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British Society of Paediatric Gastroenterology, Hepatology and Nutrition

Dear Members, 

I do hope that this message finds you and your families and friends in continuing good health. It is an unsettling update today on the situation as it unfolds, as it is anticipated that there will be a rapid climb of Covid-19 to hit our hospitals and community services this week and next.  

The focus has to be on pulling together as an NHS team to incident manage life threatening situations. When we emerge from this, there will be an important recovery phase to plan for.  

Today, BSPGHAN has helped to kick start the process and contributed towards a Gap Analysis to feed back via the RCPCH to NHS E. This will help planners understand the need for time dependent diagnostic procedures and appointments for patients who are referred with commonest or high risk PGHAN conditions.    

I am indebted to the BSPGHAN IBD Working Group and the Birmingham Children’s Hospital Nutrition nurses who have prepared the following guidance for members and the two items that you can use for information for parents/carers (attached):

1.BSPGHAN IBD Working Group statement for Health Care Professionals ​ COVID_IBDWG_HCP

Coronavirus (SARS-CoV-2) and COVID-19 in children with IBD. 

2.BSPGHAN IBD Working Group 

PARENT/CARER INFORMATION LEAFLET​ COVID_IBDWG_Parents_Carers

Coronavirus (SARS-CoV-2) and COVID-19 in children with IBD. 

3. Parent/ Carer Information Letter for families of children on home parenteral nutrition (authored by Birmingham Women’s and Children’s Hospital Nutritional Care Team nurses)  Birmingham Letter for HPN patients

I would like to draw your attention to advice  on practice and service provision for patients with IBD. Please mitigate risks of infection to theatre teams and preserve the PPE supply by limiting all but non emergency endoscopy for now. 

Importantly, the parent carer guidance, 2. and 3. provides; –  

a] paediatric-specific advice on shielding, ​helping professionals and families interpret what ” shielding” looks like for  ‘At Risk’ children with IBD who are on immunosuppression and for those on Home PN, and 

b] advice to avoid “late presentation” of febrile episodes in patients with IBD and on home PN.  

I am mindful that I would not ordinarily send out a letter intended for families unless it had been ratified by Council, but in these exceptional circumstances, there is a need for rapid guidance, especially if there is confusion on ‘shielding’ advice. Please can I ask members to check the home PN letter and amend the content as you see fit for local use before you share it with your families.  

The next few weeks may be tough for our teams. Please look after each other and make sure that you stay protected and remain safe.   

Thank you to Jochen and the IBD working Group and a personal thanks to Elaine, Louise and Gemma and all our amazing IBD, Gastroenterology and Nutrition nurses who are working tirelessly to keep our families well informed, safe and well.  

Best wishes
Sue, President of BSPGHAN  
April 7th 2020. 

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