UK paediatricians have warned that unless national and local health care leaders can restore and protect child and paediatric health services, children and young people will face a greater burden of disease, wider health inequalities, and a significantly weaker child protection system.
As part of a statement about the restoration of children’s services and COVID-19 planning, the College warns: “Without prompt attention to restore children’s health services and the workforce that delivers them, and to protect them from surge policies over the next few months, there is a real risk that current health inequalities will widen, vulnerable children will slip through the net, the burden of child ill-health and disease will grow, and there will be long term damage to workforce development and service innovation.”
The statement follows a report by the College about the impact of COVID-19 on child and paediatric services during the first phase of the pandemic. The report shows that while those working in child health services did what was necessary in terms of supporting the wider NHS during that period, it had a significant and lasting impact on core services for children and young people.
- Community paediatric services which care for vulnerable children and families, were unable to function at full capacity, as up to 46% of community trainees were redeployed to acute paediatrics.
- At the same time, paediatricians reported increased cases of children at risk due to acute mental health problems, self-harm and safeguarding issues struggling to access to care.
- Paediatric surgery experienced a huge decrease in the numbers of routine clinical procedures during the outbreak, from 10000 per week to 330 per week. This has caused a high backlog of children waiting for surgery.
- Access to dental services and routine outpatient services for managing chronic childhood conditions has been severely constrained
- Closure of schools meant lack of access to planned vaccinations, such as HPV
Professor Russell Viner, President of RCPCH said:
Even if we wanted to replicate the approach taken in the first phase of the pandemic, it would be impossible. In normal times winter brings a lot of pressure and demand upon acute paediatric and emergency care. Respiratory conditions especially lead to spikes in demand for urgent and inpatient care and this capacity needs to be protected for children and families. Like other specialties, paediatrics stepped up to help protect the adult population. That was possible in the spring and summer, but the priority this winter is to deliver child and paediatric services to the greatest extent possible while also managing the pandemic. Even without redeployment this will be challenging and support for the paediatric workforce is vital.
The College statement is based on evidence that children are less susceptible to the virus and appear not to transmit COVID-19 to the same extent as adults, so the risks associated with providing children’s services are lower and are greatly outweighed by the harm caused by stepping down services. The statement makes recommendations for service providers and planners (see statement for the full set of proposals) including system-wide, strategic leadership for children and young people and the restoration and maintenance through the winter of ‘business as usual’ services.