BACCH service resumption resources

Sections on this page:

Resuming services
Appraisal re-starting with reduced evidence requirements
Shielding patients
Information for schools
Health information on return to school
How to manage demand & capacity
Innovative service examples

(This page was first created on 15.05.20 and will be updated as information becomes available; last updated: 21.09.20.)

Resuming services

The NHSE issued a letter on 3 June 2020 indicating full service restoration of community paediatric services can begin (linked below). Where possible and appropriate, remote consultations are preferred but patients or professionals may decide a face-to-face appointment is preferable in the specific circumstances of the case.

Note also that adoption medical advice and LAC health assessments should no longer be risk stratified and assessments should be completed. Audiology services are still in the ‘partial restoration’ group.

Second phase of NHS response to COVID-19 (PDF)

An amendment was issued on 31 July 2020 on SEND requirements

EHCP flexibilities ended and CYP should receive all the support they need on return to school

The third phase response urges services to return to full capacity as soon as possible to make full use of the ‘window of opportunity’ before winter. This includes catch up immunisation campaigns in general practice and retaining the 24/7 ‘crisis helplines’ developed in mental health services:
Third phase of NHS response to COVID-19

Further guidance on restoring services including advice on inequalities and on patient-led follow up was issued on 7th August 2020:
Implementing phase 3 of the NHS response to the COVID-19 pandemic

Operating framework for service resumption in hospital settings (some apply to community settings too)

RCPCH updated guidance for community settings

RCPCH advice on resuming safeguarding & LAC services E, W & NI (updated 07.07.20)

RCPCH advice on Child protection & LAC processes in Scotland

Support for healthcare workers from volunteer service:
NHS volunteers extend support to frontline health and social care staff

GPs encouraged to use electronic repeat dispensing (where e-prescriptions are written to last up to 12 months without requesting a repeat). Note this does not apply to controlled drugs:
NHS letter to GPs, community pharmacists & commissioners

More information on electronic dispensing:
Benefits of using electronic repeat dispensing (eRD)

Standard Operating Procedure for palliative care in community settings

Guidance on continuing immunisation programmes

Appraisal resumption

Appraisals will re-start from 1st October. There are reduced evidence requirements for 2020:

Letter from NHS England 'COVID-19 and professional standards activities'

Shielding patients

New guidance (issued 06.07.20), indicates that most children and young people will no longer need to shield even in a future resurgence:
Government press release: majority of children no longer need to shield

The shielding letter (issued 22.06.20) confirms that the RCPCH guidance on shielding below should be followed, It also advises shielding will be paused on 1st August 2020 and that all children, even in shielding groups, can return to school:
NHS Shielding update

The RCPCH has issued revised guidance on which CYP should be shielded. This significantly reduces the number who need to shield:
RCPCH 'shielding' guidance - revisions & updates

Guidance on maintaining ongoing clinical care for the small number of patients who need to continue shielding includes an expectation of a care coordinator/single point of access for such patients. This may be a paediatrician.

NHS support for patients who are shielding

Parents have been advised to contact their GP or specialist to discuss shielding requirements

Information for schools

Advice for schools and colleges on NHS Test and Trace and on accepting shielded CYP back to school:
Letter from PHE and NHS Test and Trace to school and college leaders

Joint CMOs’ statement on return to school 23 Aug 2020

Schools’ advice available (note this only applies to England as schools in the other nations are not re-opening). These include advice on CYP shielding, or who live with someone who is shielding:

Government scientific overview on school re-opening

Commons summary on schools and COVID

Several other documents are available to guide schools on re-opening but do not identify any role for health services:

Guidance for full opening in September (including specific guidance for special schools & transport)

Actions for education & childcare settings to prepare for wider opening from 1 June 2020

SEND risk assessment

Early Years guide

Advice for Early Years Settings

Primary school guide

Secondary school guide

COVID-19: implementing protective measures in education & childcare settings

Safe working guidance for schools and social care available

Advice for young people

Health information on return to school

PHE research project into school prevalence

(Initial results now available)

COVID-19 - message from the |RCPCH President, 22 May

Pre-print version of paper referred to in link above (Susceptibility to & transmission of COVID-19 amongst children & adolescents compared with adults: a systematic review & meta-analysis)

BMJ letter on COVID risk vs all-cause mortality in childhood

RCPCH statement on schools re-opening, 22nd May

BMA updated Statement on schools reopening, 20 May

Other science summaries:

School closure & management practices during coronavirus outbreaks including COVID-19

COVID-19 - research evidence summaries - transmission

What is the evidence for transmission of COVID-19 by children [or in schools]?

Evidence summary of potential for children to contribute to transmission of SARS-CoV-2

ONS data shows no difference in infection rates for 2-19 vs other age groups