29.4.20 Children’s End of Life /Palliative Care
Children and young people (CYP), on the whole have experienced mild or moderate symptoms when diagnosed with COVID-19. Notwithstanding this, CYP with palliative care needs may become more vulnerable when exposed to COVID-19, impacting on a CYP’s already vulnerable health status. The Association of Paediatric Palliative Medicine (APPM) has produced clinical guidance aimed at professionals looking after children and young people (CYP) with palliative care needs who are infected with Covid-19, potentially entering their end of life phase and the decision is not for medical escalation into paediatric intensive care.
The situation to date across HIOW would suggest that there has not been an increased demand for services as these CYP are being shielded and for commissioned packages of care, the domiciliary care and residential placement providers have maintained provision.
The three children’s hospices that children and young people in HIOW typically use are Naomi House/Jacks Place (Sutton Scotney), Shooting Stars (Guildford) and Chestnut Tree (Arundel). The hospices continue to work to Public Health England, UK Government and WHO recommendations and have made the following adjustments to their service offer; –
- Planned respite both at the hospice and any hospice at home team in the community is currently not available
- End of life care is available
- Emergency or urgent respite will be available on a case by case basis for families who are in crisis and on the verge of family breakdown
- Counselling will continue to be provided in non-face to face sessions
- Naomi House and Shooting Stars have rationalised use of their buildings moving to Jacks Place and St Christopher’s respectively to ensure efficient use of funds.
The Children’s Community Nursing teams based within Solent East/West, Hampshire Hospitals FT, St Marys (IOW) and Children Family Health Surrey continue to deliver services to children and young people with complex care needs to include Palliative and End of Life care. Workforce capacity is being monitored daily.
The cause of concern for professionals is the potential unintended consequences for families due to shielding/social isolation and planned respite being paused due to government restrictions. All complex care vulnerable families were part of a HIOW system risk matrix approach with additional contingency plans identified.