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Content ArticleInfographic from Long Covid Kids & Friends on the obstacles and challenges families, children and young people with Long Covid face.
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Content ArticleSymptoms involving almost every organ system have been reported after SARS-CoV-2 infection. Estimates of the prevalence of long covid (also called post-covid-19 condition, post-acute sequelae of covid-19, or chronic covid syndrome) vary considerably, partly because of confusion around the definition. The term long covid encompasses a broad range of symptoms, including objective complications of covid-19 (pulmonary fibrosis, myocardial dysfunction), mental health conditions, and more subjective, non-specific symptoms resembling those seen in post-viral chronic fatigue syndrome (myalgic encephalomyelitis). Most studies to date have substantial limitations, including small cohorts, absence of control groups, non-standardised capture of symptoms, lack of correction for pre-existing medical conditions, participant reported infection, and variation in follow-up, as well as selection, non-response, misclassification, and recall biases. In children and adolescents, acute Covid-19 is less severe than in adults. Concern among many parents has therefore focused more on the potential long term effects of SARS-CoV-2 infection. Unfortunately, fewer data are available on long covid in young people compared with adults.
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News Article
Severe shortage of nurses in UK children’s intensive care units
Patient Safety Learning posted a news article in News
Britain’s sickest children are being treated in intensive care units that are struggling with severe shortages of the specialist nurses needed to look after them, a report says. The shortages in the UK’s 30 paediatric intensive care units (PICUs) are so severe that healthcare assistants are covering the work of nurses in an attempt to ensure that staffing levels are maintained. Only one of the PICUs – at the James Cook University hospital in Middlesbrough – was found to have enough nurses to guarantee the standards of care expected. About 15,000 children and young people a year, often with life-threatening conditions, are cared for in PICUs. Clinical standards that prevail in PICUs require them to ensure that seven nurses are on duty for each bed in a 24-hour cycle. However, the report by the Paediatric Intensive Care Audit Network (PICANet), a group of experts from Leicester and Leeds universities, found that 29 of the 30 had too few nurses to do that, and that all 30 had vacancies, sometimes large numbers of them. “Parents will find this extremely alarming”, said Patricia Marquis, the Royal College of Nursing’s England director. “Most people wouldn’t believe that only one paediatric intensive care unit across the whole UK has enough staff to function properly, but this is the reality of the workforce crisis. Key roles in specialist nursing teams are lying vacant for years.” Read full story Source: The Guardian, 23 January 2022 -
News ArticleHundreds of nurses, paramedics, health and care workers have been disciplined over allegations of sexual assault, including incidents involving child sexual abuse, The Independent can reveal. It comes as the government begins a year-long inquiry into the sexual abuse of dead patients by “morgue monster” David Fuller. Charities claim the true scale of the issue is likely to be hidden by “vast underreporting” while safeguarding experts say there is no “uniformity” in how NHS trusts handle such cases. The Health and Care Professions Council (HCPC), which regulates just under 300,000 workers including paramedics, occupational therapists, psychologists and physiotherapists, has taken action on 154 occasions following 293 investigations carried out into allegations of sexual assault or abuse since 2012, according to figures obtained by The Independent. Fifty-three clinicians were struck off, 20 were cautioned and a further 29 were either suspended, had restrictions placed on their practice or agreed to be removed from registration. More than half of the actions followed allegations of sexual abuse of a child patient. Separate data from Nursing and Midwifery Council (NMC), which has more than 700,000 registered nurses and midwives. shows action was taken 113 times in the past four years against nurses and midwives who did not maintain professional boundaries; in more than 80 per cent of those cases, the clinician was struck off. Read full story Source: The Independent, 21 January 2022
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News Article
Family of Cornwall girl, 6, misled over cause of death, coroner finds
Patient Safety Learning posted a news article in News
