid any face-to-face contact for at least 12 weeks in the first instance.This can be challenging but the consensus is it is the best way to...

This is a challenging time but amid the concern, there are uplifting stories of how people are looking out for each other and communities pulling together. The children's rainbows of hope in windows and the national clap for carers to celebrate the work of the NHS and care workers on Thursday were much appreciated.    Information is useful—but too much information can be unhelpful. I have limited news updates to new information from consensus sources. We don't generally benefit from watching the news over and over. Try to focus instead on the things you need to get done. Value the rest of the time to relax with your family or friends and reach out to those who may not have such good support networks as you may have.  The bulletins below have some reassuring observations for our patients. I hope that these help guide your practice while working differently. 1 )Statement "Gastrointestinal endoscopy in children and COVID 19 pandemic" - ESPGHAN  Endoscopy Special Interest...

All upper GI endoscopy should be considered high risk and enhanced PPE is recommended for all patients, regardless of any risk stratification. BSG also considers lower GI endoscopies to be aerosol generating procedures (AGP) but the evidence for this is less strong and there is insufficient evidence to consider these as high risk at the present timeRisk stratification of patients by symptoms and temperature is of limited value, given the widespread prevalence and incubation period of up to 14 daysWe recognise the limited availability of PPE, especially FFP3 masks, and so case selection is critical, focussing only on emergency and absolutely essential procedures. Minimising the volume of emergency activity will help preserve PPE supply. Notes on FFP3 masks and enhanced PPE Proper fitting and testing prior to use Although 'single use' can use for several hours if not removed/contaminated FFP3 uncomfortable after prolonged wearing, may affect ease of procedure Cannot e.g. use phone,...

I know that you are all supporting each other and working together in new ways remotely and face to face. Please do sign post your families to the excellent links that are updated regularly for patients with IBD by CCUK https://www.crohnsandcolitis.org.uk/news/coronavirus-covid-19-advice See  https://childliverdisease.org/coronavirus-updates/ for patients with liver disease I want to draw your attention to the Urgent message from BSG/JAG on Endoscopy 26/3/20 ( message below) and message Summary of message Stop  Review  Re-organise NOW Below also see Updated Intercollegiate General Surgery Guidance on COVID-19               25th March 2020 https://www.rcsed.ac.uk/news-public-affairs/news/2020/march/intercollegiate-general-surgery-guidance-on-covid-19 Risk situations in surgery also include: Approaching a coughing patient, for example, even if COVID-19 has not been diagnosed. Protection including eye...

Dear members I would like to draw your attention to 3 important items today 23/3/20. Letter from Simon Stevens This  sets out important actions that the NHS should put in place to redirect staff and resources, building on multiple actions already in train. https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/urgent-next-steps-on-nhs-response-to-covid-19-letter-simon-stevens.pdf To:  Free-up the maximum possible inpatient and critical care capacity. Prepare for, and respond to, the anticipated large numbers of COVID-19 patients who will need respiratory support. Support staff, and maximise their availability.  Play our part in the wider population measures newly announced by Government. Stress-test operational readiness. Remove routine burdens, so as to facilitate the above 2. Letter from CMO Stephen Powis (attached) Advice concerning those who are or may be at increased risk of severe illness from COVID-19 Please see a letter suitable to be sent...

Dear Members I trust this this finds you, family and colleagues well and bearing up in these difficult times. We find ourselves under exceptional circumstances.  I am indebted to members for coming together to support each other. We will need to step forward, share our skills as best and as appropriate as we can and reach out to those professionals who are most stretched. “.......and there are no more surgeons, urologists, orthopedists, we are only doctors who suddenly become part of a single team to face this tsunami that has overwhelmed us”. Dr Daniele Macchine, Bergamo, Italy, 9 March 2020” I would like to draw your attention to the following- Guidance for children’s services from NHS E and Advice on Covid 19 prevention and control to best keep yourself and your patients safe,  to be used in conjunction with local policies   https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control New BSPGHAN Endoscopy advice to be...

Dear members I trust that this message finds you well. I am writing to notify you that following guidance, we have taken the decision to cancel our annual trainees and associates meeting in May. The priority is the safety of our staff, patients and families.  Trusts will be running incident management teams to deal with local issues and prioritising delivery of care.   To access regular advice, please see the RCPCH guidance for paediatric services  with links to information from statutory bodies in all UK nations that will be regularly updated. I have contributed to advice being prepared to plan for services for our patients and to support challenges that will be faced by our workforce.  Please check  the daily NHS England advice for health professionals at  https://www.england.nhs.uk/coronavirus/ . 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...