BEST PRACTICE Article

BMJ September 2020

Jessica R Turnbull, Michael Farquhar

Fifteen-minute consultation on problems in the healthy child: sleep

ABSTRACT

Sleep-related issues are common reasons children present to health professionals. Many factors can adversely affect sleep quality, and there are many associations of inadequate sleep, including behavioural problems, obesity and accidental injury. We review the current evidence, and suggest practical management strategies to promote better sleep, and hopefully, better functioning for child and family alike.

Click here to read the article

Featured

RCPCH statement on Child Mental Health

1st September 2020

Mental health issues are increasingly common among children and young people—suicide is now the leading cause of death for both males and females aged five to 19 years old, and one in eight people among this age group is currently living with a mental health condition. 

Children and young people in vulnerable groups are even more at risk, including LGBTQ+ people, low income households, children in care, and those with parental mental health issues, special educational needs, on child protection plans, or in the criminal justice system. 

Underinvestment in mental health is a longstanding concern. This has been amplified by the pandemic due to the extra stress caused by prolonged school closures, social isolation, adverse social and environmental circumstances, and a lack of access to usual support services. 

RCPCH’s Assistant Officer for Mental Health and Wellbeing, Dr Karen Street, says: “Our key message is that our patients’ mental health is our business. There is a joint responsibility to provide necessary services across the children’s workforce. 

“In the wake of COVID-19, many children and young people will have greater mental health support needs. As services begin to recover, the time is ripe to connect across the entire child health workforce and local, regional, and national boundaries. Together, we can work to develop improved and integrated mental health services.” 

In its statement, the College includes a number of recommendations, including: 

  • All paediatric teams should have a nominated lead for mental health. 
  • Paediatric training must include promotion of wellbeing in children and young people and management of common mental health issues. 
  • Paediatricians with higher exposure to issues need more extensive training and support. 
  • Paediatricians should not be expected to work in isolation when managing severe cases of mental illness. 
  • Use of mental health screening tools in higher risk people should be considered. 

The College will also continue to support mental health through its activities, including: 

  • Having an Assistant Officer for Mental Health on its Health Improvement Committee. 
  • Working with NHSE and HEE to implement of the NHSE Long Term Plan. 
  • Developing training through its Child Mental Health Specialty Advisory Committee. 
  • Developing the Progress curriculum for all paediatric trainees to include mental health. 
  • Partnering with MindEd to produce a paediatric ‘learning path’. 

Read the College’s full position statement on the role of paediatricians in mental health here

Reimagining the future of paediatric care after COVID-19

Last month, the RCPCH published an interesting report Reimagining the future of paediatric care post-COVID-19 – a reflective report of rapid learning‘. The report is the first in a series of reports from the Paediatrics 2014 Project.

“This report, published on 26 June 2020, is the first in a series from the Paediatrics 2040 project that will inform RCPCH’s vision for the future of paediatrics in the UK. We summarise our learning from this period of rapid change, focusing in particular on the elements of new practice that we want to keep and take forwards into the future…

To read the report, click the link below:

https://www.rcpch.ac.uk/resources/reimagining-future-paediatric-care-post-covid-19-reflective-report-rapid-learning

RCPCH: State of Child Health 2020

In March, the RCPCH published its ‘State of Child Health 2020’ report. This landmark report provides a snapshot of infant, children and young people’s physical and mental health. 

The RCPCH say: “On 4 March 2020, RCPCH launched our new State of Child Health. The update provides the latest data from our 2017 indicators, alongside evidence for new indicators, including: looked after children, mental health, youth violence, young carers and the child health workforce. Alongside this, we’ve spoken to 2,000 children and young people to find out what makes them feel “healthy, happy and well”.

We’ve outlined our key asks for each of the UK Governments, which we hope will ensure delivery of key policy decisions to improve child health outcomes.

The State of Child Health 2020 Report utilises comparable UK data across 27 child health and wellbeing indicators to produce a range of associated recommendations aimed at improving outcomes. It builds on the 2017 Report which provided an unprecedented snapshot of how infant, children and young people’s physical and mental health was faring across the UK.  

Click below to read the report:

http://www.rcpch.ac.uk/state-of-child-health

Request for information:

Any guidance on managing unwell children in acute settings who have learning difficulties or autism

Dr. Cassie Coleman, a paediatrician in Oxford, is looking for anyone who is aware of any guidance on managing unwell children in acute settings who have learning difficulties or autism.

They are going to write guidance in Oxford but would be grateful if anyone has already done some work on this in their regions and is happy to share.

If you have any information, please can you email it to: cass81@doctors.org.uk

Thank you!

UNICEF Report: Children in Lockdown – What Coronavirus means for UK children

“Children’s lives have been turned upside down by coronavirus. For some children, with the right support and resources, the situation will
be manageable, but for others the effects of the pandemic will cast a long shadow over their lives. The response to coronavirus already is exposing the fragile situation that many children and young people live in. Hundreds of thousands of children who rely on school, health and social systems and the support of the voluntary sector are being left unprotected as these systems are weakened. Thousands more, unknown to the system, will likely find themselves in need of support over the coming weeks, but as yet remain invisible to authorities…

Click here to read full report.

NCEPOD – Mental Healthcare in Young People and Young Adults 2019

The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) recently published a review of the quality of care provided to children and young people with mental health conditions admitted to a general health hospital or mental health facility and an assessment of healthcare utilisation in this group using routinely collected national datasets.

Click on the link below to go to the publication:

NCEPOD – Mental Healthcare in Young People and Young Adults (2019)