A six-year-old girl thought to have died from sepsis was in fact suffering from a blood condition triggered by E coli infection, an inquest has found. Coco Rose Bradford was taken to the Royal Cornwall hospital in the summer of 2017 suffering from stomach problems and later transferred to the Bristol Royal hospital for children, where she died. The following year an independent review flagged up failings in her care in Cornwall and the Royal Cornwall hospitals trust apologised for how it had treated her. Her family were left with the belief she had died of sepsis and could have been saved if she had been given antibiotics. But on Friday, coroner Andrew Cox, sitting in Truro, found that Coco died from multiple organ failure caused by haemolytic uraemic syndrome (HUS). The inquest heard there is no proven treatment for HUS. Cox said Coco’s family had been misled over the sepsis diagnosis, which he said was deeply regrettable, adding: “As a matter of fact, I find Coco had overwhelming HUS, not overwhelming sepsis.” During the inquest, the court heard Coco’s family felt staff at the Cornish hospital were “dismissive, rude and arrogant” and did not take her condition seriously. Cox found that although staff had recognised the risk of HUS from the moment Coco was admitted, this was not clearly set out in a robust management plan. The coroner also said a lack of communication had made Coco “something of a hostage to fortune”. Read full story Source: The Guardian, 14 January 2022 -
News Article
Rise in non-Covid virus that can leave children struggling to breathe
Patient Safety Learning posted a news article in News
Parents are being warned to look out for signs of a non-Covid virus that is “rife” in the UK amid a surge in reports of children struggling to breathe. The British Lung Foundation (BLF) said Respiratory Syncytial Virus (RSV) is staging a comeback this winter after lockdown last year meant there were fewer infections than would normally occur. It is concerned that this year children will have “much lower immunity” at a time when the NHS is already under extreme pressure. “In the last few weeks, we have noticed a surge in calls from parents who are worried about their child’s breathing,” said Caroline Fredericks, a respiratory nurse who supports the BLF’s helpline. “Most of these parents have never heard of RSV which is worrying.” RSV is common in babies and children. Almost all will have had it by the time they are two. It may cause a cough or cold but for some it can lead to bronchiolitis, an inflammatory infection of the lower airways which can make it hard to breathe. The early symptoms of bronchiolitis are similar to those of a common cold but can develop over a few days into a high temperature, a dry and persistent cough, difficulty feeding, and wheezing. While many cases clear up in two to three weeks, some children will end up being hospitalised. “There are steps parents can take to make their child more comfortable at home if their RSV develops into bronchiolitis, such as keeping their fluid intake up, helping them to breathe more easily by holding them upright when feeding and giving them paracetamol or ibuprofen suitable for infants,” said Fredericks. Read full story Source: The Guardian, 12 January 2022 -
Content ArticleIn this blog, Debbie Ivanova, Deputy Chief Inspector — People with a learning disability and autistic people, and Jemima Burnage, Deputy Chief Inspector and Mental Health Lead, update on progress since the Care Quality Commission’s (CQC) 'Out of Sight' report published in October 2020. Their blog discusses the findings of the authors' 'Restraint, segregation and seclusion review: Progress report' published in December 2021.
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Content ArticleThis guide by the University of Birmingham's Institute for Mental Health is designed to help young people prepare to talk with their GP about self-harm and suicidal experiences. It contains advice about what to do before, during and after a GP visit.
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News Article
NHS unable to treat every child with eating disorder as cases soar
Patient Safety Learning posted a news article in News
The NHS can no longer treat every child with an eating disorder, a leading psychiatrist has warned, as “worrying” figures reveal hospital admissions have risen 41% in a year. A dramatic surge in cases during the pandemic has left already struggling community services overstretched with many unable to care for everyone who requires help, experts said. NHS Digital data for England shows a sharp rise in admissions in every area of the country. The provisional data for April to October 2021 – the most recent available – shows there were 4,238 hospital admissions for children aged 17 and under, up 41% from 3,005 in the same period the year before. Charities said the fast rising number of hospital admissions was “only the tip of the iceberg”, with thousands more children needing support for eating disorders. Dr Agnes Ayton, the chair of the eating disorders faculty at the Royal College of Psychiatrists, said: “The hidden epidemic of eating disorders has surged during the pandemic, with many community services now overstretched and unable to treat the sheer number of people needing help. We are at the point where we cannot afford to let this go on any longer." “Early intervention is key to recovery and to preventing serious illness, which is why it’s crucial that the money announced by government urgently reaches the frontline. The government must also deliver a workforce plan to tackle the shortages in eating disorder services so that they have enough staff to treat everyone who needs help.” Read full story Source: The Guardian, 4 January 2021 -
Content ArticleIn this report, the Care Quality Commission (CQC) comments on progress following publication of its 'Out of sight – who cares?' report in October 2020, and highlights the main areas where further work is still needed.
