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On Christmas Day, Gail Jackson’s 16-year-old daughter said she was in so much pain she thought she would die. Liliana had been briefly admitted to hospital with Covid in September. Her symptoms never went away and, as time went on, new ones had emerged. “For months she had a relentless, agonising headache, nausea, tinnitus, fatigue and insomnia, but the worst thing was the agonising nerve pain,” said Jackson. “I couldn’t even touch her without her screaming in pain.” On Christmas morning, Jackson drove to hospital with her daughter vomiting from pain in the passenger seat. When they got to the hospital, however, the A&E doctor said there was no such thing as long Covid in children. “He said she just needed to go home and get on with her life,” Jackson said. “It was jaw-dropping.” It is extremely rare for children and young people to contract severe Covid, but recent research has shown that even mild or asymptomatic infection can lead to long Covid in children. A study at UCL is investigating long Covid in 11- to 17-year-olds who were not hospitalised with the disease. The National Institute for Health and Care Excellence (NICE) has recommended more research to produce guidance on how children and young people are affected and how they can be treated. However, there is no case definition of long Covid in children and young people in the way there is in adults. Read full story Source: The Independent, 3 May 2021

A cutting-edge child and adolescent mental health centre hopes to help prevent young people from experiencing mental health problems. As we look hopefully towards a June bonfire of pandemic regulations and restrictions, many recognise that soaring rates of mental health problems and distress amongst our children and young people must be near the top of a 21st century list of challenges in “building back better”. School closures, uncertainty and being cut off from friends and social and sporting events have seen more children and young people referred to CAMHS — a service that was facing growing demand even before the pandemic. The long-term impact is obviously still unknown. However, a cutting-edge child and adolescent mental health centre opening in south London two years from now will play a big role in responding to the likely increased demand for ongoing support — and in developing innovative treatment responses. Read full story (paywalled) Source: HSJ, 27 April 2021

Extremely unwell eating disorder patients are having to be tube fed at home by their families owing to a lack of hospital beds, as the Royal College of Psychiatrists reports a rise in people being treated in units without specialist support. Leading psychiatrists are urging the government for an emergency cash investment as the pandemic has prompted a rise in demand for treatment for conditions such as anorexia, amid “desperate pressure in the system”. In interviews with the Guardian, a number of parents told of the struggles of helping a severely unwell person from home. A number of families said they had no choice but to tube feed their children at home daily. Other parents said their children had been admitted to general children’s wards, where they were being treated by staff who had no experience of eating disorders. It is unclear how many patients are being treated at home, but Agnes Ayton, the chair of the Eating Disorder Faculty at the Royal College of Psychiatrists, said she had heard of people being unable to find beds and being creative in the community: “There is desperate pressure in the system.” Read full story Source: The Guardian, 22 April 2021

A child was twice given double the "safe" dose of a rapid tranquilizer at a hospital run by a troubled NHS trust. The child was put at "significant risk of harm" at Telford's Princess Royal Hospital, said inspectors. Rating children's services inadequate, they said Shrewsbury and Telford Hospital NHS Trust (SaTH) must halt seeing under 18s for acute mental health needs. The trust, in special measures, was working to "urgently address concerns". The Care Quality Commission (CQC) carried out a targeted inspection on 24 February prompted by "concerning information" about treatment at the service run by SaTH. The trust is currently at the centre of the largest ever inquiry into NHS maternity care. Staff told inspectors they had seen an increase in the number of young people with "significant mental health issues" and learning disabilities over the past year. But the services, which were rated as "requiring improvement" in November 2019, were deemed "inadequate" in four of five areas tested - for being safe, effective, responsive and well-led. Read full story Source: BBC News. 19 April 2021

