BPSU 'snap-shot' survey - delayed presentations to hospitals

The COVID-19 pandemic has led to concerns that children are, for various reasons, presenting late to emergency departments. This has led to delayed diagnosis and hence a delay in treatment. Such presentation delays are well known, but they appear to have increased during this pandemic. Unfortunately, there have been reports of increased morbidity and mortality as a result. This increase in delay may be due to the warnings with regards staying home and also nervousness on behalf of parents who may worry about their child catching COVID-19 whilst at hospital.

This survey aims to give a snap-shot of the frequency of such a delay. This will be the first time the BPSU has ever undertaken such a 'snap-shot' survey.

Lead investigators

Shamez Ladhani & Richard Lynn

British Paediatric Surveillance Unit
Royal College of Paediatrics and Child Health
5-11 Theobalds Road
London WC1X 8SH

Email: bpsu@rcpch.ac.uk / shamez.ladhani@phe.gov.uk

About the 'snap-shot' survey

The BPSU has received several queries from paediatricians who concerned about late presentations of children because of current lockdown and public messages to “stay at home”. To assess the extent of the problem, a one-off email is being sent with three questions asking:

  1. Are you working on the front line?
  2. Have you seen any children with delayed presentations?
  3. In your opinion, do you think they are COVID response related?

No details on individual children will be collected.

The findings from the survey will help raise awareness of the issue of delayed diagnosis and assess whether a more in-depth study is required to help address the issue.

Case definition

A broad definition of a "Late Presentation" is any child under the age of 16 years who presented later than you would have expected (resulting in more treatment or a worse outcome, or delayed presentation of a new condition such as ALL, diabetes mellitus, etc.) because of any number of reasons, including the "stay at home" message, parental concerns about seeking medical help or coming to hospital, etc.


The survey is a one-off and will cover the last 14 days from 24 April 2020.

Two reminders will be sent to maximise the return.