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Content ArticleThis presentation was given to the Colab Partnership virtual conference in July 2021. Gill Phillips, creator of the Whose Shoes? approach to coproduction and Dr Mary Salama, Consultant Paediatrician at Birmingham Children's Hospital, speak about genuine coproduction and why is it needed for children with medical complexity, giving practical examples from their work. A mother of a child with complex needs shares her lived experience, and paediatric surgeon Joanne Minford shares her experience of coproduction using Whose Shoes?
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News ArticleMore than 167,000 children are believed to have lost parents or caregivers to Covid during the pandemic – roughly one in every 450 young people in the US under age 18. The count updates the October estimate that 140,000 minors had lost caregiving adults to the virus, and is four times more than a springtime tally that found nearly 40,000 children had experienced such loss. In a report titled Hidden Pain, researchers from the COVID Collaborative and Social Policy Analytics published the new total, which they derived by combining coronavirus death numbers with household-level data from the 2019 American Community Survey. The death toll further underscores the daunting task facing schools as they seek to help students recover not just academically, but also emotionally, from a pandemic that has already stretched 22 months and claimed more than 800,000 American lives. It’s an issue of such elevated concern that Surgeon General Vivek Murthy, on 7 December, used a rare public address to warn Americans of the pandemic’s “devastating” effects on youth mental health. An accompanying 53-page report calls out the particular difficulties experienced by young people who have lost parents or caregivers to the virus. Bereaved children have higher rates of depression and post-traumatic stress disorder than those who have not lost parents, according to a 2018 study that followed grieving children for multiple years. They are more than twice as likely to show impairments in functioning at school and at home, even seven years later, meaning these children need both immediate and long-term counseling and support to deal with such a traumatic loss. “For these children, their whole sky has fallen, and supporting them through this trauma must be a top priority.” Read full story Source: The Guardian, 22 December 2021
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Content ArticleUniversity Hospitals Leicester NHS Trust has published a guide to help parents and carers know what to do when young children fall ill. It gives advice on when and where to seek treatment for children suffering from common illnesses or injuries. The guidance, written by doctors, focuses on coughs, minor head injuries, vomiting and fever. The trust said it hoped to help families avoid long waits in A&E departments. Advice in the guide aims to help people decide whether to seek help from their GP, call 111, visit A&E or treat children at home.
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Content ArticleGomes et al. report the utilisation and impact of a novel triage-based electronic screening tool (eST) combined with clinical assessment to recognise sepsis in paediatric emergency department. An electronic sepsis screening tool was implemented in the paediatric emergency departments of two large UK secondary care hospitals between June 2018 and January 2019. Patients eligible for screening were children < 16 years of ages excluding those with minor injuries or who were brought directly to resuscitation. Utilisation of a novel triage-based eST allowed sepsis screening in over 99% of eligible patients. The screening tool showed good accuracy to recognise sepsis at triage in the ED, which was augmented further by combining it with clinician assessment. The screening tool requires further refinement through multicentre evaluation to avoid missing sepsis cases.
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Content ArticleThe Health and Social Care Committee calls for urgent action to prevent mental health services slipping backwards as a result of additional demand created by the pandemic and the scale of unmet need prior to it.
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Content ArticleThe purpose of this investigation by the Healthcare Safety Investigation Branch (HSIB) is to help improve patient safety in relation to recognition of the acutely ill infant and child, recognising the difficulty in distinguishing between simple viral illnesses and life-threatening bacterial infections in very young patients. This Healthcare Safety Investigation Branch investigation reviewed the case of Mohammad, a baby who had become unwell and was taken to an emergency department by ambulance following a call to NHS 111. He arrived at 8.04pm and was considered to have a mild viral illness, subsequently being transferred to a paediatric observational ward, and discharged at 11.45pm with a diagnosis of likely bronchiolitis. At approximately 3.40am his mother contacted the ward as his condition worsened, which resulted in a 999 call. The ambulance crew did not consider that Mohammad was seriously ill so did not conduct a ‘blue light’ emergency transfer to hospital. Mohammad was admitted to the emergency department at approximately 4.40am and suffered a respiratory and then cardiac arrest at 5:28am, with attempts to resuscitate unsuccessful and stopped at 6:10am. Mohammad died of septicaemia caused by meningococcus (serogroup B) bacteria.
