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British Society of Paediatric Gastroenterology, Hepatology and Nutrition

Dear Members

  1. Pause of the National Audit of Quality Standards for Paediatric Gastroenterology, Hepatology and Nutrition (‘the PGHAN Audit’).

The RCPCH/BSPGHAN PGHAN Audit Project Team have put the audit on hold during the COVID-19 pandemic and will reinvigorate the audit in August. The pause has given us an opportunity to discuss consider potential changes to the dataset that might be required due to the effects of COVID-19 on the healthcare system and PGHAN services in particular. 

I am grateful for all of your input and support with the PGHAN Audit to date.  The dataset had been agreed and built into a data platform which was ready to pilot in May/June. The PGHAN Audit clinical lead had registered in around 45% of Health Boards and Trusts across the UK by the end of April. 

Please can I ask you to contact your Medical Director if you haven’t recruited a PGHAN Audit clinical lead.

The pause in the audit has offered us chance to reflect on its purpose in the context of BSPGHAN’s strategic intentions-

  1. To continue to examine PGHAN professional networks and see how BSPGHAN can support research, education and training,
  2. To allow us to consider the impact and value on PGHAN health care provision that the BSPGHAN Clinical Standards provide, 
  3. To reflect critically on BSPGHAN’s function, to promote national best practice and outcomes of our patients especially moving forward from paused activity, 
  4. To harness opportunities to support service resetting and recovery post COVID-19, and how this may be done at a national level,
  5. To harness opportunities to sustain any positive changes in the way we work, capturing innovations that have been rapidly developed during the pandemic  (Please still feedback to me on innovations. See below **).

Additionally, it is timely to reflect on further intentions-

  1. To accelerate BSPGHAN’s national education strategy to develop virtual learning opportunities for trainees and members,
  2. To use our new website to share education / clinical updates; to measure the impact of the content of our new site;
  3. To build on the closer links that have arisen during the pandemic when writing joint rapid updates for example;  for BSPGHAN to work more closely with key stakeholders such as the BSG, Royal College and charitable partners
  4. To support the productivity of  BSPGHAN “task and finish” projects– using virtual get togethers. I hope that remote meetings will encourage participation from more members from devolved nations and foster rapid outputs from council and working groups.

2. Shielding Update

I know most  will have seen the latest shielding letter from the Chief Medical Officer & NHS Medical Director  AVAILABLE HERE  which provides New clinical evidence on children  

Recent experience and knowledge of the impact COVID-19 infection has on children and young people with comorbidities suggests not all those on the Shielded Patient List need to be shielding. RCPCH recently published  updated guidance  which paediatric patient groups they think should be advised to shield. They have identified three groups:

  • children and young people who are cared for just in primary care are very unlikely to need to continue to shield;
  • a small group of children who are clinically extremely vulnerable due to their pre-existing condition will need to continue to shield; and
  • a further larger group of children exists who due to their underlying condition may need to shield and the decision to continue to shield would normally result from a discussion between the clinician, the child and their family.

RCPCH expect that all patients who need to continue to shield will be seen in a specialist centre before September 2020 (but not all those with specialist appointments will need to shield).  Decisions on shielding will generally be led by a specialist, balancing the clinical and social impact of shielding. Patients should only be removed from the Shielded Patient List by their GP or specialist following consultation with the child and their family, and other clinicians where appropriate.

Further guidance on having conversations with children and families can be found on the   RCPCH website The Government works closely with the RCPCH and welcomes their valuable scientific input. We recommend that clinicians follow up with children (and their parents) on the Shielded Patient List to discuss what RCPCH guidance means for them.  

Risk stratification (adults) A team academics have been working with clinicians to develop a predictive risk model that reflects a wider range of factors such as demographics alongside long-term health conditions, to better understand cumulative risk of serious illness for individuals if they catch COVID-19.  The COVID19 risk stratification model will be set out in the BMJ soon . It will only be for people aged 18 years as fortunately there’s a paucity of data for modelling in children and young people  —  see the publication of the research protocol

3. Feedback from members on Service Innovations **

I mentioned a few weeks back,  I am keen to capture service changes relevant to our patients.

This is a polite nudge to ask those of you who haven’t got back to me,  for your thoughts,  so that I can make sure they’re captured.  

See survey via this link  or see the questions below

The survey asks the following four questions:  

  1. What beneficial innovations/changes have occurred in your specialty and within patient pathways?  
  2. Please describe the impact of these innovations/ changes (e.g. population health outcome, patient outcome, safety, wider system, efficiency, productivity). How did you measure the benefit?  
  3. What is needed to sustain the change?  
  4. What, if anything, hasn’t worked so well. 

Thank you for getting back to me by 4pm on 30th June.  If you can’t make this deadline, please still feedback as your input will be useful to harness and share improvements in patient pathways.

 4. ACCEA secretariat update  

Ministers agreed the suspension of the 2020 national Clinical Excellence Awards round

Subject to Ministerial agreement, there will be an extended National awards 2021 competition, with a lengthened timetable from November 2020 until the end of January 2021. 

Please stay well and as always, I welcome your involvement and your feedback.

Best wishes
Sue  Protheroe
BSPGHAN  President
28th  June 2020


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