Britain is facing a “terrifying” mental health crisis with tens of thousands more children needing specialist help since the start of the coronavirus pandemic. Experts from the Royal College of Psychiatrists have warned the problem facing the country will get worse before it gets better with new analysis revealing almost 400,000 children and 2.2 million adults sought help for mental health problems during the crisis. While the effect of lockdown and coronavirus has affected people of all ages, children appear to be particularly susceptible. Some 80,226 more children and young people were referred to specialist mental health services between April and December last year, up by 28% on the same months in 2019 to 372,438. Dr Bernadka Dubicka, chairwoman of the child and adolescent faculty at the Royal College of Psychiatrists, said: "Our children and young people are bearing the brunt of the mental health crisis caused by the pandemic and are at risk of lifelong mental illness." "As a frontline psychiatrist I've seen the devastating effect that school closures, disrupted friendships and the uncertainty caused by the pandemic have had on the mental health of our children and young people." Read full story Source: 9 April, 2021

In January, England's only NHS gender clinic for children and young people was rated "inadequate" by the country's health watchdog - the lowest rating, meaning it is performing badly. The findings make for sobering reading with inspectors raising "significant concerns" about the way the Gender Identity Development Service (GIDS) works. Nearly 5,000 children are waiting - sometimes for up to two years - for an appointment, and the management team has been disbanded following the inspection. Now BBC News has had exclusive sight of an external report written in 2015 which recommended GIDS take drastic action. It argued the service was "facing a crisis of capacity" to deal with an ever-increasing demand and strikingly it should "take the courageous and realistic action of capping the numbers of referrals immediately". With Care Quality Commission inspectors recently confirming many of the risks highlighted still remain, some have expressed concern about why neither GIDS, nor NHS England, which has ultimate responsibility for the service, have done more to help the children and young people it cares for. Read full story Source: BBC News, 30 March 2021

The House of Lords Public Services Select Committee is conducting an inquiry into whether reforming public services can address the growing child vulnerability crisis. Based on Solace's work with children and young people, they have submitted a response calling for better understanding and coordination from public services that intervene and support survivors of domestic abuse. Key recommendations: Training on all forms of domestic abuse as defined in the Domestic Abuse Bill should be mandatory for social work qualifications, and periodically updated through continuing professional development. Domestic abuse is the most common factor identified in assessments of children in need of children’s social care services but training is variable and can lead to social workers putting children at risk because they do not understand perpetrator behaviour. Safeguarding training for schools should also include mandatory training on domestic abuse and safeguarding designates should be informed of children’s social care safeguarding cases. Safeguarding training, which is statutory, does not have to include training on domestic abuse yet teachers can (and often do) play a crucial role in identifying the signs of abuse and intervening. Operation Encompass is an improvement on communication between the police and schools, but most domestic abuse is not reported to the police. NHS trusts should ensure staff in maternity units receive regular training on routine enquiry and support for domestic abuse survivors. Domestic violence is the leading cause of foetal death. Maternity services are required to make routine enquiries but we know from our service users that mandatory routine enquiry is still not being done correctly. Commissioners of domestic abuse services should budget for specialist support for children and young people in those services. We supported 1,392 children in our services in 2019/20. Of the nearly 200 children in our refuges in December 2020, around 30% had children’s services involvement. Upon leaving refuge, many of those mothers had increased their parenting capacity and increased their understanding of the impact of domestic abuse on parenting as a result of parenting workshops they had accessed in the refuge. Agencies should base their ways of working, communication and data-sharing for children assessed as in need and early help on how they approach children with protection plans. When children are on a child protection plan the coordination between responsible agencies tends to be much better than when children are assessed as being in need, though practice varies. The Government should make clear that sharing information in order to safeguard children is always legitimate within the General Data Protection Regulations (GDPR). Read Solace's full response

Doctors ignored the concerns of a seriously ill girl's parents before reducing her pain medication, an inquest has heard. Melody Driscoll, from Croydon, died aged 11 at King's College Hospital (KCH) in July 2018. Her mother Karina Driscoll and stepfather Nigel alleged the actions of KCH reduced Melody's quality of life. She told Southwark Coroner's Court that a reduction in painkillers also contributed to her daughter's death. The family had been in dispute with KCH over the treatment given to Melody, who had several conditions including Rett syndrome, a rare and life-limiting genetic disorder that causes mental and physical disability. Doctors wanted to wean Melody off painkillers, but her parents objected because the plan went against the treatment regime she had previously been prescribed at Great Ormond Street Hospital (GOSH). The court heard Melody suffered from very severe pain, requiring continuous relief, including morphine, for much of her life. In a written statement read out by barrister Patricia Woodcock QC, Mrs Driscoll said although her daughter could not speak, she made recognisable signs when she was in pain, including tensing her muscles. However, she claimed staff at KCH had a "we know best attitude" and did not listen to her concerns. "I would say that KCH took a very negative view about Melody, and us as a family, from an early age and, for example, started to believe that Melody's pain behaviours were not in fact expressions of pain but her simply 'acting out'," Mrs Driscoll said. Read full story Source: BBC News, 22 March 2021