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News ArticleThree pharmacy and medication safety organisations are warning clinicians about a reported increase in age-related COVID-19 vaccine mix-ups. The Institute for Safe Medication Practice's National Vaccine Errors Reporting Program said it's seen a "steady stream" of mix-ups involving the Pfizer vaccine intended for kids ages 5-11 and formulations for people 12 and older. ISMP said the reports involved hundreds of children and included young children receiving formulations meant for those 12 and up or vice versa. The safety organisation said some errors were linked to vial or syringe mix-ups. In other situations, healthcare providers gave young children a smaller or diluted dose of the formulation meant for people 12 and up. "Vaccine vials formulated for individuals 12 and up (purple cap) should never be used to prepare doses for the younger age group," the organisation said. Read full story Source: Becker's Hospital Review, 7 December 2021
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News ArticleNearly 2,000 children and teenagers have been left waiting for specialist mental health care for at least a year in Scotland, according to official figures branded “damning” by psychiatrists. New NHS Scotland data has revealed that, at the end of September, there were 1,978 patients who had been waiting 52 weeks or more for a Child and Adolescent Mental Health Services (CAMHS) appointment. That is more than double the 959 young people who were waiting that long the previous September – despite efforts by Nicola Sturgeon’s government to meet its own 2023 target for 90% of young people to receive help within 18 weeks. Ahead of the Holyrood Budget on Thursday, the figures prompted calls from service providers for a “radical transformation of our mental health services” enacted with the same zeal as the response to the coronavirus pandemic and with a focus on earlier interventions to prevent young people “giving up on their futures”. According to the latest figures, there were a total of 11,816 young people waiting for an appointment by the end of September – just 78% of them who had been seen within 18 weeks. Dr Helen Smith, chair of the CAMHS faculty of the Royal College of Psychiatrists in Scotland, said the long waits for help highlighted the “many problems” with these services “across the length and breadth of the country”. “The fact that our vulnerable children and young people are still waiting to be seen is, frankly, not good enough,” Dr Smith said. “We need them to be able to access the right support at the right time, from the correct services.” Read full story Source: The Independent, 8 December 2021
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Content ArticleCOVID-19 has highlighted the urgency of addressing violence against women and children, which reports suggest has increased during the pandemic. Often referred to as a “shadow pandemic,” the rise in violence over the past two years has been linked to lockdowns and other restrictions on movement put in place due to COVID-19, which force women and children to remain at home with their abusers. In 2016, the World Health Organization published a global plan of action to address violence against women, children, and girls. It proposed a four-pronged approach: firstly, strengthen health system leadership and governance; secondly, strengthen health service delivery and health workers’ capacity to respond; thirdly, strengthen programming to prevent interpersonal violence; and lastly, improve information and evidence. In this BMJ opinion article, Helga Fogstad discusses why, five years on, these measures are needed more than ever and why it's time to act.
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Content ArticleWhere a new or under-recognised risk identified through the NHS England's review of patient safety events doesn’t meet the criteria for a National Patient Safety Alert, NHS England look to work with partner organisations, who may be better placed to take action to address the issue. To highlight this work and show the importance of recording patient safety events, they publish regular case studies. These case studies show the direct action taken in response to patient safety events recorded by organisations, staff and the public, and how their actions support the NHS to protect patients from harm.
