17 June 2020
New guidance from the Royal College of Paediatrics and Child Health (RCPCH) has said most of the children on the Covid-19 shielding patient list who are managed in primary care could be removed from the list.
The RCPCH has submitted its recommendations as evidence to the Government's ongoing review into which patients should be shielding from coronavirus with more stringent social distancing.
The Department of Health and Social Care (DHSC) stressed that its guidance on shielding, including for children, has yet to change. It said it would take the recommendations into account as part of its work to create a better risk algorithm for who should be shielding from Covid-19.
The RCPCH said that "children and young people who are cared for just in primary care are very unlikely to need to continue to shield" and that the majority of children with conditions including asthma, diabetes, epilepsy, and kidney disease do not need to continue to shield and can, for example, return to school as it reopens.
This includes many children with conditions such as cerebral palsy and scoliosis, for whom the benefits of school, in terms of access to therapies and developmental support, far outweigh the risk of infection, according to the report.
However, the report added that a small group of children who are clinically extremely vulnerable due to their pre-existing condition will need to continue to shield; while a "further larger group of children exists who due to their underlying condition may need to shield and the decision to continue to shield would normally result from a discussion between the clinician, the child and their family".
GPs would be expected to remove children from the shielding list who are managed in primary care, following careful discussions with patients.
The RCPCH guidance, COVID-19 - Shielding Guidance for Children and Young People, is available at: www.rcpch.ac.uk
Current guidance for GPs, Shielded Patients List: Guidance for General Practice, is also at: https://digital.nhs.uk/coronavirus/shielded-patient-list/guidance-for-general-practice