An infection "probably" linked to Glasgow's children's hospital was the "primary cause of death" of a young cancer patient, the BBC has learned. Infections from contaminated water at the hospital were also found to have been an "important contributory factor" in another child's death. A review looked into the cases of 84 children who developed infections while undergoing treatment at the hospital. It found that a third of infections "probably" originated in the hospital and the rest were "possibly" acquired there. The authors of the "case note review", which should be published next week, said they recognised that some families would be disappointed that they could not have "greater certainty" about the links between their child's infection and the hospital environment. They said this was down to the limits of a retrospective review but also criticised the shortcomings in the data provided by the health board. Read full story Source: BBC News, 20 March 2021

As the UK looks to mark the first anniversary of the first COVID-19 lockdown on 23 March, Sky News has spoken to one family who say they have lived constantly with the after effects of the virus for a year. Charlie, 37, her husband Zed, 41, and their five children – Nico, 15, Beck, 12, Indiana, 10, Emmett, 8, and Mimi, 5 – fell ill with the virus in March last year. All of them – particularly the children – have been suffering ever since. Charlie said the list of symptoms is "extensive", including headaches, eye issues, nose bleeds, body rashes, horrific tummy pains, gastric issues, severe lethargy, allergic reactions, peeling hands, and feet and mouth ulcers. "It's such a long list that at times you can't believe that they've all been related to this illness," Charlie said. The family have been getting help from a support group, Long COVID Kids, which wants specialist clinics to be set up for children with the condition. Charlie said the ordeal the family has been through "really made me question my sanity at times". She added: "Long COVID centres are being set up, but they're not for children, so there is nowhere for them to be referred to. I'm really worried about the long-term health issues." Read full story Source: Sky News, 13 March 2021

Doctors are being issued with new guidance for cases where children are repeatedly brought in when there is nothing wrong. The Royal College of Paediatrics and Child Health (RCPCH) says cases where parents know there's nothing wrong are rare. Instead genuine, if misplaced, health anxieties are more common. They advise referring to "perplexing symptoms" instead of "fabricated or induced illness". Paediatricians say there has been a rise in cases where children are repeatedly brought in, despite nothing being found to be wrong. The unexplained symptoms could be because a genuine condition has not yet been diagnosed. But there are cases where a parent or carer might make up or cause illness in their children - a rare form of abuse which used to be known as Munchausen's By Proxy Syndrome. But often, doctors say, it is genuine concerns - and they believe the rise may be fuelled by bad information online. Read full story Source: BBC News, 2 March 2021

Scientists have warned that emerging data on Long Covid in children should not be ignored given the lack of a vaccine for this age group, but cautioned that the evidence describing these enduring symptoms in the young is so far uncertain. Recently published data from the Office for National Statistics (ONS) suggests that 13% of under 11s and about 15% of 12 to 16 year olds reported at least one symptom five weeks after a confirmed COVID-19 infection. Although children are relatively less likely to become infected, transmit the virus and be hospitalised, the key question is whether even mild or asymptomatic infection can lead to Long Covid in children, said Danny Altmann, professor of immunology at Imperial College London. “The answer is that it certainly can, and the Long Covid support groups contain a not insignificant number of children and teens,” Altmann said. Frances Simpson, a lecturer in psychology at Coventry University and co-founder of the Long Covid Kids group, said she was very worried about the emerging data on Long Covid in children. “We just think that there should be a much more cautious and curious approach to long Covid rather than a kind of a sweeping generalisation that children are OK, and that we should just let them all go back to school without any measures being put in place.” One issue, she said, is the sizeable gap between acute infection and Long Covid kicking off. Some children are initially asymptomatic or have mild symptoms but then it might be six or seven weeks before they start experiencing long Covid symptoms, which can range from standard post-viral fatigue and headaches to neuropsychiatric symptoms such as seizures, or even skin lesions." At the moment there is no consensus on the scale and impact of long Covid in adults, but emerging data is concerning. For children, the data is even more scarce. Recent reports from hospitals in Sweden and Italy have generated concern, but this data is not from national trials – they are single-centre studies – and include relatively small patient numbers, said Sir Terence Stephenson, a Nuffield professor of child health at University College London. Stephenson was awarded £1.36m last month to lead a study investigating Long Covid in 11- to 17-year-olds. “I don’t have a scientific view on what long Covid is in young people is – because frankly, we don’t know,” he said. Preliminary results are expected in three months. Read full story Source: The Guardian, 2 March 2021