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News Article
Poorly controlled asthma 'increases Covid risk for children'
Patient Safety Learning posted a news article in News
Children with poorly controlled asthma are up to six times more likely to be admitted to hospital with Covid than those without the condition, research has suggested. Scientists involved in the study said 5 to 17-year-olds in this category should be considered a priority for Covid vaccination. About 9,000 children in Scotland would benefit from the jab, researchers said. Vaccines are offered to the over-12s in Scotland, but not to younger children. In the study, poorly controlled asthma was defined as a prior hospital admission for the condition, or being prescribed at least two courses of oral steroids in the last two years. Prof Aziz Sheikh, director of the University of Edinburgh's Usher Institute and Eave II study lead, said: "Our national analysis has found that children with poorly controlled asthma are at much higher risk of Covid-19 hospitalisation. "Children with poorly controlled asthma should therefore be considered a priority for COVID-19 vaccination alongside other high-risk children." Prof Sheikh said it was important to consider both the "risks and benefits" from vaccinations. He added: "Emerging evidence from children aged five and older suggests that COVID-19 vaccines are overall well-tolerated by the vast majority of children." Read full story Source: BBC News, 1 December 2021 -
News ArticleNHS England is set to launch 15 new specialist clinics for children living with severe obesity after the Covid pandemic shone a ‘harsh light’ on the crisis among vulnerable young people. Obesity currently affects one in five children in the UK. Each year, around one thousand children between the age of two to 18-years-old, and their family members, will benefit from the pilot scheme. The scheme will also offer access to dietitians, psychologists, specialist nurses, social workers, youth workers and a children’s doctor. Amanda Pritchard, chief executive of the NHS in England, described the coronavirus pandemic said: “The pandemic has shone a harsh light on obesity - with many vulnerable young people struggling with weight gain during the pandemic. “Left unchecked, obesity can have other very serious consequences, ranging from diabetes to cancer. “This early intervention scheme aims to prevent children and young people enduring a lifetime of ill-health. “The NHS Long Term Plan committed to take more action to help children and young people with their physical and mental health and these new services are a landmark moment in efforts to help them lead longer, healthier and happier lives.” Read full story Source: The Independent, 15 November 2021
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Content ArticleThis editorial in The Lancet examines the growing gap between the mental health needs of children and young people in the UK, and the services available to support them. It comments on the report by the Children's Commissioner 'The state of children’s mental health services 2018/19', which highlighted that an estimated 13% of children aged 5–19 years in England have a mental health disorder, with the true numbers of children affected are likely to be much higher. The article looks at treatment delays, long waiting lists and the denial of treatment for children whose symptoms are not considered 'serious enough'. It highlights chronic underfunding and lack of parity between physical and mental health problems as major causes.
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News ArticleLondon’s fragmented children’s cancer services will finally be reformed following a decade of delays and allegations of cover-up by senior officials. NHS England has said it will adopt recommendations that will see the capital’s services brought up to standards already common across the rest of the country, with children’s cancer centres needing to be based in hospitals with full paediatric intensive care units. The changes will be imposed “with no exceptions or special arrangements permitted,” it said in a letter yesterday. This means the Royal Marsden’s children’s service at its base in Sutton, south London, will have to move to a new hospital. Currently sick children who deteriorate at the Marsden’s site have to be rushed by ambulance to St George’s Hospital 40 minutes away. More than 330 children were transferred from the Marsden to other hospitals between 2000 and 2015 and in one year 22 children were transferred for intensive care a total of 31 times, with some experiencing at least three transfers individually. The changes will also affect cancer care at University College London Hospital which links with Great Ormond Street Children’s Hospital. The world-renowned Royal Marsden trust, whose chief executive Dame Cally Palmer is also NHS England’s national cancer director, was at the centre of a cover-up scandal before the COVID-19 pandemic. In 2019, the Health Service Journal revealed a major report, commissioned by NHS bosses in London following the deaths of several children, had been “buried” by NHS England. Read full story Source: The Independent, 12 November 2021
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News Article
Alarm over ‘serious’ delays in diagnosing childhood cancer in England
Patient Safety Learning posted a news article in News
Health experts have raised the alarm over “serious” delays in diagnosing children and young people with cancer, as a study reveals the number found to have the disease during the pandemic fell by almost a fifth. The University of Oxford found a “substantial reduction in childhood, teenage and young adult cancer detection” in England last year. The research, being presented on Friday at the National Cancer Research Institute (NCRI) festival, showed a 17% drop in cases diagnosed in the under-25s last year compared with previous years. The impact of Covid on adults with cancer is well known. However, previously little has been known about the toll on younger patients. As well as the fall in the overall numbers of children diagnosed with cancer, researchers found that even those whose cancer was spotted last year were more likely to have been diagnosed only after being admitted to intensive care. That suggests long delays in accessing care may have made them much sicker, experts say. Read full story Source: The Guardian, 12 November 2021