Scotland's biggest health board should be put in "special measures" over its handling of hospital infection issues, according to an MSP. Anas Sarwar made the call after a mother accused NHS Greater Glasgow and Clyde (NHSGGC) of covering up possible factors in her daughter's death.Mr Sarwar said the health board had tried to intimidate health service whistleblowers who had raised concerns. NHSGGC said the source of the child's infection could not be determined. Earlier this week a whistleblower revealed that a doctor-led review had identified 26 infections at Glasgow's Royal Hospital for Children in 2017 which were potentially linked to problems with the water supply. Kimberly Darroch, whose daughter Milly Main died at the hospital in August 2017 while in remission from leukaemia, said health officials gave her no inkling that contaminated water could have been a factor. Health Secretary Jeane Freeman has said the first she knew of Milly's death was when Ms Darroch emailed her about her concerns in September. NHS Greater Glasgow and Clyde has offered to meet the family to discuss their concerns - but said it was impossible to accurately determine the source of Milly's infection because there was no requirement for water testing at the time. It said the hospital's water had been independently assessed as safe, and it criticised the whistleblower for causing "stress and anxiety" for Milly's parents when there was no evidence of a link. Anas Sarwar, however, insisted the health board had let down both patients and staff. He said: "There was an attempted cover-up of Milly's death, and there are still dozens of families who don't know the truth about infections contracted in the QEUH." Read full story Source: BBC News, 16 February 2021

An average of 10 pre-teen children are admitted to hospital for self-harm each week, it has been revealed, in an apparent doubling of rates. Between 2019 and 2020 there were 508 recorded hospital admissions for self-injury, such as cutting oneself, within the 9-12 age group in the UK, compared to 221 between 2013 and 2014, suggesting rates have doubled in the past six years, according to an analysis of the data from BBC Radio 4’s File on 4 programme. “The increase in the data that you've looked at is in keeping with what we're finding from our research databases,” Keith Hawton CBE, a professor of psychiatry at the University of Oxford and consultant psychiatrist at Oxford Health NHS Foundation Trust, told BBC File on 4. Prof Hawton, who is also principal investigator of the multicentre study of self-harm in England, said: “It's almost as though the problem is spreading down the age range somewhat. And I do think it is a concerning problem. And I do think it's important that it's recognised that self-harm can occur in relatively young children, which many people are surprised by." Read full story Source: The Independent, 16 February 2021

A campaign has started to prevent children and young people receiving cancer treatment alone in the pandemic. Charities behind the #Hand2Hold campaign want to enable all young people aged 16 to 25 to be allowed a chaperone, instead of only some. Mikaela Forrester, 18, from Somerset had some of her cancer treatments alone and said she did not want other young people to have that experience. She said without her mother she found it "scary" and "lonely". Miss Forrester lives in Frome and was diagnosed in July 2019 with Stage 2 Hodgkin Lymphoma, an uncommon cancer that develops in the lymphatic system. In March 2020 she was told she had relapsed and would need to undergo a further round of chemotherapy, radiotherapy, and a stem cell transplant. Because of the coronavirus pandemic, she was told she had to have those treatments on her own, without immediate support from her family or friends. She said: "When I had my transplant and my cells harvested with three weeks in hospital, with no visitors, it was just so scary. It was quite lonely." "Even if I could hug my parents, or if they could stand two metres away with a mask on, just knowing they were there during the most difficult times would have made me feel comfortable because it was so overwhelming." Read full story Source: BBC News, 16 February 2021

Availability of inpatient child and adolescent mental health services beds — particularly for eating disorders — has reached ‘crisis point’, with young people left waiting on a standard paediatric ward or at home as demand surged during the covid pandemic. A report to Surrey Heartlands Clinical Commissioning Group (CCG) in January read: “Availability of tier four beds [inpatient mental health beds for children and adolescents, commissioned centrally by NHS England] in the South East and across the country is at crisis point and providers have to compete for the small pool of beds." “Waits for beds or being placed far from home is a distressing and unacceptable experience for children and young people and families and places an additional burden on other parts of the system such as paediatric wards.” The report noted a “demand upsurge to the highest levels in the last three years” since the pandemic. It stated, in mid-January, the CCG had two patients awaiting eating disorder beds being managed on paediatric wards as they had become “physically too unwell to be managed at home”. Four others also waiting for a CAMHS bed were being managed at home. Read full story Source: 16 February 2021

A new trial is to test how well the Oxford-AstraZeneca coronavirus vaccine works in children. Some 300 volunteers will take part, with the first vaccinations in the trial taking place later in February. Researchers will assess whether the jab produces a strong immune response in children aged between six and 17. The vaccine is one of two being used to protect against serious illness and death from Covid in the UK, along with the Pfizer-BioNTech jab. As many as 240 children will receive the vaccine - and the others a control meningitis jab - when the trial gets under way. Andrew Pollard, professor of paediatric infection and immunity, and chief investigator on the Oxford vaccine trial, noted that most children were relatively unaffected by Covid and were unlikely to become unwell with the virus. But he said it was important to establish the safety and immune response to the vaccine in children and young people as some children might benefit from vaccination. Read full story Source: BBC News, 14 February 2021

Hospitals across the country are preparing for a significant increase in children needing treatment for a rare disease triggered by coronavirus. Paediatric departments across the NHS are recalling children’s nurses who have been redeployed to help care for adult patients as well as freeing up specialist intensive care beds to be ready for more cases of the rare condition first identified after the first wave last year. Because of how widespread COVID-19 infections have become in the last month, with the numbers of patients in hospital peaking at almost 40,000, experts believe they will see a larger number of children affected by the disease called Paediatric Multisystem Inflammatory Syndrome (PIMS). Modelling by London’s Evelina Children’s Hospital, which treated around 110 children with PIMS during the first wave of the virus, suggested for every 200 adults admitted to hospital across London, there was one child admitted with PIMS at the Evelina. This modelling cannot be used to predict admissions across the country, but paediatric experts believe they will begin to see a larger number of children with the condition with a peak expected in the next three weeks. It is thought COVID-19 triggers an inflammatory response among a very small minority of children – of all children infected with COVID-19, less than half of one per cent went on to develop PIMS. Those that do suffer severe inflammation in their blood vessels and can have damage to their heart. Symptoms of PIMS include a rash, fever and abdominal pain. Read full story Source: The Independent, 4 February 2021

The pandemic has had a deep impact on children, who are arriving in A&E in greater numbers and at younger ages after self-harming or taking overdoses, writes Dr John Wright of Bradford Royal Infirmary. Children are a lost tribe in the pandemic. While they remain (for the most part) perplexingly immune to the health consequences of COVID-19, their lives and daily routines have been turned upside down. From surveys and interviews carried out for the Born in Bradford study, we know that they are anxious, isolated and bored, and we see the tip of this iceberg of mental ill health in the hospital. Children in mental health crisis used to be brought to A&E about twice a week. Since the summer it's been more like once or twice a day. Some as young as 10 have cut themselves, taken overdoses, or tried to asphyxiate themselves. There was even one child aged eight. Lockdown "massively exacerbates any pre-existing mental health issues - fears, anxieties, feelings of disconnection and isolation," says A&E consultant Dave Greenhorn. Read full story Source: BBC News, 2 February 2021